March 7, 2017

Germ-free flying

To avoid getting sick, try these tips before and during your flight

So you're about to board a metal tube flying 40,000 feet above the ground at 575 mph, and you're feeling a bit nervous. The good news is that you can stop worrying — flying remains one of the safest forms of travel out there.

The bad news: Disease-causing germs love aircraft.

Other modes of transportation are havens for bacteria as well. But unlike a subway or bus, airplanes confine you to the same small space, with the same small microbes, for hours at a time.

The challenge, then, is to avoid contact with germs. Let us help you!

Before you board, get these items

Fighting off contact with germs requires some essential and simple tools. Definitely get plenty of alcohol-based hand sanitizer and disinfecting wipes, which you can find in travel-sized packages at your local drug store or airport shops.

Do you like using a pillow or blanket while flying? Bring your own, because airline pillows and blankets can be reused before being cleaned, and there's no way to know how healthy previous passengers were.

Also, consider a face mask. "Masks aren’t my go-to suggestion for patients who want to go flying as the masks can look a bit strange. However, using a mask can help prevent ingesting and inhaling large airborne droplets that contain germs," said Jay Lee, MD, who practices internal medicine at Kaiser Permanente's medical offices in Highlands Ranch, Colorado.

"Look at it this way. If you're stuck next to a passenger who is persistently coughing, a face mask is a great way to ward off any airborne germs that may otherwise make their way into your mouth and get you sick," Dr. Lee said.

When you reach your seat

Overall, keep in mind that everything you will touch will have been touched by many other people. That's why hand sanitizer is essential: Use it liberally and often, especially when you buckle in. Buckles often teem with microbes — as do tray tables and armrests.

"Armrests can host some fairly nasty bacteria such as E. coli or MRSA," said Dr. Lee. "While bacteria often die out quickly when exposed to the air, some studies show they can live from one hour to a few days on certain surfaces if the plane isn't cleaned properly." This is especially true of armrests made with porous materials such as cloth, which can protect germs for a longer time.

A small 2015 study by, which sent a microbiologist to test airplane surfaces, suggests that tray tables host the highest concentrations of germs on a plane — up to 10 times the amount found on seat belts, overhead air vents, and even the toilet flush button.

Finally, beware the backseat pocket. Yes, it's convenient for storing items. But some passengers take it too far, treating it as a trash bin for old food, used tissues — and, at times, dirty diapers. Germs can survive for days in a seat pocket.

The solution: Clean the surfaces around you thoroughly with disinfecting wipes, and avoid the backseat pocket altogether.

While in flight

We've noted why you should skip an airline's pillows or blankets. You may want to avoid drinks with ice in them, as well. Some aircraft make their own ice cubes — the problem is that the water tanks, especially on older planes, can host germs.

However, do drink lots of water. Staying hydrated is important, and not just because airplane air is notoriously dry. Your mucous membranes — which help defend your body against microbes — work best when moist.

Of course, drinking water can lead to, ahem, "necessary actions." In a perfect world, we'd all skip the airplane lavatory. But it's better to go than to hold back.

Just avoid direct contact with anything in the restroom. Use napkins or wipes to open and lock the doors. Clean surfaces with wipes before touching them. "Always wash your hands, before and after you go," said Daisy Dodd, MD, a pediatric infectious disease specialist at Kaiser Permanente's medical center in Anaheim, California.

Dr. Dodd had an additional tip: "Never touch your face — especially your eyes, nose, and mouth — before you've applied hand sanitizer."

Weeks before your trip

We've covered some ways to avoid microbes on the fly (so to speak). But a great way to avoid getting sick is to get your flu shot at least a couple weeks before boarding a plane.

"Getting your annual flu vaccine lowers your risk of getting sick while flying," said Dr. Dodd. "The vaccine offers protection for up to 12 months. Plus, it's easy to get, and you'll feel better knowing you're not spreading the flu yourself."

Happy, healthy travels!