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Respiratory Hygiene and Infections

Introduction

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 also occur due to environmental factors such as prolonged periods spent in aircraft cabins where the air is dry, or as a result of exposure to allergens or air pollution.

Recommendations for Travellers

All travellers, whatever the destination, are potentially at risk of developing RTIs. Risk of transmission is increased whenever there is crowding of people such as in airports, aircraft cabins or public transport; at mass gatherings; hotels, bars and clubs or on cruise ships. The risk of infection is increased if you have an underlying medical condition such as chronic obstructive pulmonary disease, asthma or any condition affecting your immune system.

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

  • maintaining good hand hygiene at all times by
    • washing your hands thoroughly with soap and water for at least 20 seconds; or by using an alcohol based hand sanitiser containing at least 60% alcohol if soap and water is not immediately available
    • hand hygiene should be performed regularly, particularly after coughing or sneezing; before eating, drinking or preparing food; after going to the toilet; after using public transport and being in any public spaces
  • avoid touching your face, eyes, nose and mouth with unwashed hands
  • clean and disinfect all frequently touched items such as your passport, mobile phones and personal items often
  • cover your nose and mouth with a disposable tissue whenever you are coughing or sneezing and dispose of the tissue in nearest bin immediately after use
    • if you do not have a tissue readily available, you should be cough or sneeze into your elbow
  • wherever possible try to avoid close contact with anyone else who is suffering from a respiratory illness, and avoid sharing any of their personal items such as towels or mobile phones.

If you are prone to developing chest infections (for example if you are a smoker, or have a condition such as asthma or chronic obstructive pulmonary disease) then you should discuss your travel plans with your doctor or nurse before you leave to ensure that your condition is stable; and so that you know what you should do and which medications you may need to carry with you, in the event that your condition becomes worse whilst you are away.

You should also declare any known medical conditions to your travel insurance company to make sure that you are covered in the event that you need to seek medical care abroad.

Vaccination

Vaccinations against some respiratory infections, such as pneumococcal and flu (influenza) are available and are recommended for certain people who fall into a high risk groups in the UK. Your GP or nurse can advise if you fall within a risk group. If these vaccines are recommended, you should make sure you have them before travelling.

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

  • stay indoors and avoid contact with others to minimise spread of infection
  • ensure your nose and mouth are covered with disposable tissues when coughing and sneezing, dispose of used tissues hygienically and wash your hands frequently
  • seek medical attention if you become unwell, feverish or if your symptoms become severe
  • follow the advice of local public health authorities with measures such as self-isolating or postponement of travel
  • if you become unwell during a trip, or before boarding public transport such an aircraft or a bus, you should alert someone as soon as possible (such as cabin steward or seeking local medical advice) and wait until given the ‘all clear’ to continue with your travel.
  • contact your travel insurance for assistance with issues such as medical expenses for local medical care or postponement of travel due to illness.

The Illnesses

URTIs are mostly caused by viruses and may cause:

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

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 symptoms such as:

  • fever
  • sweating and shivering
  • a cough, often productive of green, brown or blood-stained spit
  • chest pain, which gets worse with breathing or coughing
  • shortness of breath, even when resting
  • muscle and joint pain.

Treatment

Treatment will depend on the cause of your RTI:

  • viral RTIs, such as the common cold, usually get better over 1-2 weeks without any treatment. Resting and keeping well hydrated with oral fluids will help and medications from the pharmacy such as paracetamol and decongestants may also ease your symptoms. Antibiotics won't help with viral infections.
  • bacterial RTIs, such as pneumonia, often require antibiotic treatment. Mild illness can often be treated at home with rest and drinking plenty of fluids. Hospital admission may be necessary if you develop any complications or become very unwell.

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