Bugs get the train too

allroad

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Full marks for sneezing etiquette....
Rail safety experts are investigating the cold and flu risks faced by commuters packed on trains. With the flu season upon us, we ask experts what does lurk among bus, rail and Tube passengers?

It's been a bad news week for those who struggle to work each day on public transport. First a study claimed it can be more stressful being a commuter than a fighter pilot.

Now BBC News has learnt the Rail Safety Standards Board is investigating the impact of overcrowding on trains and the Tube, including how much passengers share bugs.

No scientific research has yet been done on this but experts in virology believe poor ventilation and a lack of space can make some forms of public transport a fertile breeding ground. However there is a strong argument this fear may be over-hyped.


Carriage handles

"The London Underground must be an absolute goldmine for viruses trying to find someone to spread to because it's so packed," says Dr Rosy McNaught, a consultant in communicable disease control for Sheffield.

"The closer people are packed together and poorer the ventilation, the more likely people close to you will get a face full of it when you sneeze."

If someone coughs in your face and you breathe it in there's probably quite a high chance of transmission of cold or flu

Charles Penn
Professor in microbiology
Cold and flu viruses travel through the air from a cough or sneeze and get into the body through the mouth or eye. They can also be passed from hand to mouth via carriage handles or straps.

"Airborne transfer is probably more significant in those confined surroundings and if someone coughs in your face and you breathe it in there's probably quite a high chance of transmission of cold or flu," says Charles Penn, professor in microbiology at the University of Birmingham. "That's their natural route of transmission so in close proximity you're breathing in drops from other people's respiratory systems."

However, at least Tube trains have opening windows - at the end of each carriage. On the railways, much of the new rolling stock uses air-conditioning, which re-circulates air. Bus passengers have also complained that new models are overheated and lack ventilation because of smaller windows.

Consultant biologist Colin Fink says better ventilation and the confidence to open windows, where possible, is the key to tackling this. Although not aware of any scientific studies, he thinks there is undoubtedly a great deal of transfer of respiratory illnesses on overcrowded transport, especially in conditions of high humidity.

HOW TO CATCH A COLD...
Respiratory viruses like colds and flus are spread by droplets from coughs and sneezes
Some droplets are invisible but can still be inhaled through the mouth or passed through the eyes
Transmission can also happen when someone sneezes or coughs into their hands and then touches a rail or strap before someone else

"If you ventilate and keep the humidity down, you reduce the risk of airborne viruses, and persistence of organisms on surfaces so it is always better to have a well-ventilated cool bus rather than a fuggy and warm one.

"Some long distance trains these days are air-conditioned and unless the system is perfectly maintained this creates conditions of greater humidity. I am not aware that the train companies think about the potential for cross infection.

"The take-home message is people should keep windows open on transport so there's a flow-through of fresh air. No one wants to be the first to open the window as this may be seen as an inconvenience to other passengers."

The London Transport Users Committee says anecdotal evidence suggests passengers are getting colds from these conditions so it would be interested to hear the results of the investigation.


...AND HOW TO PREVENT ONE
Open bus or train windows to increase ventilation and reduce humidity
Avoid cramped spaces if possible
Practise coughing etiquette - use a hanky or a disposable tissue
If you have a virus, don't travel
Wash your hands when you get to work and don't touch your mouth before doing so
But before commuters dash for the mask (and one expert recommended a full facial respirator as the only virus-proof measure), there is cause for optimism.

The Health Protection Agency says there is no indication that passengers in London and the South East - where public transport is more crowded - suffer more respiratory illnesses than other parts of the UK.

And two items of research indirectly related to this area suggest the risks may be over-hyped.

University students have been found to suffer colds and flus more in autumn than spring. This has been interpreted as meaning the overriding factor is the arrival of new people living close together, rather than public transport which is constant all year round.

And the infection risk of air-conditioning may not be as high as feared. A study by the Air Transport Association of America claims there is no added risk due to filters. And in cases where a long-haul passenger has been identified with tuberculosis, no other passengers on board are known to have caught it.

Plus, there is a simple step passengers can take to minimise the risk.

"Coughing etiquette or respiratory hygiene - coughing into a hanky - sounds a bit like common sense but it works and it will reduce the spread," says Ms McNaught. "And just think 'Do I need to go into a public place and expose everyone else to my germs?'"
 
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