Travel: Planes, Trains, and Germs (cont.)

"Norovirus is not tracked in the normal public. But cruise ships are required to report to us, so anyone who visits the medical center on a ship, the doctor or nurse will report all cases to us," Beaumier tells WebMD.

So how do you protect yourself from norovirus infection? Beaumier's main advice is going to sound familiar.

"One main thing is to wash your hands before eating, smoking, touching your face, or going to the bathroom -- and using hand sanitizers in conjunction with hand washing," she says. "Other things you can do is if you see someone get sick, with vomiting or diarrhea, you should leave the area because you could get sick from contaminated air. If you see someone with diarrhea in the bathroom, you should leave and notify the ship staff."

You can actually see up-to-date health reports on all ships sailing from U.S. ports -- and a list of all ships getting a perfect score -- at the CDC's vessel sanitation program web site.

Down in the Train, the Germs' Domain

Maybe, after thinking about airplanes and ships, you've decided to postpone your vacation and go back to work. And maybe you'll be taking the subway. That's how occupational health and safety specialist Robyn Gershon, DrPh, gets to work at Columbia University's Mailman School of Public Health in New York City.

Gershon didn't start out looking at germs. She got interested in subways when she heard reports of hearing loss among transit workers. While studying the issue, she decided to look at other subway health issues. What she found was ... not much. It turns out there's very little scientific information on infectious disease in the subways.

"Subway systems are big public-use spaces," Gershon tells WebMD. "There are 14 big U.S. subway systems and millions and millions of riders. For any number of reasons, there are health hazards. But there is this huge volume of people, and we are not studying it."

When Gershon turned her attention to infectious disease spread on subway systems, she found "not one scientific paper at all."

"You can imagine because of all the surfaces, all kinds of organisms can be transmitted from the hand rails, the head rests, the seats," she says. "It is almost inevitable disease transmission has happened, but it is hard to prove."

Meanwhile, Gershon is taking precautions.

"After riding the subway, I never put anything in my mouth without washing my hands," she says. "I don't touch a thing in my office without going to the sink. The rails and everything are loaded with pathogens. Hand washing is a simple thing, and it is the only thing you can do. I have seen a couple of people wearing face masks, but I wouldn't go that far. Clearly data are needed."

SOURCES: Roy L. DeHart, MD, MPH, senior consultant in occupational and aviation medicine, Vanderbilt University, Nashville, Tenn. Mark A. Gendreau, MD, senior staff physician, department of emergency medicine, Lahey Clinic Medical Center, Burlington, Mass. Lisa Beaumier, public health analyst, vessel sanitation program, CDC. Robyn Gershon, DrPh, occupational health and safety specialist and associate professor, Mailman School of Public Health, Columbia University, New York. Gershon, R.R.M. Journal of Urban Health, March 2005; vol 82: pp 10-20 and 7-9.Mangili, A. and Gendreau, M.A. The Lancet, March 12, 2005; vol 365: pp. 989-996. Ozonoff, D. and Pepper, L. The Lancet, March 12, 2005; vol 365: pp. 917-919. Gendreau, M.A. and DeJohn, C. The New England Journal of Medicine, Dec. 18, 2003; vol 346: pp 1067-1073. U.S. EPA web site. U.S. CDC web site. Olsen, S.J. The New England Journal of Medicine, Dec. 18, 2003; vol 349: pp 2416-2422. DeHart, R.L. Annual Reviews of Public Health, December 2003; vol 24: pp 133-51.

Reviewed on October 01, 2006 © 2004 WebMD, Inc. All rights reserved.


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