What to Do When Seated Next to a Sick Person on a Plane

Dear SmarterTravel,

What are the airline rules about allowing obviously ill passengers to board flights, and if an ill passenger does get on board, what can travelers seated nearby do?

—Eileen M.

The answers might surprise you.

As far as I can tell, there are no federal laws or regulations stating sick people can’t board planes. But airlines reserve the right to refuse boarding for any passenger the ground agents consider to be too sick to fly; this is listed in airline contracts of carriage.

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Delta’s rules, which are par for the course, say “Delta may refuse to transport any passenger, or may remove any passenger from its aircraft, when refusal to transport or removal of the passenger is reasonably necessary in Delta’s sole discretion for the passenger’s comfort or safety, for the comfort or safety of other passengers or Delta employees, or for the prevention of damage to the property of Delta or its passengers or employees.” And the contract goes on to enumerate specific conditions, including “When the passenger is seriously ill, and fails to provide a physician’s written permission to fly.”

Other airlines’ contracts contain similar language, and they enumerate specific causes for refusal, generally using terms such as passengers who are “seriously ill,” “suffering a contagious disease,” or similar.

It is the responsibility of airline personnel—who are typically not medically trained—to make what amounts to a medical decision about whether any passenger is or is not “seriously ill.” In practice, the airlines appear to err on the side of caution to catch seriously ill passengers before they get onboard. This decision is in the hands of the boarding agents.

What are your options if you’re seated near someone who seems to be ill and possibly spreading contagion? Here, your choices are limited. If the plane has empty seats, you can ask to be relocated, or maybe to have the sick person relocated. But in a full plane, that might not be possible. If the flight is full, you can either tough it out or ask the captain to solve the problem. Presumably, the captain would start with the time-honored approach of going on the PA and asking, “Is there a doctor in the house?” If there isn’t, and if the captain concludes that the person involved may be sick enough to spread contagion, the only recourse is to land the plane and transfer the sick passenger to ground medical services. Obviously, captains are very reluctant to make unscheduled landings, so the bar is pretty high on the decision to land.

Keep your cool when you deal with the captain or chief flight attendant. If you lose it, you may find a police escort waiting for you at your arrival gate.

The idea that people not medically trained have to make spot medical decisions is off-putting. But, at least for now, that’s the situation.

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