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Respiratory Hygiene and Infections


Respiratory tract infections (RTIs) may affect the upper respiratory tract or the lower respiratory tract. Upper respiratory tract infections (URTIs) may involve the nose, sinuses, or throat, for example:

  • the common cold
  • sore throat
  • sinusitis.

Lower respiratory tract infections (LRTIs) may involve the large airways or lungs, for example:

  • bronchitis
  • pneumonia.

Respiratory symptoms may occur in the absence of infection, for example as a result of dry cabin air in aircraft, or as a result of exposure to allergens and air pollution.

Recommendations for Travellers

All travellers, whatever the destination, are potentially at risk of RTIs. Risk of transmission is increased by crowding, for example in airports, aircraft cabins, hotels, cruise ships, bars and clubs. The risk and severity of infection is increased by pre-existing conditions such as chronic obstructive pulmonary disease, asthma, asplenism and immune-suppression.

You can reduce your risk of acquiring and spreading respiratory infections by practising good respiratory hygiene, such as:

  • avoiding direct hand contact with your eyes, nose and mouth
  • maintaining good hand hygiene;
    • washing hands with soap and water or alcohol hand sanitiser, after coughing or sneezing, after going to the toilet, and prior to eating and drinking
  • wherever possible avoid direct contact with people that have a respiratory illness and avoid using their personal items such as their mobile phone
  • when coughing or sneezing cover your nose and mouth with disposable tissues and disposing of them in nearest waste bin after use.

Those susceptible to chest infections, for example; smokers, asthmatics and those with chronic obstructive pulmonary disease, should discuss travel plans with their doctor or nurse prior to departure to ensure their health is optimised.


Vaccination against some infections, such as pneumococcal and flu (influenza) are available and are recommended for certain risk groups in the UK. Your GP or nurse can advise if you are in a risk group - if it is advisable for you, you should be up-to-date prior to travel.

If you develop an acute respiratory illness during travel you should:

    • ensure your nose and mouth are covered when coughing or sneezing with disposable tissues, dispose of them appropriately and wash your hands
    • seek medical attention if unwell, feverish or if symptoms persist for three weeks or more.

The Illnesses

URTIs are mainly caused by viruses and may cause:

  • cold symptoms such as a sore throat, blocked or runny nose, sneezing and coughing
  • "flu-like" symptoms such as headache, fever and muscle tenderness.

LRTIs such as bronchitis and pneumonia are less common. Most bronchitis cases are caused by viruses, whereas most pneumonia cases are due to bacteria. LRTIs may cause:

  • fever
  • sweats
  • cough, often productive of green, brown or blood-stained spit
  • chest pain
  • shortness of breath
  • muscle tenderness.


Treatment will depend on the cause of your RTI:

  • viral RTIs, such as the common cold usually get better without any treatment over days to weeks. Symptomatic relief such as paracetamol, decongestants and maintenance of oral fluid intake will help. Antibiotics won't help
  • bacterial RTIs, such as pneumonia – often require antibiotic treatment. Hospital admission may be necessary for those that become very unwell.

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