As exciting as those first steps onto a plane can be for most people, there are a range of health issues that can crop up before or during a flight. Whether you’re worried about jet lag, the flight itself, or are unsure about a pre-existing condition that could prevent you from travelling, we’ve come up with a guide to help you on your way.

Airline Restrictions For Flying

Airlines have the right to refuse passengers entry onto a flight if they have pre-existing conditions that could get worse or have dangerous consequences during the flight. Airlines will prevent you from travelling if they think this is the case by seeking clearance from a medical advisor. If a passenger is suffering from a disease or a physical or mental condition that could affect the safety of their fellow passengers, crew and/or aircraft then they will not be able to travel.

Normally, airlines will refuse travel in the following cases:

  • Newborn babies less than 48 hours old, or longer in case of premature birth.
  • Pregnant women after the 36th week, or 32nd week if they are expecting a multiple pregnancy.
  • If the passenger experiences breathlessness, angina or chest pains at rest.
  • If the passenger has had a recent myocardial infarction, stroke, surgery or injury where trapped air could be present e.g. abdominal trauma, gastrointestinal surgery, brain surgery or eye operations.
  • If the passenger has a severe chronic respiratory disease, unresolved pneumothorax or sickle cell anaemia.
  • Passengers with infections of the sinuses, ear, nose or eustachian tubes, or those suffering from increased intracranial pressure.
  • If there is evidence of a psychotic illness, unless it is fully controlled.
  • If the passenger has an active ‘communicable disease’ (see below).

This list isn’t exhaustive, so make sure that you ask your GP or someone at a local Superdrug Travel Clinic if you’re unsure. The regulations will also vary from airline to airline so, if in doubt, speak to someone from the airline’s medical department to confirm.

Communicable Diseases

You’re no more likely to catch an infectious disease on board an aircraft than you are on any other mode of transport. Still, it’s possible to catch something from as little as a cough, sneeze or handshake from another passenger if you’re sitting close by. If an airline suspects that a passenger has an actively contagious disease, they have the right to refuse that person entry to the flight.

It’s important for all passengers with an active illness, especially a fever, that they delay travelling until they are fully recovered in order to reduce the risk of passing infection. In cases like chicken pox where the rash remains for days after recovery, even recently recovered passengers should carry a letter from their GP saying that they are no longer contagious. Here’s a guideline for the communicability periods (the time when a patient is infectious to other people) of some common infections, but always ask the advice a doctor first or at your local Superdrug Travel Clinic if you’re unsure. During these periods, airlines have the right to refuse passengers entry to a flight:

  • Chicken pox: 1-2 days before ‘onset’ (the first appearance of the signs or symptoms), up until all the spots have dried and crusted, which tends to be about 5 days after. This is longer in patients who have been immunocompromised.
  • Influenza: up to 3-5 days from onset in adults, and 7 days in young children.
  • Measles: usually from up to 4 days before onset until 4 days after the rash has fully cleared.
  • Mumps: up to 7 days before and until 9 days after the onset of ‘parotitis’ (inflammation of the glands). With mumps, you’re most infectious 2 days before and for 4 days after onset.
  • Whooping cough: this illness is highly communicable in the early ‘catarrhal stage’ and at the beginning of the ‘paroxysmal’ cough stage, which lasts for the first 2 weeks. After treatment, infectiousness decreases until the third week when it should be gone.
  • Rubella: this is highly contagious, with the communicable period lasting from at least 1 week before and 4 days after the onset of the rash.
  • Tuberculosis: after TB has been successfully treated, it is contagious for at least another 2 weeks.

SPECIAL NOTICE: With more and more cases of tuberculosis worldwide, the World Health Organisation (WHO) has advised that there is now a slight but very real chance of it being transmitted during air flights. Records show that TB infections have only been transmitted in flights that lasted at least 8 hours long, and that the risk is greater when lots of passengers are coming from countries with high levels of the disease. Luckily, there has yet to be a case of active TB being the direct result of travel on a commercial flight. But, WHO are still recommending that all infectious TB patients should not fly for at least 2 weeks after effective treatment. In cases where the patient has a strand of multidrug resistant TB, then they should not fly until they have medical evidence to say that they are no longer infectious.

Fear Of Flying

For nine million unlucky Britons, the prospect of an upcoming flight is very unwelcome indeed. Often, this fear is rooted in a particularly bad experience of a rough flight or because of news coverage of plane crashes or hijacks. Anyone can develop a fear of flying, and sometimes the anxiety is so great that passenger’s experience is ruined completely by panic attacks or can even stop them wanting to make the trip. We know how daunting this prospect can be, but it shouldn’t mean you have to miss that holiday of a lifetime or any exciting opportunities with work. Hopefully, by following our top tips for travelling with a fear of flying, you should be able to put your mind at rest.

5 top tips for nervous fliers:

  • Try to distract yourself by watching in-flight movies, reading a good book or by talking to other passengers. Aim to make a new friend on every trip!
  • Ask one of the friendly nurses at your local Superdrug Travel Clinic for some advice and reassurance about air travel whilst you’re there for travel vaccinations.
  • Don’t be shy about telling the cabin crew how you feel: they’ve had years of experience with people just like you, and can help put you at ease by explaining any funny noises or bumps during the flight.
  • If your doctor decides its OK, then sometimes a mild sedative can help. Remember: these drugs don’t mix with alcohol, so lay off the drinks cart if you have any!

In more extreme cases, research shows that counselling or cognitive behavioural therapy (CBT) is helpful for people who want to learn different strategies for overcoming their fears. Elaine Foreman is a clinical psychologist who runs an independent course called ‘Freedom to Fly’ (phone: 0208 4593428 or email: elaine@freedomtofly.biz). Heathrow and Manchester airports also offer ‘Aviatour’ courses (phone: 01252 793250) and Virgin Active have a fantastic ‘Flying without Fear’ course for £255.

Aircraft Security

There’s always a long list of things you can’t take with you onto an aircraft cabin, but if you need to take anything sharp or technically forbidden with you for medical reasons, be sure to bring proof with you that you need it from your GP. Things you might need to take on board include: hypodermic needles or syringes in cases of diabetes or an allergy. With the exception of hypodermic needles, you will usually be asked to place these items into your hold luggage, and without the appropriate evidence it could be destroyed. Always find out what your airline’s policies are, but for general advice on fitness, travel and specific health issues, British Airways Medical Service offers a great booklet called ‘Your Patient and Air Travel’.

In-Flight Health Issues

There are a few things to be mindful of while travelling by air if you want to stay happy and healthy for your trip.

  • Take care not to get dehydrated while on board your flight. The air on board the aircraft takes very little moisture from outside the cabin, especially at high altitudes, and can therefore be dry. Bring a travel-sized moisturiser in your hand luggage to guard your skin and lips against dryness, and try to wear glasses instead of contact lenses to stop them irritating your eyes. Drink plenty of water while you fly to stay hydrated, again especially if you’re enjoying drinks with alcohol or caffeine!
  • Keeping hydrated is also important to prevent cramps or deep vein thrombosis (DVT) while flying for a long period of time. Sitting still for so long in a cramped seat can be uncomfortable, so try to take a walk or two along the aisle in long trips and stretch your legs whenever you can.
  • The same goes for DVT, which has the potential to be more dangerous: drink lots of water, keep moving, and speak to a pharmacist about special compression stockings to reduce ankle swelling and minimise the risk of DVT happening. Check out our useful guide for preventing DVT when travelling (link).
  • ‘Air rage’ is a little known term that’s used to describe instances of psychological or physical violence from passengers when flying. This can happen for several reasons: personal problems, flight delays, lack of sleep, heavy drinking, or clashes with fellow passengers. On long haul flights, it can also be triggered by nicotine withdrawal in heavy smokers, in which case nicotine gum or substitutes are a good thing to bring in your hand luggage. E-cigarettes are often banned by specific airlines, like EasyJet. Passengers should also avoid excessive drinking on flights if they are prone to aggression. In extreme cases, aircrafts have landed prematurely to eject passengers who are causing a disturbance in the aircraft, and legal action can been taken. Airlines use a ‘warning’ system much like the yellow/red card at a football match, and can refuse to let those passengers board their other flights. Don’t spoil the flight for everyone else by doing all you can to avoid air rage.

Jet Lag

There’s nothing more frustrating after a long-awaited trip than losing the next few days recovering from it. Jet lag happens when we experience a change to our ‘Circadian Rhythm’ which controls  our normal sleeping patterns. When we travel into different time zones, we usually need at least one day per time zone before our sleeping habits adjust to the local time and we’re back to our usual, chirpy selves. Some people find they get less jet lagged when travelling westward, but travelling in either direction can cause problems. Typically, jet lag causes tiredness, confusion, loss of appetite, nausea, and changes to your normal bowel movements and sleeping habits. Thankfully, there are some things you can do to minimise your chances of getting it too badly:

  • Travelling if you’re already tired will only make it worse, so make sure you’ve had a proper rest before you set off! On the flight, get as much sleep as you possibly can and try to leave the first day of your trip free from anything too important. Be prepared to be sleepy in the evenings for the first few days.
  • Jet lag tablets are useful if you need help for the first few nights to sleep. Research has shown that taking these after arrival will help you wake up and stay alert on the next day, however these won’t speed up your body clock’s adjustment to a new time zone.
  • Like most things, a jet lag will only be made worse by a hangover! Try to avoid heavy drinking the night before, and drink plenty of water on and after the flight.
  • Take a stopover flight in the middle of your journey. This will help you adjust to the time change more gradually, and you’ll be less tired when you finally get there.
  • Follow the sun’s example! Try to familiarise yourself with the new time zone by keeping in tune with the natural light patterns. Why not sleep for the first few nights with your curtains open to wake up with the morning birds?

Altitude Sickness

Above 2400 metres (8000 feet) is usually considered as ‘high altitude’, and travelling to places this high can cause passengers some minor health problems. While you’re on board the aircraft cabin, the air pressure is maintained well and so altitude sickness symptoms during the flight are unusual. However, even the healthiest passengers can experience symptoms after arriving at airports like those in the Himalayas and the Andes, which are well above 2400 metres. Symptoms of altitude sickness can include headaches, nausea, difficulty breathing and confusion. If you have a pre-existing cardiac or respiratory problem, then you’re also more likely to have these symptoms both during and after the flight. Sometimes though, even being aware of this can help the passenger to stay calm and feel better. Drinking plenty of water will also help, as dehydration and any strenuous activity will make the symptoms worse. For those with serious pre-existing hypoxic respiratory disease, you should always talk to your GP or someone at your local Superdrug Travel Clinic for specialist medical advice before flying. They should be able to estimate whether or not you’ll have any problems, and arrange for extra oxygen supplies for the flight or on arrival for you.

Happy Flying!

Hopefully, this little guide has helped you with everything you needed to know before jet setting off across the world. But, if not, pop down to one of our specialist Superdrug Travel Clinics for some more expert advice on all things related to travel healthcare.