Influenza outbreaks in travel groups

Last updated: 06 June 2008

What is influenza?

• Influenza, commonly called the "flu", is a respiratory illness caused by the influenza virus
• The virus is spread from person to person through droplets after an infected person coughs or sneezes, or through touching (for example when a person shakes hands with another)
• Symptoms of influenza include fever, cough, sore throat, tiredness, and aches and pains
• Most people with influenza get better within a week
• Elderly people and people with underlying medical conditions are at increased risk of severe disease and complications
• Seasonal influenza affects 10-30% of the community each winter and outbreaks are common
• In groups of people travelling together, for example on a bus trip, outbreaks of influenza can spread rapidly and be very disruptive.

What can I do before the trip to help prevent flu?

• Get an influenza vaccination from your doctor at least 2 weeks before departure
• Buy an alcohol based hand rub and tissues for the trip
• You should NOT travel if you are unwell. This will allow you to rest and prevent the infection from spreading to the rest of the group. Check with your doctor if you are not sure.

What should I do while on the trip?

• Wash your hands regularly with soap and running water for at least 10 seconds: after coughing or blowing your nose, after using the toilet, before eating and before and after touching other people
• If water is not accessible, use the alcohol based hand rub to clean your hands. As alcohol based rubs are not effective for cleaning visibly dirty hands, hands should be washed with soap and running water at the first opportunity
• If you become unwell with flu like symptoms while travelling:
• Tell the group leader
• Seek medical advice
• Cover your coughs and sneezes with a tissue, dispose of the tissue immediately, and clean your hands regularly
• It may be best to leave the group and rest until you are better. This may speed your recovery and stop the infection spreading to others in the group
• If you continue with the group you will need to separate yourself from others (stay at least 1 metre away) at all times, and not participate in group activities such as trips to public venues
• If you are unable to separate yourself, you should wear a surgical mask
• If there is an outbreak of influenza in the travel group, and you are at high risk for complications from influenza (for example, if you are aged 65 years or older, have a weakened immune system, or have a chronic heart, lung or other medical conditions such as diabetes) you should consider leaving the group until the outbreak is over and seek medical advice in regards to taking preventive medication.

What should the group leader do if there is an outbreak of influenza?

Where an outbreak of influenza is suspected, the group leader should:

• Seek medical advice for those who are unwell
• Ensure that all members of the group are aware of what to do
• Monitor the group for new cases (a person with fever and either cough or shortness of breath)
• Make sure there is an adequate supply of alcohol based hand rub available to everyone in the group, and surgical masks for those who are sick and can't be isolated (these can be purchased at pharmacies)
• Reinforce the importance of regular hand cleaning, and of covering coughs and sneezes
• Provide enough tissues for everyone and disposal bins or plastic bags
• Where the group involves school children, ensure that parents and relevant education authorities are notified
• Call the local public health unit for advice.

People with influenza should avoid travelling on public transport, including airplanes, trains and buses. This is to protect other passengers from infection.

What about anti-influenza medicine?

• Anti-influenza medications can be used to treat or prevent influenza. They are generally safe but may not be suitable for everyone. Side effects can occur, most commonly nausea and vomiting.
• During an influenza outbreak in a travelling group, the use of anti-influenza medicines to prevent illness is not routinely recommended, except for people at high risk of complications.