air travel medical guidelines

• COVID-19 travel advice

Lower your risk of COVID-19 as you travel for a safe and fun adventure.

Successful travel starts with being prepared for the unexpected. Coronavirus disease 2019, known as COVID-19, is now a part of standard travel planning.

As you choose a destination, travel group or event, add COVID-19 to the list of things to research. When packing for yourself or anyone you're caring for on the trip, consider COVID-19 prevention and testing.

No one wants to plan for the worst. But having a plan in case you catch the COVID-19 virus while traveling can save time if you need medical care.

To start, it can help to ask these basic questions as you make plans.

Am I up to date with my COVID-19 vaccine?

Staying up to date on your COVID-19 vaccine helps prevent serious illness, the need for hospital care and death due to COVID-19 .

If you need a vaccine, plan to get it at least a few weeks before you travel. Protection from the vaccine isn't immediate.

Am I, a travel companion or a person I live with at high risk of serious COVID-19 illness?

Many people with COVID-19 have no symptoms or mild illness. But for older adults and people of any age with certain medical conditions, COVID-19 can lead to the need for care in the hospital or death.

If you or those around you are at high risk of serious COVID-19 illness, take extra safety measures during or after travel.

Ask a healthcare professional if there are any specific actions you should take.

Does my destination, tour group or event need proof that I had a COVID-19 vaccine? Do I need to show proof of a negative COVID-19 test?

The country you travel to may not need to know your COVID-19 status. But you might need the information for other reasons.

Events, venues or tour groups might require proof that you are COVID-19 negative or are up to date on a COVID-19 vaccine. Check before you go so you have all the paperwork you need.

What's the plan if I get COVID-19 on my trip?

No one wants to get sick while traveling. But in case you do, it helps to know where you can get medical care and whether you'll be able to stay apart from others while you have symptoms.

Put together a COVID-19 kit with rapid home tests, masks, a thermometer, disinfectant wipes and hand sanitizer that contains at least 60% alcohol.

Before you leave, gather health information from your healthcare professional. Make sure it gives the details on any health conditions you're managing and medicine you take.

COVID-19 spread during travel

The virus that causes COVID-19 spreads mainly from person to person. When the virus is spreading, spending time indoors with a crowd of people raises your risk of catching it. The risk is higher if the indoor space has poor airflow.

The coronavirus is carried by a person's breath.

The virus spreads when a person with COVID-19 breathes, coughs, sneezes, sings or talks. The droplets or particles the infected person breathes out could possibly be breathed in by other people if they are close together or in areas with low airflow.

The virus carried by a person's breath can land directly on the face of a nearby person, after a sneeze or cough, for example. And people may touch a surface that has respiratory droplets and then touch their faces with hands that have the coronavirus on them.

Clean hands

While you travel, one way to lower your risk of COVID-19 is to clean your hands often.

Wash your hands after using the bathroom, before making food or eating, and after coughing, sneezing or blowing your nose. If you touch something that others regularly touch, such as an elevator button or a handrail, make sure to clean your hands afterward.

Also, try to avoid touching your eyes, nose or mouth.

Wearing a face mask is another way to lower your risk of COVID-19 .

Travel brings people together from areas where viruses may be spreading at higher levels. Masks can help slow the spread of respiratory viruses in general, including the COVID-19 virus.

Masks help the most in places with low airflow and where you are in close contact with other people. Also, masks can help if viruses are spreading at high levels in the places you travel to or through.

Masking is especially important if you or a companion have a high risk of serious COVID-19 illness. Choose the most protective mask that fits well and is comfortable.

Get the COVID-19 vaccine

As the virus that causes COVID-19 changes, COVID-19 vaccines are updated, so stay up to date with the recommended shots.

Know when the COVID-19 virus is spreading in your area

Check with health agencies in the area to see where the COVID-19 virus is spreading. Information about the spread of the virus may include the number of people in the hospital with COVID-19 or the number of people who test positive for the disease.

Keep some space around you

Choose outdoor activities and keep some distance between yourself and others. Poor airflow plus lots of people crowded together equals a higher chance you'll come in contact with the virus that causes COVID-19 .

If you can, try to avoid spending time with people who have COVID-19 symptoms or who are sick.

There will likely be times during travel when you don't have a choice about how close you are to others. Here are some tips for air travel, public transportation and lodging.

The risk of catching the virus that causes COVID-19 from air travel is thought to be low.

Air in the plane's cabin changes over quickly during the flight, being replaced every few minutes in some planes. Airplane air also is often filtered. So germs, including viruses, are trapped before they spread.

The air flowing down from vents above the seats in each row may help keep germs from spreading. Seats also may act as a barrier to germ spread on a plane, unless the person who is ill is sitting close to you.

You can help lower your risk by spreading out to keep distance between you and others when you can and cleaning your hands regularly.

Wearing a mask in crowded areas, such as security lines and bathrooms, can help protect you from COVID-19 and other respiratory illnesses.

Trains, buses and cars

Trains and buses may have good airflow and air filtering. But check before you travel so you know what to expect. When a vehicle is crowded, wear a face mask and take other steps, such as cleaning your hands.

Taxis and private cars used for ride-sharing may not have air filtering. But in most cases, rolling down a window could be an option to improve airflow.

Rental car companies may post their cleaning policies on the internet, or you can ask directly when you book the vehicle.

Hotels and other lodging

Cleaning protocols at hotels, vacation rentals and other lodging have largely returned to the way they were before the COVID-19 pandemic. If you have questions about how hosts or businesses protect guests, contact them directly. In public areas of hotels, take steps to lower your risk of catching the virus that causes COVID-19 .

Put safety first

Despite your planning, an illness may delay or cancel your trip. Stay home if you or anyone you're traveling with has:

• Symptoms of COVID-19 , such as fever or new loss of taste or smell.
• Taken a COVID-19 test and is waiting for results.
• Been diagnosed with COVID-19 .

Keep watch for serious symptoms of COVID-19 , such as trouble breathing or chest pain. If you or a person you're taking care of has symptoms that worry you, get help.

Once the fever is gone and symptoms are getting better, you may choose to travel. But for about five days after feeling better, you could still give others the virus that causes COVID-19 . Take extra actions to protect the people around you.

• Wear a mask.
• Keep your distance from others, especially when indoors.
• Clean your hands regularly.
• Keep the air flowing by turning on fans or opening windows when you can.

If you start to feel worse or your fever comes back, avoid being around others again until you feel better.

Stay flexible

With COVID-19 vaccinations, testing and treatment, events and travel are back to typical levels in many places. But as waves of COVID-19 outbreaks happen, it's important to stay flexible with your plans. Knowing whether the COVID-19 virus is spreading in your area or in places where you're traveling can help you make decisions about whether to go and what to put on your agenda.

• Stay up to date with COVID-19 vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Accessed May 15, 2024.
• Understanding how COVID-19 vaccines work. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html. Accessed May 15, 2024.
• People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed May 15, 2024.
• Coronavirus disease (COVID-19): Travel advice for the general public. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-travel-advice-for-the-general-public. Accessed May 15, 2024.
• Centers for Disease Control and Prevention. COVID-19. In: CDC Yellow Book 2024. https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/covid-19. Accessed May 15, 2024.
• Centers for Disease Control and Prevention. Obtaining health care abroad. In: CDC Yellow Book 2024. https://wwwnc.cdc.gov/travel/yellowbook/2024/health-care-abroad/health-care-abroad. Accessed May 15, 2024.
• Goldman L, et al., eds. COVID-19: Epidemiology, clinical manifestations, diagnosis, community prevention, and prognosis. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed May 16, 202.
• Taking steps for cleaner air for respiratory virus prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/air-quality.html. Accessed May 16, 2024.
• How COVID-19 spreads. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html. Accessed May 16, 2024.
• COVID-19 overview and infection prevention and control priorities in non-U.S. healthcare settings. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/overview/index.html. Accessed May 16, 2024.
• Hygiene and respiratory viruses prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/hygiene.html. Accessed May 14, 2024.
• About handwashing. Centers for Disease Control and Prevention. https://www.cdc.gov/clean-hands/about/index.html. Accessed May 16, 2024.
• Masking during travel. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/page/masks. Accessed May 16, 2024.
• Masks and respiratory virus prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/masks.html. Accessed May 16, 2024.
• How to protect yourself and others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed May 16, 2024.
• About physical distancing and respiratory viruses. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/physical-distancing.html. Accessed May 16, 2024.
• How can ventilation reduce the risk of contracting COVID-19 on airplanes? World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-travel-advice-for-the-general-public. Accessed May 16, 2024.
• Bielecki M, et al. Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review. Travel Medicine and Infectious Disease. 2021; doi:10.1016/j.tmaid.2020.101915.
• Symptoms of COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Accessed May 16, 2024.
• Preventing spread of respiratory viruses when you're sick. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/precautions-when-sick.html. Accessed May 16, 2024.

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INTRODUCTION

It is estimated that over one billion passengers travel by air each year [ 1-3 ]. Although up to 5 percent of passengers have some form of disability or chronic medical illness, in-flight emergencies are infrequent [ 4 ]. Only one of every 39,000 passengers (0.003 percent) experiences an in-flight medical problem serious enough to come to the attention of emergency personnel [ 5,6 ]. Death during commercial flight is even rarer. During the year July 1998 to July 1999, the Federal Aviation Administration (FAA) collected medical events data, and 43 deaths occurred in-flight out of 600 million passengers [ 7 ].

The incidence, pathogenesis, and management of in-flight and previous pneumothorax/pneumomediastinum (PTX/PMD) will be reviewed here. Pre-flight medical assessment, the prevention of in-flight hypoxemia in patients with underlying lung disease, and the management of spontaneous PTX are discussed separately. (See "Assessment of adult patients for air travel" and "Evaluation of patients for supplemental oxygen during air travel" and "Treatment of secondary spontaneous pneumothorax in adults" and "Thoracostomy tubes and catheters: Indications and tube selection in adults and children" and "Treatment of primary spontaneous pneumothorax in adults" and "Pneumothorax: Definitive management and prevention of recurrence" .)

The exact incidence of pneumothorax/pneumomediastinum (PTX/PMD) during commercial air travel is unknown due to non-standardized reporting requirements for in-flight medical emergencies, difficulty in making an in-flight diagnosis, and possible delay in symptoms [ 8 ]. Anecdotal reports of in-flight pneumothoraces have been published [ 9-11 ]. However, in-flight PTX must be rare, because it is not mentioned in most reports addressing in-flight emergencies [ 5,6,12-14 ].

A few reports have described the experience of individuals at high risk for pulmonary complications during air travel [ 15-17 ]:

● In a series of 1115 passengers referred to an airline medical advisory service for pre-flight evaluation, 704 had chronic obstructive pulmonary disease (COPD) or another pulmonary disorder [ 15 ]. Over 90 percent were "cleared" for transport. None of those cleared for air travel was known to have experienced a significant in-flight medical problem.

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What to Know About the C.D.C. Guidelines on Vaccinated Travel

In updated recommendations, the federal health agency said both domestic and international travel was low risk for fully vaccinated Americans. But travel remains far from simple.

• Share full article

By Ceylan Yeginsu

The Centers for Disease Control and Prevention updated its guidance for fully vaccinated Americans in April, saying that traveling both domestically and internationally was low risk.

The long-awaited recommendations were issued by federal health officials after a series of studies found that vaccines administered in the United States were robustly effective in preventing infections in real-life conditions.

One is considered fully vaccinated two weeks after receiving the single dose of the Johnson & Johnson vaccine, or two weeks after receiving the second dose of the Pfizer-BioNTech or Moderna shots.

If you decide to travel, you might still have some questions. Here are the answers.

Will I still need to wear a mask and socially distance while traveling?

Yes. Under federal law, masks must be worn at airports in the United States, onboard domestic flights and in all transport hubs. The C.D.C. says that as long as coronavirus measures are taken in these scenarios, including mask wearing, fully vaccinated Americans can travel domestically without having to take a test or quarantine, although the agency warns that some states and territories may keep their local travel restrictions and recommendations in place.

For those wishing to travel internationally, a coronavirus test will not be required before departure from the United States unless mandated by the government of their destination. Vaccinated travelers are still required to get tested three days before travel by air into the United States, and are advised to take a test three to five days after their return, but will not need to self-quarantine.

Can I go abroad?

Yes, but only to countries that will have you.

More than half the world’s countries have reopened to tourists from the United States, including the countries of the European Union , which on June 18 added the United States to its “safe list” of countries, meaning that American travelers can now visit. While the European Union aims to take a coordinated approach to travel this summer, member states will be allowed to set their own requirements for travelers from individual countries based on their own epidemiological criteria, which means they may require testing or vaccination.

Some places like Turkey, Croatia and Montenegro had already been welcoming Americans with negative test results. Greece joined that growing list in May, ahead of most European countries, opening to fully vaccinated tourists and other foreigners with a negative test.

Many Caribbean nations have reopened to American tourists, but each has its own coronavirus protocols and entry requirements.

Here’s a full list of countries Americans can currently travel to.

What about domestic travel? Is it free and clear to cross state borders?

If you are fully vaccinated, the C.D.C. says you can travel freely within the United States and that you do not need to get tested, or self-quarantine, before or after traveling. But some states and local governments may choose to keep travel restrictions in place, including testing, quarantine and stay-at-home orders. Hawaii , for instance, still has travel restrictions in place.

Before you travel across state lines, check the current rules at your destination.

How are they going to check that I’m fully vaccinated?

Right now, the best way to prove that you have been vaccinated is to show your vaccine card .

Digital vaccine and health certificates showing that people have been vaccinated or tested are in various stages of development around the world and are expected, eventually, to be widely used to speed up travel.

The subject of “ vaccine passports ” is currently one of the most hotly debated topics within the travel industry, with questions over the equity of their use and concerns over health and data privacy.

In early April, Gov. Ron DeSantis of Florida issued an executive order that would ban local governments and state businesses from requiring proof of vaccination for services.

And in March, the European Union endorsed its own vaccine certificate , which some countries are already using, with more expected to adopt it by July 1.

But what about my kids? What’s the guidance on traveling with unvaccinated people?

The C.D.C. advises people against travel unless they have been vaccinated. If you must travel, the agency recommends testing one to three days before a trip and following all coronavirus guidance at your destination.

In May, the F.D.A. expanded its emergency use authorization of the Pfizer-BioNTech coronavirus vaccine to include adolescents between 12 and 15 years of age.

All air passengers aged two and older coming into the United States, including fully vaccinated people, are required to have a negative Covid-19 test result taken no more than three days before they board their flight.

What is my moral obligation to the places I visit where most people are not vaccinated?

The United States inoculation rollout has been among the fastest in the world, but there is a stark gap between its rapid rollout and the vaccination programs in different countries. Some nations have yet to report a single dose being administered.

Many countries are currently seeing a surge in new cases and are implementing strict coronavirus protocols, including mask mandates in public spaces, capacity limits at restaurants and tourist sites and other lockdown restrictions.

It is important to check coronavirus case rates, measures and medical infrastructure before traveling to your destination and not to let your guard down when you get there. Even though you are fully vaccinated, you may still be able to transmit the disease to local communities who have not yet been inoculated.

You can track coronavirus vaccination rollouts around the world here.

Follow New York Times Travel on Instagram , Twitter and Facebook . And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation.

Ceylan Yeginsu is a London-based reporter. She joined The Times in 2013, and was previously a correspondent in Turkey covering politics, the migrant crisis, the Kurdish conflict, and the rise of Islamic State extremism in Syria and the region. More about Ceylan Yeginsu

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Information on how to stay safe and healthy abroad. About us.

• General Travel Health Advice

Air Travel 

Introduction, airline restrictions on flying.

• Consideration of security measures

Health considerations when flying

Potential in-flight health problems.

Air travel can expose you to a number of factors that can impact your health and well-being.  Although most travellers won't notice any adverse effects to their health during a flight, the effects from flying may present challenges if you have certain underlying health conditions .

The airline you plan to fly with needs to make sure it is medically safe for you to fly, so you might need to tell them about any health condition you have.  Airlines might not let you travel with them:

• if they are concerned that you have a medical condition that might get worse during a flight
• if you have an illness that could infect other passengers

Restrictions and rules can vary between airlines, so if you are in any doubt, you should seek advice from the medical department of the airline. Most airlines have a medical advisory service, details of which can usually be found on their website.

If you think your health might be affected by flying, you should contact your GP or specialist before you book a flight.

Travel by air is not normally advised in the following cases (this list is not exhaustive):

• infants less than 48 hours old (longer after premature births)
• women after the 36th week of pregnancy or 32nd week for multiple pregnancy
• if you suffer from or have had:
• angina or chest pain at rest
• an infectious disease (e.g. chickenpox, flu), including COVID-19
• decompression sickness after diving (sometimes called 'the bends')
• increased pressure in the brain (due to bleeding, injury or infection)
• infection of your ears or sinuses
• recent heart attack
• recent stroke
• recent operation or injury where trapped air or gas may be present in the body (e.g. stomach ,bowel, eyes, face, brain)
• severe long term diseases that affect your breathing
• breathlessness at rest
• unresolved pneumothorax (punctured lung)
• sickle cell anaemia
• unstable mental health or psychotic illness

Consideration of security measures 

Security restrictions on the type of equipment and fluids which can be taken into the aircraft cabin might affect what medical equipment or medication you can bring with you for use during a flight.

• Please see the Travelling with Medicines advice page for further details.

If you have been fitted with any metal devices such as an artificial joint, a pacemaker or internal automatic defibrillator, then you should:

• carry a medical alert letter from your doctor
• alert the security staff that you have a medical device fitted before passing through any screening equipment

High Altitude

High altitude is generally considered to be 2,400 metres (8000 feet) and above. Aircraft cabins are kept at a pressure approximately equivalent to between 1,800 to 2,400 metres; developing symptoms due to high altitude ( altitude sickness ) is not usual during flights for most people. However, if you have a lung or heart condition, you might need to use oxygen during a flight because of the higher altitude.

If you fly in to an airport that is above 2,400 metres, for example in the Andes and Himalayas, you might get signs of altitude sickness. 

• For further information on the effects of altitude, see the Altitude and Travel advice page.

Using oxygen whilst flying

If you have a lung or heart (cardiac) condition, your symptoms might become worse during or after a flight, particularly if you become dehydrated or have over exerted yourself. You may need oxygen during the flight, even if you do not usually need it:

• If you use your own home oxygen, you must still contact the airline in advance to discuss if you are able to use it on the flight.
• You will need to contact your GP or specialist as they may need to provide medical information to the airline.

If you are healthy and your pregnancy has been straightforward, then air travel is generally considered safe. However, some pregnant women with underlying risk factors might be at increased risk of complications such as deep vein thrombosis (DVT) from flying.

• You should get advice from your midwife or obstetrician before booking any flights.

Airlines request a medical certificate from pregnant travellers if travelling after 28 weeks of pregnancy:

• most airlines won't allow air travel after 36 weeks for a single pregnancy, and 32 weeks for multiple pregnancies
• the medical certificate should detail your estimated delivery date and confirm that your pregnancy is uncomplicated and progressing normally

You must ensure you have travel insurance which covers both yourself and your unborn baby (in the event you need to give birth unexpectedly during your trip).

• See the Advice for Pregnant Travellers page for more details.

Flying with a disability

Navigating an airport and flying can at times be stressful, cause anxiety and be physically exhausting.  Many airports offer assistance services for those who have physical or hidden disabilities but these may need to be booked in advance.  Cabin crew are not allowed to assist passengers who are unable to look after their own physical needs (such as using the toilet, assistance with meals or mobility) during a flight.

• It is important that you make the airline aware of any special requirements you may need during the flight as soon as possible.

You should contact your airline well in advance of travel to check what assistance might be available to you for:

• your journey through your departure airport
• boarding the aircraft and during the flight
• disembarking the aircraft
• transferring between flights
• travelling through your destination airport

If you use an electric mobility aid such as an electric scooter or wheelchair, you will need to provide your airline with details of your equipment (such as make, model, size or weight) well in advance of your flight to enable the airline to check they can safely load and stow your equipment and undertake a fire risk of electrical equipment.

• If you use a wheelchair and wish to remain in your own chair to the aircraft door rather than transfer to an airline wheelchair at check-in, you should inform your airline of your particular needs as soon as you can.
• Showing airline crew your equipment’s operating manual may be helpful, especially if they have any issues loading, disassembling or reassembling your equipment into the aircraft hold.

Infectious Diseases

To reduce the potential risk of passing on infections to others on board an aircraft, you should postpone travel if you are actively unwell, especially if you have a fever, until you have fully recovered.

The quality of aircraft cabin air is carefully controlled and research has shown that there is a very low risk of infectious diseases being transmitted on board. The risk is no different from being sat close to someone on other forms of transport such as a bus or train. When transmission of infection does occur between passengers, usually as a result of a cough or sneeze or by touching surfaces which have been contaminated, they are usually seated in the same area of an aircraft.

An airline can deny boarding of any passenger who looks unwell, especially if they suspect the passenger might be infectious (infect other passengers). 

• If you have recently recovered from an infectious disease, but are still showing physical signs of being unwell, for example crusted spots following chicken pox, then you should carry a letter from a GP confirming that you are no longer infectious.

If someone has already travelled and is then found to have a highly infectious illness (such as measles or mpox ) which could be a potential risk to other passengers, then contact tracing of passengers will be carried out by local public health authorities.

Dehydration

The circulating air inside aircraft cabins is very dry and can affect your skin, lips, nose and eyes. Discomfort can be reduced by using:

• skin moisturisers
• saline nasal sprays
• glasses instead of contact lenses, which may cause irritation

Alcohol and caffeine containing drinks can make you pee more which can lead to dehydration:

• you should try to drink plenty of clear fluids, such as water, during long flights and limit how much alcohol and caffeine you drink

Deep Vein Thrombosis (DVT)

The cramped conditions and long periods of being less active on a flight can cause pain, stiffness or swelling of your legs. Being less active can lead to slow blood flow in your veins which increases your risk of developing a blood clot, known as deep vein thrombosis (DVT). DVTs most commonly form in the legs. Part of the clot may break off and travel to the lungs, causing a pulmonary embolism (PE) which is potentially life threatening.

• See the Deep Vein Thrombosis advice page for further information and advice on reducing your risk of DVT during travel.

Ear nose, throat and dental conditions

It is common to experience a 'popping' sensation in your ears during take-off and landing. This is caused by the air pressure changes that occur during a flight mean that during take-off air moves out of your middle ear and sinuses and during landing it flows back into your sinuses and middle ears.

 If you experience any discomfort, simple measures usually relieve symptoms such as:

• using a pacifier (dummy) in infants (as it mimics swallowing)

If you are suffering from an ear or sinus infection you may experience intense pain during take-off and landing.

• You should discuss this with a doctor prior to flying as it may potentially cause an injury within your ear.

General dental treatment, such as dental fillings, are not usually a contraindication for flying. However, some dental conditions or treatment can result in pockets of trapped gas (for example, unfinished root canal treatment, dental decay or abscesses) which may cause pain and discomfort when flying. You should seek advice from your dentist before flying in this instance.

Flying after diving

Flying too soon after diving might lead to you developing complications such as decompression sickness (more commonly called “the bends”). The general rule is to avoid flying until 12 -24 hours after your last dive. If in any doubt, you should seek specialist advice from your diving school before flying.

Jet lag is the term used for when your normal sleep pattern is disrupted due to crossing multiple time zones.

Jet lag can cause:

• difficulty sleeping at night
• wanting to sleep during the day
• difficulties in concentration and remembering things
• changes to your mood
• changes to your appetite
• nausea (feeling sick), indigestion and constipation

Effects of jet lag gradually wear off as your body adapts to the new time zone.

To minimise the effects of jet lag, you can consider the following measures:

• Try to begin adjusting your body to the new time few days before travel by going to bed 1 to 2 hours later if travelling westward, or earlier if travelling eastward.
• Change your sleep schedule to your new time zone as soon as possible after arrival.
• If you take medication that needs to be taken at a specific time (for example antibiotics or insulin), you should speak to your GP or specialist to plan an altered schedule for taking your medication which takes time zone differences into consideration.
• On long haul flights, you should:
• stretch and walk in the cabin when you can
• drink plenty of water
• avoid excess alcohol or caffeine
• try to sleep on the plane during an overnight flight
• Once at your destination:
• spend plenty of time outdoors in the natural daylight
• try to eat meals and go to bed according to local times
• If you are tired during the day, try taking a short nap (approximately 20-30 minutes) as this is unlikely to affect your ability to sleep at night.
• Avoid heavy commitments on the first day after travelling:
• be prepared for tiredness in the evenings and early waking, which can last up to 5 days or more

Motion sickness

It is uncommon to experience motion sickness during flying unless there is severe turbulence. If you are known to suffer from motion sickness in flight, you should:

• choose a seat in the mid-section of the aircraft
• keep motion sickness bags nearby
• avoid alcohol during and for 24 hours before a flight
• discuss with your GP medications to manage your symptoms if they can be severe

Fear of Flying

Fear of flying is a common phobia to have.  If you suffer from fear of flying, the following tips might be useful:

• A visit to your doctor prior to travel can provide you with reassurance about your general fitness for air travel:
• in severe cases, your doctor may be able to refer you for cognitive behavioural therapy in order to learn different ways to overcome your fears
• Tell the cabin crew:
• reassurance about routine aircraft sounds and inflight activities can help reassure you
• On a flight, try distracting yourself by talking with other passengers, watching a film, listening to music or reading.

A number of airlines run courses aimed at alleviating fear of flying. Some of these are listed here:

• British Airways Flying with Confidence
• Virgin Atlantic Flying without Fear
• Easyjet Fearless Flyer

This term is used to describe threatening behaviour or violence occurring on an aircraft, usually provoked or worsened by stress and frustration.  Airlines will, when necessary, divert aircraft to offload disruptive passengers and legal action taken against those involved.

Minimising the triggers causing air rage involves:

• avoiding excess alcohol and substance misuse
• remaining calm when dealing with stressful situation such as crowding, delays and lack of information
• using nicotine gum or patches to avoid the agitation of nicotine withdrawal when smoking is not allowed in airport buildings and during the flight

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• Disease Prevention Advice

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Passenger Health and Safety Specific Medical Topics

• In-Flight Radiation Exposure During Pregnancy
• Management of In-flight Medical Emergencies
• Quarantine Stations
• SARS  Guidance for Travelers
• H1N1 Influenza (Swine Flu)
• Surgical and Medical Emergencies on Board European Aircraft: A Retrospective Study of 10189 Cases   ( PDF )
• Deep Vein Thrombosis and Travel   ( PDF )
• Venous Thromboembolic Disease: Risk for Passengers and Aircrew?
• Adriene Rodriguez v. Ansett Australia Ltd. & Air New Zealand Ltd.   ( PDF )
• Michael Shawn Blansett v. Continental Airlines, Inc.   ( PDF )
• Milton B. Witty, III v. Delta Air Lines, Inc.   ( PDF )
• The End of the Economy Class Syndrome   ( PDF )
• Air Travel and Venous Thromboembolism   ( PDF )
• Investigations into  USA  air passenger with  XDR-TB
• Tuberculosis and Air Travel: Guidelines for Prevention and Control, 2008

AsMA Medical Guidelines for Air Travel: Airline Special Services

• PMID: 26102149
• DOI: 10.3357/AMHP.4224.2015

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Treating physicians should advise patients in need of special services to contact the airline well before travel to find out if the required services will be available. Ensuring the required services are available throughout a journey can be challenging, especially when different airlines and aircraft types are involved. For example, airlines carry a limited supply of oxygen for use in the event of an unexpected in-flight emergency; however, this supply is not intended for use by passengers needing supplemental oxygen. Arrangements must be made in advance with the airline. Therefore, early contact with the airline is helpful.

• Aerospace Medicine / methods*
• Aerospace Medicine / standards*
• Air Travel*
• Aircraft / standards*
• Guidelines as Topic
• Oxygen Inhalation Therapy
• Travel Medicine / standards*