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The Honolulu Advertiser
Updated at 4:39 p.m., Wednesday, April 29, 2009

Swine flu: Airport surveys could boost health security

Few would dispute the need for enhanced surveillance for any swine flu cases that enter Hawaii, and it now seems likely that cases will turn up here.

State Sen. Mike Gabbard's basic notion that airport screening should intensify is sensible: A remote state should intercept cases as soon as possible.

Gabbard cites models of surveillance in other countries — Hong Kong, Singapore and elsewhere in Asia — in defense against Severe Acute Respiratory Syndrome (SARS).

While Hawai'i may not need to match these countries' high-tech electronics to detect elevated temperature in travelers, there may be less costly ways to check for fevers that should be explored. And there are other steps government can take.

For example, it would be practical to disseminate questionnaires to incoming passengers, in tandem with surveys they already complete on agricultural imports, asking them where they've traveled and what symptoms, if any, they have experienced. Giving visitors a point of contact should symptoms develop later is a rational step, since people can be infectious without exhibiting symptoms.

The state has been laudably proactive about disease surveillance, long before the current outbreak. In addition to reports of illness that cruise-ship and flight crews must make under federal regulations, this state already has an airport medical lab that can test sick passengers.

But this looming pandemic calls for stepping it up a notch.

State officials are right to urge people in the general population and especially providers within the healthcare networks to sharpen awareness to all possible cases of swine flu. In epidemics of the past, it's largely in the local community where disease is usually uncovered and controlled.

Experts caution against expecting airports to provide a perfect shield; a false sense of security is the last thing the state should want to convey. But the airports are also the islands' front door, though which millions of travelers pass.

It makes perfect sense to sharpen the state's alert system and increase vigilance at these points of entry.