Onboard Safety: How To Prevent Infections Diseases During the Flight?

General Health, Healthy Living, Infectious Diseases, Your Very Special Child
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Traveling is a wonderful opportunity to gain new life experiences, but it can also pose health risks. When in enclosed spaces such as airplanes, or in crowded places like airports, travelers are more likely to encounter infections that spread from person to person.

The events of recent years, associated with the coronavirus pandemic, have shown how quickly diseases can spread around the world. But viruses are only part of the problem. During travel, one may also encounter bacterial infections, which can be just as dangerous. That’s why it is important not only to understand how infections are transmitted, but also to know how to protect yourself.

In this article, we will look at how infections spread during travel. You will learn how viruses and bacteria can be transmitted through air, droplets, or contact with surfaces, and what measures can help reduce the risks. This knowledge will help you prepare for your trip and stay healthy while enjoying your travels.

Modes of transmission during air travel

During airplane trips, travelers face specific infection-related risks. The greatest threats are respiratory infections, such as influenza, coronavirus infections, and other viruses transmitted via airborne droplets. In the confined space of an airplane cabin, where passengers are seated in close proximity, the risk of infection increases significantly.

On board, infections can spread through tiny aerosols, which can remain suspended in the air and circulate through the cabin via ventilation flows. This is especially dangerous on long-haul flights, where passengers are confined for several hours. Larger droplets released by coughing or sneezing can infect nearby neighbors directly.

Contact transmission also plays an important role. Surfaces such as armrests, seats, tray tables, seat belts, air vent buttons, and toilet doors are frequently touched by different passengers, making them potential sources of viral or bacterial contamination. Special attention should be paid to fabric surfaces like seats and seat belts, which are difficult to clean properly between flights. Biological fluids such as vomit may contain infectious agents related to the infections described in this article. Contact with contaminated surfaces or incomplete disinfection may facilitate their transmission.

Airports differ from airplanes in terms of risk characteristics. Here, the main threat is associated with the mass movement of people, increased contact with various surfaces, and the possibility of food poisoning in airport cafés or restaurants.

What infections are commonly encountered during air travel?

Let’s look at the infections for which the risk of transmission on a plane may be higher:

Influenza virus

  • Reinfection is possible: A new strain emerges each season, so immunity from one infection usually doesn’t protect against another.
  • Mode of transmission: Airborne droplets and surface contact. The enclosed space of the airplane increases the risk.
  • Symptoms: High fever, cough, sore throat, muscle aches, chills, weakness, and sometimes nausea and diarrhea (more often in children).

Adenovirus

  • Reinfection is possible: There are many serotypes, and infection with one does not protect against others.
  • Mode of transmission: Droplets and surface contact.
  • Symptoms: Runny nose, cough, sore throat, eye inflammation (redness and tearing), diarrhea, vomiting, high fever.

Coronavirus

  • Reinfection is possible: Immunity weakens over time, and new strains increase the risk.
  • Mode of transmission: Through droplets, aerosols, and contaminated surfaces.
  • Symptoms: High fever, cough, shortness of breath, loss of smell or taste, extreme fatigue, sometimes muscle aches, headache, diarrhea.

Rhinovirus

  • Reinfection is very common: More than 160 virus types exist, and immunity to one does not protect against others.
  • Mode of transmission: Airborne droplets and contaminated surfaces.
  • Symptoms: Runny nose, sneezing, sore throat, fatigue, mild fever.

Respiratory Syncytial Virus (RSV)

  • Reinfection is possible: Immunity is temporary, especially in children and the elderly.
  • Mode of transmission: Via large droplets and direct contact.
  • Symptoms: Nasal congestion, severe cough, wheezing, difficulty breathing; in infants — feeding refusal and irritability.

Mycoplasma pneumoniae

  • Reinfection is possible: Immunity is short-lived; reinfection is common in crowded places.
  • Mode of transmission: Via airborne droplets.
  • Symptoms: Dry, persistent cough, fatigue, sore throat, headache, low-grade fever, sometimes chest pain.

Personal hygiene first

These personal hygiene practices are especially important while traveling, where access to regular hygiene methods may be limited, and the risk of infection increases due to close contact with large numbers of people and shared surfaces.

  • The importance of handwashing and how to do it properly: Handwashing remains one of the most effective ways to prevent infection. Wash hands thoroughly with soap and water for at least 20 seconds, paying attention to all areas: between the fingers, under the nails, and around the wrists.
  • When and how to use hand sanitizers effectively: Alcohol-based hand sanitizers (containing at least 70% alcohol) are a good alternative when soap and water are not available. Apply enough sanitizer to cover all surfaces of the hands, including fingers, nails, and backs of hands, and rub until completely dry. However, note that sanitizers do not remove visible dirt, and their effectiveness is reduced on soiled hands.
  • The importance of using disinfectants: Infectious agents can survive on surfaces for extended periods. Regular disinfection, especially in high-traffic areas (armrests, tray tables, door handles), significantly reduces the risk of contact transmission. Use disinfectant wipes on areas frequently touched by others. Keep in mind, however, that many people may experience allergic reactions to the scents or ingredients in disinfectants, such as skin irritation, watery eyes, or breathing difficulties. Choose only hypoallergenic, unscented disinfectant wipes when flying.

Washing hands with soap

Washing hands with soap and water is the most effective and safest method of removing dirt and microbes for people of all ages. It is non-toxic and non-irritating when using quality, low-allergen soap.

It is important to avoid antibacterial soaps containing triclosan, which is unnecessary for proper hygiene and may contribute to bacterial resistance. Also, soap should be free from other harmful additives that could negatively affect health and the environment.

Information about sanitizers:

Sanitizers are used in situations where access to water and soap is limited.

  • Alcohol-based sanitizers: Should contain 70%+ ethanol or isopropanol. They are effective against most viruses and bacteria.
  • Alcohol-free sanitizers: Use gentle antiseptics such as benzalkonium chloride. They are less irritating and safer if accidentally ingested, but not as effective against certain viruses (e.g., COVID-19).

Specifics and risks of using sanitizers:

  • People who tend to put their hands in their mouths (e.g., children or adults with special needs) are at risk of ingesting toxic ingredients, especially in alcohol-based sanitizers. For them, handwashing, alcohol-free sanitizers, or alternative methods such as non-toxic wet wipes are preferred.
  • Fragrances, dyes, and alcohol may be toxic and irritating.
  • Frequent use of alcohol-based sanitizers can damage the skin barrier.

Baby wipes:

  • Composition: It’s preferable to use products that are free from alcohol, parabens, fragrances, and harsh chemicals. Ideally, the base should be water (up to 99%) with moisturizing agents such as glycerin or aloe extract.
  • Advantages: Safe even if accidentally ingested, suitable for the sensitive skin of newborns, convenient for outdoor use when regular access to water is not available.
  • Limitations: Do not kill microbes, only clean the skin, and may be less effective for heavy contamination.
  • When to use: For cleaning hands, face, and body of both adults and babies, especially outdoors as an alternative to washing when water is unavailable.

Hypoallergenic disinfectant wipes based on hydrogen peroxide:

  • What they are: Disinfectants based on hydrogen peroxide are chemical compounds that effectively kill a broad spectrum of microbes, including viruses, bacteria, and spores. They are used to disinfect surfaces in both household and professional settings.
  • Advantages: Effectively kill viruses, bacteria, spores. Less toxic, no strong odor—which is especially important in enclosed spaces—and suitable for disinfecting surfaces like tray tables and armrests.
  • Disadvantages: Not suitable for skin, as they can cause irritation and dryness. Hydrogen peroxide evaporates quickly, so containers must be tightly sealed after use.

The role of masks on airplanes

The use of masks on airplanes may raise concerns, especially due to the lower oxygen levels at cruising altitude.

  • Mask effectiveness: Masks reduce the risk of spreading respiratory infections by trapping large and small droplets that may contain viruses and bacteria. Studies confirm that masks do not reduce blood oxygen levels, even in the lower-oxygen environment of an aircraft cabin.
  • Types of masks: Cloth masks offer protection to others but limited protection to the wearer. Medical masks or respirators (e.g., N95) are more effective, capturing both droplets and aerosols, providing two-way protection.

Air filtration on airplanes

In an aircraft environment where air circulates within an enclosed space, the efficiency of HEPA filters is crucial for minimizing infection transmission risk.

  • The role of HEPA filters: HEPA filters on airplanes capture up to 99.97% of fine particles, including viruses and bacteria, greatly reducing the spread of infections in enclosed spaces. Their effectiveness makes air filtration a key safety factor.
  • Use of HEPA filters in different countries: In Canada and the U.S., HEPA filters are not mandatory on commercial flights, but most modern aircraft are equipped with them. However, the absence of such filters in some airlines creates additional risks that should be considered when planning a trip.

Choosing a Seat on the Plane

These recommendations can help travelers minimize contact with pathogens and reduce the risk of infection during a flight.

  • Window seats: A window seat helps minimize contact with other passengers, as you are less likely to interact with people walking through the aisle or crew members. More people move through the aisle, increasing the likelihood of exposure to droplets or aerosols.
  • Ventilation influence: In modern aircraft, air is supplied from top to bottom through ventilation systems, which helps reduce horizontal spread of aerosols.
  • Oxygen levels during flight: According to research, the rear of the plane may have slightly higher oxygen levels due to airflow inertia, as the aircraft moves forward and air accumulates at the back of the cabin.
  • Staying away from crowded areas: Choosing a seat away from restrooms, galley zones, and high-traffic areas (like the aisle) helps reduce contact with potential sources of infection.

Therefore, a window seat near the rear of the aircraft is the best option, where oxygen levels may be slightly higher. If you are traveling with family, try to book an entire row to minimize interaction with other passengers. Check with the airline to confirm whether HEPA filters are used onboard.

Hydration, Nutrition, and Immunity

  • Hydration and its role in immunity: Cabin air has very low humidity (less than 20%), which can lead to dehydration. This weakens the protective function of the mucous membranes in the nose and throat, making them less effective barriers against pathogens. Drinking water regularly helps keep them moist and lowers the risk of viral or bacterial entry.
  • Role of nutrition in immunity: A balanced diet supports the immune system during travel. Foods rich in vitamins (especially vitamin C), zinc, and iron help the body cope with potential infections. Avoid perishable foods and opt for packaged items.

Caution and Preparedness

  • Recognizing symptoms:

    • Be alert to symptoms during travel, such as fever, cough, runny nose, sore throat, headache, fatigue, and gastrointestinal symptoms (nausea, vomiting, diarrhea).
    • If a passenger vomits, avoid contact with contaminated surfaces, as vomit can contain infectious agents. Immediately notify the crew so they can sanitize the area.
    • Remember that the incubation period for infections may range from 1 to 14 days.
    • Keep in mind that infections are not the only potential health issue during travel. Avoid self-diagnosing; if you experience unusual symptoms, seek help promptly.

  • What to do if you feel unwell during a flight:

    • If you feel sick during the flight, inform the crew immediately. They have medical kits and oxygen masks to provide emergency assistance.
    • The crew can contact ground services if necessary, request medical help at the destination, or make an emergency landing.

  • Post-flight actions:

    • If symptoms appear within a few days after the flight, consult a doctor and inform them of your recent travel.
    • Avoid public places until you’ve seen a medical professional, to prevent putting others at risk.

Risks in Other Types of Travel

In addition to air travel, it’s worth considering other types of travel such as trains and cruise ships.

  • Risks on trains: Risk of infection is somewhat lower on trains due to reduced passenger density, but there is still potential exposure through surfaces like armrests, tray tables, door handles, and food (gastrointestinal infections: norovirus, salmonella, campylobacter, E. coli).
  • Risks on cruise ships: Cruise ships present more complex challenges. In addition to shared surfaces (railings, doors) and food (gastrointestinal infections: norovirus, salmonella, campylobacter, E. coli, hepatitis A—especially through seafood), there is an added risk from centralized ventilation systems (respiratory infections: legionellosis, influenza viruses, COVID-19). In the confined space of a ship, respiratory infections can spread rapidly.

Conclusion

Travel brings new experiences and discoveries, but it also carries health risks. Respiratory and gastrointestinal infections can spread through contact with people, contaminated surfaces, or food—especially in enclosed environments.

To reduce risks, it’s important to follow basic precautions: maintain hygiene, eat well, stay hydrated, and use protective tools like masks and sanitizers. At the first sign of illness, seek help from flight crew or healthcare professionals.

Taking care of your health ensures a safe and enjoyable journey, allowing you to focus on the best parts of travel!