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Dealing with Germs and Epidemics When You Travel

Man with luggage and airplane, dealing with travel germs, image
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These days we can travel faster than ever before—and so can whatever germs we're toting.

On April 1, an American Airlines flight from Tokyo landed at San Jose International Airport—and was greeted by ambulances, fire engines, and emergency response workers. Five passengers were suspected carriers of the virus SARS, a lethal new respiratory illness for which there is no effective treatment. The other passengers voluntarily quarantined themselves.

It turned out to be a false alarm. But the incident spoke volumes about the widespread paranoia over the SARS epidemic last spring. Severe acute respiratory syndrome emerged in southern China and, with alarming speed, winged its way along air routes to 28 other countries, including the United States. The disease progresses from fever and coughing to pneumonia and is typically spread by close contact with someone who's infected. And, for a time, fear was rampant: Travel to Asia plummeted and people shunned the Chinatowns of San Francisco and New York.

SARS was scary because it was a new threat caused by an unknown virus. But the crisis was just a speeded-up modern version of an ancient tale. Throughout history, traders, pilgrims, explorers, and soldiers have helped conquer fresh territory not only for God, gold, and glory, but also for germs—the most opportunistic travelers of all.

In the 1300s, the plague swept from Asia to Europe via overland trade routes and merchant vessels sailing from the Black Sea to Italy. The scourge was transmitted by fleas that lived on stowaway rats; it wiped out a third of all Europeans.

Then, starting in the 15th century, Columbus and other explorers imported smallpox, malaria, and yellow fever to the New World. The diseases eradicated a substantial portion of the native population.

And in one of the worst epidemics ever, a virulent flu raged around the planet with the unwitting help of the soldiers fighting World War I. The 1918 flu killed 30 million to 50 million people.

These days we can travel faster than ever before—and so can whatever germs we're toting. We can hop on a jet and reach nearly any destination within 36 hours, which means we live in a global village where diseases know no bounds. Take the AIDS epidemic: HIV originated in African apes, jumped to humans, then spread to every remote corner of the world in just a few decades, says Mary Wilson, an infectious diseases specialist at Harvard Medical School. More than 60 million people have been infected with the virus so far.

By mid-June, the SARS epidemic was subsiding, after killing over 800 people and sickening thousands. The United States tallied 421 probable or suspected cases; the highest numbers were in New York state, Washington state, and California. While experts worry that SARS might reemerge during the winter flu season, making it tricky to distinguish the new illness from influenza, for now the disease seems to be under control. No need to cancel travel plans out of fear of this bug. More-over, the best way to stay healthy isn't xenophobia and a surgical mask, but good hygiene. "If you wash your hands, you've taken a huge step toward protecting yourself not just from SARS, but also from influenza and the common cold," says Karen Smith, an infectious diseases specialist with California's Santa Clara County health department, who responded to the San Jose scare. Most respiratory pathogens spread when someone coughs or sneezes out droplets that are later picked up from contaminated surfaces.

If you're planning a trip, you can keep up with the SARS situation by visiting the CDC at To learn about other health issues, visit the Travelers' Health Web site at

Photography by William Duke

This article was first published in September 2003. Some facts may have aged gracelessly. Please call ahead to verify information.