Flu experts counter Biden's travel advice

Apr 30, 2009 (CIDRAP News) – Vice President Joe Biden today told Matt Lauer on NBC's "Today" show that he has advised his family not to fly on airlines or ride subways to avoid exposure to the swine flu virus, a message that goes well beyond the government's current travel advice for Americans to avoid nonessential trips to Mexico.

But shortly after his television interview, his spokeswoman, Elizabeth Alexander, scaled back his remarks, Reuters reported. "The advice he is giving family members is the same advice the administration is giving to all Americans: that they should avoid unnecessary air travel to and from Mexico," she said.

Infectious disease experts are concerned that Biden's comments could confuse and alarm the public about the safety of air travel during the swine flu outbreak. Richard P. Wenzel, MD, Va., past president of the Infectious Diseases Society of America (IDSA), told CIDRAP News that to put the influenza outbreak and air travel issue into perspective, if this were January and the US were in the midst of a widespread seasonal flu epidemic, no one would be talking about avoiding air travel or subways.

"This flu has an exotic name and origin, and diseases with exotic names and origins sometimes create extreme reactions," said Wenzel, who is chair of internal medicine at Virginia Commonwealth University in Richmond. "It creates a fear above and beyond the familiar."

Influenza spreads mostly through large droplets, which would typically spread within a foot or two of an infected traveler, Wenzel said, adding that newer, larger airliners generally recirculate about 50% of the air, which is generally clean and circulates in a laminar (top to bottom), unidirectional pattern.

Wenzel said influenza is always a concern because the disease is linked to about 36,000 deaths a year, but said at this stage of the swine flu outbreak, Biden's comment was an extreme response.

William Schaffner, MD, a flu expert and chair of the Department of Preventive Medicine at Vanderbilt University School of Medicine in Nashville, said, "his [Biden's] expressions of concern were a little generous," but there is no need for Americans to curb their travel to anywhere but Mexico. The public should keep in mind that out of a national population of about 300 million, only just over 100 people in the United States have been sick with the mostly mild swine flu virus, he said.

Airline and subway travelers should take sensible measures such as washing their hands and avoiding people who are coughing or sneezing, he said.

"And if you're the person who's sick, you're the person who should stay home," Schaffner said.

Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, offered similar advice in a news teleconference this morning.

When he was asked whether it is safe to fly, he said, "If you have a fever and flu-like symptoms you should not be getting on an airplane. That is part of being a responsible part of our community; you don't want to put people at risk. I think flying is safe; going on the subway is safe. People should go out and live their lives.

"There are some people who may not be comfortable doing that. But as a public health community we can put in context what the risk is, so that people are doing the things that we know will reduce their risk: the hand-washing, the covering of the cough, the avoiding ill people. And if we look to each other to be responsible and not get on airplanes and places when we are sick, that makes everyone's health safer.
Contributing writer Maryn McKenna contributed to this story.

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