Page last updated: 2008-8-31
AircrewHealth.comBecause they constantly travel from place to place, people who fly for a living may experience increased exposure to infectious diseases.
Crews may have direct contact with individuals, including passengers, who may be carriers of contagious diseases.
Trips may take aircrews to locations where outbreaks of diseases are underway.
Crews may be subject to illnesses from improperly handled food and contaminated water, both aboard the aircraft and at destinations.
During layovers, especially in tropical areas, crews may be exposed to diseases carried by mosquitoes and other insects.
Finally, the stresses of frequently changing schedules, long work hours, time zone changes, and irregular sleeping and eating patterns can impair immune function, resulting in a greater susceptibility to infection.
Infectious diseases are caused by countless kinds of bacteria, viruses, parasites, fungi, and other microorganisms.
A useful way to consider infectious diseases is to categorize them according to how they are transmitted. This will help you to understand what measures to take in order to prevent them.
Note: While there are literally thousands of infectious diseases in the world, we will focus here on those most likely to be encountered by working aircrews.
Bacteria, viruses and protozoa can contaminate food and water and cause illnesses. The U.S. Centers for Disease Control and Prevention (CDC) estimates that foodborne bacteria cause 76 million illnesses, 325,000 hospitalizations and 5,200 deaths in the U.S. each year.
Improper hygiene practices by food handlers, insufficient refrigeration, improper food preparation practices, and poor food manufacturing processes can result in illnesses, some of which can be fatal.
Bacteria and other harmful organisms from human and animal waste can get into public water supplies, infecting the people who then drink the contaminated water. Similarly, contaminated water in lakes, rivers, ponds, and pools can transmit diseases to swimmers or waders.
The potable water on board aircraft is sometimes unsafe to drink unless it is boiled.
The most common diseases acquired through contaminated food and water are gastrointestinal disturbances such as "Traveler's Diarrhea." A number of more serious diseases can be acquired through contaminated food and/or water, such as Cholera, Hepatitis A, Hepatitis E, and Typhoid Fever.
Avian Influenza (Bird Flu) is a relatively new disease risk associated with food. This viral disease is acquired from contact with infected poultry, while alive, and also before the meat is cooked. Please visit our Avian Influenza web page for more information about this emerging disease, especially if you fly routes to or within Asia. We also have a page with current news about Bird Flu.
Some infectious diseases carried by people are spread through the air, as in coughing or sneezing. The microbes can be breathed in by another person while they are still in the air. Some of the infectious material from coughs and sneezes may then settle on objects like telephone, doorknobs, handrails, and so on. Diseases transmitted this way include: Colds, Influenza (Flu), Mumps, Severe Acute Respiratory Syndrome (SARS), and Tuberculosis (TB).
Other diseases carried by people are transmitted through direct contact with saliva, blood, or other bodily fluids. Sexually transmitted diseases are included in this category. Some examples are HIV/AIDS, Hepatitis B, Hepatitis C, Hepatitis D, Herpes, and Chlamydia.
Some insects that "bite" can transmit diseases from one human to another, or from animals to humans. This happens when they first bite an infected person or animal, and subsequently bite you! Here are some examples of diseases transmitted to humans from insect bites:
Mosquitoes: Dengue Fever, Malaria, West Nile Virus, Japanese Encephalitis, Yellow Fever
Ticks: Colorado Tick Fever, Lyme Disease, Rocky Mountain Spotted Fever
Fleas: Plague
Knowledge is your number one defense! Learn what kinds of diseases you may be exposed to and how they are transmitted, and understand what you can do to prevent infection!
If you will be traveling to a country or region of the world where you have not been before, take the time to learn what diseases may be prevalent there, and what precautions you should take.
Handwashing is one of the simplest, easiest, and most effective ways to prevent transmission of diseases caused by bacteria and viruses, such as colds and flu. Wash your hands vigorously with soap and running water. If this is impractical, use of the newer gel "hand sanitizer" products also has been shown to be very effective. Keep a small bottle in your pocket!
Vaccinations are available for many infectious diseases. Make sure that you are up to date on vaccinations for infectious diseases that you may be exposed to, both at work and at home. If you fly internationally, find out which vaccinations are recommended for travel to your overseas destinations. Some diseases that are rare in North America or Europe are much more prevalent in other parts of the world.
Mind what you eat and drink. When you are away from home, eat only well-cooked foods. In particular, avoid raw meat and seafood. Drink water and soft drinks from sealed bottles and cans only. Avoid juices and milk that are not pasteurized. Pass up foods from street vendors!
Safe Sex practices are necessary everywhere. If you have sexual contact with anyone, anywhere other than your regular exclusive partner, use a latex condom properly every time. Keep a supply of condoms -- and use them!
Don't smoke. Research has shown that cigarette smoking is a substantial risk factor for certain kinds of bacterial and viral infections, including colds, influenza, gum diseases, pneumonia, tuberculosis, and meningococcal diseases. Smoking causes structural changes in the respiratory tract, and decreases immune responses. As a result, smokers become more susceptible to these diseases.
You should call a doctor immediately if:
Source: NIH Publication No. 01-4914, September 2001, U.S. Dept. of Health & Human Services, National Institute of Allergy & Infectious Diseases.
In 2005, the International Air Transport Association (IATA) published a set of general guidelines for air transport employees:
We urge aviation personnel to familiarize themselves with this set of guidelines from IATA.
Click here for recent news stories about Infectious Diseases.
Note:
Click here for news about Bird Flu (Avian Influenza).
For complete background info about Bird Flu, please visit our information page about that topic.
Here are some trustworthy on-line sources of information related to the topic of Aircrew Exposure to Infectious Diseases.
Featured Articles:
New information about how flu is transmitted - Aircrew Health News
Air travel and the spread of flu - Crew Health News
Tuberculosis and Air Travel: Guidelines for Prevention and Control -
World Health Organization, 2006 
[PDF format - 46 pages]
Guidelines for the Management of Airline Passengers Exposed to Meningococcal Disease - U.S. Centers for Disease Control & Prevention, May, 2005
Traveling abroad: Plan ahead to prevent illness - advice from MayoClinic.com, April, 2006
Q&A: Airlines and Communicable Disease - Air Transport Assn. (ATA), January 2006
Air Transport and Communicable Diseases - International Air Transport Assn. (IATA)
National Institute of Allergy & Infectious Diseases - U.S. National Institutes of Health
Travelers' Health - National Center for Infectious Diseases, US Centers for Disease Control & Prevention (CDC)
Information for Travelers - Travel Medicine Program, Public Health Agency of Canada
International Travel and Health - on-line publication of the World Health Organization (WHO)
Frequently Asked Questions About Traveler's Diarrhea - U.S. Centers for Disease Control (CDC), October, 2005
New Drug Approved for the Treatment of Traveler's Diarrhea - U.S. Centers for Disease Control (CDC), October, 2004
Food Poisoning From Marine Toxins - U.S. Centers for Disease Control (CDC)
Food Safety & Foodborne Illness - World Health Organization Fact Sheet, June, 2002
8 ways to prevent food poisoning at home - MayoClinic.com, July, 2006
Risks From Food and Water - U.S. Centers for Disease Control (CDC)
Treatment of Water to Make It Safe for Drinking - U.S. Centers for Disease Control (CDC), May, 2005
In the interest of facilitating further research on the topic of Aircrew Exposure to Infectious Diseases, we have compiled a list journal articles and other references related to the topic.
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