When are you too ill to fly?
You have been looking forward to your Mallorca holiday but, as the long-awaited day is drawing closer, you are not feeling well. Or maybe you have fallen ill on holiday and your return flight is looming. Should you still go ahead with your flight?
➪Am I fit to fly?
➪Can I be denied boarding?
➪Does air travel exacerbate illnesses?
➪What should I do if I am too ill to fly?
➪How soon after an illness can I fly again?
How do I know if I am fit to fly?
Whether or not you are fit to fly when unwell can be a difficult decision, and it depends on several factors, including the nature and severity of your illness. You will need to consider your own comfort and safety as well as the impact you may have on your fellow passengers.
With regards to contagious diseases, do keep in mind that there might be passengers with a weaker immune system on the plane, who could be severely affected by a disease, even if it is only causing relatively mild symptoms for yourself.
Please note
As illnesses can affect people very differently, the advice on this page should be used as general guidance only. If in doubt, you will need to consult with a medical professional and with your airline.
Acute illness
Mild illnesses
Common cold: If you have a mild cold, flying is generally safe, though you might experience discomfort, particularly during take-off and landing due to changes in cabin pressure affecting your sinuses and ears.
Mild flu-like illnesses: Flying with mild flu symptoms is also typically possible, but it’s important to manage your symptoms and consider the risk of spreading the illness to others.
More Serious Conditions
Fever: If you have a fever, it’s usually advisable to avoid flying as it can be a sign of a more serious infection.
Respiratory issues: If you have a respiratory condition, such as bronchitis or pneumonia, flying can exacerbate symptoms. Consult your GP before flying.
Gastrointestinal issues: Diarrhoea or vomiting can be extremely uncomfortable and difficult to manage on a flight. The illness can also be highly infectious and can easily be spread to other passengers. You should delay travel until symptoms have subsided.
Other medical conditions
Recent surgery
If you’ve recently had surgery, particularly abdominal or thoracic, you may be advised to avoid flying for a period of time due to the risk of complications.
Chronic conditions
If you have a chronic condition, such as heart disease or diabetes, ensure it is well-managed and bring the necessary medications. Consult your doctor for advice.
Respiratory conditions like severe asthma or COPD can be exacerbated by the lower oxygen levels and dry air in the cabin. You will need to consult with your doctor and ensure that your condition is well-managed and stable before you decide to fly.
If you have a serious heart condition, such as recent heart surgery or a heart attack, flying can pose significant risks. A medical certificate from your doctor may be required to confirm you are fit to fly.
When Not to Fly
If you have a serious or worsening illness, you should postpone your travel. If your doctor advises against flying, follow their guidance.
Can I be denied boarding?
Yes, that is possible, as airlines do have a duty of care to ensure the safety and well-being of all passengers and crew members. Airline staff at check-in counters and boarding gates are trained to observe passengers for visible signs of illness. If a passenger appears to be significantly unwell, the staff can initiate further assessment and/or deny them boarding.
Reasons why boarding can be denied
Contagious illnesses
If you have a contagious illness such as influenza, measles, chickenpox, or COVID-19, you can be denied boarding to prevent the spread of the infection to other passengers and crew members. Airline staff will be watching out for symptoms like severe coughing, sneezing, skin rashes, or other visible signs of an infectious disease.
Potential medical emergencies
To prevent a medical emergency in the air, you can be denied boarding if airline staff are concerned about in-flight health risks. Crew members will be looking out for symptoms that suggest you may need medical attention during the flight, such as chest pain, severe shortness of breath, or uncontrolled bleeding.
Recent surgery
If you have recently undergone major surgery, particularly abdominal or thoracic surgery, you may be at risk of complications due to cabin pressure changes and the physical demands of flying. Airlines may require a doctor’s clearance to ensure it is safe for you to travel.
Incapacity to care for yourself
If you appear too ill to care for yourself during the flight, or if your illness prevents you from following safety instructions or moving without assistance, you may be denied boarding. It is best to consult with your airline prior to your flight. You may also find some useful advice on our page Air Travel for People with Disabilities.
Medical support needs
If your condition requires constant medical supervision or equipment that cannot be accommodated on the flight, airlines may refuse boarding for your safety and the safety of others. As above, you should contact your airline in advance to discuss your needs.
Does air travel exacerbate certain illnesses?
Yes, air travel can exacerbate certain illnesses due to the unique conditions and environment of flying. Here are some examples of how specific illnesses can be affected:
Respiratory Conditions
Asthma
The low humidity and reduced oxygen levels in the cabin can trigger asthma symptoms. Passengers should carry their inhalers and any necessary medication.
Chronic Obstructive Pulmonary Disease (COPD)
Reduced cabin pressure can lead to lower oxygen levels, exacerbating symptoms. Supplemental oxygen might be needed, and this should be arranged with the airline in advance.
Respiratory Infections
Conditions such as bronchitis or pneumonia can worsen due to the dry air and pressure changes. Passengers should consult a doctor before flying.
Cardiovascular Conditions
Heart Disease
Reduced oxygen levels and changes in cabin pressure can increase the heart’s workload, potentially exacerbating conditions like angina or heart failure. Passengers with serious heart conditions should seek medical advice before flying.
Recent Heart Surgery
Passengers who have had recent heart surgery may be at risk of complications due to changes in cabin pressure and should wait for medical clearance before flying.
Deep Vein Thrombosis (DVT)
Prolonged immobility during long flights can increase the risk of DVT, particularly for those with a history of blood clots, recent surgery, or certain genetic conditions. Wearing compression stockings, staying hydrated, and moving around the cabin can help mitigate this risk.
Ear and Sinus Problems
Sinusitis
Changes in cabin pressure can cause pain and discomfort in the sinuses. Using a decongestant or nasal spray before the flight can help.
Ear Infections
Passengers with ear infections may experience significant pain during ascent and descent due to pressure changes. Swallowing, yawning, or using decongestants can alleviate some discomfort.
Gastrointestinal Conditions
Irritable Bowel Syndrome (IBS)
Stress and changes in routine can exacerbate IBS symptoms. Passengers should manage their diet and stress levels carefully.
Recent Abdominal Surgery
Flying soon after abdominal surgery can increase the risk of complications like deep vein thrombosis (DVT) and should be avoided until medically cleared.
Neurological Conditions
Epilepsy
The stress of travel, sleep disruption, and potential dehydration can trigger seizures. Passengers should ensure they take their medication and stay hydrated.
Migraine
Changes in pressure, dehydration, and stress can trigger migraines. Carrying necessary medication and staying hydrated is essential.
Mental Health Conditions
Anxiety and panic disorders
The confined space and perceived lack of control can trigger anxiety or panic attacks. Techniques such as deep breathing, medication, or consulting with a healthcare provider for additional strategies can be helpful.
Depression
Changes in routine and sleep disruption can worsen depression symptoms. Maintaining a regular routine and taking prescribed medication is important.
Weakened immune system
Passengers with weakened immune systems, such as those undergoing chemotherapy, are at increased risk of infections due to close proximity to others. Wearing a mask and practising good hand hygiene can reduce this risk.
What should I do if I am too unwell to fly?
If you find yourself too unwell to fly, it’s important to take the right steps to ensure your health and well-being, as well as to manage the logistics of your travel plans. Here’s what you should do:
Medical assessment
- See your GP or a medical professional to get an assessment of your condition. They can provide a medical certificate if needed, confirming that you are unfit to fly.
- Adhere to the recommendations given by your healthcare provider, whether it involves rest, medication, or further treatment.
Contact your airline
- Contact your airline as soon as possible to inform them of your situation. Many airlines have policies in place for passengers who are too unwell to travel.
- Be prepared to provide a medical certificate or a doctor’s note if the airline requests it.
Change or cancel your booking
- Check if your ticket is flexible or if the airline offers options for changing or cancelling flights due to medical reasons. Some airlines may offer refunds, travel vouchers, or the possibility to rebook at a later date.
- If you have travel insurance, contact your provider to see if your policy covers trip cancellations or changes due to illness. Provide any necessary documentation to support your claim.
Accommodation
- Inform your hotel or accommodation provider about your situation.
- If you are too unwell to travel back from your holiday, arrange to extend your accommodation until you’re fit to fly or ask for help in finding alternative accommodation.
Notifications and rescheduling
- Depending on the circumstances, inform any relevant parties, e.g. the transfer- or car hire company, friends or family, or your employer about the change in your travel plans.
- If your trip includes appointments or events, reschedule them as necessary.
Preparing for future travel
- Ensure you have fully recovered and are medically cleared to fly before making new travel arrangements.
- When rebooking, consider a more flexible travel plan that accommodates potential changes if your health condition is unpredictable.
How soon after an illness can I fly again?
The appropriate time to wait before flying after an illness depends on the type and severity of the illness, individual recovery rates, and the specific rules and regulations of your airline. Regardless of the illness, it’s important to wait until you feel strong enough to handle the physical demands of travel, including carrying luggage and navigating airports.
Below are some general guidelines, however, you should always seek medical advice and get clearance from your healthcare provider, especially if you have a chronic condition or have undergone significant medical treatment.
Respiratory infections
Common cold
You can usually fly once your symptoms have significantly improved and you feel well enough to travel. Typically, this might be 3-7 days after the onset of symptoms.
Flu/influenza
It’s advisable to wait at least a week after the flu symptoms have subsided, ensuring you are no longer contagious and feel strong enough for travel.
Pneumonia or Bronchitis
These conditions can be more serious. You should wait until you have fully recovered and your doctor has given you the all-clear, which can be a few weeks.
Gastrointestinal issues
Diarrhoea and Vomiting
You should wait 48 hours after your symptoms have stopped to ensure you are no longer contagious and can manage the flight comfortably.
Gastroenteritis
Similar to other gastrointestinal issues, wait until at least 48 hours after your symptoms have resolved.
Surgical procedures
Minor surgery
For minor procedures, you might be able to fly within a few days to a week, depending on your recovery and your doctor’s advice.
Major surgery
For major surgeries, such as abdominal or thoracic surgery, you might need to wait several weeks to a few months before flying. Always follow your surgeon’s specific recommendations.
Cardiovascular conditions
Heart attack
After a heart attack, you should wait at least 1-2 weeks and get clearance from your cardiologist before flying.
Heart surgery
Recovery from heart surgery typically requires a longer wait, often around 6-8 weeks, but it’s essential to follow your doctor’s advice.
Deep Vein Thrombosis (DVT)
If you’ve had DVT, you might need to wait a few weeks and will likely need to take precautions such as wearing compression stockings and taking anticoagulant medication. Consult your doctor for personalised advice.
Contagious diseases
Measles, Chickenpox, etc.: You should wait until you are no longer contagious. For diseases like measles or chickenpox, this is usually when all lesions have crusted over and you have a doctor’s clearance, typically a couple of weeks.
Further Information
Featured image courtesy of Polina Tankilevitch, Pexels