web Musings of The Global Traveller

Monday, April 27, 2009

Swine Flu and Travel

Travellers are affecting by major disease outbreaks in several ways, and not just through contracting the disease themselves.

  1. Exposure to the disease (currently swine flu but previously avian flu, SARS, etc).
  2. Denied boarding.
  3. Closed borders.
  4. Quarantine.
  5. Aftermath (travel bargains).

1. Exposure to disease

The nature of travel means that travellers are generally more exposed to influenza-based diseases than the general public. However this greater exposure doesn't necessarily mean high exposure. For example at time of writing the World Health Organisation (WHO) reports 73 confirmed cases of swine flu (H1N1), with almost all confirmed cases being from Mexico and USA. While the number of actual cases is undoubtedly much higher, it is still a very small number compared to the number of people currently with regular influenza. The odds are extremely good that the person coughing or sneezing on the train, plane or bus does not have swine flu.

Travellers should keep themselves informed of public health warnings. For some travellers, in some countries, there may be language barriers to being informed through the media (and local media suppression is an issue in some countries). However WHO is a good source of detailed information (and Centre for Disease Control or CDC a good backup in USA and neighbouring countries).

2. Denied boarding

All airlines have the right to deny travel to passengers who present symptoms of an infectious disease, or to require medical certification of suitability of travel. In practice, most of the time you need to be seriously unwell to be denied boarding. We've all been on flights were someone nearby appears to be fairly sick. Indeed, just a week ago I developed a head cold while travelling.

At time there are public health alerts airlines may take a stronger line, and those with normal sniffles may be denied boarding or requested to have a check up. I haven't yet seen reports of this happening with swine flu, but it is only a matter of time.

If you are moderately unwell and really need to fly it may be worth a pre-emptive medical check to certify that you are okay to travel, especially if you are flying from an area deemed at moderate or higher risk (bearing in mind this can rapidly change from day to day or even hour to hour). If you don't need to fly consider deferring your travel.

3. Closed borders

A more extreme case of denied boarding is when a country or region closes its borders and prohibits travel across it. In today's connected society this is unlikely except in the event of full blown pandemic. However, it is in WHO and many countries' risk management plans for dealing with pandemics. Accordingly, travellers should be aware of the possibility of being stuck inside a high risk area, or being prevented from returning home, at least for a period. In theory travel insurance may cover this, however in the event of a bad pandemic with widespread & lengthy border closures I am sceptical. This is a very low risk but potentially high impact event. Most likely if it occurs travellers who are away from home at the time may have to throw themselves on the mercy of local authorities and charities for assistance, if they are unable to support themselves.

4. Quarantine

A traveller who is on a flight with a suspected case of highly infectious disease may find themselves placed under quarantine on arrival. Also some airports screen all arriving passengers and may detain those with symptoms (such as a temperature) - Hong Kong, Seoul and Tokyo spring to mind from my recent travels. At the minimum a quarantine is likely to be as long as required to be cleared by test results (assuming they come back negative), namely a few days, but could be longer if the test return is positive or there is a backlog in testing.

My suggestion is, where possible, try to avoid international flights which arrive on or immediately before any important events. It wouldn't be nice to have a last minute deferrment of a wedding for example, or to miss it.

5. Aftermath

When public health authorities warn against travel to certain (or all) areas, it is natural that travel loads fall. When SARS happened many intra-Asian flights were very nearly empty and others cancelled. Airlines and hotels that are already struggling with the financial recession may be hit hard by disease-induced drop in travel.

I'd expect more flight cancellations, more flight and hotel bargains (especially hotels - you can't cancel a hotel room like you can cancel a flight!) and incentives (bonus miles, free nights, etc). Obviously some areas will be affected more than others. With swine flu (and other influenza-based diseases) it is more likely to affect airlines and hotels that depend on international passengers/visitors, and especially areas with the most reported cases.


I am not qualified in medical advice. However, at this stage I have not changed any of my travel plans and nor do I expect to in the short term. Instead I am reminding myself of the above advice, reviewing updated information and being aware of options.

Safe travels and happy bargain hunting.

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