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

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

Originally posted: 7th Jan 2020

We've all had coughs and colds, but what does it mean for travel?

Mention the word ‘holiday’ and the last thing that springs to mind is illness, but coughs and colds are extremely common and viruses don’t consult your calendar before they strike. That means all too many of us are faced with a case of the sniffles and a hacking cough at just the time we’re supposed to be printing our tickets, packing our suitcases and heading for the airport.

Where conditions affecting your airways are concerned, you need to take three factors into account before flying:

  • The impact being in a pressurised airplane could have on your symptoms.
  • Whether you have existing chest problems which could mean flying could make your symptoms worse.
  • Whether you’re fit to fly at all.

If in doubt, always consult your doctor before you head off to the airport.

Why is an aircraft cabin different from being on the ground?

Air pressure varies, depending on the height above sea level. Cruising altitude for an airplane might be 35,000 feet, and the cabin air needs to be pressurised to keep it at a stable level. The pressure is kept at an equivalent to being at an altitude of 1700-2100 metres above sea level.

As part of this process, most of the air in the cabin is recirculated. That means it’s easier for germs to spread to other passengers (and from them to you).

Because air in the cabin tends to be dry, it can make your mucus stickier and harder to shift.

It also means not as much oxygen reaches your bloodstream. If your body is already low on oxygen because you have a chest condition such as chronic obstructive pulmonary disease (COPD - sometimes called chronic bronchitis or emphysema), even slightly lower levels of oxygen can leave you feeling more breathless.

If you have a more serious chest infection, this can further affect your blood oxygen levels.

Colds, flying and your ears

Everyone who has had a cold (that’s everyone!) knows colds lead to a blocked nose and lots of mucus. It also leads to inflammation of your upper airways around your throat. Your middle ear (the area behind your eardrum) is connected to the outside world via a tiny tube - the eustachian tube - leading from your middle ear to your throat. This allows you to equalise the pressure inside and outside the middle ear. This connection is important because a build-up of pressure on one side or other of the eardrum can be intensely painful.

Although the cabin is pressurised, the pressure varies slightly, especially as the plane takes off and lands. As the plane rises, the air pressure outside your ears decreases, increasing again as the plane descends for landing. This means that as you take off, the air in the middle ear pushes out and as you land, the eardrum is sucked in.

If one or both of your eustachian tubes are blocked by swelling of your upper airways or congestion (or if the tubes are very small, as in children), your body can’t equalise the pressure if the pressure outside your ear changes quickly. That’s why it’s more common to get ear pain during ascent and descent.

Taking decongestants, chewing gum or sucking boiled sweets can help to equalise the pressure. So can swallowing or yawning regularly.

When am I unfit to fly?

As a rule of thumb, you should avoid flying if you have:

  • A fever of 38° C or higher and a severe cough or
  • Difficulty breathing or
  • Chest pain or
  • If you can’t control your symptoms with medications from your pharmacist (decongestants, simple painkillers etc).

It’s also important to think about your comfort. If you’re travelling long haul with a chesty cough, you’re unlikely to rest properly, placing additional strain on your body and leaving you feeling exhausted.

If you have existing lung problems, you should always consult your doctor before flying if you have any sort of cough or cold. Even if you’re given the all clear, it’s essential to take your regular medication, including inhalers, with you in your hand luggage.

Can I fly with a cold?

The vast majority of people can fly with a cold. A cold is what’s called an ‘upper respiratory tract infection’ – your nose and throat may be bunged up, but your lungs are not affected. That means if you don’t have an existing chest condition, flying shouldn’t be a problem.

If you have a lung condition like asthma or COPD, it’s important to check with your doctor first to make sure the combination of flying and having a cold won’t worsen your condition.

It’s worth bearing in mind that the cold virus is highly contagious and travelling in the enclosed space of an aircraft will leave other people on the flight-prone to infection. Disease can spread through direct touch, a sneeze, a cough, or via contaminated objects like used tissues or eating and drinking utensils.

Try to prevent the spread of infectious inflight germs by:

  • Washing your hands more often to remove germs that can be spread by touch, especially after coming into contact with your nose or mouth.
  • Covering your nose and mouth with a disposable tissue when you cough or sneeze.
  • Throwing away used tissues immediately.
  • Carrying and using antibacterial hand gel or cleanser, especially if hand washing isn’t easy to access.

When flying with a cold, you’re likely to feel a little uncomfortable. In your carry-on bag, keep a supply of tissues and any medications you’ll need to relieve or treat your symptoms, such as pain relief, throat lozenges, or decongestant remedies.

It will also be helpful to keep your water intake up to prevent dehydration.

Flying with the flu

First, let’s be clear – there is no such thing as a ‘touch of flu’. While flu is caused by a virus, like the common cold, the symptoms of flu are much more severe. They include high fever (often above 40° C), aching all over and harsh, sore throat, wracking cough and feeling extremely tired.

That means you’re highly unlikely to feel well enough to travel if you’re in the middle of a bout of flu. Once your symptoms are on the mend and your fever has settled, you may feel up to embarking on a trip.

However, sitting on a flight with even mild tail-end symptoms is likely to be uncomfortable, especially if you’re flying long haul. And don’t forget that the pressurised cabin may make them worse.  Make sure you stay hydrated, are stocked up with any medicines you might need, and take precautions to prevent the spread of infection throughout the aircraft.

Again, there is always the possibility that you might pass it on, so it might be worth postponing your trip and travelling when you’re feeling better in future.

Can I fly with bronchitis?

Bronchitis is an infection that causes inflammation of the airways leading to the lungs and can be categorised as either acute bronchitis or chronic bronchitis.

Chronic bronchitis is the old name for a condition called COPD, which mostly (but not always) affects smokers. Symptoms include chronic cough and breathlessness. It’s diagnosed on the basis of lung function tests from your doctor (where you blow into a special machine) and mainly treated with inhalers. COPD affects your body’s ability to absorb oxygen, leading to shortness of breath. 

If you have COPD, your oxygen levels may already be lower than usual. It’s important to check with your doctor before you fly whether it’s safe for you to travel. If you have a flare-up of your condition, with increased cough, sputum and breathlessness, your doctor may well recommend delaying travel until your symptoms are back to their normal level.

Acute bronchitis stems from a short-term infection that inflames your mid-sized airways (between the throat and the lungs) temporarily. It may lead to shortness of breath, coughing, a sore throat, headache, nasal congestion, aches and pains, and fatigue. Acute bronchitis usually clears up on its own but increasing fluid intake and getting lots of rest is advised to aid recovery. However, while you’re acutely unwell with fever and severe cough, you’re likely to be unfit to fly.

Can I fly with pneumonia?

Pneumonia is a type of lung infection. As well as shortness of breath and strenuous coughing, you’re likely to experience fever and chills. It can be a difficult condition to recover from. Your doctor may prescribe medication such as antibiotics to treat the infection, with the recommendation to rest to promote a speedy and full recovery.

Pneumonia can be caused by a viral or bacterial infection. Viral pneumonia tends to be less severe than bacterial. However, bacterial infection can be treated with antibiotics, and once you’ve been taking them for a couple of days, you’re no longer infectious. Because antibiotics are useless against viruses, you’re likely to be infectious for much longer.

As a rule, doctors don’t recommend that you fly with pneumonia. They will certainly not recommend that you embark on a holiday while you’re suffering from it. It’s essential that you check with a doctor before you fly – if you need to return from abroad while recovering from pneumonia, you may need special equipment such as oxygen, and trained medical staff to hand.

Cancelling your trip

If you’ve booked a holiday abroad, but when the time comes to fly you feel unwell, you may worry about cancelling your plans and feel tempted to persevere with the flight.

Arranging travel insurance in advance of your trip will offer protection if you are too unwell to make the flight. If your chest infection or flu affects your ability to fly leaving you to cancel your holiday, you can make a claim on the cancellation cover included in your travel insurance policy. Do remember that your insurance company is likely to seek confirmation from your GP – so let them know beforehand that you are not able to travel and why.

If you decide to travel despite your chest infection, cold, or flu symptoms, you can arrange specialist cover for any pre-existing conditions to ensure you and your getaway are fully protected.

Specialist travel insurance will allow you to claim for any medical intervention or treatment you might need when you’re abroad in relation to any medical conditions you’ve declared before your holiday.

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Frequently Asked Questions

A pre-existing condition is a diagnosed medical condition that existed before taking out a policy. We'll ask a series of questions about the medical history for you and any travellers on your quote. If you answer yes to any of these, you will need to tell us about the traveller's conditions. This could be a condition that a traveller has now, or has had in the past. If you are not sure what conditions you need to declare, we have online support available to help you 24/7!
It's really simple and quick to do! After you've told us about your trip details and answered some medical history questions you can add your pre-existing conditions, one by one, for each traveller. You'll only need to enter your details once, it's all online and there's no need to call, or provide details of your conditions in writing.
Once you've declared all of your relevant pre-existing medical conditions we'll only show you quotes based on the conditions you have told us about.
No, we are unable to provide cover with any of your pre-existing medical conditions excluded.
If you are taking out single trip cover, and have cancellation cover included, you'll be covered for cancellation from the moment you buy your policy. However, if you are taking out annual trip cover, and have cancellation cover included, you'll be covered from the start date of your policy. Consider starting your annual trip cover as soon as possible, especially if you have already booked your trip!
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