Airline operating realities and the global spread of infectious diseases.

The advent of long-haul travel in the past 10 years has considerably reduced the time of potential disease spread from one side of the world to the other. The implication for travelers is that they may unwittingly be in the prodromal phase of influenza and become symptomatic a few days after travel. Alternatively they may knowingly travel with an infectious disease by masking symptoms. This article outlines the myths that have abounded about the cabin environment being "unclean" and discusses the low likelihood of in-flight transmission with effective air-conditioning and filtration systems. The 2009 H1N1 pandemic highlighted the operational challenges of dealing with infectious disease, including the need for accurate passenger information to allow contact tracing, in contrast to futile measures such as thermal scanners. Containment attempts did not stop the rapid global spread of H1N1 influenza.