Are You At Risk of Catching Ebola on Public Transportation?

Photo by Joe Raedle/Getty Images

Yelling, “I have Ebola!” on a bus is apparently the fastest way to spark an FBI manhunt. On Monday, an unidentified man in a surgical mask declared he was infected while riding a Los Angeles bus — and now the FBI is trying to track him down.

Of course, that L.A. bus passenger was most likely just creating panic by playing a cruel joke on concerned people. But the fear surrounding Amber Vinson — the second Dallas nurse to be infected — is more well-founded: The day before her diagnosis, she flew from Cleveland to Dallas on a commercial jet with 132 other passengers. Although Vinson— who had already developed a low-grade fever —sought CDC permission before taking the flight, CDC Director Dr. Tom Frieden said she should never have boarded “because at that point she was in a group of individuals known to have exposure to Ebola.”

“In retrospect, I think she should have been told to stay home,” agreed Dr. Art Reingold, head of epidemiology at the UC Berkeley School of Public Health. “But I would be extremely surprised if there turns out to be any individuals who acquired Ebola as a result of [her] flying on an airplane. I would be astonished.”

In fact, the level of concern regarding transmission to Vinson’s fellow passengers has remained low, likely because Ebola isn’t an airborne illness like the flu, even though early symptoms do often mimic influenza.

As Frieden stated, “We think there is an extremely low likelihood that anyone who traveled on this plane would have been exposed, but we’re putting into place extra margins of safety and we’re contacting everyone who was on that flight.” Last week, in a video message, President Obama conveyed a similar message to residents of infected countries in West Africa, reassuring them that they “cannot get [Ebola] from casual contact like sitting next to someone on a bus.”

Related: Ebola Fears Are Triggering Mass Hypochondria

“Even though there’s a been a lot of news in the last 48 hours, the virus itself has not changed,” pointed out Dr. Eden Wells, a clinical associate professor of epidemiology at the University of Michigan School of Public Health. “It still requires that you have close contact with body fluids of a person with Ebola.”

And even then, transmission isn’t guaranteed. As Wells pointed out, Thomas Eric Duncan’s family took care of him prior to his diagnosis — and they’re rapidly nearing the end of their 21-day quarantine, totally symptom-free. “The two nurses went in when he became really ill — copious amounts of watery diarrhea, probably bleeding, sweating, fever, throwing up,” Wells told Yahoo Health. “Somebody who is that ill on a plane is going to be immediately removed.”

So why are officials urging potential Ebola patients to steer clear of public transportation? “I think it’s really an abundance of caution more than it is a true need — we really don’t think that simply sitting on the same airplane would result in transmission,” Reingold said. “But this is such a deadly virus, and there is so much public and political concern that I think people are going to err on the side of caution, rather than be perceived as under-responding.”

And there is always a risk, however small. “Bodily fluids” includes the obvious — blood and vomit — but also sweat, saliva, and tears. Which means that you could, in theory, catch the virus via sweat on an airplane armrest, for example. “If [the sick person] is touching surfaces and they’re contaminated by their own fluid, then you contact the same surface before the fluid dries, there is a risk of transmission there,” Well allowed. “We never say never.”

Related: How Plasma Transfusions from Survivors Fight Ebola

Luckily, there are things you can do to exercise extra caution, even though you won’t likely ever encounter an Ebola-infected person.

Don't touch your face 

The Ebola virus makes its way into your body in two ways: through breaks in the skin, or through your eyes, nose, and mouth. Of course, covering wounds — scratches, cuts, etc. — is always advisable, whether you’re worried about Ebola or not, but “breaks in the skin might not be quite so obvious. We often can’t even see them,” Wells told Yahoo Health. You can, however, shield your eyes, nose, and mouth, simply by keeping your fingers away from your face until you’ve had a chance to scrub up, she said.

Notify your flight attendant

Suspect the passenger next to you is sick? Ask if he or she is feeling okay — it could just be a case of pre-flight jitters — and if your seatmate is truly ill, notify the in-flight crew. The U.S. Department of Transportation does allow airlines to turn away passengers with serious contagious diseases, including those with possible Ebola symptoms, according to the CDC. If the sick passenger isn’t removed, “it is reasonable to ask the flight staff if you can be moved,” Wells said.

Stock up on hand sanitizer

You’ve probably been there: sitting in a window seat, unable to scoot past your neighbor to use the airplane bathroom. In case you can’t make it to a sink right away, carry a small squirt bottle of hand sanitizer with you that contains at least 60 percent alcohol, and use if you’ve inadvertently touched a potentially ill person next to you, said Wells. While it does not eliminate all types of germs or remove any bodily fluids from your palms, it can quickly reduce the number of microbes on your hands. Follow up with a hand wash later.

Wash your hands

When it comes to staying healthy, the simplest solution is often the most effective option. “Washing your hands is the best — 20 seconds, singing “Happy Birthday” a couple times,” Wells said. “When you’re traveling, it doesn’t hurt. Go wash your hands as often as you think is prudent.” (Even if you’re nowhere near an Ebola patient, it is flu season.)