WEDNESDAY, June 15 (HealthDay News) -- During the H1N1 flu
pandemic of 2009, some people stopped flying out of fear of
catching the virus while in the close quarters of an airplane
cabin, but a new study shows that the "danger zone" for flu
transmission is just a two-seat circumference around where you are
It had been thought that this hot zone was much larger,
according to research published in the July issue of
Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention.
Scientists tracked illnesses among passengers on two long
flights to Australia in May 2009, where several passengers were
known to be infected with H1N1. Passengers were surveyed three
months after arrival about any flu-like symptoms. Two percent of
passengers had a flu-like illness during flight, and 5 percent (32)
developed such an illness the week after they arrived at their
Travelers were at a 3.6 percent increased risk for flu if they
sat within two rows of a passenger with symptoms, and this risk
jumped to 7.7 percent for those who sat within two seats of the
sick passenger, the study showed. The two-seat danger zone refers
to a sick passenger seated in the two seats in front of you, two
seats behind you or two seats to either side of you.
Still, "it's not a given, but our 2x2x2 seats box is definitely
the highest risk zone," said study author Dr. Paul M. Kelly, an
associate professor at Australian National University in
"Change seats if you find yourself within two seats of someone who is sneezing, coughing and looks like they have a fever," he said. "If you have a mask, wear it or suggest your neighbor wears it [and] wash your hands and avoid touching your own face to minimize the chances of spread via that route."
There are certain travel seasons that may be worse than others,
he said. "Flu season is definitely the worst, and that is different
in the northern (November-March) and the southern (June-September)
hemispheres," Kelly said.
Dr. Michael Zimring, director of the Center for Wilderness and
Travel Medicine at Mercy Medical Center in Baltimore, said the two
biggest risk factors for getting the flu while flying are proximity
to the sick passenger and the length of the flight.
The longer the flight, the greater the risk, he said. It is not
the airplane air per se that ups the risk for flu transmission as
airplanes do use air filters, which minimize the spread of
"Infectious diseases such as the flu can pass via sneezing and/or coughing directly into someone's face or onto an object someone will come in contact with," Zimring said.
For example, "if someone coughs and the droplets land on a
headrest or armrest, the next person touches that object and then
eats with that same hand or touches ones face, the virus or
bacteria passes from one to another," Zimring explained.
"The further you are away from the ill person, the less chance you will get the illness, and the shorter time you are exposed, the less chance you will contract that illness," he noted.
"Wash your hands frequently on the flight, especially if you are about to eat something, and remember the germs on the bathroom doorknob and the germs on the back of the seats as you hold on while you walk back to your seat," Zimring said.
"If you are in good health, got a good night's sleep and eat healthy, there is also less of a chance that you will get sick," he added.
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital
in New York City, agreed. "If you are worried, wear a mask," he
said. "You will never see these people again so who cares if they
think you are sick."
Viral particles can live on surfaces for 24 hours. "Always wash
your hands before touching your face," he advised.
The air jets above the seats can also propel viral particles
your way, Horovitz warned.
"These germs can travel up to seven feet on a subway and they probably go even farther on planes because of the mixing of the air by the overhead jets," he said.
Getting your flu shot each year can also lower your risk of
developing the flu even if the passenger next to you coughs and
sneezes for the whole flight, he said.
Dr. Neil Schachter, medical director of the respiratory care
department at Mount Sinai Medical Center in New York City, said
there have been a growing number of anecdotal reports that people
develop upper respiratory infections (URI) after flights longer
than five hours.
"While the study finds that the range of infection is no larger than two rows in each direction, there were several people with URI on each plane -- which certainly covered a large portion of the aircraft," Schachter said.
There have been several new infections in the past few years,
including H1N1. "I think that increased surveillance of passengers
is helpful to keeping sick passengers off the plane," he said. "We
can anticipate emerging new infections, and better airport controls
is certainly a step in the right direction, but this type of policy
change takes time."
Until then, "I would advise my high-risk patients with
underlying health problems to ask to be moved to another area if
they are seated close to someone who is coughing and sneezing,"
There's more on protecting yourself from the flu at the
U.S. Centers for
Disease Control and Prevention.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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