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By Murray Grossan, M.D.
Recent articles, including one in the Journal of the American Medical Association, discussed the problems of catching the common cold among persons who fly on commercial flights. Most airplanes today recirculate the air (wchi somehow saves on fuel). There was a comparison of flights with filtered and unfiltered fresh air which actually showed that there was little observable difference —both found about 20% incidence of common colds among passengers who fly. This 20% is much too high to be an acceptable number. Certain patients of mine refuse to fly at all because on every flight they did catch a cold which often leads to complications. In fact, many of these colds are preventable.
The Primary reason for a cold is failure of the natural defense of the body called the Mucociliary Clearance system. This is the protective system that grabs the virus and bacteria, and moves it by cilia to the stomach where the acids kill the bacteria or virus. Normally these cilia move at 16 pulses per second. They act as oars to move a blanket of thin mucus, where the virus is trapped, out of the nose to the stomach. This prevents the virus from entering the body through the nose. But the key here is thin mucus.
On commercial flights the air is quite dry. This dries the nose. So, even if the cilia do their best, the mucus is still too thick to move. Because it is stagnant, bacteria and viruses can multiply and enter the body. Therefore it is vital to intake adequate fluids during flight. But not alcohol and coffee. What is needed is warm water, preferably a mint tea — and lots of it! Lemon and honey are also good. Warm tea with or without caffeine helps move the cilia. Ice drinks slow the cilia. Since the key here is moisturizing the nose, saline nasal sprays (free of preservatives - see below) and nasal moisturizing gels are helpful.
Taking antihistamines is contraindicated because these tend to dry the nose. Many ordinary medications may be a cause of dryness to the nose. For my patients I find that certain types of nasal moisturizing gels are best. In order for the virus to enter the body it must attach to a protein called ICAM-1. A gel with the appropriate formulation can help to prevent this attachment. The best gels have ingredients which allow the body's natural defense elements — lysozyme, good whiteblood cells, etc., to be able to travel to where they are needed to fight invading organisms in this way. Read the ingredients to see if your gel aids lysozyme action. One must be careful in using moisturizing sprays and gels to avoid various preservatives such as benzalkonium which themselves can irritate the nose to allow for viruses to enter.
Bring your own mint type tea bags. Avoid getting chilled as that will lower your resistance. Avoid undue fatigue. For saline type sprays, use before boarding, and about every two hours during the flight. With gels, use before boarding and about every 3-4 hours during flight. In particular, use twice a day after arrival as this will help fight any infection trying to get a foothold. Don't forget the liquid intake! Some doctors may prescribe an antibiotic ointment that similarly covers the nasal membranes, as an antibiotic kills certain bacteria. The problem here is that they are expensive, and most require the use of fingers or a Q tip to get it positioned, and there is the risk of developing a sensitivity or resistance to the antibiotic. Whatever gel or ointment is used MUST be water soluble, any only water soluble products should be used in the nose. (Petrolium-based or other non-water soluble materials could end up in the lungs, where they could remain permanently, because they aren't water soluble. )
In summary: To prevent getting a common cold while flying:
Aircraft Cabin Air Recirculation and Symptoms of the Common Cold Jessica Nutik Zitter; Peter D. Mazonson; Dave P. Miller; Stephen B. Hulley; John R. Balmes - Journal of the American Medical Association. 2002;288:483-486
Copyright© 2002,2003 Dr. Murray Grossan and Hydro-Med
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