Appendix C. Border Measures Implemented During Pandemic (H1N1) 2009

In-flight announcements

On 27 April 2009, notice was given under subsection 74AA(1) of the Quarantine Act 1908 for all flights originating from countries in North, Central and South America and arriving in Australia to make in-flight announcements prior to arrival to inform passengers of facts regarding pandemic (H1N1) 2009 influenza, border entry requirements and appropriate behaviour (including hygiene practices) after their arrival.

Quarantinable diseases list

On 28 April 2009, the Governor General proclaimed ‘human swine influenza with pandemic potential’ a quarantinable disease under the Quarantine Act 1908. This allowed Quarantine Officers to take action where suspected or actual cases were identified.

Border nurses

From 28 April 2009, border nurses were deployed to the eight major airports (Adelaide, Brisbane, Cairns, Coolangatta, Darwin, Melbourne, Perth and Sydney) to provide advice and check symptoms of individual travellers referred to them following identification as unwell through any of the three screening methods (non-automatic pratique, HDCs and thermal scanners).

• The nurse checked whether the person met the Communicable Diseases Network of Australia’s case definition, which required taking the person’s temperature and interviewing them.
• If the case definition was met, nasal swabs were taken for laboratory testing. If laboratory testing was positive, the person was contacted and requested to place themselves in voluntary quarantine at home or in their hotel.
• If the person was symptomatic:
  • if their symptoms were not severe, they were asked to place themselves in (voluntary) quarantine at home or in their hotel until test results were available, and provided with a mask (along with instructions for wearing it), their hands disinfected, advised on the use of alcohol wipes and provided with hard-copy information sheets that included details of relevant websites and telephone hotline numbers
  • if their symptoms were severe, they were hospitalised.

Non-automatic pratique

From midnight on 29 April 2009, non-automatic pratique was implemented on all international flights into Australia whereby the aircraft captains were required to report to the Australian Quarantine and Inspection Service (AQIS) on the health status of passengers and crew on the aircraft prior to landing. This was required in order to provide advance notice of any need for further screening for symptoms. This required in-flight announcements to be made advising passengers experiencing influenza-like symptoms to self-identify as unwell. Upon landing, identified passengers were assessed by an AQIS officer to determine whether medical attention was required. If the assessment indicated possible pandemic (H1N1) 2009 influenza, the person was escorted to a border nurse for further assessment.

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Health Declaration Cards

From 29 April 2009, Health Declaration Cards (HDCs) were distributed to the Australian Customs and Border Protection Service at each of the eight major airports (Adelaide, Brisbane, Cairns, Coolangatta, Darwin, Melbourne, Perth and Sydney) (see Table C.1: Average number of incoming international passengers per day at Australia’s major international airports for the period 1 May 2009 to 1 June 2009). The purpose of HDCs was to provide information on pandemic (H1N1) 2009 influenza to incoming passengers and crew; to provide an initial screening tool to allow further screening of incoming passengers and crew if they reported symptoms; and to allow tracing of incoming passengers and crew who had been close contacts of passengers and crew confirmed to be infected with pandemic (H1N1) 2009 influenza (known as ‘contact tracing’).

The HDC was a requirement in addition to the routine Incoming Passenger Card, to be handed to the Customs and Border Protection Service Officer at the primary line along with the passenger’s passport and Incoming Passenger Card. The HDC required passengers to provide their personal details and seat number, answer questions about symptoms and provide contact details of people they would be in contact with over the following seven days. If the passenger ticked ‘yes’ to any of the questions about symptoms, they were escorted to a border nurse for further assessment.

The completed cards were collected by the Customs and Border Protection Service and provided to information management firm Decipha, which scanned the cards and placed the information on the secure GovDex website. The information was accessed if contact tracing was needed.

The HDC also served a valuable purpose for passengers and crew, as it had a take-home section that included a health alert notice and recommended that the traveller keep the notice for 14 days after arrival to provide to their doctor for information and reporting purposes should the traveller become unwell.

Thermal scanners

From 29 April 2009, 25 thermal scanners were delivered to the eight major airports (Adelaide, Brisbane, Cairns, Coolangatta, Darwin, Melbourne, Perth and Sydney) and set up close to the primary line. The purpose of thermal scanning is to detect incoming passengers and crew with raised temperatures (higher than 38^o Celsius) to allow further screening for symptoms. They were operated by AQIS personnel. Travellers passed in front of the thermal scanners and, if identified as having a raised temperature, were escorted to the border nurse for further assessment.

Emergency quarantine measures

On 30 April 2009, the Australian Government Minister for Health and Ageing authorised the implementation of emergency quarantine measures under subsection 12A(1) of the Quarantine Act 1908. Under this authorisation, airports and airlines could be directed to accommodate enhanced border measures to minimise the public health risk from potentially infective incoming international travellers. No directions were subsequently made by the minister as all agencies, governments and companies voluntarily complied with requests to enhance border measures.

Under the emergency provisions of the Act (Section 2B), the Governor General could declare an epidemic. This would provide the minister with extensive powers to address an emergency.

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Public health messages

Signage relating to the risk of infection from pandemic (H1N1) 2009 influenza was placed around all international airports. The Customs and Border Protection Service also placed messages on their electronic signs near primary lines at all international airports. Business card–sized notices with information were also available at primary lines.

Border measures for cruise ships

Non-automatic pratique and HDCs were used. A national protocol for managing cases on cruise ships was developed during the pandemic response.

Table C.1: Average number of incoming international passengers per day at Australia’s major international airports for the period 1 May 2009 to 1 June 2009

Airport	Number of passengers	Percentage (approximate)
Adelaide	593	2
Brisbane	4,956	17
Cairns	510	2
Coolangatta	766	3
Darwin	532	2
Melbourne	5,953	21
Perth	3,193	11
Sydney	12,182	42
Total	28,685	100