Table 4. Competency profile for professionals involved in infectious disease preparedness and response at airports.

General
Communication
Communicator	• Understand and implement the basic principles of risk communication to airport and airline staff, travelers, the public and media. • Establish trust with airport and airline staff, travelers, the public and media by using rapid communication channels and ongoing two-way communication. • Understand the terminology used by different levels and organizations at the airport.
Professionalism
Professional	• Minimize the discomfort or distress associated with public health measures experienced by crewmembers, ground staff, and passengers. • Apply relevant laws to data collection, storage, management, dissemination and use of information.
Collaboration
Collaborator	• Understand the importance of multidisciplinary collaboration during acute outbreak management. • Be an effective team member, adopting the role necessary to contribute constructively to the accomplishment of tasks by the group. • Participate in the implementation of established plans which ensure the continuity of operations. • Create and manage a network of key partners in rapid response and recovery.
Preparedness
Training
Health expert	• Provide training and exercises on communication within, and between, involved airport organizations and include healthcare providers in this training.
Organizer	• Identify training needs, and plan and organize courses. • Periodically practice and test the ability to make decisions in unpredictable circumstances.
Contingency planning
Health Expert	• Be familiar with job-related standards and recommended practices concerning infectious disease control of national and international aviation organizations (IATA, ICAO and CAPSCA). • Periodically assess whether the implementation of strategies, standard operating procedures (SOPs) and action plans requires any changes. • Before the response operation, identify which triggers will require key decisions to be made during the outbreak response (keeping in mind that triggers may need modification to fit specific situations). • Before the response operation, plan for the storage and stockpiling of medical and non-medical countermeasures.
Organizer	• Understand the logistical structure of the airport and the international context of airports and their functioning. • Identify key partners and develop a common understanding of roles, resources, planning assumptions, risks or vulnerabilities, and information needs. • Support core-capacity-building at the airport and understand the importance of it. • Develop, test and evaluate a Public Health Emergency Contingency Plan (PHECP) on a periodical basis. • Provide healthcare workers with clinical guidelines for emerging infections from abroad, especially those that may be carried by travelers and the severely contagious.
Surveillance
Health Expert	• Recognize a potentially infectious disease by key symptoms and signs of events among travelers. • Understand the relevance of early detection of public health threats. • Understand the components of surveillance systems and how these work.
Organizer	• Understand the roles and responsibilities of local, national and international organizations involved in infectious disease control. • Be familiar with laws on the surveillance and reporting of infectious diseases at national, European Union level and globally (International Health Regulations).
Response
Risk assessment
Health Expert	• Understand risk analysis frameworks, with the elements of risk assessment, risk management and risk communication. • Determine when a risk assessment should be carried out, and appropriate measures taken. • Perform a risk assessment and continuously review the risk assessment as further information becomes available. • Interpret the diagnostic and epidemiological significance of laboratory tests reports.
Organizer	• Collect and integrate the facts of an event, based on information from multiple sources, including the traveler, the aircraft operator, ground-based medical services for aircraft in flight (when available) or the agent responsible for the baggage or cargo. • Know when case reports or clusters require further investigation, and how to initiate such investigations.
Outbreak investigation
Health Expert	• Conduct outbreak investigations to identify pathogens and other agents, characterize affected population groups, and sources of exposure. • Use reliable systems for disseminating case definitions to standardize both the diagnosis and the reporting of case numbers (e.g. confirmed, suspected, probable, or possible, cases). • Systematically generate required information about the number of travelers such as those targeted for screening, screened, referred to secondary screening, and identified as confirmed cases. • Implement contact-tracing based on a careful, case-by-case, risk assessment basis, taking into account factors such as feasibility, the severity of the disease and its potential for epidemic spread, the infectivity of index patients, and the duration of the trip.
Organizer	• Identify who is responsible at national level for receiving the information on the investigation from the local or intermediate level health authority.
Scholar	• Maintain up-to-date and job-specific knowledge about characteristics of infectious diseases such as the reservoir, potential sources, modes of transmission, risk groups, and duration. • Be able to contact professionals who have the biological, clinical, and epidemiological knowledge necessary to characterize (potentially novel) pathogens and other agents responsible for an outbreak disease. • Use evidence-based methods to identify and recommend control and preventive measures to control an outbreak.
Management of ill and exposed travelers
Health Expert	• Provide ground-based medical support (GBMS) regarding infectious disease events, including medical recommendations to manage the discovery of a suspected communicable disease during flights, to support decisions regarding medical treatment and use of on-board medications or equipment. • Assess the health status and travel history of travelers arriving from, or going to, an affected region, or who have been exposed to a potential public health risk during air travel.
Organizer	• Provide disembarking travelers with information regarding the precautions to take in the event of illness, information sources for any updates on the event and the public health authority (PHA) contact information where subsequent enquiries can be made. • Provide advice concerning the appropriate parking stand for an incoming affected aircraft and the order of disembarkation of passengers. • Provide advice to ensure port health staff respond efficiently so as reduce the time that travelers spend on a board-affected aircraft, and identify space requirements for interviews and health assessments of arriving travelers. • Provide advice on a traveler’s possible transfer to a medical facility by ambulance and facilitate the rapid transport of suspected cases of an infectious disease.
Public health measures
Health Expert	• Recognize when it is necessary to wear Personal Protective Equipment (PPE), what PPE is required, where the equipment is stored and how PPE is donned or doffed.• Determine triggers for appropriate public health measures to be taken, such as travel restrictions, quarantine, treatment and isolation, that are commensurate with the risk and do not unduly interfere with international travel.• Relate information regarding medical clearance for travelers with health conditions which may affect their suitability for air travel. • Provide information regarding vaccination or other prophylaxis to affected travelers. • Determine, based on results of the inspection, if further disinfection, decontamination, disinsection or deratting measures of the aircraft or at the airport are required. • Recognize when to implement the special handling of baggage or cargo from affected regions, including inspection, fumigation, and other decontamination of possibly destruction.
Organizer	• Assess whether the costs of the public health measures and resulting liabilities are proportionate to the risk. • Equip relevant airport and airline staff with information regarding the public health event so that they can protect themselves and safeguard healthy travelers as required.
Scholar	• Organize the use of public health measures underpinned by scientific evidence and expert public health opinions, so as to avoid any contradictory or unnecessary restrictions of individuals.
Recovery
Evaluation and recovery
Health Expert	• Clearly define goals and objectives of the evaluation of training, exercises or real response. • Develop a formal evaluation of the response, including recommendations for prevention and mitigation for future incidents, and share the evaluation with all stakeholders when the public health event is under control or has concluded.
Organizer	• Deactivate the plan and return to recovery once the situation is under control or able to be de-escalated. • Update plans according to the key lessons learnt after a formal review of training, exercises or real response.