Hawai'i has become the first state in the nation to begin airport monitoring of ill passengers to detect signs of bird flu or other viruses.

Passengers and airport visitors will not be required to submit to examinations but will be tested only on a voluntary basis for flu viruses, health officials said.

Making flu testing available is expected to improve the state's ability to detect and respond to the threat of a pandemic flu, according to Catherine Chow, a medical prevention officer for the U.S. Centers for Disease Control and Prevention, who is assigned to the state Health Department.

The new surveillance measures began Monday under an agreement between the Health Department and The Queen's Medical Center, according to department spokeswoman Janice Okubo.

Passengers could be referred to the hospital's airport clinic by the CDC's airport quarantine station, by an airline, or from anywhere in the airport, by requesting medical assistance.

Public health officials will collect nose or throat specimens from sick passengers to test for flu, Chow said. Detailed information will allow officials to trace contacts and begin disease control and containment if necessary, she said.

Under a contract with the state Department of Transportation, The Queen's Medical Center operates an airport clinic staffed by registered nurses trained to respond to emergencies, said hospital spokeswoman Kara Hughes.

If someone shows up feeling ill, the patient may be assessed to see if he or she meets criteria for regular or avian flu, Hughes said.

Meanwhile, Hawai'i's health- care and civil-defense leaders have been working on plans for broader detection and response to bird flu and other infectious diseases.

For the past several months, the state has been putting together a plan to combat the spread of bird flu, including watching out for signs of the disease, and planning for distributing vaccine and quarantining sections of the population, health officials have said.

Dr. Chiyome Fukino, the state health director, said President Bush's proposal to spend $7.1 billion to prepare for a flu pandemic, three of which have occurred during the past century, "is a very positive thing for public health."

Fukino also urged residents, especially those in high-risk groups such as children and the elderly, to get flu shots to guard against the seasonal flu, which kills an average of 35,000 Americans each year.