• airline crew
• SARS

Severe acute respiratory syndrome (SARS) first surfaced in Guangdong, China in November 2002. It simmered there for three months, under a shroud of secrecy, before arriving in Hong Kong, Vietnam, Singapore, and Canada on modern jet planes. Thirty countries are now affected. As of 10 June, WHO has reported 8430 probable SARS cases and 789 deaths, giving a case fatality rate of 10.7%.¹

The illness is caused by a novel coronavirus (SARS-CoV) measuring between 0.1 and 0.2 microns.^2,3 Clinical features are those of atypical pneumonia, with the common presenting symptoms being fever greater than 38°C and a dry cough.⁴ Empirical treatment consists of corticosteroids, broad spectrum antiviral agents, and antibacterial cover.⁵ The primary mode of transmission is through droplets, as when an infected person sneezes or coughs. World Health Organisation (WHO) officials have acknowledged that air travellers “within two rows of an infected person could be in danger”.⁶ However, the virus has also been found to survive for days in the environment,⁷ giving rise to the possibility of spread by contact with surfaces such as armrests and tray tables.

Coming close on the heels of international terrorism and the Iraq war, SARS has all but dashed the hopes of an early recovery for the ailing airline industry. As panic stricken travellers stay at home, anxious aircrew are clamouring for protection from occupational exposures.

In the first documented case of in-flight, occupationally related transmission of the disease, a Singapore Airlines (SIA) flight attendant has been diagnosed with SARS after working on a 14 March flight between New York and Frankfurt, Germany, which had carried an infected doctor, his pregnant wife, and mother-in-law, all of whom it is now known, …