Air travel/infants and children/ importance of vaccination

August 1, 2010

Posted in Destinations, Prevention, Safe & Healthy Travel, Travel, Vaccinations No Comments »
Tags: air travel children, air travel infants, aircraft cabin, CDC, chickenpox, contagious, disease-causing organisms, diseases transmitted, flu epidemics, ill passengers, ill travelers, in flight, infectious illness, influenza vaccination, measles, medical staff, microorganisms, mumps, passengers traveling with disease, pertussis, spreading disease, symptomatic, traveling with infants, typhoid, unvaccinated children, unvaccinated visitors, vaccinated children, vaccination children, vaccine-preventable, yellow fever

According to the Centers for Disease Control (CDC), in the past year alone there were more than 3,000 known airline passengers traveling while ill with a contagious disease.

Are your children’s vaccinations up-to-date before traveling by air?

1. The aircraft cabin environment abets the spread of disease-causing microorganisms.

Infected passengers cough up, sneeze out and exhale these organisms. Factors that favor this spread include close and prolonged contact with other passengers and, possibly, the vagaries of ventilation systems, dryness of the cabin air, and the presence of passengers originating in countries where such diseases are prevalent.

2. Likely, the number of ill passengers is far greater than the number reported. This further increases the risk of spreading disease. Some ill travelers conceal the fact that they are ill while others are in the incubation period – already contagious but not yet symptomatic and thus unaware that they are ill. The CDC recommends not traveling until 24 hours after fever subsides.  But ill persons are often reluctant to cancel scheduled trips.  One reason is that some airlines penalize for last-minute cancellations regardless of the reason are an additional disincentive.

3. Airport personnel can refuse boarding when passengers appear ill. But, in fact, this is rarely done. (Most people denied boarding are under the influence of alcohol or drugs.)Airport personnel are poorly trained in recognizing infectious illnesses and say it is a “hassle to get involved.” They can telephone airline medical staff for advice but the staff is rarely on the premises.

4. The CDC has guidelines for handling visibly ill passengers in flight. But the crew rarely takes action. They can ask passengers to wear surgical masks (carried on most aircraft), isolate the passengers (if room is available), contact consultants on the ground for guidance, have quarantine officers meet the aircraft on landing, and, for long flights, make unscheduled stops at a closer airport than the destination. 

5. Most diseases transmitted on aircraft are vaccine-preventable. The diseases most commonly found in the CDC survey were so-called childhood diseases: measles, mumps, chickenpox and pertussis (whooping cough). Other studies, done during flu epidemics, found passengers traveling with that disease.

Optimally vaccinated children are already immune to these diseases. But an increasing number of parents refuse to vaccinate their children – though there is no known evidence that there are harmful effects.

6. Check with experts when traveling with infants. In infancy, immunity to vaccine-preventable diseases depends on many factors: the disease in question, immunity received from the mother during pregnancy, and vaccines administered to the infant. Generally routine vaccinations are started at about two months of age but infants are not fully protected until months later; many immunizations require multiple doses over many months to become protective. Sometimes, for travel, routine vaccination schedules may have to be altered, started earlier and repeated later, for example. Rarely, travel should be postponed. Decisions may depend on current disease activity at the destination. 

Influenza vaccination is recommended for everyone who is six months of age and older. Influenza can be a serious disease for infants; hospitalization rates for infants from influenza approach those for the elderly.

7. Adults need vaccinations, too.  Many parents who opt not to vaccinate their children erroneously believe that the so-called “childhood” diseases affect only children. Unvaccinated children become unvaccinated adults. And infected adults spread diseases. Also, for some diseases, protection from vaccine administered in childhood wanes with age; in these cases booster doses are necessary.

8. Many childhood diseases are more serious in adulthood. Compared to children, adults who do become infected are more likely to have complications, the complications tend to be more severe, and the illness may last longer, prolonging the period that the adult remains contagious and is able to spread the disease. If women become infected during pregnancy, the fetus may be adversely affected.

9. Vaccinations are especially important for overseas travel.

The lower the percentage of children vaccinated against a given disease in a country, the greater the risk of unvaccinated visitors contracting that disease. In many developing countries, many vaccines are largely unavailable. Moreover, travel to developing countries may require vaccines against diseases not seen back home (yellow fever and typhoid, for example).

10. Check vaccinations for cruises. Some conditions favoring the spread of disease-causing organisms in flight also occur on cruise ships: crowding (albeit less so than on aircraft), prolonged togetherness, common ventilation systems, and passengers from different parts of the world, for example. Also, check if vaccinations are necessary at scheduled ports-of call.

Posted in Destinations, Prevention, Safe & Healthy Travel, Travel, Vaccinations No Comments »
Tags: air travel children, air travel infants, aircraft cabin, CDC, chickenpox, contagious, disease-causing organisms, diseases transmitted, flu epidemics, ill passengers, ill travelers, in flight, infectious illness, influenza vaccination, measles, medical staff, microorganisms, mumps, passengers traveling with disease, pertussis, spreading disease, symptomatic, traveling with infants, typhoid, unvaccinated children, unvaccinated visitors, vaccinated children, vaccination children, vaccine-preventable, yellow fever