Flu-Free Flying

12 Ways to Avoid Getting Sick When You Fly
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Does every single airline trip you take seem to end with a case of the sniffles, or worse, with a full-on case of the flu? If you're starting to feel just a tad paranoid about picking up a nasty virus when you fly, you're not alone. It's a common perception that airline cabins are happy incubators for cold and flu germs.

Is it true, though? Researchers are still debating the issue. But a Canadian study published in the Journal of Environmental Health Research in 2004 reviewed passenger health histories after a five-hour flight between San Francisco and Denver and found passengers were 113 times more likely to have caught a cold during the flight than during normal daily life.

The publishers of the study point to a number of possible causes, including close quarters, shared air, and extremely low cabin humidity. Today, with the H1N1 virus making flu season an even scarier scenario, airline passengers are taking the cold and flu risk associated with flying more seriously.

Here, then, are 12 ways to dodge those flu and cold viruses when you fly:

Stay well hydrated.

Drink plenty of water before getting on the plane, and continue to drink while flying. The researchers who documented the high incidence of colds after flights concluded that low humidity in an airplane cabin was the prime cause for susceptibility to common colds and flu after air travel. Most commercial planes fly at elevations between 30,000 and 35,000 feet, where humidity is 10 percent or lower. When the air is this dry, it sabotages the natural defense system of mucus membranes in our noses and throats, making it easier for germs to penetrate to the nasopharynx --where nasal passages meet the mouth at the back of the throat -- which is the "sweet spot" for cold viruses.

Doctors' number-one tip when you're flying: Buy a big bottle of water as soon as you get through security and start drinking before you fly, so you're well hydrated when you get on the plane. Drinking water keeps the mucus membranes in the nose and throat moist and better equipped to fight germs. Continue to drink water throughout the flight. If you're on an international flight where they confiscate water bottles, request glasses of water from the attendant. Or bring your own refillable bottle -- just be sure it's empty when you try to board, and then ask the attendant to fill it for you once you're on the plane.

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Protect your nasal membranes from dry air.

Nasal mists and saline nasal sprays have been found to be effective in boosting your body's own system of germ eradication, which works to flush germs from your nose. There's even a product developed especially for this purpose called Flight Mist, but any nasal mist or spray will work fine. Some people swear by the technique of applying a small amount of Neosporin or Vaseline just inside the nostrils (use a Q-tip if your hands aren't freshly washed). Experts say the antibacterial action of Neosporin is unlikely to present much of a barrier when used in this way, but it never hurts to moisturize the inside of the nose.

Hot drinks are also a good way to keep your protective mucous membranes working; they trigger your nasal passages to release moisture and also provide direct moisture as you inhale the steam. Remember, though, that coffee is mildly dehydrating, since caffeine is a diuretic. (Recent studies show the antioxidants in tea offset the caffeine's dehydrating action.) So ask for tea or hot chocolate, or carry your own tea bags and just ask for hot water.

Don't touch the seat pocket in front of you.

Of course it's the handiest place to stash your stuff, but think about it: Previous passengers have put everything and anything in there, from used tissues to dirty diapers. According to the National Institute of Allergy and Infectious Diseases, rhinoviruses -- the primary culprits behind the common cold -- can live up to three hours on any surface, whether that's your armrest, your tray table, or the seat pocket the passenger before you put his tissues in. Keep your books, magazines, reading glasses, and other personal items in your carry-on, if possible. If that's not practical, slide your sleeves over your hands before reaching into the seat pocket.

Disinfect any surfaces you touch.

Using an alcohol-based disinfection product is a good second choice when you can't wash your hands. You can also use disinfecting wipes to wash down surfaces you can't avoid touching. Carry a pack of disinfectant wipes in your travel bag and wipe down armrests, tray tables, and the seat back in front of you.

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Travel with your own blanket and pillow.

Not only do few airlines reliably provide blankets anymore, but the ones they do offer can harbor germs. In fact, this fall several airlines removed all blankets and pillows from flights as a precaution against cold and flu transmission. Carry a light, foldable blanket in your bag; ladies, a pashmina shawl works well. Traveling with an inflatable or foldable neck pillow is a good idea, too. If you want to conserve space, you can bring along your own pillowcase and put it over the pillow provided, but wash your hands after the switch.

Open the air vents to turn on the air.

It might sound counterintuitive, but the lack of circulating ventilation is one of the main reasons airplanes are safe havens for germs. In fact, the airline study showed that flights featuring actively recirculated air, which is filtered, had lower cold and flu transmission rates than those that didn't. Some experts advise opening the air vents above your seat as far as possible, so the blowing air can help push away the germs that might float into your space from a nearby passenger.

Close the toilet lid before flushing in plane and airport bathrooms.

Most people try to avoid touching toilet seats but don't think about the spraying action of flushing. But researchers do. In one 2005 study, researchers measured the microorganisms in the air and on nearby surfaces after the first and subsequent flushes and found that "large numbers of microorganisms persisted on the toilet bowl surface and in the bowl water, which were disseminated into the air by further flushes." And because plane bathrooms and airport cubicles are tiny, you tend to be standing much closer -- or even directly over -- the toilet while flushing. A simple solution: Close the lid first before reaching for the handle. After flushing, wash your hands thoroughly with soap.

Skip that cocktail.

Drinking alcohol on a flight not only contributes to jet lag; it dehydrates your system. And research shows that heavy drinking actually suppresses the immune system; big drinkers are more prone to infections and illness. If you usually have a drink to combat anxiety or help you sleep, consider using an alternative remedy such as melatonin or chamomile tea for this purpose.

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Use your seat as a barrier.

If the people behind you are coughing or sneezing, don't tip your seat back, or you put yourself directly in their line of fire. Likewise, if the germ factories are in the row in front of you, gaining even a few inches of distance from them can help.

Wear a face mask.

Yes, it looks silly. But the National Institutes of Health (NIH) cite airborne germs as one of the top two sources of cold virus infection. If someone near you is coughing or sneezing and you're unable to change seats, a mask is the only effective barrier between you and the airborne virus.

Ask to change seats if someone's coughing or sneezing on you.

This one can be tough for the shy or well mannered. If you're one of those who stay glued in your seat, terrified, for the entire flight, see our suggestions on how to change seats gracefully to avoid sick passengers. Of course, it's not always possible to move if the flight is fully booked and no one's willing to swap places. But it's always worth alerting the flight attendant that you wish to be moved. Sometimes a seat becomes available when another passenger upgrades to business class or vacates a bulkhead seat because of emergency requirements.

Protest if you're held on the runway with the ventilation system shut off.

There are documented outbreaks of flu on airlines in which passengers were held on the plane with the ventilation system turned off. In one case, researchers studied 54 people who were delayed on the ground for three hours because of engine failure before takeoff. Within two days, 72 per cent of the passengers became ill -- and the researchers traced the flu strain back to one sick passenger.

Current recommendations require that "passengers be removed from an aircraft within 30 minutes of shutting off the ventilation system," but the rule isn't always followed. If you're on a delayed flight and you notice the air go off, check your watch. After half an hour, approach a flight attendant and remind him or her that regulations require that the ventilation be turned on. If much more time passes, talk to your fellow passengers and see if you can garner some support, then approach the attendant again. In several such cases, irate passengers were able to get the ventilation system turned back on.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio