Stephen J.LurieMD, PhD, Senior Editor
In Reply: Drs Hocking and Foster assert that our data implicate air travel as a risk factor for viral URIs. It is important to note the limitations of our study in supporting this conclusion, with its concerning public health implications.
First, the estimated incidence of URIs in our study varies depending on which of the 3 outcome measures we studied. Hocking and Foster refer to our least restrictive definition, "self-report of a cold." Although this outcome occurred in 20% of respondents, our most restrictive outcome (Jackson score >13) was reported by only 3%. Thus, the incidence of viral URI under our most restrictive definition is similar to rates reported in the literature. The self-report of a cold may be affected by noninfectious conditions (eg, changes in pressure and humidity, irritant exposure, travel effects) as well as public concern about a possible relationship between flying and colds.
Nutik Zitter J. Upper Respiratory Tract Infections Among Airline Passengers. JAMA. 2002;288(23):2972. doi:10.1001/jama.288.23.2972-JLT1218-4-1
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