By Marlene R. Fedin, The Wellness Concierge®

UPDATE: SARS

SINGLE FLYER INFECTS MULTIPLE PASSENGERS: A December report in the New England Journal of Medicine confirms that airplane travel has spread SARS. The study, which included interviews with passengers and crews on three flights with SARS patients, found that a single infected flyer on a single flight resulted in 22 people (out of 119 passengers) contracting SARS. The infected passengers became ill, on average, about four days after the flight. Although the study said the risk to passengers is "quite low," it noted that precautionary measures (by airlines) were "warranted."

The World Health Organization (WHO) and the CDC have provided airlines with a detailed screening process that is to be implemented at the airport and in flight.

See SARS articles at MedicineNet.com. Check SARS-Related News Headlines.

UPDATE: AVIAN (BIRD) FLU

THE WHO SAYS BIRD FLU IS SPREADING 'FASTER THAN WE CAN GET TO IT': With the human death toll at 15 (February 4), the World Health Organization says that no part of Asia is safe from the virus. But even as avian influenza is spreading, the WHO cautions that the disease is not even close to being declared a pandemic.

Although human-to-human transmission is suspected in one case, most individuals contract the disease via direct contact with sick birds. Authorities have killed some 50 million birds in 10 countries in an effort to control the outbreak.

LATE REPORTING SAID TO HAVE FUELED SPREAD: A Bangkok Post article reported that three global healthcare agencies are accusing Asian countries of late reporting that they believe contributed to the virus' rapid spread. In a report issued following an emergency meeting in Rome, the FAO (the UN's Food and Agriculture Organisation); WHO (World Health Organization); and OIE (World Organisation on Animal Health) cited "lack of transparency, failed early warnings and a lack of a surveillance system" as factors in rapid disease transmission in countries affected by the bird flu.

While the organizations declined to name the specific countries, many believe the comments are directed at Thailand and China.

Check out related Avian Flu News Headlines.

A QUICK WAY TO STAY ON TOP OF BIRD FLU NEWS: Keeping up with the latest news is a time-consuming process even if you regularly check on- and off-line media when you're on the road. But you can find just about everything you'll need to know at the new International SOS Avian Flu Information Center.

The online center, which debuted the last week of January, is a terrific, timely, one-stop resource for relevant news, background, and advice for world travelers (or anyone else who wants to keep on top of bird flu news).

BIRD FLU CONCERNS RESHAPING HOTEL, AIRLINE, RESTAURANT MENUS

Although the World Health Organization is assuring consumers that properly cooked chicken is safe to eat, many international travelers are still bypassing menu items that contain chicken or chicken byproducts. (Can you guess how many menu items contain chicken stock or eggs? Think non-chicken soups. Mayonnaise. Salad dressing. ) Better safe than sorry seems to be the thought.

Given chicken's popularity, many Asian hotels and restaurants, as well as airlines who ply Asian routes or source food from Asian vendors, are reworking menus to provide chicken alternatives. Many restaurants in countries where the avian flu has hit hardest, such as Thailand and Vietnam, have already deleted chicken from their kitchens.

A February 5 New York Times article notes that Thai Airways' flight attendants are steering passengers away from chicken and telling them that it isn't "safe."  The Times article also reports that eight KFC outlets in Vietnam are planning to debut all-fish menus. But in a move said to be based on a desire to reassure consumers, but clearly driven by economic concerns, the Thai government is handing out free cooked chicken and eggs. The government has even enlisted KFC, who is also distributing chicken pieces.

AIRLINES USING CHICKEN FROM COUNTRIES WITH AVIAN-FLU FACE CULINARY, SAFETY CHALLENGES: Chicken is a favorite menu item around the globe. Now its popularity has got global food suppliers—and the international carriers they serve—scrambling for alternative menu options. Their concern? The safety of the chickens purchased from countries that have either been identified as having—or suspected of—the avian influenza outbreak.

Cathay Pacific Airlines has posted information on menu changes and how it is handling food-safety in response to the Avian flu outbreak. (Something every carrier serving routes that include infected countries should do.)  Cathay is no longer serving chicken dishes on flights out of Hong Kong, Thailand, Vietnam, Indonesia, South Korea, Japan, mainland China, Pakistan, and Taiwan. (The carrier still offers chicken on flights from non-affected countries but is cooking them at higher temperatures and only using chickens from countries who are not affected by the outbreak.)

Indian Airlines is still serving chicken (from India) on its flights. However, the carrier is no longer using birds from Kuala Lumpur, Singapore, and Bangkok and is considering chicken alternatives on flights from countries infected with the bird flu.

Traveling through Asia and not sure what your airline is doing with its food service? Ask the airlines. (Contact their in-flight caterer if necessary.) Don't have the time to check? Uncertain about their responses? Bring your own food that's been purchased from a reputable food retailer or restaurant.  And only pack foods that will travel well. (Pack an insulated pouch.) Most foods are safe but foods from questionable vendors, or food that's been improperly cooked or stored, can still make you sick.

Tourism (and the revenue it generates), rather than the primary issue of personal health, appears to be the driving force behind many country's efforts to implement smoking bans. Vocal, vehement, organized, and determined opposition from local businesses and other associations (as well as individuals who view no-smoking bans as a violation of personal freedom) continues. But tourist organizations are banding together with governments and health organizations to lobby hard for total bans even as they reluctantly admit that they may have to settle for limited or partial bans.

SMOKE-FREE DINING: Want to know which states have imposed statewide no-smoking bans in restaurants? Check out ASH's (Action on Smoking and Health) directory.

► HAWAII: A new smoking ban went into effect on February 1 for the Big Island, the last county to enact smoke-free workplace laws. Smoking is banned in restaurants, state airports, hotels, elevators, and restrooms as well as theaters, museums, galleries, enclosed auditoriums and sports arenas and meeting and conference rooms. You also won't be able to light up in public spaces such as shopping centers.

Exclusions: Nightclubs and stand-alone bars. Bars within restaurants have until September 1 to go smoke-free or to create an area that is physically separated (and ventilated) from the restaurant. Fines for Personal Violations: $25 to $50

► GEORGIA: Health activists may be jumping for joy at the the mere thought of Georgia lawmakers' announcement that they are considering a ban on smoking in cars where children are passengers. If passed—and that is a major "if" given Georgia's opposition to smoking bans—it would be the first ban on smoking in private vehicles.

► IRELAND: The Health Minister originally ordered all workplaces (including the country's famed pubs and restaurants) to be smoke-free beginning January 1. But vehement objections from pub owners and ongoing controversy over the ban have delayed the start date, which is expected to be announced by mid-February. Anticipated start date: March or April.

But the date won't matter to many pub owners who flat out refuse to comply. In the meantime, some pubs are skirting the soon-to-be-enacted ban by creating separate areas for smokers. Others have set up special outdoor areas (complete with ashtrays and heating) to accommodate patrons who smoke.

► CANADA: Ontario is set to push legislation to bar smoking in public places and the workplace this year with a goal of a smoke-free province by 2006. The government considers the no-smoking ban a top priority. If passed, it may KO the smoking rooms that some restaurants throughout the province have created.  (British Columbia had a short-lived no-smoking ban.)

► LONDON: In an Internet poll funded by the London Health Commission, more than three-quarters of respondents said they preferred a smoke-free environment in closed-in public places. Although London's mayor cannot introduce a smoking ban, the government could enact laws that would allow him to impose restrictions on local smokers.

(FYI: It's estimated that 80 percent of the people in the UK are non-smokers. No numbers on London's citizenry or tourists.)

Smoking curbs are being considered by Birmingham, Brighton, Liverpool, Poole, and Sheffield. 

► SCOTLAND: Seeking to promote the country as a health-conscious destination, and citing Ireland's no-smoking efforts, tourism advocates are urging local pubs and restaurants to voluntarily adopt no-smoking policies. First Minister Jack McConnell has admitted that a total smoking ban would be "impractical," but indicated that local smoke-free zones could be an option. "There should be some areas in public where people can go where they know there won't be any smoking," McConnell notes in a Glasgow Evening Times article.

On February 4, Stewart Maxwell, SNP, MSP, was scheduled to debut a Prohibition of Smoking in Regulated Areas Bill in Edinburgh. The bill is designed to snuff out smoking in public places where food is served. If passed, smoking would be banned in any restaurant, pub, cafe, hotel, or other venue where food is on the menu. ("Food" as Maxwell defines it, is "anything above nuts or crisps.") Maxwell wants to make smoking in a restaurant a criminal offense that could result in a fine of up to ₤1,000. Maxwell hopes to land cross-party support in the Scottish Parliament. Unsurprisingly, the smoking lobby is outraged by what it considers another violation of personal freedom.

REPEALED: In mid-December, Carnival reversed its non-smoking policy on its Paradise cruise ship, which had been smoke-free since its first sailing in 1998. The reversal caught many consumers and industry observers by surprise, since the no-smoking ban had been an effective marketing tool. Beginning next fall, guests can light up on the Paradise, which had been the only smoke-free (crew and guests) cruise ship. The September 20, 2004, cruise, when Paradise is deployed to Long Beach, California, will be the last cruise where no-smoking rules will be in effect.

Worth noting: The ship had earned high marks from those passengers desperately seeking smoke-free journeys. (Wonder where these rejected cruisers will take their business now.) Carnival had a strict "no tolerance" policy that was strictly enforced: Cruisers who were caught lighting up (or even simply packing smoking materials) were fined and some were even forced to leave the ship mid-cruise.

Industry experts speculate that Carnival abandoned non-smokers because they failed to spend enough on booze and gambling. Given how much health-oriented consumers (who tend to be non-smokers) spend on products for a healthy lifestyle (Consider the soaring sales for health-related products, as well as the increase in the numbers of spas and spa and medical-treatment services.), Carnival could have found some way to generate revenue other than liquor and gambling if they truly wanted to keep these loyal customers.

Need a good reason to hit the gym—rather than the mattress—when you're feeling jet lagged? A study published in the fall of 2003 in Genome Biology found that resistance (strength) training can help your body better adjust to time-zone changes. Can't make it to a gym to lift weights or use the machines? Exercise in your hotel room using packable resistance bands.

DC BAN ON HANDHELD CELL PHONES SET FOR JULY: DC motorists who attempt to drive and talk on a handheld cell phone will be subject to a $100 fine starting in July. (New York, the first state to implement a cell-phone ban, barred handheld auto chats beginning in 2001.)

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CELL PHONE DANGERS... Want to make sure your cell phone doesn't turn into an explosive device? Use the appropriate (and manufacturer-approved) batteries. Last fall a number of Nokia cell phone owners experienced accidents where phones reportedly exploded. According to Nokia, the batteries didn't "explode;" they actually "vented" as the batteries tried to dissipate heat to prevent an explosion.  Nokia claimed the the problem stemmed from poorly made, inferior-quality, counterfeit batteries that short-circuited.

 ...AND DANGEROUS CELL PHONES: Don't be surprised if your cell phone is the next item to be closely scrutinized by airport security. Time magazine reports that global law-enforcement officials have seized mobile phones that have been rigged to function as guns. Bulkier and heavier than than typical cell phones, these weapons can still pass for their less-lethal (see above) counterparts. The keypads act as triggers on the hollowed-out units and punching them can shoot out several bullets in succession.

CELL PHONES AND BRAIN CANCER: NEW DANISH STUDY FINDS NO SHORT-TERM RISK: Health authorities are paying close attention to the results of the first in a series of nationwide studies to evaluate the safety of cell-phone usage. The Danish study, which was recently published in the American Journal of Epidemiology (vol 159, p 277), has been deemed "authoritative" based on its well-structured design and large sample size. That makes the results more credible than other studies that reportedly found a linkage between cancer and cell phone usage. The bottom-line: Cell phone usage appears to pose no increased risk of brain cancer. But (and there's always a but or two) that finding applies to the first 10 years of usage. (There weren't enough study subjects who had used the phones for more than 10 years.) Scientists believe that they'll be able to quantify the risk beyond 10 years of use when they collect the data from a total of 14 studies over the next 18 months.

AND THE BRITS AGREE... A review of research on the health effects of cell phone use by an independent group of British scientists concludes that mobile phones pose no cancer risk. However, the Brits also noted the lack of data on long-term usage and urged more research  into potential health risks.

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UK 'NO-FRILLS' CARRIER STUDY:

PILOT FATIGUE + STRESS = A RECIPE FOR DISASTER?

According to a first-of-its-kind study published in The International Journal of Risk Assessment and Management, passengers flying low-fare carriers could be at risk due to pilot fatigue and stress. The study's respondents (pilots flying "no-frills" carriers) described themselves as "stressed and tired" due to demanding flight schedules (flying six consecutive days); working for as much as 12 hours without eating; and regularly "plane hopping" (switching planes). Unsurprisingly, these subjects had disrupted sleep patterns and said they were often so fatigued that they couldn't concentrate.

The study's author, Dr. Simon Bennett, an aviation consultant and safety researcher based at the University of Leicester, acknowledges its limitations: It's hard to measure stress and fatigue and subjective self-assessments are hardly scientific. But Bennett's contention—that further research is necessary to assess the risks to flyers—is valid. A body of research has already shown how deadly a factor fatigue is in auto accidents. Why would we think sleep-deprived pilots are not as potentially dangerous to air travel—no matter who they work for or how much they're paid?

THREE FLYERS DIE ON VIRGIN, BA FLIGHTS ON SAME ROUTE: In what may be a record, the Miami to Heathrow route registered three passenger deaths on two flights in mid-January within a two-day period. A 19-year-old female Brit died before landing on a Virgin Atlantic flight departing Miami for Heathrow. Cause of death: unknown. The day before, two flyers on a BA flight on the same route also died. Authorities are uncertain whether one passenger, a female, died on the plane or in the hospital where she was treated when BA flight 208 was diverted to Nova Scotia. A male passenger subsequently became ill on that flight and died before the flight arrived at Heathrow. Health officials believe the deaths are unrelated and attribute the man's death to a suspected case of viral meningitis. The woman's death is believed to have been caused by a heart attack.

VIRGIN OFFERS IN-FLIGHT 'MEDITAINMENT': Virgin Atlantic Airways is offering an in-flight audio program that features guided meditation exercises. The series is designed to help passengers relax and de-stress and to help them sleep. Virgin has dubbed the meditative exercises "journeys," which include Desert Island and Summer Meadow. The "meditainment" program is offered on all VA aircraft equipped with the Vport entertainment system.

Virgin also offers Flying Without Fear  featuring David Landau, a psychoanalyst. The audio session, targeted at those who are afraid of flying, includes soundscapes, relaxation techniques, and stress-relief strategies.

RYANAIR 'LOSES' WHEELCHAIR CHARGE SUIT: A British traveler has won his suit against Ryanair for fees (about US$33) charged for the use of a wheelchair to take him from check-in to the aircraft. The judge said that Ryanair unlawfully charged the passenger flying out of Stansted Airport, awarding him about US$2,420. The Disability Rights Commission is considering a class-action suit on behalf of 35 other passengers.

Citing the judgment as "defective," Ryanair will appeal. And in a move reminiscent of the U.S.'s full-fare Big Six, the low-fare carrier is adding a fee to pay for the cost of supplying "free" wheelchairs in the future. The 50-pence charge (a little over $.90US) will be levied on all Stansted passengers, as well as those at three other airports.  So now all passengers are paying for wheelchair usage, even if they don't avail themselves of the service. Makes you wonder who really "won" the suit.

GOING TO BRAZIL? BETTER MIND YOUR MANNERS: An apparently drunk, very asocial,  and querulous flyer was recently arrested and detained in Sao Paulo before he was booted out of the country, stripped of his visa, and sent back to the U.S. He started his journey by being denied boarding in Miami because of his behavior and moved on to assaulting a baby (He poured water over its head when it wouldn't stop crying.) when he landed a seat on another flight. His fellow passengers, some of whom had to be stopped from assaulting him, clapped when he was arrested. The incident comes on the heels of the arrest of an American Airlines pilot at Sao Paulo Airport in January after he made an obscene gesture at immigration agents.

Physically abusing children? He's lucky he only got booted off a flight and out of the country. Sign this guy (and the many others who can't seem to control themselves) up for anger management and behavior modification courses. Throw in sine sensitivity training. If that doesn't work, book him on Dr. Phil.

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THE INFO YOU NEED TO REALLY 'DO IT YOUR WAY': Nutritional information is the key to healthy food choices on and off the road. But finding the details of menu offerings is hit or miss. So kudos to Boston Market. The chain recently released a new "Wellness Guide"  that's a mini-primer of its offerings and their nutritional values (calories; fat/protein/carbs; fiber; servings) .

The three-page in-store guide (also available in PDF for easy printing or downloading) segments menu items into categories such as Low-Fat Meals; High-Protein, Controlled Carb; Vegetarian; and Fruits and Vegetables. If you're menu-challenged, you can opt for the suggested groupings in the "Create Your Own Meal" sections.

The guide may provide more information than some diners want to know—you can't pretend something isn't high-fat or high-calorie when the numbers pop right out of the page—but it's a great resource for those of us struggling to make healthy choices.  And it's the sign of a responsible food retailer, one who isn't afraid to tell the public exactly what they're getting.

WAL-MART ADDS BLIMPIE, LOW-CARB SECTION: With a nod to the low-carb food trend, Wal-Mart has started stocking an assortment of low-carb items near its cash registers. It also plans to add a Blimpie salad-and-sandwich restaurant to 100 of its stores, with a planned launch set for April. Blimpie now offers low-carb menu items along with its more traditional sandwich fare.

FYI: Blimpie offers a downloadable online Carb Counter Menu and a Carb Counter Journal.

ELSEWHERE ON THE LOW-CARB FRONT: The number of online resources for info on low-carb foods and restaurant offerings is staggering. If you're tracking changes in fast-food and family chain restaurants, bookmark LowCarbFreedom.com. The site, the personal creation of Katherine Prouty, a special interest Web publisher with a passionate commitment to healthy eating and the low-carb lifestyle, showcases menu offerings in hotels, fast food and other restaurant chains. There are related articles and recipes and more (Prouty even offers food retailers suggestion on how to go low-carb!). It's another example of how committed individuals can provide timely and in-depth info that often exceeds the coverage of big-staffed media.

CHOCOHOLIC ALERT: If you're a chocolate lover who plans to be in Manhattan in February, head downtown to the Ritz-Carlton New York in Battery Park. Beginning February 6 (through February 28), its Rise bar will offer a special chocolate buffet that features 30+ chocolate desserts. Availability: 8 p.m. to midnight, Fridays and Saturdays only; $35 per person, including a glass of Champagne. Reservations recommended; 917-790-2571.

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LOOK BEFORE YOU... Need some incentive to use those disposable toilet seat covers? Consider the fate of a woman who suffered serious chemical burns on her bum after a sit-down on a New Zealand loo that had been covered with a gel-like substance. The woman, one of four who suffered bum burns, will require plastic surgery. (And we thought germ transmission was our biggest worry!)

REV UP TOOTHBRUSH HYGIENE TO KO GERMS: Oral hygiene is a key component in staying healthy. To keep unwanted bacteria and germs out of your mouth—and your body (which can reduce your risk of infection), be sure to ditch the toothbrush you've used during your latest bout with the cold or flu. Keep a new brush (or two) packed in your toiletry kit.

Protect yourself from unnecessary risk of infection by:

• Replacing your current brush with a new one at least every three months.

• Storing toothbrushes away from the toilet and sink. Flushed toilets spew germs up and out across a wide area.

• Regularly disinfecting your toothbrush. Thoroughly rinse the brush each week using very hot (preferably boiling) water in a heatproof glass or cup. (Avoid using tap water, which may include contaminants.) To avoid cross-contamination, never put more than one brush in the same container.

A new product called AquaBlast claims to rid your brush of almost all (99%) of bacteria. The fizzy tablets, available at drugstores, cost less than $2 for about four months' worth of protection.

• Letting your brush air dry between usage. Moist toothbrushes are a magnet for bacteria. To avoid contamination, place your brush in a vertical (upright) position so water can drain off.

If you do nothing else: Don't pack a wet/soggy toothbrush. If you must brush and pack, as we often do on the road, use an aerated plastic cover. (Or punch holes in a small plastic bag and temporarily store the brush in it but don't seal it.) Don't bury your toothbrush in your toiletries bag or regular luggage; store it in a briefcase or handbag to remind you to unpack it as soon as you reach home (or your next destination).

If you'll be traveling for more than a few hours, ditch the wet brush. Replacing a toothbrush is infinitely more cost-effective than compromising your health.

TAKE THE MYSTERY—AND FEAR—OUT OF MEDICAL SCREENING TESTS: If you (or someone you know) is scheduled for a lab test, head over to LabTestsOnline.com. The peer-reviewed, patient-centric site was created by lab scientists who wanted to educate consumers and demystify the process of testing. The site offers patient-friendly descriptions of lab tests for more than 70 conditions.

Considering how little information is often provided by even the most professional medical caregivers, it's reassuring to know you can log on and learn more about the testing process before you begin yours. Knowing what to expect can lessen your concerns,  help ensure that you are properly prepared, and improve the test's accuracy and results.

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Noteworthy news items from around the globe:

► Reuters: Citing Economic Toll on Tourism, WHO Is Urged to Be More Cautious in Issuing Travel Alerts

► TelegraphUK: Pressure Mounts to Name Banned European Airlines, Share Data Across Countries

Disease/Outbreaks:

► ChinaView/Xinhuanet: First Case of Imported Dengue Fever Confirmed in Hong Kong

Avian Influenza:

► Taipei Times/Reuters: Bird Flu Strain Spreads to Indonesia

► Medline/UPI: China's Bird Flu Toll Rises

► SIFY News (India): Bird Flu Could Prove More Lethal Than SARS

► ChannelNewsAsia.com: Malaysia Employs Anti-SARS Strategies to Ward Off Bird Flu

► Bangkok Post: Three International Health Agencies Criticize Late Reporting

SARS-Related Stories:

► ABCNews/AP: Air Carriers Say They Are Better Prepared to Battle SARS

► Asia Pacific Media Network: Newspaper Fined Over Alleged Herbal SARS Cure Ads

► Genome News Network: SARS May Still Be Spreading From Animals to Humans
► Toronto Star: World Concern Grows Over Rise in China SARS Cases, Failure to ID Infection Sources

► CIDRAP News: WHO Questions China's Handling of Recent SARS Case

► Reuters: Severity of SARS Symptoms Varies

► Sci Tech/ABC News: U.S. Scientists Claim SARS Vaccine Breakthrough

Safety & Security

► Hotels-Online/Knight Ridder/Tribune Business News: Hoteliers Check Fire Safety Measures Following Comfort Inn Fire Deaths