Extra Baggage—How Disease Is Transmitted on Airplanes

Most people who find air travel unpleasant object to the long lines, intrusive security, price gouging and cramped quarters. Thanks to so many people jammed into such a small space, what they also should be concerned about is sharing their fellow travelers’ germs.

Conventional wisdom says that sitting an airplane with sick people puts you at risk. But there’s slim scientific pickings to quantify the risk or how to reduce it, so researchers from the Georgia Institute of Technology and Emory University have set out to define just how infectious diseases might be transmitted onboard commercial airliners.

Infectious diseases transmitted during commercial flights have been of concern particularly since 2002, when 20 people on an international flight were infected by a single SARS patient. Severe Acute Respiratory Syndrome is a viral pneumonia that can lead to respiratory failure. Symptoms include high fever, malaise, dry cough and shortness of breath.

Sponsored in part by Boeing and Delta Air Lines, the three-year study will document how passengers move around aircraft cabins, and inventory the microbes found in the air and on surfaces including tray tables and lavatory fixtures. Researchers hope to establish patterns that will enable airlines to implement procedures that improve the health and safety of crew and travelers.

The SARS episode, according to the information from Emory, demonstrated how air travel can promote the rapid spread of known diseases and emerging infections. On airplanes, bacteria (which respond to antibiotics) and viruses (which don’t) can be transmitted in three ways:

  • inhaling small droplets coughed or sneezed by infected people that carry throughout cabin air;
  • inhaling larger droplets within about 3 feet of their source; and
  • transferring droplets from surfaces into the eyes or noses of susceptible individuals. This method accounts for as many as 8 in 10 disease transmissions, thanks to passengers touching contaminated surfaces, such as seat tray tables, lavatory door knobs or sink handles.

Although researchers have studied how microbes find their hosts, the airplane environment poses special challenges. In medical facilities, such as hospital emergency rooms, radio-frequency identification tags (RFID) are used to record how people interact. But that technology isn’t available at 30,000 feet because it might interfere with airline communications.

Instead, researchers will use sophisticated sampling equipment that collects information about the contents of cabin air. They’ll also swipe surfaces, and analyze the samples with polymerase chain reaction (PCR–a molecular biology technique that amplifies a single or a few copies of a piece of DNA or RNA to generate a large amount for more specific examination) and mass spectrometry (which identifies chemicals within a substance by their mass and charge, essentially by weighing molecules).

The processes can detect as many as 1,500 different microbes, including 300 different respiratory viruses and 1,200 different bacteria.

As described by Vicki Hertzberg, professor at Emory’s school of public health, the researchers “will be actively looking at who’s getting up and down, when they are doing it, and where they are going when they do.”

They plan to begin collecting data in the autumn to coincide with what’s typically the start of the cold and flu season.

To reduce the chances of catching somebody’s else’s germs, take a few precautions whenever you fly:

  • Carry sanitary wipes and use them on your tray table, arm rests and storage bin handles.
  • Wash your hands. A lot. Wipe off the lavatory surfaces before touching them.
  • Avoid touching your eyes, nose and mouth, and encourage your children to follow this practice.
  • If you’re seated near a coughing or clearly ill person, ask to be reseated. If that’s not possible, consider using face masks that cover your nose and mouth; generally, they’re available at hardware and often drug stores. Yes, they look odd and may not be impervious to bugs that can make you sick. But isn’t a bit of precautionary goofiness worth it?
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