Swine Flu: Airline Passengers Lack Hygiene
Denver Post
August 24, 2009
The new H1N1 flu has already been transmitted from one passenger to another on a commercial airline, and it is likely that more such incidents will occur if the virus resurges this fall. The aviation industry and the Centers for Disease Control and Prevention have tried to reassure passengers that air travel is still safe, but so far they have done too little to try to limit the number of such transmissions.
It is not practical to screen all airline passengers to identify those who harbor infection. A better approach is to educate the public on proper hand-washing and cough etiquette and to give them the hand sanitizer they need to keep clean. Yet on a recent full flight from Boston to Orlando, Fla., I was horrified to see that most of my fellow passengers failed to periodically wash or sanitize their hands.
Several of my fellow doctors have likewise observed a lack of hygiene by airplane passengers, and no effort by airline personnel to educate people.
Research has shown that people touch their mouths and noses as many as 200 times a day, and that good hand hygiene can reduce infectious disease transmission in public spaces by half.
The lack of communication about the importance of hand cleaning extends to airline web sites and online travel vendors. Disturbingly, there seem to be no public announcements or printed bulletins in most airports either.
Airlines have said they have contingency plans for responding to infectious outbreaks, but in May, the president of the Association of Flight Attendants told members of a congressional subcommittee that all flight attendants should be given training in how to handle a person with flu and help in communicating to passengers the importance of keeping clean hands. She also said that flight attendants need to be provided the gloves and facemasks they need to deal with flu-stricken passengers.
Airports and airline personnel should be fully trained in infection control measures, and alcohol-based gel hand sanitizers should be available throughout airports and aboard aircraft. The cruise ship industry has been doing this for years.
Airlines should ensure that passenger cabins are always properly ventilated, including during any flight delays in which passengers are kept aboard the plane. Last year, the American Society of Heating, Refrigerating and Air-Conditioning Engineers published the first standard for airplane cabins, which calls, for example, for all air to pass through high-efficiency particulate filters. It should be adopted.
The global threat from new pathogens will not soon disappear. Airlines have the means to simply and effectively reduce the risk of rapidly spreading infectious diseases, and the traveling public should be able to count on their doing all they can.
Mark Gendreau is the vice chairman of emergency medicine at Lahey Clinic and an assistant professor of emergency medicine at Tufts University.