title: [Exercise scenario of a highly contagious, life-threatening disease in intercontinental aviation : a case report in the context of the International Health Regulations (IHR)].
abstract: BACKGROUND
  The International Health Regulations (IHR) 2005 were conformed to German law on July 20, 2007 and described in detail by the Implementing Act (IHR DG). According to these legal bases, "designated airports" must maintain special capacities for protection against health threats, and are also responsible for performing regular IHR exercises.
  
  
  OBJECTIVE
  Representation of the optimization of established operational concepts of various professions to manage infectious biological threats without obstruction of international travel, and mediation of experience to IHR professionals.
  
  
  METHODS
  An exercise based on the case scenario of a travel-related febrile illness was performed at Munich International Airport on November 11, 2013. Preparations took 6 months and the exercise itself lasted nearly 12 h. The follow-up lasted an additional 9 months. A qualitative and quantitative evaluation of the exercise was completed.
  
  
  RESULTS
  From an Individual Medicine and Public Health perspective, modular work structures and risk communication functioned adequately. The medical examination of passengers was also well managed. Areas requiring further optimization included arrival/departure times of external actors, transport of the index patient to hospital and protective measures for individual participants. Overall, a defined biological threat scenario representing a double infection with two highly pathogenic germs was handled satisfactorily without affecting international air travel.
  
  
  CONCLUSIONS
  Modular supply components are an effective and forward-looking means in protection against threats occurring at airports. Key success factors include sufficient staff mobility, immediate self-protection of actors involved, effective risk communication and a strong overall coordination and monitoring of the situation.
authors.affiliation: Abteilung Gesundheitswesen, Landratsamt Erding, Bajuwarenstrasse 3, 85435, Erding, Deutschland, heribert.stich@lra-ed.de.
authors.forename: Heribert
authors.initials: H
authors.lastname: Stich
authors.forename: W
authors.initials: W
authors.lastname: Guggemos
authors.forename: A
authors.initials: A
authors.lastname: Mühlhaus
authors.forename: B
authors.initials: B
authors.lastname: Wicklein
authors.forename: J
authors.initials: J
authors.lastname: Dietl
authors.forename: A
authors.initials: A
authors.lastname: Hoffmann
authors.forename: J
authors.initials: J
authors.lastname: Leiwering
authors.forename: D
authors.initials: D
authors.lastname: Frangoulidis
authors.forename: S
authors.initials: S
authors.lastname: Zange
authors.forename: B
authors.initials: B
authors.lastname: Königstein
authors.forename: S
authors.initials: S
authors.lastname: Ippisch
mesh_terms: D000337:Aerospace Medicine / Q000331:legislation & jurisprudence*; D001359:Aviation / Q000331:legislation & jurisprudence*; D019091:Critical Pathways / Q000331:legislation & jurisprudence; D005858:Germany; D014943:Global Health / Q000331:legislation & jurisprudence; D055819:Hospitals, Isolation / Q000331:legislation & jurisprudence*; D006801:Humans; D000069516:International Law; D038622:Internationality; D017146:Models, Organizational; D010356:Patient Isolation / Q000331:legislation & jurisprudence*; D010357:Patient Isolators / Q000592:standards; D016544:Patient Simulation; D014187:Transportation of Patients / Q000331:legislation & jurisprudence*