Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

7 min read

When the COVID-19 pandemic first started, we had no idea what to expect. Nobody was sure how the virus was spread – although we did know a lot about how other common respiratory viruses infect people.

So doctors recommended a combination of tried and tested advice for the most common routes of virus transmission:

  • Keeping your distance from someone who might be infected.
  • Improving ventilation.
  • Stopping coughs and sneezes firing out virus droplets.
  • Cleaning potentially infected surfaces – and hands – regularly.

With lockdowns due to the pandemic fortunately a bad memory for most, much of this advice still holds true. But if you’re travelling, it’s not just coughs and colds you need to bear in mind.

Is the risk of germs higher on holiday?

Travelling by plane will inevitably mean you come into contact with many other people. Airport terminals are often crowded, and while airport (and plane) surfaces are regularly cleaned, thousands of people touch them regularly.

In addition, you may be stressed and sleep-deprived when you’re travelling. Both of these mean your immune system may be more vulnerable to infection.

Finally, while food in airports and on planes is prepared under strict hygiene conditions, the same may not be true of food at your destination. Do be sure to follow good hygiene measures while you’re away to reduce the risk of a nasty tummy bug.

Washing Hands

Where are the germ hot-spots?

Airport surfaces are teaming with viruses that can cause a range of illnesses, including coughs, colds and ‘flu. The most common areas to find germs in this study included:

  • Toys in children’s play areas
  • Luggage trays at security check-in
  • Buttons on shop pay terminals
  • Stair handrails
  • The passenger side desk and divider glass at passport control.

On board the plane, seat chair handles are particularly common sources of contamination.

How do infections spread and how can I avoid them?

Many respiratory viruses can spread either from droplets from people coughing or sneezing, or from contaminated surfaces where viruses have landed. For respiratory viruses, they’ll often end up on surfaces after being coughed out. Viruses and bacteria that cause tummy bugs are transferred from the hands of infected people.

  • Droplet spread. These droplets are relatively large (5-10 µm in diameter) and heavy enough not to remain suspended in the air. While they’re shot out at high speed from someone coughing or sneezing, they tend to come to earth within 1-2 metres. Trapping germs in a paper handkerchief (The old saying ‘Coughs and sneezes spread diseases, trap those germs in your handkerchiefs’) is largely effective if you’re the one who’s infected – as long as you then dispose of the tissue and wash your hands. If you see someone coughing and sneezing, try and stay at least 1 metre away from them.
  • Aerosol spread. During the pandemic, it became clear that COVID-19 could be spread by ‘aerosol’ – tiny particles (much smaller than droplets) breathed out and suspended in the air. It was after this discovery that face coverings were widely recommended during the pandemic. Do bear in mind that unless you’re wearing a medical-grade face covering, they’re more effective at protecting others if you’re infected than at protecting you from breathing in germs.
  • ‘Fomites’ are any objects that might carry infection. The flu virus can last up to 24 hours on hard surfaces, and germs can linger between flights. If a virus-laden droplet lands on a surface, you could pick it up on your hands and transfer it to your eyes, mouth or nose. Regular hand-washing and disinfecting areas you’re going to be touching the order of the day. Tray tables, seats, seatbelts and buckets, armrests, and buttons for the fan and light are all surfaces that can have germs living on them. It’s wise to use disinfectant wipes to wipe these areas.
  • The faecal-oral route. Yes, this is as revolting as it sounds! Tummy bugs are largely spread when an infected person doesn’t wash their hands properly when they’ve been to the toilet. You can then pick up germs either by touching their hands or from surfaces they’ve touched. These germs infect you when you swallow them, so being scrupulous about hand-washing before you eat and after you’ve been to the loo is key.

Hand wash or hand sanitiser?

The short answer is – hand washing when you can, hand sanitiser when you can’t. Ideally, you should follow the rules we all took up during the pandemic, and wash your hands with soap and water for at least 20 seconds.

If you don’t have access to a sink, hand sanitiser can be an effective alternative. However, you should either use a version with at least 60% alcohol content, or a sanitiser with at least 200PPM (parts per million) hypochlorous acid, which is kinder to sensitive skin.

Flu Jab

Get your vaccines

When travelling outside Western Europe, the USA, or Australasia, it's crucial to consult your practice nurse or pharmacist well in advance regarding necessary travel vaccines. Although the risk of catching a tropical disease on the plane is minimal, it's reassuring to know you're safeguarded during your trip.

If you qualify for a flu vaccine or COVID-19 booster, consider getting vaccinated at least 4 weeks before your journey if possible. This allows your immune system to reach maximum resilience.

For insights on the essential vaccines for international travel, delve into our detailed guide packed with valuable information.

Find Out More


Stress can lower your immune system and your ability to fight off germs - and let’s be honest, a day at the airport can frazzle the nerves of the most experienced traveller.

Getting to the airport, navigating your way through security and finding the right gate can be extremely stressful experiences. As a result, we can start engaging in anxious behaviours such as biting your nails and rubbing your eyes.

Much of the stress can be reduced by good preparation, so you know you’ve done everything you can to minimise the risk of unpleasant surprises. Important tips are:

  • Thinking about steps you need to take if you have a particular medical condition. Our top tips cover ideas for a wide range of medical issues.
  • Check that your passport is up to date and you have all the documentation you need.
  • Make sure you’ve taken out travel insurance, even if you’re travelling to a part of the world covered by the GHIC.
  • Booking transfers to the airport (including train tickets, parking and collection at your destination) well in advance.

On the day you fly, it’s worth allowing extra time to get to the airport, so you’re not in a rush. You could also try downloading relaxing music on your phone that you can listen to on the plane. Take a good book that you can get really engrossed in – or, if you’re like me, a book of word puzzles or Sudoku.

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