For months, travelers have been zooming through the skies, locked into a tight space with strangers, without benefit of an H1N1 vaccination. That situation probably won't change before Thanksgiving, historically the busiest travel season of the year. The Minnesota Department of Health reports that the majority of doses of the vaccine may not arrive until after the holiday. What's a worried ticket-holder to do? In most cases, fly, but use vigilance.

"Most of the [H1N1 flu] transmissions appear to be contact and not airborne," said Dr. Frank Rhame, an infectious-diseases physician at Abbott Northwestern Hospital in Minneapolis. "If you pay close attention to what you touch and don't convey to your face, you should be safe," he said. In other words, do in the air what you do on the ground: Wash your hands frequently and avoid touching your eyes, nose and mouth.

Passengers can also bring hand sanitizer and sanitizing wipes aboard, provided they are 3 ounces or less and placed in a quart-size, zip-top plastic bag. The Centers for Disease Control (CDC) recommends using alcohol-based hand rubs when soap and water are unavailable. Wipes will help clean a drop-down tray and seat area. Rhame notes, however, that you cannot disinfect all the surfaces you'll encounter on a plane and frequent hand washing is the best defense. Also, some airlines, including Southwest, have removed pillows and blankets in response to the H1N1 scare.

Even before the pandemic, commercial airlines had been taking precautions against infectious diseases, said Elizabeth Merida, a spokeswoman for the Air Transport Association, a trade organization representing major airlines. They use hospital-quality air filters. Monthly deep cleanings of planes are supplemented with between-flight spot cleaning of any area occupied by a person who became ill in the air. Gate agents are trained to recognize the signs of illness, and can prevent a sick person from boarding. Delta Airlines has on-call doctors whom agents can consult, according to spokesman Anthony Black. When passengers drop out of a flight due to illness, many airlines, including Delta and Southwest, will not charge a rebooking fee.

Despite these precautions, some people should think twice before hopping on a plane. According to the CDC, travelers at high risk for complications from any form of flu, from pregnant women to anyone with immune deficiencies, should discuss their travel plans with their doctor. And anyone with flu-like symptoms should stay home. "If you have febrile respiratory illness, you shouldn't travel until you are clearly getting better for your own sake, and you shouldn't travel for 24 hours post-fever for others' sake," said Rhame.

Kerri Westenberg • 612-673-4282