Disease Carriers in the Air

I spent today in the air heading to Lynchburg Virginia to visit family. US Airways from LAX to Charlotte was fine. Upgrade to first class on a newish Airbus 320.Decent, albeit tepid breakfast. Reasonably clean. Slept most of the way.

Flight from Charlotte to Lynchburg was on one of those cramped little Dash 8-100. From the moment the door closed, it sounded like a hospital ward. People were sneezing, coughing, hacking, sniffling and wheezing. Am I doomed? (Here's a blog post linking medical research on transmission of disease on an airplane that gives me some hope.) I'm mainly worried about the guy in the row behind me (Seat 7A, you know who you are) who hacked up a lung about every 5 minutes. And, reportedly, I worry with good reason:

On airplanes, you're most likely to catch an illness from the people sitting in your row and in the row behind you, according to researchers at Purdue University, who developed an animation showing how germs move around an airplane. "The bad news is if you're in that strike zone, you're at risk," Gerberding said. "If someone sitting right near you has the flu, there's a pretty good chance you'll get it. Flu is very transmissible."

Personally, I vote that sickies (along with small children) should have to ride in the cargo section. Since that's unlikely to happen anytime soon, however, I'm doing some research on the efficacy of hospital masks in preventing the spread of airborne diseases. The answer seems to be that it is helpful if patients who are already sick wear a surgical mask. Those of us who are healthy get modest benefits from surgical masks, but should get decent protection from N95 masks.

Comments

[Cornellian]

I wouldn't even let them fly in cargo. I'd make them take special quarantine flights away from healthy people. Ideally, they should just stay home. Getting stuck on a flight with sick people is one of the worst things about flying.

[C.E. Petit]

I'd substitute Yankees fans (or, more generally, baseball fans during the playoffs) and drunk sorority girls for the small children.

[Adam]

Actually, a recent article published in JAMA showed no statistical difference in the percent of healthcare workers infected by influenza when wearing a surgical mask vs an N95 mask (I don't have the reference handy, but I'd be happy to look it up if you like). Whether any kind of mask is helpful is still an open question. Some older studies have shown that healthcare workers who wear masks have significantly reduced rates of respiratory infections. However, in other studies in which household members of sick patients were given masks, little benefit was seen. These studies suggested that compliance and proper mask wearing may be a major issue. In addition, a significant amount of infectious spread occurs through contact with the eyes, so wearing a mask without any eye protection may be of limited use. It's also important to point out that good handwashing hygiene may be the most important thing you can do to avoid infection.

[Festus]

I would have them dragged from the plane and executed on the spot. How dare anyone get ill in Obama's America!

[Occasional Reader of Your Site]

Influenza spreads much more rapidly in conditions of lower absolute humidity. Warming and moistening the air in the cabin might go a long way to reducing the spread of the flu in airplanes.

See here,">http://www.sciencedaily.com/releases/2009/02/090209205148.htm">here, for example.

[ex-pilot]

Having spent well over 3 decades as an airline pilot, a couple of suggestions that I found helpful, though maybe not all medically proven.

Keep lots of hand disinfectant available, and use it frequently.

There seems to be debate about how effective N95s are at disease control, but wearing one does keep the nasal passages from drying out on long flights. Alternatively, spreading an ointment, I prefered a triple anti-biotic, also helps to keep them from drying out.

Finally, keep well hydrated.

[Amber]

Perhaps those that are clearly sick should be given a mask to prevent transmission? Alternatively, all passengers may be given one to wear.

[Cyril]

Surgical masks and N95 masks are equally effective:

http://scienceblogs.com/effectmeasure/2009/11/surgical_masks_versus_respirat.php

Here in Japan you can wear surgical masks and look normal, since people do it all the time if they have the slightest cold, out of consideration of the feelings of others. But when I travel to the U.S. I feel silly with a mask on.

[comatus]

I want to see the TSA agent's face when you step up to the "kiosk" wearing a mask. Staying hydrated on a long flight is a special challenge, since the water in the tank is almost certainly crawling with bacteria, and any container over 3 ounces brands you a terrorist. What size tube does NeoSporin come in? Isn't its base stock a known accelerant?