Flying soon? Safeguard your health in the air

Plenty of us have experienced getting sick after a long haul flight. But what if you’re the person feeling peaky before you board your flight on your next escapade? Should you abandon the trip and incur the cancellation or rescheduling costs or soldier on and risk making your flightmates sick, too? Citro explores what you should know before you fly off to your next destination.

Worried sick about being sick at 35,000 feet?

Air travel creates its fair share of tall tales about health woes: some people get airsick, others have panic attacks and there’s always unlucky stories of people who have a heart attack, stroke, breathing issues or other unplanned emergencies that test the first aid training of even the most experienced flight attendants.

Perhaps one of the most frightening medical mishaps to happen on a plane occurs when people pop a sleeping pill with alcohol to snooze away the flight, but actually end up sleepwalking and streaking or - even more embarrassingly - try to make love to the stranger seated next to them.

What are the risks of getting sick from plane travel?

We know that global air travel has made the spread of viruses from one country to another faster and more deadly. 

The recent COVID-19 pandemic showed us how fast a virus that started in China could take hold in other countries.

But with lockdowns long behind us and physical distancing a long forgotten memory, how do we stay well when we fly?

Until COVID-19 closed down the world, health advice for travellers focussed on simple travel tips to manage swollen legs - along with the real risk of deep vein thrombosis - jet lag and dehydration.

A 2018 study into the transmission and risk of airplane-borne diseases like flus and viruses can tell us more.

Basically, viruses and infectious diseases that have a long period of illness - think of flu or COVID-19, for example - will cause a higher natural spread than diseases where the duration of illness is short. 

This is because people with viruses or infections that have short durations - such as pneumonic plague - don’t have the same symptom-free infectious period as those harbouring diseases with longer illness durations.

Essentially, this means that if you feel too unwell to travel, you should not fly.

This not only protects yourself (you don’t want to be one of those people with breathing problems who diverts a flight, do you?) but also others on the flight with you.

The real problem - for other passengers and yourself - occurs when you’ve caught an infection that has a long illness period but you are still symptom-free and think you’re perfectly fine to travel.

If you’ve been in contact with someone who has infected you with a virus but don’t yet know you’re ill, you can end up sick in bed instead of sightseeing AND you carry the guilt of knowing you infected other people.

To be cautious, you can also try to avoid seeing too many people for 3-5 days before you travel (to reduce your risk of catching something) and do the usual infectious disease precautions of washing your hands regularly and wearing masks.

How to stay safe from viruses on airplanes

A very small study of 205 travellers found that the older people were, the more likely they were to worry about the risk of catching a virus or bacterial infection on an airplane.

Sitting within 2 rows of someone carrying flu-like symptoms puts you at a 3.6% increased risk of getting sick with what they have.

Basic infection prevention measures you can take to avoid getting sick on planes include:

• Wearing an N95 mask.
• Washing hands regularly and carry hand sanitiser or wipes.
• Consider going snack-free to avoid taking off your mask or having too much contact with someone who may be sick (of course, you need to eat if you’re hungry though!).
• Being up to date with flu and COVID-19 vaccinations for your age and health status.

Some destinations are riskier for illness than others

Australia’s Smart Traveller service has excellent information on your risk of illness and infection when travelling to other countries.

Whether you get sick on the flight might not matter so much as the risk of contracting infectious diseases at your final destination.

Do your research before you fly and understand the risks of travelling by air, land, train or boat in other countries.

Countries with water and sanitation issues, insects that carry diseases or low vaccination rates - including developed countries - will likely make you sicker than other destinations.

Destinations which are suffering war and unrest - think of Russia, Iran or some African nations - are best avoided altogether.  

When it comes to staying healthy when travelling, it’s best to:

• Know the risks of where you are travelling to before you go.
• Read Smart Traveller advice for your destination and check the health risks or vaccinations that are recommended.
• Talk to your doctor, tell them where you're going and ask their advice on prevention.
• Get your vaccinations well before you travel, some vaccinations take 6-8 weeks to work.

Midflight health emergencies tend to turn out OK, according to one study

The good news is that it isn't all bad news.

A 2013 study of American midflight health emergencies found the most common health emergencies on planes included:

• Fainting, also called syncope or presyncope (37.4% of cases)
• Breathing issues and respiratory symptoms (12.1%)
• Nausea or vomiting (9.5%). 

Passengers who were doctors on flights provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. 

Of the nearly 11,000 patients for whom postflight follow-up data was available, 25.8% were transported to a hospital by emergency services, 8.6% were admitted to hospital, and 0.3% died. Those odds mean that dying in the air is actually rare.

The most common triggers for admission to hospital during a medical episode on a plane were possible stroke, breathing problems and cardiac symptoms.

Of course, this study happened before COVID-19 made people wary of the viruses we can catch from other people on a plane.

Travel insurance is vital: but it won’t stop you getting sick and ruining your holiday

Health cover is one of the main reasons Australians get travel insurance. It won't prevent you getting sick or injured, though it can prevent you suffering financially. Medical assistance overseas can be expensive - most countries don’t have Medicare.

You must pay for all medical care you need when overseas. If you can't pay, some countries may even arrest you.  

So what’s the upshot: 7 takeaways to stay healthy when flying

1. Before you fly long haul, this is what Qantas recommends: Ensure you’re well-rested, organised and relaxed in the lead-up to your trip. Avoid coming into contact with sick people.

2. Be up to date with flu and COVID-19 vaccinations: This is the best way to avoid being laid low in bed in a foreign country, where it might be hard to find a doctor and get the medication you need. You can also take infection prevention measures like wearing masks and handwashing while you are on a flight.

3. Consider your health before flying: If you are feeling unwell before your flight, especially if you have certain medical conditions like angina, infectious diseases, or recent surgeries, see your doctor and consider postponing your travel if necessary.

4. Airlines may refuse boarding: Airlines have the right to refuse boarding if passengers appear unwell, as flying can exacerbate certain medical conditions.

5. Common inflight medical issues: The most common medical problems onboard include nausea, dizziness, and temporary loss of consciousness due to low blood pressure. If you have travel sickness, there are medications you can take. To avoid the risk of your feet swelling or developing a deep vein thrombosis, some people wear compression hosiery or socks. It’s important to move around, drink plenty of water and stretch to get the blood moving while you fly.

6. Get help if you feel sick on a plane: If you feel unwell during a flight, inform the cabin crew immediately. They are trained to handle medical emergencies.

7. Transit stops and medical help: If you're unwell during a transit stop, inform your cabin crew. Large airports often have a health clinic that can help you if you feel unwell.  

No one wants to be the person that sparks the dreaded inflight announcement: “If there’s a doctor on board would he or she make themselves known to the cabin crew?”

_{The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites which are linked to on this page should be verified with your professional health care provider.}