Travelling is a wonderful opportunity to gain new experiences in life, but it can also bring health risks. Being in confined spaces, such as airplanes, or in crowded places like airports, travellers are more likely to encounter infections transmitted from person to person.
The events of recent years, particularly the COVID-19 pandemic, have demonstrated how quickly diseases can spread globally. However, viruses are only part of the problem. During trips, travellers can also encounter bacterial infections that are no less dangerous. Therefore, it is crucial not only to understand how infections are transmitted but also to know how to protect yourself.
In this article, we explore the spread of infections in travel settings. You will learn how viruses and bacteria can be transmitted through the air, droplets, or contact surfaces, as well as which measures can help reduce risks. This knowledge will help you prepare for your trip and maintain your health while enjoying the journey.
Transmission risks during air travel
While travelling by plane, passengers face specific risks associated with infections. The greatest threat comes from respiratory infections, such as the flu, coronaviruses, and other viruses transmitted through airborne droplets. In the confined space of an aircraft cabin, where passengers are in close proximity to one another, the risk of infection is significantly higher.
Onboard, infections can spread through tiny aerosols that “hover” in the air and circulate through the cabin via ventilation systems. This is especially dangerous on long-haul flights, where passengers remain in a confined space for several hours. Large droplets expelled during coughing or sneezing can infect nearby passengers.
The contact transmission route also plays a significant role. Surfaces such as armrests, seats, tray tables, seat belts, ventilation buttons, and restroom doors are frequently touched by various passengers, making them potential sources of contamination with viruses or bacteria. Special attention should be given to fabric surfaces, such as seats and seat belts, which are difficult to clean thoroughly between flights. Biological fluids, such as vomit, may contain infectious agents related to the infections mentioned in this article. Contact with contaminated surfaces or incomplete disinfection can facilitate their transmission.
Airports present a different set of risks compared to airplanes. The primary risks here are associated with large crowds, increased contact with various surfaces, and the possibility of foodborne illnesses from cafes or restaurants in the terminal.
What Infections Can You Encounter While Traveling by Plane?
Let’s take a look at infections that present a higher risk of transmission on airplanes:
Influenza Virus
- Reinfection possible: Each season brings a new strain, so immunity from a previous infection usually does not protect against another.
- Mode of transmission: Airborne droplets and surface contact. The confined space of an airplane increases the risk.
- Symptoms: High fever, cough, sore throat, muscle aches, chills, weakness, and sometimes nausea and diarrhea (more common in children).
Adenovirus
- Reinfection possible: Many serotypes exist, and infection with one does not provide immunity against others.
- Mode of transmission: Droplets and surface contact.
- Symptoms: Runny nose, cough, sore throat, eye inflammation (redness and tearing), diarrhea, vomiting, and high fever.
Coronavirus
- Reinfection possible: Immunity weakens over time, and new variants increase the risk.
- Mode of transmission: Droplets, aerosols, and surface contact.
- Symptoms: High fever, cough, difficulty breathing, loss of taste or smell, severe fatigue, and sometimes muscle pain, headache, or diarrhea.
Rhinovirus
- Reinfection is very common: Over 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, weakness, and mild fever.
Respiratory Syncytial Virus (RSV)
- Reinfection is possible: Immunity is temporary, especially in children and the elderly.
- Mode of transmission: Large droplets and direct contact.
- Symptoms: Nasal congestion, severe cough, wheezing, difficulty breathing, feeding difficulties and irritability in infants.
Mycoplasma pneumonia
- Reinfection is possible: Immunity is short-lived, and reinfections are common in crowded spaces.
- Mode of transmission: Airborne droplets.
- Symptoms: Persistent dry cough, fatigue, sore throat, headache, mild fever, and occasionally chest pain.
Personal Hygiene First
- These personal hygiene measures are especially important during travel, where access to standard hygiene practices 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 the spread of infections. Hands should be washed thoroughly with soap and water for at least 20 seconds, paying attention to all areas, including between the fingers, under the nails, and around the wrists. - When and how to use hand sanitizers effectively:
Hand sanitizers containing at least 70% alcohol are a good alternative when soap and water are not available. Use enough sanitizer to cover all surfaces of your hands, including fingers, nails, and the backs of your hands, and rub until fully dry. However, keep in mind that sanitizers cannot remove visible dirt, and their effectiveness decreases on dirty hands. - The importance of disinfectants:
Infectious agents can survive on surfaces for extended periods. Regular use of disinfectants, especially in high-contact areas like armrests, tray tables, and door handles, can significantly reduce the risk of contact transmission. Use disinfectant wipes to clean surfaces frequently touched by others. However, be aware that the scents or components of some disinfectants can cause allergic reactions in certain individuals, such as skin irritation, watery eyes, or difficulty breathing. When travelling by plane, it’s best to choose hypoallergenic, unscented disinfectant wipes.
Handwashing with Soap
Washing hands with soap and water is the most effective and safest way to remove dirt and microbes for people of all ages. It does not cause toxicity or irritation when using high-quality, low-allergen soap.
It is important to avoid antibacterial soap containing triclosan, as it is unnecessary for achieving the desired effect, and its regular use can lead to bacterial resistance. Additionally, the soap should be free from other harmful additives that may negatively impact 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% or more 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 are less effective against some viruses (e.g., COVID-19).
Features and Risks of Using Sanitizers
- Individuals with a habit of putting their hands in their mouths (e.g., children or adults with special needs) are at risk of ingesting toxic components, especially those in alcohol-based sanitizers. For them, handwashing, alcohol-free sanitizers, or alternatives such as wet wipes with non-toxic formulas are preferable.
- Fragrances, dyes, and alcohol in sanitizers can be toxic and may cause irritation.
- Frequent use of alcohol-based sanitizers may damage the skin’s barrier function.
Wet Wipes for Newborns
- Composition: Prefer products that do not contain alcohol, parabens, fragrances, or harsh chemicals. Ideally, they should be water-based (up to 99%) with moisturizing components such as glycerin or aloe extract.
- Advantages: Safe even if accidentally ingested, suitable for sensitive newborn skin, and convenient for use outside the home when water is not readily available.
- Limitations: Do not kill germs but only clean the skin and may be less effective on heavily soiled areas.
- When to use: For cleaning the hands, face, and body of adults and infants, especially outside the home, as an alternative to handwashing when water is unavailable.
Hypoallergenic Disinfectant Wipes with Hydrogen Peroxide
- What they are: Disinfectant products based on hydrogen peroxide are chemical solutions that effectively eliminate a wide range of microbes, including viruses, bacteria, and spores. They are used for surface cleaning in both domestic and professional settings.
- Advantages: They effectively destroy viruses, bacteria, and spores. They are less toxic, have no strong odour (important in enclosed spaces), and are suitable for cleaning surfaces such as tray tables and armrests.
- Disadvantages: They are not suitable for the skin as they may cause irritation and dryness. Hydrogen peroxide evaporates quickly, so packaging must be tightly sealed after use.
The Role of Masks on Airplanes
Wearing masks on airplanes can raise concerns, particularly due to the lower oxygen levels in the cabin at high altitudes.
- Effectiveness of masks: Masks reduce the risk of transmitting respiratory infections by capturing large and small droplets that may carry viruses and bacteria. Studies confirm that masks do not decrease blood oxygen levels, even in the lower-oxygen environment of an airplane cabin.
- Types of masks: Cloth masks primarily protect others but offer limited protection for the wearer. Medical masks or respirators (such as N95) are more effective as they capture both droplets and aerosols, providing two-way protection.
Air Filtration in Airplanes
In the confined space of an airplane, where air circulates continuously, the effectiveness of HEPA filters is crucial for minimizing the risk of infection spread.
- Role of HEPA filters: HEPA filters on airplanes capture up to 99.97% of small particles, including viruses and bacteria, significantly reducing the risk of infection in an enclosed space. Their effectiveness makes air filtration an essential factor in passenger protection.
- Use of HEPA filters in different countries: In Canada and the United States, the installation of HEPA filters on commercial flights is not legally required, but most modern aircraft are equipped with them. However, the absence of such filters on some airlines poses additional risks that should be considered when planning a trip.
Seat Selection in Airplanes
These recommendations can help travellers minimize contact with pathogens and reduce the likelihood of infection during a flight.
- Window seats: Choosing a window seat helps minimize contact with other passengers, as you are less exposed to people moving through the aisle and crew members. The aisle area experiences higher traffic, increasing the likelihood of contact with droplets or aerosols.
- Ventilation effects: In modern airplanes, air is delivered vertically through ventilation systems, which reduces horizontal aerosol spread.
- Oxygen levels during flights: Studies suggest that the tail section of the airplane may have slightly higher oxygen levels due to the forward motion of the plane, which creates conditions for air to accumulate in the rear.
- Avoiding high-traffic areas: Selecting seats away from toilets, galley areas, and other high-traffic zones (such as the aisle) helps reduce exposure to potential sources of infection.
Thus, an optimal choice is a window seat closer to the rear of the airplane, where oxygen levels may be higher. If travelling with family, aim to book an entire row to minimize interaction with other passengers. Always check with the airline to confirm the availability of HEPA filters for improved air quality during the flight.
Hydration, Nutrition, and Immunity
- Hydration and its impact on immunity: Airplanes have low humidity levels (less than 20%), which can lead to dehydration. This weakens the protective functions of the nasal and throat mucous membranes, making them less effective barriers against pathogens. Drinking water regularly helps keep these membranes hydrated, reducing the risk of viruses and bacteria entering the body.
- The role of nutrition for immunity: Proper nutrition supports the immune system during travel. Foods rich in vitamins (especially vitamin C), zinc, and iron help the body better combat potential infections. Avoid foods that spoil quickly and opt for packaged products instead.
Caution and Preparedness
- Recognizing Symptoms:
- During travel, it is essential to be attentive to symptoms such as fever, cough, runny nose, sore throat, headache, fatigue, and gastrointestinal issues like nausea, vomiting, or diarrhea.
- If a passenger experiences vomiting, it is crucial to avoid contact with contaminated surfaces, as vomit can be a source of various infections. Immediately inform the crew so they can disinfect the area.
- Keep in mind that the incubation period for infections can range from 1 to 14 days.
- Remember that infections are not the only potential health issues during travel. Avoid self-diagnosis, and if you notice any new concerns, seek medical assistance promptly.
- Actions During Deterioration of Health During the Flight:
- If you feel unwell during the flight, notify the crew immediately. They are equipped with a first aid kit and oxygen masks for emergency situations.
- If necessary, the crew can contact ground services, request medical assistance at your destination, or arrange for an emergency landing.
- Actions After the Flight:
- If symptoms appear within a few days after the flight, consult a doctor and inform them about your recent travel.
- Avoid visiting public places until you have consulted a medical professional to minimize the risk to others.
Risks in Other Types of Travel
In addition to airplanes, other modes of travel, such as trains and cruise ships, also present health risks.
- Risks in trains: The risk of infection in trains is somewhat lower due to reduced passenger density. However, there is still a chance of transmission through surfaces like armrests, tray tables, and door handles, as well as through food (gastrointestinal infections such as norovirus, salmonella, campylobacter, and E. coli).
- Risks on cruise ships: Cruise ships pose a greater challenge. Infections can spread through shared surfaces such as railings and doors, as well as through food (gastrointestinal infections such as norovirus, salmonella, campylobacter, E. coli, and hepatitis A—particularly from seafood). Additionally, the shared ventilation systems on cruise ships create added risks for respiratory infections (e.g., Legionnaires’ disease, influenza viruses, and COVID-19). In the enclosed environment of a ship, respiratory infections can spread more rapidly.
Conclusion
Travel offers new experiences and discoveries, but it also comes with health risks. Respiratory and gastrointestinal infections can be transmitted through contact with people, contaminated surfaces, or food, especially in enclosed spaces.
To reduce risks, it is important to follow basic precautions: maintain hygiene, eat properly, drink enough water, and use protective measures such as masks and disinfectants. At the first signs of illness, seek help from the crew or medical professionals.
Taking care of your health ensures safety and comfort during your journey, allowing you to focus on the positive moments of your travels!