How to Avoid Germs on Airplanes
By Eric Milefchik, MD, Chairman of Infection Prevention Torrance Memorial
Summer is high season for travel. And air travel presents an increased
risk for infection due to the close quarters and the repeated use of airplanes.
Seats and other surfaces accumulate infectious agents. Planes are cleaned
in between each use, but cleaning is limited by the turnaround time of
the flights—with most airplanes only getting a deep cleaning every
The good news is air filtration systems in most modern airliners are actually
very good. They utilize HEPA filtration which markedly limits circulating
agents. The bad news is this is not enough to protect passengers within
three to six feet of someone who is infected with most viral respiratory
germs spread by air droplets coughing or sneezing. These include influenza,
parainfluenza, rhinoviruses (common cold), respiratory syncytial virus
(RSV), human metapneumovirus as well as the bacteria group A Streptococcus
It’s important to remember these agents are spread when we touch
the droplets and then touch our faces, which we do often. Here are some
answers to popular questions about staying germ-free during air travel:
What’s the germiest part of the airplane?
Bathrooms are by far where the most germs are found due to the increased
contamination from enteric organisms (bacteria found in stool), which
through exposure have the potential for causing gastrointestinal illness.
These could include Clostridium difficile, pathogenic E coli species,
which are usually food borne (E coli O157, Enteropathogenic E coli and
others) and others.
Seats and seat fabric including the seat pockets (where people place items
like diapers and food) harbor bacteria—including staphylococcus—that
can stick around for days. This would include strains of methicillin-resistant
staphylococcus aureus (MRSA), which can cause spontaneous skin abscesses
or other more invasive infections.
Pillows, tray tables and even touchscreens all present risk for bacterial
contamination given serial exposures from many passengers.
This information might be enough to make you want to cancel your vacation,
but there are ways to give your immune system a hand in not letting these
villainous germs get the better of you.
What can I do to stay healthy?
1. Before flying, make sure you are well hydrated and well rested to assure
the healthiest immune system possible.
2. Frequently wash your hands after touching surfaces, throughout the flight
and after using the restroom.
3. An alcohol-based hand de-sanitizer is helpful to avoid infections at
times when soap and water is not accessible.
4. During the flight, try not to touch your face and avoid people who cough
by closely paying attention to who is sitting around you.
5. Consider using bleach wipes on tray tables, touch screens and bathroom
areas for bacterial contamination given serial exposures from many passengers.
6. Wearing a mask will offer some protection from air droplets, but is
not completely effective due to the potential for spread by touching droplets
with your hands, and then touching your face.
7. Easier said than done, but if possible, it is more effective to convince
the coughing passenger to wear a mask, which offers the best protection
for everyone within 3 to 6 feet. •
Eric Milefchik, MD, is chairman of infection prevention at Torrance Memorial
Medical Center; please call 310-784-6954 for more information.