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The latest U.S. Ebola patient rode the New York City subway. But don't freak! Here are the things you should think about instead.

October 24, 2014

Yesterday, the New York Times reported the first confirmed Ebola case in New York City, a metropolis of 8 million people. The patient, Craig Spencer, MD, contracted the virus while treating patients in Guinea with Doctors Without Borders. Officials say he rode the subway, took a cab, and went bowling before he got sick.

Eek. It’s by all accounts unsettling that Dr. Spencer rode the subway and took a cab before realizing he was infected, but just like one of the Texas nurses, Amber Vinson, who contracted Ebola and traveled by plane just prior to her diagnosis, he wasn't obviously symptomatic at the time, Governor Andrew Cuomo (D - NY) said at last night's press conference, CBS News reported.

While it's frustrating that Vinson, who's now free of the virus, was allowed to fly—even Thomas Frieden, president of the Centers for Disease Control and Prevention, acknowledged she shouldn't have gotten clearance to do so—Governor Cuomo said that New York is "as ready as one could be" and the city's health officials learned a lot from the debacle in Dallas.

As the Ebola outbreak continues in West Africa and unwarranted panic ensues here in the States, we thought now would be a good time for a "fearbola" reality check.

It's important for everyone to understand that Ebola doesn’t spread through the air, according to the CDC. It’s spread only through blood or bodily fluids, including urine, saliva, sweat, feces, vomit, breast milk, and semen, and it can only survive on a surface for a few hours. "Unless you are flying with someone who is symptomatic and you have exposure to these body fluids, you are not likely to get an Ebola infection," says Shilpi Agarwal, MD, a board-certified family physician in Washington, DC.

The reality is that there are things you can catch on a plane, train or bus, things you should focus on right now instead of Ebola. So, to re-direct your stay-healthy efforts on your morning commute and any upcoming trips, we had experts weigh in on what you're much more likely to actually catch as you travel. Plus, how to reduce your risk.

The flu

There are few things more cringe-worthy than realizing that the guy who just got on the plane or train doesn't look so good. Flu viruses can travel in the air via tiny droplets that get released when someone coughs, sneezes, or talks. “In an airplane, train or bus, the flu is particularly easy to spread because you are in such close proximity to others, so you’re more likely to come across these droplets," Dr. Agarwal says. "Especially on a plane, the dry air from the altitude reduces our body's natural immune defenses, making it easier for the virus to enter the body."

The common cold

Similarly to the flu, the common cold is caused by a few different viral strains that can also be transferred by air. “Many of these viruses remain active on surfaces like arm rests, tray tables and seat back pockets for several hours, so washing your hands and disinfecting the surfaces around you can help reduce the spread,” notes Dr. Agarwal.

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Tuberculosis

While cases of this are very rare, getting tuberculosis (TB) is still more likely than picking up Ebola thanks to, again, those icky airborne droplets, Dr. Agarwal says. For example, you can catch tuberculosis, which is caused by bacteria, when someone with the untreated, active form of it coughs, sneezes, spits, or speaks. Luckily, TB is not as infectious as the cold or flu. “You're much more likely to get tuberculosis from someone you live with or work with than from a stranger,” according to the Mayo Clinic.

Viral meningitis

Your chances of getting viral meningitis at the train station are also super slim, but it is "spread through respiratory secretions of another person," according to the CDC. On the other hand, bacterial meningitis, the more dangerous and deadly of the two, would be virtually impossible to get from someone near you—unless, for example, you take a swig of your neighbor's coffee or in-flight beverage—as the bacteria are not spread by casual contact or by simply breathing the same air as someone with bacterial meningitis, notes the CDC. Still more likely than Ebola at this point.

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So you’re feeling sick—should you stay home?

Yes! "People who take the bus to work have six times the risk of getting sick," says Charles Gerba, PhD, professor of microbiology at The University of Arizona. "And it's because people too often go to work sick." If you have a fever or have been around a seriously sick person, you should not take a commercial flight—bite the bullet and reschedule, Dr. Agarwal adds.

Stop the spread

During cold and flu season, it's more important than ever to stay hydrated and get plenty of rest, which can also give your immune system a boost, Dr. Agarwal says. And don't forget the golden rule, Gerba adds: wash your hands frequently. "The average person touches their face 16 times an hour. The flu spreads when you rub your eyes, for example." Lastly, carry a hand sanitizer that's at least 60% alcohol so you can disinfect your hands wherever you're going.

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