It’s officially flu season: How to avoid getting sick on a plane

It's officially that time of year. Temperatures are plummeting, hot tea is flowing and flu season is here. But that's not the only illness looming over travelers this holiday season.

According to Dr. Waleed Javaid, epidemiologist and professor of medicine at West Virginia University, "Currently, there is a mix of respiratory illnesses, including COVID-19, influenza and RSV (respiratory syncytial virus). Other common illnesses include norovirus and bacterial infections like E. coli. As we enter the colder months and holiday gatherings, respiratory infections are on the rise due to increased close contact and indoor activities."

Thankfully, we learned much about mitigating sickness while traveling during the COVID-19 pandemic. "COVID taught us the importance of hand hygiene and boosting immunity through lifestyle practices," said Dr. Taz Bhatia, a board-certified integrative medicine physician and medical adviser to the cold and flu medicine brand Genexa. Fortunately, many precautions you learned to stop the spread of COVID-19 should also help protect you from seasonal influenza, according to Healthline (which is owned by TPG's parent company, Red Ventures).

The last thing you want is to catch a bug on a plane and be miserable for the rest of your vacation. To protect yourself — and your family — from catching the flu and other illnesses while traveling, follow these tips.

Wear a mask

In the past, wearing a mask was a requirement when flying. Though these regulations have been lifted, wearing a face covering on your next flight can still help prevent you from getting sick. A 2020 study by the U.S. Department of Defense found the risk of COVID-19 transmission on a plane was "extremely unlikely" when masks are worn. Masks will also protect you from other common respiratory viruses, like influenza, that are transmitted through the air.

Currently, the Centers for Disease Control and Prevention recommends the use of masks for sick travelers (with fever or respiratory symptoms) to help reduce the spread of respiratory germs and for people sitting near sick travelers (with fever or respiratory symptoms) when the sick traveler cannot tolerate wearing a mask.

Keep your hands clean

We all know that washing our hands is key to preventing sickness, but it's especially true when traveling.

"Keep your hands clean," said Dr. Nicholas Testa, California regional chief medical officer at CommonSpirit Health. "This means a combination of good hand hygiene with either soap and water or an alcohol-based hand sanitizer."

According to the CDC, hand washing is the "single most important infection control measure." It recommends using "alcohol-based hand sanitizer (containing at least 60% alcohol) if soap and water are not available."

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Skip the bathroom

If it's a short flight, make sure you go to the bathroom before your flight takes off, New York-based primary care physician Dr. Marina Gafanovich told TPG. Why?

"You have to understand that many people are sharing that bathroom," she said. "And research suggests that there are significant germs on sinks, flush handles and toilet seats on airplane bathrooms. That is why it's best to use paper towels when you touch the toilet seat or faucet or even the door latch."

Stay hydrated

While a comfortable indoor humidity is anywhere from 30% to 65%, the humidity inside an airplane cabin is only around 10% to 20%, according to Northwestern Medicine. The very low humidity of the cabin air can dry out the mucous membranes of your nose and airways. When these tissues dry out, they are much more susceptible to viruses and bacteria. To combat this, stay hydrated.

"Bring your own bottle of water and aim to drink 8 ounces of water per hour you're in the air to maintain your hydration," said Dr. Nate Favini, the chief medical officer at Pair Team, a virtual care company. "Alcohol and caffeine will dehydrate you even more, so save the cocktails and coffee for your destination."

Avoid certain areas of the plane

In addition to washing your hands, be cognizant of those areas on a plane that are particularly high-touch surfaces. The flu virus, for example, can live on any hard surface for up to 24 hours.

"Don't use the tray table and, if you really have to, make sure you carry sanitary wipes with you and clean it before you use it," said Gafanovich. "Also, don't store items in the seatback pocket. We know many people use it, so it's likely to be full of germs."

Testa also recommends avoiding or wiping down overhead air vents, lavatory flush buttons and seat belt buckles. So, be sure to stock up on hand sanitizing wipes before your next flight.

Stick with the classics, like Purell, or try Trip Wipes, antibacterial towelettes with a refreshing citrus scent designed specifically for travelers. And if you just want to spray your hands (or everything), try Dr. Bronner's lavender-scented organic hand sanitizer spray in Transportation Security Administration-friendly bottles.

Don't touch your face

Even if your hands are clean, it's best to keep them away from your face, too.

"Even if your hands have touched the dirtiest, germiest surfaces, you won't get sick from that unless you bring those germs to a point of entry (nose, mouth, eyes)," said Florida-based internist Dr. Frank Contacessa. "Get in the habit of never rubbing your eyes, touching your mouth or your nose unless you just washed your hands. This is one of the greatest ways to avoid getting sick."

Wear gloves

Just can't kick the habit of touching your face? Try gloves.

Dr. Julie Fischer, an associate research professor in the department of microbiology and immunology at Georgetown University, told TPG, "Gloves are useful in that they remind people not to touch their own noses and mouth ... when you're wearing gloves, you become hyper-conscious of that. But the best protection for individuals is to be very careful about handwashing."

Choose your seat carefully

Studies have shown that the aisle seats on an airplane experience significantly more traffic and run a greater risk of exposure. Why? Well, in part, sick patients tend to brace themselves on those seats when walking to the bathroom.

"The window seat is a better selection if you want to minimize the risk of respiratory transmission," said Testa. These seats generally don't have as much contact with passengers.

Keep your air vent on

While you might think that sitting in recycled air for hours could increase your risk of illness, keeping your air vent on may actually help.

"There's been some research that showed that using the overhead air vent, directed straight downward, can create a cone of protection," said Contacessa. "It can actually prevent airborne germs from getting close to you. The airflow from the vent can help to ward off another passenger's sneeze germs."

In fact, high-efficiency particulate air, or HEPA, filters found on planes remove at least 99.97% of airborne viruses and bacteria. That air is also refreshed about 20 times per hour, whereas an office only gets refreshed about 10 times.

Prepare your body

Before you even set foot on a plane, you can start preventive measures to avoid getting sick. The CDC recommends staying updated on vaccinations, including annual flu shots, COVID-19 boosters and RSV vaccines for those eligible, to minimize the risk of severe illness.

In addition, "Prioritize sleep, a balanced diet, and supplements like vitamin D and zinc," said Bhatia.

It's also worth packing vitamin C. "Studies have shown that people under stress who take 1,000 milligrams of vitamin C per day are less likely to fall ill with viral infections," said Favini. "And travel is often stressful."

Bottom line

Even though the worst of the COVID-19 pandemic is long gone, staying healthy when traveling is still important. The above tips can help minimize your risk this flu season so you can make the most of your holiday travels.

When stocking up on supplements, hand wipes and other supplies, don't forget that some credit cards earn bonus points at drugstores or grocery stores. And when it comes time to update your vaccines, consider the best credit cards for medical expenses.