An Atlanta lawyer made news recently when he flew to Greece and back while infected with drug-resistant tuberculosis. Tests later showed he wasn't as contagious as health officials first thought, and no airline passengers came down with the illness. But the case sparked fear among fliers everywhere.

Their anxiety isn't unfounded.

"People definitely should think about their health when they travel," says David Dale, M.D., FACP, president of the American College of Physicians. "Airline passengers are at risk for colds, common respiratory infections, and more serious problems, like tuberculosis, when they fly with other passengers who have these contagious conditions."

Small spaces

Many new planes circulate some fresh air and have first-rate filters. The air may be no more risky than other crowded venues. The problem is confinement in a small space, sometimes for many hours, with ill passengers. When they cough, you may breathe their germs. The risk is real, but the question is: How much should you worry?

"People shouldn't overlook the health risks of flying, but many people are more worried than they need to be," says Vibhuti Arya, Pharm.D., R.Ph., a spokeswoman for the American Pharmacists Association.

You can't prevent all contagious ailments, but you can help ward off germs. Try these tips:

  • Make sure you're healthy enough to travel. If a health problem has weakened your immune system or you're pregnant, talk to your health care provider before you make travel plans.

  • Pack all the medications you'll need in your carry-on luggage. You'll have them if you need them during your flight or your checked bags get lost.

  • Practice healthy habits. Get plenty of rest before you travel. Try to sleep during the trip. Drink lots of fluids and avoid overeating or drinking too much alcohol before and during the flight.

  • Wash your hands or use antibacterial lotions or disinfecting wipes during your flight. "Hand washing is the most important way to prevent infections," Dr. Dale says.

Some fliers take supplements that claim to boost the immune system, such as vitamin C or echinacea. But studies have found little proof they help. "People who take prescription or over-the-counter medications should talk with their doctor or pharmacist before taking any herbal supplements because they may interact with their regular medications," Dr. Arya adds.

Experts have this advice if you have a contagious condition, like the flu, before you travel: Stay home. When delaying travel isn't an option or you don't think you're too sick to travel, be considerate of others. Wear a mask or cover your mouth and nose with a tissue when you cough. You'll be less likely to contaminate those around you.

What if your seatmate is the one with the cough—but without the tissue? Consider bringing a mask, especially if your current health gives you reason to fear serious infections such as the flu.

Specific air travel issues

Blood clots

Sitting for long periods causes the blood in your legs to stagnate and form clots that can break free and travel to the lungs, a potentially life-threatening condition called deep vein thrombosis. Flight plan: Choose seats with more legroom when possible. "People who are flying should stand up and stretch every hour or so if they can to help prevent blood clots from forming," Dr. Dale says.

Sinus and ear problems

When a plane rises or descends quickly, the pressure outside your body may change faster than the pressure inside your sinuses and ears. This difference can make your ears "pop." You may experience pain and dizziness. Flight plan: Chewing gum and pinching your nose while you exhale with your mouth closed may help. You may need decongestant medications and nasal sprays if you have a cold or allergies.

Jet lag

Your body needs time to adjust if you travel to a different time zone. Fatigue, daytime sleepiness, and loss of concentration are common effects of jet lag. Flight plan: Be well-rested when you travel. Taking the supplement melatonin for a few days before, while, and after you fly may make it easier to sleep. Try to get yourself on the right timetable at once. That means eating and sleeping at the proper time at your destination.

Stress

 More people are flying, lines are longer, and passengers must go through security procedures. Flight plan: Arrive early so you have lots of time to check in and board your flight. Pack your tickets, identification, and other important items where you can reach them with ease. Relaxation techniques, such as deep breathing or listening to music on a portable player, may make it easier to relax and enjoy your trip.

Medical Reviewer: [Dwyer, Johanna, D.Sc., R.D., Fleck, Steve, Ph.D., Gonnella, Joseph, M.D., McDonough, Brian, M.D., Whorton, Donald, M.D.] Last Annual Review Date: 2008-01-14T00:00:00-07:00 Copyright: Copyright Health Ink & Vitality Communications

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If you have the flu, you are contagious one day before symptoms appear and up to five days after.