Holiday Travel Health: 10 Ways to Avoid Germs on an Airplane

Dr. Mary Anne Jackson

Mary Anne Jackson, Division Director, Infectious Diseases

The holiday season is prime time for air travel, so how can you protect yourself and your little ones from getting sick on your next flight?

We’ve all heard planes are a breeding ground for germs. The good news is there have been improvements in ventilation and air quality in commercial airplanes which reduce exposure to infectious pathogens. In part, this reduction is because newer planes are equipped with HEPA filters that are reported to remove 99.9 percent of bacteria, fungi and larger viruses.

Instead, diseases are spread when you come in contact with an infected traveler or contaminated surface. Norovirus, common cold viruses and influenza can all be transmitted easily when you find yourself in close quarters on a plane.

Here are 10 tips to protect yourself and your children when flying:

1. Postpone travel until a newborn is at least 48 hours old. If you are ill or pregnant beyond 36 weeks of pregnancy, avoid flying.

2. Prepare ahead of time. Confirm with your child’s doctor that your child has had all appropriate immunizations for their age. This should include influenza vaccine for anyone six months of age or older.

3. If traveling outside of the United States, make sure to get destination specific vaccines and other pre-exposure counseling to avoid contact with infectious pathogens. Consider supplemental health insurance for international travel.

4. Keep yourself and your little ones well hydrated during the trip. Carry bottled water on the flights for you and older children, and pack food and drinks for the youngest family members.

5. Avoid aisle seats since these are high touch areas for those boarding planes. Norovirus is highly contagious and causes nausea, vomiting and diarrhea. It’s easily transmitted and only takes a few viral particles to transmit infection. You’ve probably heard about norovirus on cruise ships, but airplane outbreaks have also been reported. In 2008, a group of passengers traveling on a flight from Boston to Los Angeles, had the norovirus infection when they boarded the plane. The plane had to make an emergency landing just three hours after take-off because so many were ill. Those sitting next to an infected passenger were more likely to become sick with norovirus 1-2 days later.People sitting in an aisle seat were also more likely to become ill, because those infected had touched the aisle passenger seat as they were boarding the plane.

6. Pack alcohol wipes and hand sanitizer. As soon as you get to your seat, clean the tray table and any other non-porous surface with the wipes. Keep in mind that other non-porous surfaces, which include arm-rests, seat pockets, windows, overhead bins, taps, sinks, and toilet handles are the most likely sites to be contaminated. After you clean your seat area, deposit the used wipes in the air sickness bag at your seat and clean your hands with the hand sanitizer.

7. Avoid placing any items in the pocket in front of your seat. Most passengers use the pockets as a place to stash trash and the area is cloth so cannot be cleaned with wipes.

8. If you need to change a child’s diaper on the plane, be prepared. The quarters are tight but most planes have a changing table on the restroom wall that can be used. Cover the changing surface area with a disposable liner, and have a diaper and wipes handy, and ready to use. Use an alcohol wipe on the surface after. Use hand sanitizer after diaper changing for both the diaper changer and your child.

9. Among all infections, seasonal influenza is the most prevalent among travelers. If you have an option, avoid sitting next to someone who appears to have respiratory symptoms and move seats if you’re concerned. The improvements in air circulation are said to limit the spread of small-particle aerosols around the infected passenger, so moving away by just a couple seats may help. If you can’t move, some suggest to use the overhead vent to redirect air flow away from your face.

10. Ear pain is common with flying and most likely to occur when the plane is descending for landing; this occurs because the change in air pressure results in trauma to the eardrum. During descent, encourage little ones to drink, chew or use a pacifier. Adults who have had barotrauma in the past might want to use a vaso-constricting nasal spray before traveling.

With these helpful tips, your family has a better chance of not developing an infection related to flying. During this holiday season, even if you don’t travel, make sure you are immunized against influenza, use hand hygiene at home as you would at work, do what you can to avoid stress and to get appropriate sleep and enjoy spending time with your family.

Learn more about staying healthy during flu season.

Learn more about Flu Shots: Debunking 5 Popular Myths about the Flu Vaccine.

Learn more about the Division of Infectious Diseases at Children’s Mercy.