Two Scabies Cases Reported at Boston Logan International Airport
We’ve received some e-mails as well as several blog comments asking us to address the Scabies incident at Boston Logan International Airport.
You just never know what you’re going to write about around here. Formaldehyde, tin mint cans, frozen monkey heads, pie, exploding chickens, scabies, what next? Please don’t answer that…
As Google will show you, scabies is not all that uncommon. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The disease can strike anyone of any race or age, regardless of personal hygiene.
With that said, here is the lowdown on what happened at BOS and how TSA reacted. I think you’ll find that we thoroughly and swiftly addressed the issue.
TSA management at BOS was made aware of 8 suspected cases of scabies. TSA management immediately reached out to the Centers for Disease Control (CDC), the Boston Public Health Commission and Massport. The Boston Public Health Commission informed TSA that only 2 of the 8 suspected cases were actually confirmed cases of scabies, and one of those cases was described as “mild.”
CDC and Public Health inspectors visited the airport and provided advice on how to proceed, ensuring every precaution was being taken. The Boston Public Health Commission also sent an Environmental Specialist to perform an onsite assessment.
Health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required. Keep in mind, TSOs are required to wear gloves during the screening process while handling passengers’ belongings. You can always request that a TSO change gloves prior to a bag search or pat down.
TSA worked with Massport to ensure the checkpoints, break rooms and other offices where these employees are assigned were professionally cleaned, including the floors and carpets.
Information on scabies (provided by the CDC) was shared with the TSA workforce, including recommendations on how to protect oneself. Employees were all instructed to wash their uniforms and coats as well as other personal belongings before bringing them back to work.
Blogger Bob
EoS Blog Team
Update ***04/09/2009 10:10 PM***
I have just been informed that 3 more cases have been confirmed at BOS. If there are any new developments, I'll post them here on the blog. ~ Blogger Bob
Update ***04/10/2009 1:17 PM***
TSA has provided details on these new cases to the Infectious Disease Bureau of the Boston Public Health Commission for their vetting and also made arrangements to have another checkpoint professionally cleaned. Additionally a local hotline for communicable diseases is available for personnel at the airport and for the general public to address any concerns (617-534-5611 or www.bphc.org). Again, health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required. ~ Blogger Bob
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10:28 AM
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54 Comments:
Okay, so what's being done to prevent the checkpoints from becoming a vector in contagious diseases? Scabies is annoying. Ebola kills.
People have commented on the filthy conditions at checkpoints before and their criticisms were ignored.
April 9, 2009 10:42 AM
Bob, I don't refute anything stated in your post but I do have a concern.
In the Gate Screening thread it seems that TSO's routinely place unused gloves in their pockets instead of doing the sensible thing and taking the box of gloves to the gates. This may also be happening at the main checkpoints.
If this is in fact the way things are being done then asking for a glove change does absolutely no good. The gloves are already contaminated.
Would you please see if this is in fact happening and I suggest that a policy be promulgated that outlines how to do any inspection of a person's property while maintaining high standards of hygiene.
This action would benefit both the TSO and a traveler.
Finally, should a person have to ask for a glove change?
I think not!
April 9, 2009 10:50 AM
Why has TSA not suspended its shoe removal policy at this airport to prevent further spread of the disease?
Do citizens traveling through disease-infected checkpoints have alternative screening methods available to shoe removal?
Is TSA's current mandatory shoe policy tied to DHS's perpetual "orange alert"?
April 9, 2009 11:01 AM
I'm glad to read that you are aware of the situation. I am sure that you will take this opportunity to remind screening teams at all airports that they are required to change their gloves whenever a passenger requests it.
Mike
April 9, 2009 11:15 AM
Bob-in the thread on this topic that has been running on Flyer Talk since March 29, when the story actually first broke, media reports cited document at least 6 confirmed cases spread over 2 terminals (A & B, which are not connected, btw) @ BOS-why does your blog report only show 2 cases?
Among the questions that have been raised in the FT thread, but gone unanswered are:
1. Assuming the media reports are correct, & since they have been corraborated by a BOS screener I see no reason why they aren't, how did this spread from Terminal B to A when the terminals aren't connected. Did the infected screeners float between the terminals?
2. How long did the infected screeners work before being officially diagnosed & finally sent home?
3. What steps have been taken to prevent further spreading? Again, citing the media reports, there was quite a lengthy period of time between the first screener in Terminal B being diagnosed & the latest screeners in Terminal A being sent home.
4. Media reports have stated the traveling public was never made aware of this contagious infectious disease outbreak so how can TSA, DPH, et al be sure nothing was spread to a traveler transiting one of the infected checkpoints?
5. Yes, screeners wear gloves, but as has been repeatedly documented by travelers both here in this blog as well as in other forums, they are notoriously uncooperative when asked, by a traveler, to change gloves prior to handling the traveler's personal belongings. What steps have been taken to rectify this issue w/in the screener population?
April 9, 2009 11:17 AM
Well, if you expect an airport to be clean, at all, then you should find another mode of travel. To expect TSAI to change gloves after each passenger is a reach. I don't expect them to change them more than once a shift unless they are damaged. The gloves are to protect the screeners, not the traveling public.
I would not expect the shoe ban to be lifted in the US anytime soon. Or any of the irrational security methods that have been instituted. The window dressing is much to important to the perception that "something is being done" until something is actually done.
April 9, 2009 11:32 AM
Bob at TSA wrote:
"Health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required."
What kind of skin-to-skin contact do you suppose was happening at the airport when this parasite was spread among your staff?
"Keep in mind, TSOs are required to wear gloves during the screening process while handling passengers’ belongings."
Is that for their protection, passengers', or both? Victor.echo recently posted a comment here suggesting that it is for the protection of your staff.
"You can always request that a TSO change gloves prior to a bag search or pat down."
Why is that not a requirement? Do you notify passengers that it is an option?
Before you move on, could you tell us whether people are prohibited by law from photographing computer monitors at your airport search stations? First you told us that it was discouraged, then you told us that it was prohibited, but you have not responded to multiple requests for the source of your information.
Also, when your new partners Kelly, Tim, and West post comments here now, will they be speaking on behalf of TSA?
Why does TSA count people's money when they find it during a search?
Are people required by law to answer questions from TSA staff about their money?
--
Phil
Add your own questions at TSAFAQ.net
April 9, 2009 11:45 AM
Victor Echo, I cannot believe you wrote:
"To expect TSAI to change gloves after each passenger is a reach. I don't expect them to change them more than once a shift unless they are damaged. The gloves are to protect the screeners, not the traveling public."
You rifle through someone's poopy underdrawers then, without changing gloves, turn to me, reach for my bag and say, "Next."
That's gross.
April 9, 2009 12:09 PM
In response to RB's comments, I have sent a broadcast to our workforce to remind them that gloves should not be stored on one's person but always in the original box to remain sterile.
I do not think we were doing this here in our airport but better safe than sorry.
P.K.
TSA-PHX
April 9, 2009 12:19 PM
Quote:
" Anonymous said...
Why has TSA not suspended its shoe removal policy at this airport to prevent further spread of the disease?"
--------------------------
The HUGE spread of the disease that TWO (2) people contacted?
"The Boston Public Health Commission informed TSA that only 2 of the 8 suspected cases were actually confirmed cases of scabies, and one of those cases was described as “mild.”
Guess you didn't read that part.
Guess you also didn't read the part about the disease being contacted through "prolonged skin to skin" (not sock to carpet) contact.
"Health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required."
So, the shoe ban is relevant how?
April 9, 2009 12:24 PM
PK said...
In response to RB's comments, I have sent a broadcast to our workforce to remind them that gloves should not be stored on one's person but always in the original box to remain sterile.
I do not think we were doing this here in our airport but better safe than sorry.
P.K.
TSA-PHX
April 9, 2009 12:19 PM
Thanks, your information is helpful.
Was this a broadcast to the entire TSA workforce nationwide and is it a required procedure or just a suggestion?
April 9, 2009 1:01 PM
The HUGE spread of the disease that TWO (2) people contacted?
.......................
The local Fox affiliate in Boston has presented different information.
6 people, 3 each from two different checkpoints.
We know that information from TSA cannot be taken at face value given the number of times incorrect information has been provided by this blog.
So I will go with the media reporters as the more reliable source.
April 9, 2009 1:08 PM
Bob at TSA wrote:
"Health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required."
Bob, who were those experts? It seems that either they or you are being misleading.
The CDC says that skin-to-skin contact is not required for transmission:
"Scabies usually is passed by direct, prolonged skin-to-skin contact with an infested person. However, a person with crusted (Norwegian) scabies can spread the infestation by brief skin-to-skin contact or by exposure to bedding, clothing, or even furniture that he/she has used.
"Scabies is prevented by avoiding direct skin-to-skin contact with an infested person or with items such as clothing or bedding used by an infested person."
WebMD says:
"Scabies mites spread by close contact with someone who has scabies. Scabies can also be spread by sharing towels, bed sheets, and other personal belongings"
--
Phil
Add your own questions at TSAFAQ.net
April 9, 2009 1:33 PM
Kudos to PK who said on April 9, 2009 12:19 PM...
In response to RB's comments, I have sent a broadcast to our workforce to remind them that gloves should not be stored on one's person but always in the original box to remain sterile.
I do not think we were doing this here in our airport but better safe than sorry.
P.K.
TSA-PHX
*****************************
Thank you for doing the right thing, P.K., especially as I will be transitting your airport (T3 AA concourse) in 2 weeks.
For the record Bob, it is exactly this kind of infectious disease issue that has prompted so many to insist on the glove changes in the past, for which we were generally given at minimm the evil eye by the screener in question or out right ridiculed for. Honestly, I'm surprised it has taken this long for something like this to happen. This time scabies-what's next?
THAT is the real concern & that is why the traveling public is owed an explanation by the TSA of what policies &/or procedures have been put into place or changed as a result of this. No one is expecting you to name the names of the itchy, so that should alleviate 'privacy' concerns.
April 9, 2009 1:47 PM
I wish blogger had an ignore feature. I can think of a few regulars I would ignore.
April 9, 2009 2:43 PM
The TSA's Propaganda Department must be working overtime on damage control. They have three simultaneous fiascoes to spin and deflect. First the STL incident, then the baggage thefts in Philadelphia, and now scabies.
This indicates yet again the systemic flaw in the TSA's "security" approach that I've mentioned several times before. The TSA is so narrowly focused on interdicting Contraband du Jour that they ignore the other risks their procedures may cause or exacerbate. My previous concerns have been about theft (including the new increased risk of identity theft caused by the need to divest my wallet before undergoing a MMW strip search). But now we have to worry about communicable diseases.
I have already mentioned my experience with having a TSO paw through my toiletries kit, without having changed his gloves during the entire time I was waiting to be screened. Since I was not aware that the SSI SOP accorded me the right to insist that he change his gloves, I did not think to ask. But I found the situation so repugnant that I dumped the contaminated contents of the toiletries bag in the first trashcan I saw in the sterile area.
I realize that it's impractical to disinfect the bins, the conveyor belt, and the floor on which we're forced to walk without shoes. But simple measures to protect TSOs and passengers are practical and essential. TSOs should be required to change their gloves every time, before they open any bag! It should be part of the SSI SOP, and it should happen automatically every time a TSO responds to "Bag Check," not just on those occasions when an assertive passenger happens to know the secret policy and demands it! That's basic common sense (and basic "professionalism" and courtesy) that seems to get ignored in the interest of speed-- and clearly because TSOs aren't accountable for it and can easily get away with it.
I would hope that the TSA uses this incident to correct the flaws in their procedures. But I expect they'll spin it and sweep it under the rug, just as they always do.
And another question-- particularly for Tim, who has vigorously defended the need for SOPs to be SSI: If the SOP gives passengers rights, why in the heck should that be buried in something that a passenger isn't supposed to know about because it's SSI? Yes, it's much easier for TSOs if passengers are blissfully ignorant of their rights, since screening is so much faster and easier when passengers behave like good docile little sheep and don't cause difficulty or delay by asking questions or asserting their rights. But then I have to wonder how much of your "rules" are SSI not for "security" reasons, but to allow TSOs to avoid accountability? I know the answer to that is SSI, but it's a question that needs to be asked.
April 9, 2009 4:43 PM
Just a few notes . . . .
First, I do wish posters would stop referring to scabies as an "infectious disease". Scabies is not a disease; it's a condition -- a parasite, to be exact. Specifically, it's a tiny mite that burrows under the skin, causing an itchy rash.
Second, when listening to media reports, be aware that "a case" may or may not mean "a confirmed case". It's sloppily common for health officials to say something like "we have nine cases, three confirmed". That's because we work by something called "case definition", which means if you have symptom #1, #2, and #3 and you've been in contact, in such a way that you might be at risk of infection, with another person having the suspect disease or condition, we ASSUME you have a related case until proven otherwise. We call that "meeting case definition" or "an unconfirmed case", until we get laboratory confirmation. The problem is, way too many media folk hear "a case" and stop there, just skipping the confirmed or unconfirmed part. The last I saw, Massport (which, btw, is NOT the Health Dept where I work - not even the same state) was reporting three confirmed cases. There's no reason to believe TSA or Massport is lying about this. Health Departments tend to be scrupulously honest about these reports.
Third, ALL personal protective equipment (and gloves are "PPE") is intended to protect the wearer, hence the name "personal protective equipment". PPE generally has the secondary benefit of protecting those with whom the wearer comes into contact -- assuming, of course, that outside of the PPE is uncontaminated. But it was never meant for that, and TSA PPE was never meant to protect passengers, no matter what they say. Doesn't work that way.
Irish
April 9, 2009 5:15 PM
" Anonymous said...
I wish blogger had an ignore feature. I can think of a few regulars I would ignore.
April 9, 2009 2:43 PM"
It would be a tedious, boring blog if everyone thought alike... Perhaps you should skip the computer and just have a conversation with yourself.
April 9, 2009 5:26 PM
Phil said...
Bob at TSA wrote:
"Health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required."
Bob, who were those experts? It seems that either they or you are being misleading.
The CDC says that skin-to-skin contact is not required for transmission
-----
Phil, he wasn't being misleading. "Crusted" or "Norwegian" scabies is a condition caused by the same little critter, S. scabiei, but characterized by very little itching, which leads to a much greater spread of the parasite. The rash is very obvious and very easy to misdiagnose. It is because of the large numbers of parasites present that they will shed onto things like towels, bedclothes and other shared household objects. The normal infestation has nowhere near such large numbers of parasites, and they stay burrowed into the skin.
The likelihood that that you'd run across this rare variant are about the same as the odds that a binary explosive would be successfully assembled on an aircraft.
Bob is giving you the straight scoop.
Irish
April 9, 2009 5:57 PM
@Anonymous: "I wish blogger had an ignore feature. I can think of a few regulars I would ignore."
The same goes for the Anonymous ones.
Unfortunately, by doing so, I'd be blocking the Anonymous people that have something good to say while ignoring statements like the one I'm responding to.
If you're going to make comments like this, at least man/woman up to them instead of hiding behind Anonymous.
Earl
April 9, 2009 5:59 PM
[b]
http://www.wftv.com/news/19130582/detail.html#-
ORANGE COUNTY, Fla. -- Drug agents have arrested a TSA security officer Wednesday who worked at Orlando International Airport on drug and weapons charges.
Eyewitness News has learned that the employee worked as a transportation security officer while going through the TSA's checkpoint at Orlando International Airport, but early Wednesday morning police arrested 41-year-old Timothy Monroe during a high-risk search warrant of his home on Coral Reef Road in Palm Bay.
Officers said that's where agents with Palm Bay's special investigations unit found guns, drugs and cash they said he's used in an illegal drug trafficking for quite some time.
Agents found 40 grams of cocaine, a scale used to weigh and measure the drugs and 65 grams of marijuana all packaged up for sale.
Agents also seized numerous weapons including a shotgun, several handguns and a Keltec pistol. Police say he had the ammunition to go with it, along with the proceeds from drug sales.
Palm Bay police collected just over $6,100 in cash obtained through the illegal sale of cocaine and marijuana.
TSA representative said they are aware of the allegations and will take the appropriate action. [/b]
Wow arent you all supposed to be trustworthy and have clean background checks? Look another black eye in less then two weeks. You wonder why the public has such a deep distrust and lack of faith in anything you do. This just reinforces that point.
It just makes you wonder what he might have been putting on the plane or in bags. This is if your going to screen passengers you have to screen everyone/everytime NO EXCEPTIONS
The appropriate actions would be termination post haste and that this person get the max penalty under law
April 9, 2009 6:45 PM
Earl Pitts sez:
"If you're going to make comments like this, at least man/woman up to them instead of hiding behind Anonymous."
It's like this, Earl. This is a blog maintained by an organization that has the right to conduct warrantless searches as a condition for me to board a commercial aircraft, then chooses to routinely go past the bounds of that already awesome authority--illegally detaining a young man in St Louis for 29 minutes (care to argue they had a perfect right to detain him?), by imposing retaliatory secondary searches on those who assert their rights (by, for example, questioning the authoritaaaa of a TSA or even exerting the right to insist on a new pair of gloves before you rifle through my toiletries) and by generally ignoring their assignment to keep dangerous items off airplanes (thanks for the info, Red Team!!).
Most egregious, this TSA puts people on a "do not fly list"
I'd like to fly today, tomorrow and forever.
So I'll go by a handle that exposes my first initial and last name on other boards, but on this board I choose to remain anonymous, so long as TSA operates as an organization that imperils liberty with total impunity.
But just to be clear, I will always be the Anon who is 1 of the 5 or 6.
April 9, 2009 9:44 PM
I have just been informed that 3 more cases have been confirmed at BOS. If there are any new developments, I'll post them here on the blog.
Bob
EoS Blog Team
April 9, 2009 10:15 PM
Hey Bob, any comments on the TSO at MCO arrested for weapons and drug violations? He was given a pass because he had a background check. Guess that the background check wasn't worth the paper it was printed on.
Any hope of running 100% of all TSOs through the screening process whenever they either enter or leave the secured area?
April 9, 2009 10:40 PM
Irish, I'm going to disagree to some extent with your statement about gloves being for personal protection.
As you know, Joseph Lister was the "father" of infection control. He learned that if surgeons washed their hands prior to surgery the possibility of infection dropped.
Later, surgeons, in addition to scrubbing well prior to surgery, also began to wear gloves, which further reduced the possibility of infection.
In today's world, gloves are worn to help control the spread of bacteria in hospitals. Bacteria such as MRSA.
So gloves might be known as "personal" protection but the intent of wearing them is to stop the spread of bacteria and other nasties amongst individuals.
That is why we must demand that screeners change gloves between bag riflings.
April 10, 2009 7:37 AM
Quote:
"Third, ALL personal protective equipment (and gloves are "PPE") is intended to protect the wearer, hence the name "personal protective equipment". PPE generally has the secondary benefit of protecting those with whom the wearer comes into contact -- assuming, of course, that outside of the PPE is uncontaminated. But it was never meant for that, and TSA PPE was never meant to protect passengers, no matter what they say. Doesn't work that way.
Irish
April 9, 2009 5:15 PM"
------------------------------
Hey Bob,
Can we get this guy on the staff? (maybe as an "unofficial" medical consultant?) Now this guy actually seems to know what he is talking about!
-----------------------------
So, basically, stop sqauking about gloves in TSOs pockets! Not meant to protect you anyway!! We only change them at your request because we're such nice people!
April 10, 2009 10:48 AM
On April 9, 2009 10:15 PM Bob said...
I have just been informed that 3 more cases have been confirmed at BOS. If there are any new developments, I'll post them here on the blog.
Bob
EoS Blog Team
***********************************
Are these really new cases, Bob, or just 'new to you' cases that have already been accounted for in the thread on Flyer Talk which has been covering this since the story first broke in the Boston media on 3/29/09? There is a big difference in the 2. If these are truly new cases, which terminal(s) are the itchy screeners from? Regardless of the terminal, there are 2 further potential problems w/that-if from A or B, homes of the previous known cases, then the thorough cleaning you stated took place clearly didn't work. If from C-E, then the problem has continued to spread amongst the screener workforce, in spite of the measures you referenced in your original blog post (thorough cleaning of the terminal checkpoints & instructions to the screeners to wash their uniforms). Further, if this has continued to spread amongst the workforce as well as across the airport itself, it is beyond unlikely that a passenger, somewhere along the line, hasn't also been infected.
There is more to 'protecting' the traveling public besides mandatory shoe removal & playing w/blacklights.
April 10, 2009 10:56 AM
@Irish: Third, ALL personal protective equipment (and gloves are "PPE") is intended to protect the wearer, hence the name "personal protective equipment". PPE generally has the secondary benefit of protecting those with whom the wearer comes into contact -- assuming, of course, that outside of the PPE is uncontaminated. But it was never meant for that, and TSA PPE was never meant to protect passengers, no matter what they say. Doesn't work that way.
Then the TSA's system has a severe flaw that needs immediate correction. The TSA's job of interdicting Prohibited Items necessarily requires them to paw through and rifle passengers' belongings when the x-ray machine raises suspicion (or when a passenger is honored with a SSSSecondary SSSScreening). That creates a risk of transmitting pathogens (viral, bacterial, fungal, or parasitic) between passengers through the TSOs' hands.
I can't say what the actual risk of such transmission is, or the extent to which it has occurred. (Any such data is surely at least SSI, since disclosure would definitely harm National Security by severely embarrassing the TSA and DHS.) But whatever that risk actually is, its sole cause is TSOs pawing through and rifling belongings without changing their gloves. In other words, it's a risk created entirely by TSA procedures. Since a simple change in those procedures could easily eliminate (or at least reduce) that risk, the TSA needs to respond to this public exposure by updating the SSI SOP to require TSOs to change their gloves every time they do a "bag check," training every TSO on this policy, and communicating this requirement to passengers so they can call TSOs on it when they cut corners and don't do it. There's no excuse for the current policy of changing gloves only when a passenger who happens to know the secret demands it.
The scabies outbreak is a wakeup call. It's an opportunity for the TSA to show that it is truly interested in passenger health and safety beyond keeping oversized bottles of lotion off planes. It's a chance to start repairing their reputation. But if the TSA follows its usual practice of spinning, deflecting, and sweeping it under the rug without changing anything, it will only strengthen their reputation as a bunch of incompetent, arrogant, and utterly unprofessional bullies who have only contempt for the public.
April 10, 2009 12:15 PM
UPDATE
TSA has provided details on these new cases to the Infectious Disease Bureau of the Boston Public Health Commission for their vetting and also made arrangements to have another checkpoint professionally cleaned. Additionally a local hotline for communicable diseases is available for personnel at the airport and for the general public to address any concerns (617-534-5611 or www.bphc.org). Again, health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required.
Blogger Bob
Eos Blog Team
April 10, 2009 1:25 PM
Bob, if scabies is such a difficult thing to spread by casual contact then why were all of the TSO's at Logan told to take all of their clothing home to launder it? Seems that if scabies can be spread from a person to clothing then it stands to reason that passengers belongings could indeed be contaminated by the parasites.
April 10, 2009 1:32 PM
Another reason not to fly. I gave up flying after first going through the demeaning process on a business trip. Now it looks like the TSA people are on the internet against the innocent.http://www.dailynewscaster.com/2009/04/10/dept-of-homeland-security-steve-bierfeldt-should-go-to-jail/
Our tax dollars at work.
April 10, 2009 3:25 PM
Dept. of Homeland Security employee, Ron Paul’s C4L staffer Steve Bierfeldt should go to jail
“You all need to listen better! That was the police asking the questions and NOT TSA.
People that carry large amounts of money throws up a red flag to fund terrorists groups or drugs.
There is no reason for this moron to be carring that much CASH with him. Get a Money order or something! He should go to jail for being dumb!
Let the TSA ask questions to make you idiots feel safe! I would rather have them ask questions than not.”
J.D.
Department of Homeland Security
.........................
Why should I not be surprised that the words above came from a DHS employee.
I think the mindset of the poster is pretty much dead on for most of DHS/TSA.
April 10, 2009 4:20 PM
This post has been removed by the author.
April 10, 2009 5:01 PM
Bob said...
UPDATE
TSA has provided details on these new cases to the Infectious Disease Bureau of the Boston Public Health Commission for their vetting and also made arrangements to have another checkpoint professionally cleaned. Additionally a local hotline for communicable diseases is available for personnel at the airport and for the general public to address any concerns (617-534-5611 or www.bphc.org). Again, health experts have continued to tell TSA that transmission to passengers is highly improbable given that prolonged skin to skin contact is required.
Blogger Bob
Eos Blog Team
April 10, 2009 1:25 PM
...................
I've got an itchy feeling that we've not heard the end of this story.
April 10, 2009 5:17 PM
You know, reading the last few threads together is kind of interesting:
If the alleged drug-dealing TSO hooked up with the alleged STL discipline-problem TSO, then the unchaperoned STL TSO when he found a large amount of cash ($4700) he could wear his gloves while planting a tiny baggie of something that looked suspiciously like drugs, then that whole ugly Ron-Paul problem would have become the DEA's problem.
I am not going in any private room with a TSO.
April 10, 2009 5:31 PM
Thanks for adding a lot to this thread Irish.
-Tim “H2H”
EoS Blog Team
April 10, 2009 5:40 PM
H2H, you've done it again. Irish is pretty much anti-TSA and actually the information she posted is not quite correct as you would have known had you read Sandra's post about the origin of the use of gloves.
April 10, 2009 7:17 PM
That is all I need is to end up with something like this.I have enough health issues. Something really needs to be done. You don't expect to get scabbies at these kind of locations.
April 10, 2009 10:06 PM
Sandra said...
Irish, I'm going to disagree to some extent with your statement about gloves being for personal protection.
As you know, Joseph Lister was the "father" of infection control. He learned that if surgeons washed their hands prior to surgery the possibility of infection dropped.
Later, surgeons, in addition to scrubbing well prior to surgery, also began to wear gloves, which further reduced the possibility of infection.
In today's world, gloves are worn to help control the spread of bacteria in hospitals. Bacteria such as MRSA.
So gloves might be known as "personal" protection but the intent of wearing them is to stop the spread of bacteria and other nasties amongst individuals.
That is why we must demand that screeners change gloves between bag riflings."
Yeah, poor old Semmelweis always gets short shrift.
Even in healthcare settings, the intent varies depending on the context, but there is no true protection for the patients unless the outside of the gloves is, at the very least, uncontaminated -- preferably, sterile. Whenever a healthcare provider cracks open sterile gloves, then the intent is to protect the patient. On the other hand, when a healthcare provider snatches a pair of clean, non-sterile gloves from a box or rack, the intent is to protect the healthcare provider. The #1 recommendation to prevent cross-contamination by disease-causing organisms in healthcare settings is still proper hand hygiene and effective environmental cleaning by the antiseptic techniques pioneered by Semmelweis and Lister. Gloves, in this context, aren't even on the list.
That said, though, you're right about appropriate procedure. If gloves are going to be used, whether to ostensibly to reduce cross-contamination or for any other reason, they work ONLY IF a fresh pair of clean gloves is used to screen each passenger.
Irish
April 11, 2009 7:03 PM
Yet Another Anonymously Curious soul asked...
"Bob, if scabies is such a difficult thing to spread by casual contact then why were all of the TSO's at Logan told to take all of their clothing home to launder it? Seems that if scabies can be spread from a person to clothing then it stands to reason that passengers belongings could indeed be contaminated by the parasites."
One has to understand the life cycle of the mite. Sarcoptes scabiei needs to be able to burrow into the top layers of human skin (and only human skin will do) to successfully reproduce, and generally only survives about 24 hours or so when not in contact with a human.
They're itchy because they shed fairly potent allergens and they leaves behind lots of debris to sensitize the affected individual. Because they stay in the topmost layers of the skin, scratching dislodges them pretty easily and it's unusual to find more than a few dozen (often less) actual mites on an affected individual. There just aren't that many mites present to spread around. However, the "leavings" (eggs, dander, excreta, etc.) continue to exacerbate the allergic reaction and the resultant scratching more often than not makes a scabies infestation look much worse than it really is.
Where do the mites that get scratched off wind up? Mostly inside the affected individual's clothing, or in bedding. Therefore, even though the critters can't reproduce -- or even live very long -- once out of contact with their human host, in an abundance of caution, we advise affected individuals to launder clothing and bedding in HOT water to get rid of any stragglers or dislodged viable eggs which might reinfect the individual.
And advising all of the TSO's to wash their clothing? Two reasons. An abundance of caution (public health officials are nothing if not over-endowed with caution -- it's an occupational hazard) combined with, quite frankly, a psychological component. People seem to feel better if they are doing something. (In all honesty, even the checkpoint sanitation is largely overkill. The evil little critters won't live very long, anyway. But a couple of them might be hanging on for the killing, and it certainly can't hurt.)
All of that said, I guess the bottom-line burning question is: can fomite (person-object-person transmission possibly occur? It is, in theory, possible. But it is terribly inefficient and very, very unlikely. These critters are pretty passive. They don't fly, jump or pole-vault, come off pretty much only when scratched off (they live beneath the skin surface, remember), and then crawl only far enough to maintain contact with their human.
How did they spread at Logan? I haven't seen the case contact records, so I don't have a clue. If I had to speculate, I would speculate that at least one team of affected TOS's probably initially picked them up from a transiting passenger, probably someone with the crusted form of infestation? How they moved on, I won't even speculate. Inadequate data.
Irish
April 11, 2009 8:59 PM
Marshall's SO said...
"H2H, you've done it again. Irish is pretty much anti-TSA and actually the information she posted is not quite correct as you would have known had you read Sandra's post about the origin of the use of gloves."
You are a master of understatement. Saying that Irish is "pretty much anti-TSA" is analogous to saying that Ted Bundy was "a kind of unpleasant guy". ;o)
But what Irish is, is -- Irish is a pretty good public health advocate who won't sacrifice fact on the altar of her dislike for TSA.
The fact is: the way TSA is using gloves, they are PPE and their value in preventing cross-contamination is limited. Nonexistent if they don't change them between EACH screening, and limited otherwise. Moreover, I'm willing to bet that proper technique for changing gloves isn't even taught (much less enforced), so even their value as PPE probably isn't very high.
That might not be what TSA wants and might not be what they teach in TSO school and it might not fit the propaganda, but it is as it is.
The only bright spot I see (and it's only my sense of it; there's no empiric data I know of) is that the risk of a significant disease outbreak attributable to checkpoint operations is probably no greater than the risk of a significant disease outbreak attributable to any other large public space. But, as I said -- there's no empiric data.
Irish
April 11, 2009 10:29 PM
Irish said...
But what Irish is, is -- Irish is a pretty good public health advocate who won't sacrifice fact on the altar of her dislike for TSA.
......................
Irish, you may have stated at some point and I missed it but would you mind stating what your medical training encompasses. Doctor, RN, EMT or such..?
Thanks.
April 12, 2009 11:02 AM
The focus on the particulars of scabies transmission is obscuring what I believe is the important point: As I understand it, the current SSI SOP does not require TSOs to change their gloves between inspections of passengers' personal effects unless a passenger (who knows the secret) demands it. While that may not be sufficient to transmit scabies, this deficiency in the SOP makes TSOs who paw through bags a potential vector for transmitting any number of other pathogens between passengers.
This isn't about scabies. Rather, the scabies outbreak has shined light on a particular aspect of TSA procedures that would otherwise remain in the deep darkness of SSI. I'm sure the TSA would prefer that it remain secret, not for "national security" reasons but to avoid burdening TSOs with procedures that inconvenience them and slow down screening.
So what is the TSA going to do now that their deficiency has been exposed? I certainly applaud Bob for communicating about it here. That's a very good sign. But the TSA Leadership really needs to get away from defending their secrecy and delusions of infallibility, and make a simple change to their SSI SOPs that will protect the health of both TSOs and the public. And just as importantly, they need to communicate that change to the public, so that any passenger knows that TSOs are accountable for using clean gloves whenever they need to paw through their belongings.
TSA Leadership, this is your chance to show the public that you're responsive and interested in improvement, and not just a bunch of arrogant goons who hassle passengers with silly rules for the sake of Security Theatre. If you fail to take those simple and obvious measures, you are entirely to blame for the disdain and distrust the public has for your agency.
April 12, 2009 3:27 PM
RB said...
"Irish, you may have stated at some point and I missed it but would you mind stating what your medical training encompasses. Doctor, RN, EMT or such..?"
Certainly, RB, although I wear many hats. Medically, I'm an EMT ... but my primary job is in the emergency preparedness division of a local health department. (I'm trained to a higher level than EMT, but since much of what I do is administrative these days, I don't have time to maintain my higher-level license.) I actually got sort of dragged into emergency preparedness when my city became part of the original "domestic preparedness" planning back in the 90's, because the program I run was the only one in the HD with the requisite field emergency response background (which, with some pretty interesting supplemental training through DoD, covered the chem/incendiary/explosive part) AND background in acute communicable disease investigation and response (which covered the bio part). I love my job. We're sort of the Dirty Harry of the Health Department here. ;-)
Irish
April 12, 2009 4:13 PM
Irish wrote:
Moreover, I'm willing to bet that proper technique for changing gloves isn't even taught (much less enforced), so even their value as PPE probably isn't very high.
Is that the one where you peel the glove off with one gloved hand up to the fingers, then through the glove peel the other one off and over the glove to make a little self-contained glove 'bag' that all gets thrown away and keeps the 'outside' of the glove on the inside?
That's how the TSA trains us to remove gloves.
April 12, 2009 11:47 PM
Irish said...
RB said...
"Irish, you may have stated at some point and I missed it but would you mind stating what your medical training encompasses. Doctor, RN, EMT or such..?"
Certainly, RB, although I wear many hats. Medically, I'm an EMT ... but my primary job is in the emergency preparedness division of a local health department.
................
Thanks Irish, helps to understand your background and point of view.
Perhaps someone at TSA will pick up on your remarks here.
April 13, 2009 9:58 PM
Have there been ANY cases of scabies reported by passengers? I haven't heard about any, have you? NO!
April 13, 2009 11:33 PM
HSVTSO Dean said...
"Is that the one where you peel the glove off with one gloved hand up to the fingers, then through the glove peel the other one off and over the glove to make a little self-contained glove 'bag' that all gets thrown away and keeps the 'outside' of the glove on the inside?
That's how the TSA trains us to remove gloves."I'm honestly glad to hear that, Dean; I stand corrected and thank you.
Now, if I just saw TSOs consistently doing it that way and if we could just get TSA to require glove changing before every TSO's hand went into a passenger's bag, we'd have something approaching infection control.
Irish
April 14, 2009 7:09 AM
TSO KTD said...
Have there been ANY cases of scabies reported by passengers? I haven't heard about any, have you? NO!
April 13, 2009 11:33 PMA day care center has had an outbreak in that area. Whether or not it was contracted in the airport remains to be seen.
April 14, 2009 8:56 AM
Irish wrote:I'm honestly glad to hear that, Dean; I stand corrected and thank you.
Now, if I just saw TSOs consistently doing it that way and if we could just get TSA to require glove changing before every TSO's hand went into a passenger's bag, we'd have something approaching infection control.Oh, well, actually doing it and enforcement are totally different beasts. :P But, yeah, that's how we're taught to remove the gloves.
As of right now, before a TSO touches any part of a passenger's body or reaches inside of a passenger's bag, we're required to wear gloves (which means that TSOs at the bag check position, and the HHMD position, must be wearing gloves. TSOs at the WTMD position might also be wearing gloves if the airport does patdowns there at the WTMD [we do, in HSV; it's very efficient]. Other TSOs at other positions do not have to wear gloves, but might be because they were wearing them before and rotated to a new position).
However, as you point out, there is no stipulation for the changing of gloves between each passenger, except by passenger request.
If a passenger requests us to change our gloves, we're supposed to (though, by god, it's hard as hell getting a new pair on. The OJ-like contortions are because our hands sweat, and the non-sterile nitrile gloves are powder-free, making it devilishly hard to pull a new one on if you just took a pair off) but it does have limits: we're not required, for example, to change gloves over and over again. What I mean by that is, if there's a bag check and we're asked to change gloves at the onset, we don't have to change them again when the passenger asks in the middle of the bag check. One passenger, one change of gloves.
Now, obviously, some common sense should be used in this case - if I just pulled out a big, leaky bottle of shampoo and got purple goopy stuff all over my gloved hand, then yeah, I'm probably going to want to change my glove before going back into the bag if only out of courtesy. But the "please change your gloves" line isn't supposed to be used as a battle-axe against TSOs doing their job, and a passenger standing there demanding that the gloves be changed every five seconds.
April 14, 2009 9:54 AM
TSO KTD said...
"Have there been ANY cases of scabies reported by passengers? I haven't heard about any, have you? NO!
April 13, 2009 11:33 PM"
Gee, now all passengers must report their scabies infection to TSA? This is SSI, or is it in the public domain TSA rules?
April 14, 2009 10:58 AM
@TSO KTD: "Have there been ANY cases of scabies reported by passengers? I haven't heard about any, have you? NO!"
Absence of evidence is not evidence of absence.
The point is that it COULD have been commuincated to passengers. If you can't see how a disease outbreak can affect and upset passengers, then we can't help you.
At least TSA is having the checkpoints cleaned.
April 14, 2009 11:06 AM
"I am not going in any private room with a TSO."
YOU have to request it, first.
April 14, 2009 4:25 PM
"I am not going in any private room with a TSO."
YOU have to request it, first.
April 14, 2009 4:28 PM
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