A guy sitting next to you is sneezing and hacking, possibly spewing H1N1 flu germs like a lawn sprinkler.
Just move away, right?
That's not so easy at 30,000 feet.
Thanksgiving next week kicks off the holiday travel season, and doctors say there are potential flu risks when flying to visit family — and when you arrive. Whether you arrive there by plane or by car, big family gatherings with food can present plenty of chances for exposure. Imagine your 10-year-old nephew sneezing into the bowl of chips.
But it's particularly the confined space of an airplane that provides the close contact where germs can move faster than a flight attendant passing out peanuts.
“If you are on a full plane and someone sitting next to you is coughing, there is nowhere to go,'' said Anne Banas, executive editor of SmarterTravel, a Web site with advice for travelers. “You are stuck.”
That's what worried Omaha mom Cheryl Kmiecik. She waited in line an hour and a half last week with her three teenage sons for the vaccine at a public flu clinic, partly because two of them will be flying to Orlando, Fla., over Thanksgiving.
Even though her boys got the vaccine, Kmiecik is still a little worried, because she knows it can take a couple of weeks to take full effect. She also knows that teens are among those who are at risk for complications from H1N1.
“It's scary,'' she said.
Even though H1N1 flu remains widespread nationally, doctors are advising people not to worry excessively. Most flu cases are mild, and an increasing number of people are getting vaccinated.
So don't skip that flight to visit cousins in California or that holiday feast at Grandma's. Just take precautions.
Pass the hand sanitizer along with the potatoes and stuffing. Keep your hands clean on flights, and consider bringing a face mask to wear if your seatmate might be sharing more than just photos of the grandkids.
Finding a seat away from a passenger with symptoms could be tough.
Planes are always packed during the holidays, and that's particularly true now that some airlines have cut the number of flights in the wake of the recession.
Tight space isn't the only potential problem. The air on flights can dry out the nose, making it easier for germs to sneak inside your body. Armrests and other parts of the plane — particularly seat-back pockets, which sometimes get stuffed with used tissues — can be good places for germs to gather.
Airlines are taking extra steps to keep passengers safe.
On United Airlines flights, for example, face masks and hand sanitizer are being made available to passengers. Southwest Airlines removed pillows and blankets from planes in the spring and is keeping them off to reduce the spread of germs. Airline officials say they are continuing to regularly clean armrests and other areas of their planes.
Travelers are thinking of H1N1 flu, but they aren't canceling trips as they did in the spring when the virus first began spreading, said Audrey Hulsey of Pegasus Travel/American Express in Omaha.
The AAA motor club said the vast majority of Nebraska and Iowa customers who booked trips have not canceled because of the flu.
Hulsey said it has become more common for people to purchase trip insurance in case they get sick, particularly for cruises and travel packages to destinations such as Mexico and Hawaii.
Kmiecik didn't purchase trip insurance for her sons' flight. So far, they've stayed healthy, and she's hoping they'll be able to make their trip to watch Creighton University play in a basketball tournament.
She will be sending hand sanitizer with them and will remind them to use it on the flight and while waiting at airports.
Keeping hands clean is the best precaution, said Dr. Kari Simonsen, an infectious disease specialist at the University of Nebraska Medical Center. It's also smart to bring sanitized wipes to clean off seat trays and armrests, she said.
Both H1N1 and the regular seasonal flu virus spread mostly through droplets from coughs and sneezes. Those droplets can fly six feet, which means even someone sitting a couple of rows away could spread flu germs to you, said Dr. Meera Varman, an infectious disease specialist at the Creighton University School of Medicine.
The longer the flight, the greater the risk of exposure, she said.
Varman said it would be smart to take face masks for you and your children, but wear them only if there is someone nearby coughing and sneezing.
Simonsen cautioned not to be shy about offering a mask to a person nearby who is coughing.
Once you get where you're going, clean hands are the best way to stay healthy and avoid contracting the flu.
Grabbing a handful of chips out of a bowl, for example, is an easy way to pick up or spread germs.
Keeping bottles of hand sanitizer where guests can see them will be a good reminder.
It's smart to avoid shaking hands, and it's best to resist snuggling babies.
Simonsen said that, after the holidays, doctors notice a higher number of kids with the flu, colds and similar illnesses. Doctors suspect that family gatherings are one place where kids pick up germs during the holiday break, she said.
Simonsen said people shouldn't let H1N1 take the fun out family parties.
“Enjoy the holidays,'' she said. “Just be careful.”
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