Dr. Mark Gendreau offers some very reasonable advice, mostly about travel, for those who wish to avoid swine flu or any other airborne illness.  A combination of individual, corporate and governmental action could make a great difference.

[H]and hygiene is...the single most significant thing you can do to protect yourself and your family when you are traveling or out in public.  Study after study shows marked reductions in transmission in public spaces when hand hygiene is practiced, and a recent study found nearly undetectable influenza particle levels after hands contaminated with influenza were washed with either soap and water or an over-the-counter gel containing at least 50 percent alcohol.  Sanitize your hands before eating, drinking and after retrieving something from the overhead bin or returning from the restroom, and you have just cut your chances of getting infected by at least 40 percent. One of my disappointments with the airline industry is its lack of providing alcohol-based hand sanitizers to passengers. Such a service would go a long way in eliminating infection spread within aircraft.

Unlike antibacterial soaps, plain handwashing and alcohol-based hand cleaners have not been shown to promote the development of resistant strains of microbes.  I've always been in favor of handwashing (with plain soap), but it was the advice of a physician friend during the SARS crisis that led to the habit of carrying a pocket-sized bottle of hand sanitizer—particularly useful in restaurants and grocery stores, before the Eucharist at church, after changing diapers in public place, and before consuming airplane food.

Most commercial aircraft in service recirculate 50 percent of the air delivered to the passenger cabin....The recirculated air usually passes through high-efficiency particulate (HEPA) filters before delivery into the cabin.  HEPA filtering of recirculated cabin air to minimize exposure to infectious particles is established within scientific literature, practiced daily in health care facilities and is strongly endorsed by the medical community and cabin health experts.  However...the Federal Aviation Administration, its British counterpart, the Civil Aviation Authority, and Europe's Joint Aviation Authorities do not require the use of these filters on commercial airlines.  Efforts to improve international regulations regarding the certification, inspection and maintenance of aircraft environmental control systems are needed. To minimize the risk of disease spread by aircraft, regulations requiring HEPA filters for any aircraft that uses recirculated air should be seriously considered....In the meantime, you can improve the ventilation at your seat by turning on the overhead air vent to low and positioning the airflow to be slightly in front of your face. This may create enough air turbulence to push a viral particle from landing on your face and mucous membranes.

I haven't tried this portable air filter device, but frequent air travellers might want to consider it.  (Hat tip to Heather.)

Use a surgical mask when you are traveling to areas that have reported cases of swine flu and bring an additional one to give to anyone near you who forgot one or appears to be sick and is coughing or sneezing....A recent analysis of public health interventions used during the SARS epidemic suggests that the use of masks by the public was 68 percent effective in decreasing rates of infection, with simple face masks, and 91 percent effective for more sophisticated N95 face masks.

Okay, so it's very uncool to wear a face mask when ill, but it needn't be so.  "Sick masks" are common in Japan, even amongst the coolest high school students, who see them for what they are:  an invitation to sympathy, especially from teachers and pretty girls.

The only way to eliminate any risk of cross-infection in the aircraft cabin—or the rapid worldwide spread of an infectious agent—is to prevent would-be passengers who are either substantially exposed to or carrying transmissible infections from flying....This needs to come from education and promoting individual responsibility, since the systematic screening of passengers for contagious diseases is impractical. Although thermal scanners used in airports may detect travelers with symptoms, they are not effective since people exposed to an infectious disease could travel without any signs or symptoms and yet still be infectious.

May I suggest a change in the way airplane ticket refunds are handled?  When a family is about to embark on a long-planned vacation, and one of the children begins to sniffle or develops a low-grade fever, it's unlikely that any policy change will make them decide to stay home, as brief, inconsequential illnesses happen frequently to children.  However, many people with health issues are deterred from rescheduling their flights because of the financial consequences of cancelling a flight.  If the airlines had a standing policy of rebooking, at no additional charge, all the members of the sick person's party, I suspect we'd see a substantial increase in the number of people who were civic-minded enough to stay home when ill.  In a health emergency, during which flight cancellations could be expected to have a substantial impact on the airlines' financial situation, it would be appropriate for the federal government to bear some of the burden, much in the same way our local government lifts the tolls on major roads during a hurricane evacuation.

Be prudent, fear not, have fun, and stay safe, my friends.
Posted by sursumcorda on Thursday, April 30, 2009 at 8:53 am | Edit
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