The Unwanted Holiday Travelers

Ah, the holidays are before us all. More Americans than ever on record – 115.6 million – will travel this holiday season, from Saturday, Dec. 21 through Wednesday, Jan. 1. That is the most in nearly 20 years since AAA began tracking in 2000, and represents an increase of 3.9% over last year, or 4.3 million more people packing up their sleighs for a holiday getaway. Automobiles, planes, trains, buses and cruise ships - all of these modern miracles of transport will be transporting us back to our childhood homes or perhaps to other family and friends homes around the globe very soon. Likewise, we will likely gather around each other at office parties, grandparent's healthcare facilities (long term care or otherwise), church, and kitchen tables to reconnect with loved ones or others. As we approach 2020 and a brand new decade we often surround ourselves with not only loved ones, but others that have traveled from across a vast geographic landscape.

Christmas and the new year celebration are full of magic and wonderful times and we should enjoy them to the fullest. However, there is a bit of a dark side to the holiday season. Our own microbial population also comes along with us and / or we encounter new microbial visitors in our travels. Exposure to more people than usual can increase your chances of becoming ill. So during this holiday season, spending some time to take extra precautions may help keep you from catching someone else’s illness or if you are ill, preventing the spread to others.

As an infectious disease specialist and clinical / public health microbiologist, it's important to share what I often am thinking about during these "high contact" holiday gatherings and travels. Yes, it's a hazard of my career and education. While many are seeing new sights, visiting with family and friends, and enjoying amazing food and drink I am seeing the invisible travelers that come along with each of us - the microbial traveler. Yes, each of us brings along all of our own microbial party (pun intended) to enjoy perhaps the company of a new host to multiply and amplify their microbe holiday - an infection!

You see, ALL #SurfacesMatter in the transmission of pathogens (dangerous microbes - viruses, bacteria, and others) to our neighbors.

Surfaces you find on airplanes, buses, cars, as well as your own body surfaces. Your very hands can be dangerous vehicles for microbes to move from one place to another. This is why we should always be thinking about #handhygiene in our daily lives. Whether you are at home, work, or traveling during the holidays. Remember, those modern miracles of transport (airplanes, automobiles, etc.) remind me of an incubator in one of my laboratories. A place for microbes to multiply and amplify and lie in wait for its next encounter to hop onboard for a ride (infection).

It's even more important to consider these microbial travelers during the holidays because we (and others) are often introducing new cold or flu viruses to a naive and possible immunocompromised population. Think about the elderly grandparents in a nursing home or your home, or the newborn baby that everyone wants to pass around to family and friends that have traveled by plane. The numbers of microbes traveling with them is staggering when you consider the likelihood of the number of contacts (other people and surfaces) they have encountered.

Welcome to my brain and what I see each time I travel or engage in a new environment, like a business conference or a classroom - the microbial traveler!

Unfortunately, there are all sorts of microbes that come out to play during the winter. Primarily, the respiratory agents of infection. One thing we do not want to give or receive at Christmas is an infection. Cold (usually a rhinovirus) and flu (influenza) season usually coincides with the holiday season in North America. Everyone catches a cold now and then and for most people, a cold causes a week or so of feeling miserable: stuffy nose, headache, cough, and more, and then it goes away. The cough associated with a cold can last for a while longer, sometimes weeks if it is a particularly nasty one. However, some people can become seriously ill if they catch a cold. The virus can make them vulnerable to developing other illnesses, like bronchitis or even pneumonia, particularly among the very old, very young, or those who have weakened immune systems or chronic illnesses. To make matters worse, antibiotics are useless against a virus.

According to the Centers for Disease Control and Prevention (CDC), depending on the flu season, between 9.3 million and 49 million people in the U.S. are affected annually, with 140,000 and 960,000 flu-related hospitalizations, and up to 79,000 deaths each year. Grandparents visiting their grandchildren could be particularly at risk. Children are "super-spreaders" of flu and the over-65s are one of the "at-risk" groups that can develop health complications, such as pneumonia, if they catch it. It is a serious respiratory infection. Influenza, the flu, is easily spread in close quarters. The flu is not a gastrointestinal illness; there is no such thing as the stomach flu.

To make matters worse, the flu virus can live on surfaces (doorknobs and tables) — and potentially infect people — for 48 hours, according to the CDC. Remember, a home, vehicle, or community environment can serve as a reservoir too for any pathogen or antimicrobial resistant microbe such as respiratory syncytial virus (RSV), parainfluenza (croup), or even pertussis (whooping cough) to name a few others. Flu and these other respiratory microbes can be launched from a cough, sneeze or even a laugh for up to six feet away to another person or surface!

Enjoying a good meal and drinks are a central part of many wonderful holiday gatherings. Like anyone, I love a great meal with friends and family. Often, my family even prepares a meal together for enjoying the time together. One major precaution is critical during the preparation and/or consumption of any food and anytime of the year - proper cooking temperatures and cleaning between the use of cutting boards, utensils and other devices is a must. Otherwise, we risk an gastroenteritis (GE) infection which is another illness often mistakenly referred to as a “stomach flu.” GE occurs when a microbe infection irritates and inflames the gastrointestinal lining, resulting in nausea, vomiting, cramping, stomach pain, fever, and diarrhea. The infection spreads either through direct contact with someone who is already ill, through touching objects that have the bacteria or virus on it, or through contaminated food or drink. Because of the many ways it spreads, it is particularly important to be vigilant when you are at a large gathering.

So, should we all just stay home and become a scrooge? No, but we can do some simple and smart things to avoid a holiday microbial traveler from sabotaging our fun! To avoid giving or receiving these unwanted microbial “gifts,” we can follow these simple steps for prevention:

• Get the seasonal flu vaccine (and other recommended vaccines)
• Wash your hands and properly discard of tissues, wipes, or similar products
• Ensure that cold food is kept cold and hot food hot [follow the proper cooking directions and storage temperatures]
• Stay away from gatherings if you are ill
• Avoid others who are ill
• While traveling, shaking hands, touching new or unknown surfaces (think airplane, taxis, etc.), be especially vigilant with hand hygiene!

I hope each of you have a safe and Merry Christmas and Happy 2020! Stay vigilant and healthy out there on the road and with loved ones!

Doc R

Learn more about my microbial musings and thoughts in my invited Healthcare Hygiene Magazine monthly column "Under the Microscope" as well as my other #MedicalLaboratory and #PublicHealth research interests. #WeSaveLivesEveryday

Dr. Rodney E. Rohde (Twitter: @RodneyRohde & @TXST_CLS) is Professor and Chair of the Clinical Laboratory Science Program (CLS) Program, as well as Research Dean in the College of Health Professions of Texas State University. Dr. Rohde serves as Associate Director of the Translational Health Research Initiative at Texas State and has been named an Honorary Professor of International Studies, a Global Fellow, and a Fellow of the Association of Clinical Scientists.