Health Watch: Flu, Flying, and What Pilots Need to Know

By ALPA Staff

This season’s flu outbreak has repeatedly made front-page news as more and more cases, hospitalizations, and deaths from influenza infections have occurred. The U.S. Centers for Disease Control and Prevention (CDC) announced that 49 out of 50 states have recently experienced “widespread” flu activity. The Public Health Agency of Canada reported that there were more than 15,500 laboratory-confirmed cases in early January.

A respiratory illness caused by viruses that infect the nose, throat, and lungs, the flu can induce mild to severe illness and in extreme cases can lead to death. Symptoms of this sickness include fever, chills, muscle aches, cough, congestion, runny nose, headaches, and general fatigue. In addition, it’s easy to develop complications that can be life-threatening. A flu virus can inflame the lungs, making it easier to develop a bacterial infection, which can lead to pneumonia.

The flu is highly contagious, which should be of concern since pilots spend extended periods transitioning through public areas like airports and in confined spaces with others.

Although there are multiple kinds of flu, the dominant strain in both Canada and the United States this season has been H3N2, a known variety of Influenza A. The particular problem with H3N2 is that it’s prone to mutation. Consequently, health-care professionals have acknowledged that the vaccine developed to prevent it appears to protect recipients only about 33 percent of the time.

Regardless, the CDC, the Public Health Agency of Canada, and other health organizations recommend getting a flu shot, noting that some protection against H3N2 is better than none. The vaccine can help lessen the symptoms and offers a strong defense against other flu strains in circulation, including H1N1 (another subtype of Influenza A).

If you catch the virus, keep in mind that there are medications than can help. Antiviral drugs that help defend against the flu include FDA-approved oseltamivir (Tamiflu®), zanamivir (Relenza®), and peramivir (Rapivab®). However, these remedies require prescriptions, which should raise a red flag.

Prescription drugs often affect performance and cognitive abilities, as well as fatigue level. Both the FAA and Transport Canada outline on their websites some, but not all, medications that aren’t acceptable to take when flying. The FAA will allow a pilot to take the three previously mentioned medications and fly, but only after a 48-hour ground-observation period to determine that there are no side effects. The FAA notes, “Airmen who develop short-term, self-limited illnesses are best advised to avoid performing aviation duties while medications are used.”

Keep in mind that some symptom-relief medications may prohibit you from flying, particularly those containing antihistamines, cough suppressants, or alcohol. For prohibited drugs, the general rule is to allow five times the medicine’s dosing interval. For example, for a drug taken every six hours, you should wait at least 30 hours before flying.

It’s wise to consult an aviation medical examiner who can assess your condition, treatment, and any potential side effects to help determine when you can safely fly again. Also take steps to prevent getting sick. Get plenty of rest and drink lots of fluids. Frequently wash hands and use alcohol-based wipes to clean surfaces that will be routinely touched, such as the yoke/side stick, thrust levers, and oxygen masks.

Although this season’s flu is not considered a global pandemic, if you’re flying internationally be aware that large-scale outbreaks have also been declared in Great Britain, Japan, and South Korea.

The Lowdown on Influenza

ALPA members with questions about the flu should call the Aviation Medicine Advisory Service, ALPA’s Aeromedical Office, at 303-341-4435, Monday through Friday, 8:30 a.m. to 4:00 p.m. mountain time or visit Canadian ALPA members can call David Noble, the Association’s pilot health consultant, in the Association’s Toronto, Ont., office toll-free at 1-800-561-9576.

Flu Emergency Checklist

If you have the flu and your condition worsens (i.e., you experience the following symptoms), seek immediate medical attention:

  • Difficulty breathing, shortness of breath.
  • Pain/pressure in the chest or abdomen.
  • Sudden dizziness, confusion.
  • Severe or persistent vomiting.
  • Flu-like symptoms that diminish but later return with fever and a worse cough.

This article was originally published in the March 2018 issue of Air Line Pilot.

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