The wise traveller: when not to get on a plane

Why is it important to travel when you are healthy?

Travelling when you are unwell can have serious health implications and can impact on the comfort and even the health of others. Whether it is just a cold or something more serious, flying can make you really unwell.

Most people don't have problems but changes in air pressure that you experience when flying can affect both your heart and respiratory systems so it is best to take some simple precautions.

When you cough or sneeze small droplets carry germs that spread in air currents. If you (or the person next to you) breathe in an airborne virus, bacterium or other germ, you may become infected and get the disease. Colds caused by viruses, influenza and pneumonia are a few types of infectious diseases that usually spread through the air. ¹
Deep vein thrombosis (DVT) gained "fame" as "Economy Class Syndrome". It mainly affects the veins in the lower leg. DVT occurs when blood flow is slow, usually because of inactivity, and a clot forms in the larger veins. Clots may break off and travel to other parts of the body such as the lungs and this can be quite serious. Especially during long flights, try to move your feet and ankles regularly, and get up and walk around every hour or so. Drink plenty of water, avoid alcohol and excessive coffee, stretch your calf muscles and especially if you know you have poor circulation, get swollen ankles or may be at risk, wearing support stockings may also be beneficial. ² Your doctor may recommend a low dose of a blood thinner like aspirin.
Most airlines will not permit women to fly after 36 weeks of pregnancy (or earlier) and if you are expecting a multiple birth you will require medical clearance. ² In any case, check with your obstetrician, GP or midwife that there are no additional risks to you if you fly.
If you have sinus problems, try taking a decongestant or nasal spray before takeoff and possibly before landing on a very long flight. Whether or not you have sinus problems, for most people, swallowing, 'popping' your ears (Valsalva manoeuvre), sucking on a sweet, or chewing gum may help and babies can suck on bottles or pacifiers during the flight. ³

General statistics

Australians are now making over 4.7 million overseas trips each year, compared to 3.4 million three years ago. Many more travel within Australia. ⁴
Although each year in Australia there are up to 400 deaths from pulmonary embolism (blood clot in the lung), only a very small number appear to be associated with air travel. Many occur in association with identified risk factors for DVT, which include increasing age, obesity, smoking, pregnancy, the use of oral contraceptives or hormone replacement therapy, cancer, lower limb injury or surgery, family history of DVT, prolonged periods of immobility (like being confined to bed for a period) and previous thrombosis or embolism. ⁵

How do I stay well and decrease the risk of infection for others?

Infection control should begin immediately with the onset of infection and if you are coughing or spluttering, spreading the germs around, this means going home if you are at work or staying home if you intend to travel.

It is important for you to consider your fellow travellers by covering your mouth and nose when you cough or sneeze and disposing of dirty tissues immediately. Perhaps not as infectious as equine influenza, coughing or sneezing in a confined space can easily spread other infections.

Another important way to reduce infectious disease transmission during travel is to wash your hands carefully and frequently.

Soap and water will help remove potentially infectious materials from your hands and alcohol-based hand wash gels can help if soap and water aren't available.

Other ways you can decrease your risk of infecting yourself or others before travelling:

Get vaccinated. Immunization can drastically reduce your chances of contracting many diseases. Make sure to keep your recommended vaccinations, as well as your children's, up-to-date.
Use antibiotics sensibly. Only take antibiotics when necessary. And if they're prescribed, take them exactly as directed â€” don't stop taking them early because your symptoms have gone away.
Travel wisely. Don't fly when you're ill. With so many people confined to a small area, you may infect other passengers on the plane. And your trip won't be comfortable, either. Depending on where your travels take you, talk to your doctor about any special immunizations you may need.

If I have a medical condition, what should I do before I travel?

See your GP before you fly. Get advice regarding any specific precautions you need to take, vaccination and medications. Some of your medications may not be readily available in other countries. If you are unwell and you must fly, the airline may require you to obtain medical clearance.
Carry all of your medications with you along with a letter from your doctor about your condition, treatment and any medications you may be carrying.
Be aware of any risks of medical conditions or side effects of drugs that may arise through flying.
Safety regulations state that mobility impaired passengers must not occupy seats next to exits.