How Flu Spreads on a Plane

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As if the generally horrific experience of flying wasn’t bad enough (maybe I’m just a little sour about the 90 minutes I spent on the tarmac at Newark last night), a new study [PDF] in Emerging Infectious Diseases shows that flying can make you as sick as you are miserable.

Australian researchers studied flu infections that spread aboard two large airliners during May 2009, at the height of the H1N1/A flu pandemic, and found a zone of infection around sick passengers. And — no surprise here — the closer you sit to someone who’s sick, the better the chance you’ll be coming down with the flu.

Sit within two rows of someone with flu-like symptoms, and your chance of getting ill increases by 3.6%. Sit within two seats of the sick passenger, and your chance of coming down with the flu goes up by 7.7% (and, I imagine, your chance of generally having a horrible flight increases by 100%).

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Paul Kelly, one of the paper’s authors and an epidemiologist at Australian National University, told LiveScience that the time spent aboard the plane played a role in the chance of infection as well:

“The closer you are to an infectious person, the higher your chances of becoming infected yourself,” said study researcher Paul Kelly, an epidemiologist at Australian National University in Canberra. “This is especially the case on long-haul flights,” those lasting more than four hours.

Kelly believes that governments should screen patients for flu symptoms and prevent them from flying — a practice that tends to spike during pandemics and other outbreaks, but usually wanes not long after. (From my experience, you’d need to be breaking out with bubonic plague before most U.S. airlines would take you off a flight.)

If you do end up near a sick person, Kelly suggests you ask to be moved — good luck with that — wear a cotton mask, or even suggest that you’re sick neighbor wears one. (It’s considered common courtesy in Asia for those with flu-like illnesses to wear masks when venturing out in public.)

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The results of the study have consequences for infectious disease control beyond stopping the sniffles. Modern airline travel allows us to move from one end of the globe to the other in less than a day, and that means we can bring our germs with us. In the case of the SARS outbreaks of 2003, the disease was almost always introduced into a new country via airline passengers. The next big infectious disease — which could be much more deadly than SARS or H1N1 — is out there somewhere, and it will almost certainly be riding a plane.

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