Respiratory Hygiene and Infections

• Introduction
• Recommendations
• Vaccination
• The Illnesses
• Treatment

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.  Examples include:

• the common cold
• sore throat
• sinusitis.

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

• bronchitis
• pneumonia.

Respiratory symptoms can occur without the presence of infection. These may be due to environmental factors, for example prolonged periods spent in aircraft cabins where the air is dry, or as a result of exposure to allergens (such as pollen) or air pollution.

Recommendations for Travellers

All travellers, whatever the destination, are potentially at risk of developing RTIs. The risk of infection is increased wherever 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.

If you are prone to developing chest infections (for example if you have a condition such as asthma or chronic obstructive pulmonary disease) then you should discuss your travel plans with your doctor or nurse before travel to ensure that your condition is stable. They can advise which medications to carry with you and when to seek help if your condition worsens whilst you are away.

You must 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.

Respiratory Hygiene

Reduce your risk of catching RTIs

• Maintain good hand hygiene at all times:
  • 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 eyes, nose and mouth with unwashed hands.
• Regularly clean and disinfect all frequently touched items such as your personal items, passport, mobile phones.
• Avoid close contact with anyone else who is suffering from a respiratory illness where possible and avoid sharing any of their personal items such as towels or mobile phones.

Reducing your risk of spreading RTIs

• Maintain hand hygiene (as above) even if you have no symptoms
• 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.
• If you develop an acute respiratory illness (upper or lower) during travel you should:
  • stay indoors and avoid contact with others to minimise spread of infection
  • seek medical attention if you become unwell, feverish or if your symptoms become severe
  • contact your travel insurance company for assistance with issues such as medical expenses for local medical care or postponement of travel due to illness.

Vaccination

There are no available vaccines that protect against all RTIs. However, there are vaccines available that protect against some specific RTIs, for example flu (influenza), COVID-19 and pneumococcal pneumonia vaccines.

These are recommended in the UK for certain people who fall into high risk groups. Your GP or nurse can advise if you are in a risk group. If these vaccines are recommended, you should make sure you have them before travelling.

• Practising good respiratory hygiene helps protect you from infection.
• Further information on vaccine eligibility can be found on: NHS inform (Scotland) or NHS UK (Rest of UK)

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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