Health and Medical Guide
WHEN IS AIR TRAVEL NOT RECOMMENDED?
Travel by air is not recommended in the following cases:
i) Infants less than 39 weeks minimum.
- After 32 weeks of pregnancy for those with multiple or complicated pregnancies for international and domestic flights.
- After 36 weeks of pregnancy for those with normal pregnancy for international and domestic flights.
- Until seven days after normal delivery. (Post-ceasarian section surgery – a letter from attending doctor is required indicating fit to fly).
iii) Those suffering from:
- Angina pectoris or chest pain at rest.
- Serious or acute infectious disease.
- Decompression sickness after diving.
- Increased intracranial pressure due to haemorrhage, trauma or infection.
- Infections of the sinuses or infections of the ear and nose, particularly if the Eustachian tube is blocked.
- Skull fracture, if the sinuses are involved.
- Recent myocardial infarction and stroke (time period depending on severity of illness and duration of travel).
- Recent surgery or injury where trapped air or gas may be present, especially abdominal trauma and gastrointestinal surgery, cranio-facial and ocular injuries, brain operations, eye operations and penetrating injuries of the eyeball.
- Severe chronic respiratory disease, breathlessness at rest, or unresolved pneumothorax.
- Psychotic illness, except when fully controlled with medication.
For medical professionals, further information is available from Aerospace Medical Association's Medical Guidelines for Airline Travel.
Medical clearance is required to assess an individual's fitness to fly. Passengers requiring medical clearance are those who may
- be suffering from acute or chronic diseases that need supplemental oxygen or medical equipment on board aircraft (acute asthmatics)
- be flying after an illness or operation and may aggravate their condition due to the flight environment
- be travelling with their own medical equipment such as oxygen supply, infusion pumps and suction apparatus
- be considered a potential hazard to the safety of the aircraft, other passengers or crew members
- Expectant mothers approaching 36 weeks (international or domestic flights) for normal pregnancy or 32 weeks for multiple or complicated pregnancy (international or domestic flights)
- Elderly passengers (not accompanied by any family member)
- Infants in incubators
- Newborn babies within the first 7 days of birth or premature birth
- Passengers on stretchers
- Passengers suffering from infectious or post-infectious disease such as leprosy or pulmonary tuberculosis
- Passengers with allergies such as food or peanut allergies (see under Other Medical Info).
Malaysia Airlines reserves the right to refuse to carry passengers with conditions where adverse effects or hazard may result during the flight. When a cabin crew suspects that a passenger may be ill, the Commander of the aircraft will be informed and a decision will be taken on whether the passenger is fit to travel.
Medical clearance for stretcher booking must be submitted at least ten working days before departure while non-stretcher medical clearance must be submitted at least seven working days before.
For further information or answers to medical clearance enquiries, please contact the MEDA Desk team at [email protected]
WHAT MEDICAL CARE IS AVAILABLE IN THE AIR?
Malaysia Airlines carries millions of passengers each year, yet medical incidents are fortunately rare. The most common in-flight medical incidents are fainting, stomach upsets and giddiness. Cabin crew are equipped with basic medical training and the aircraft with medical supplies to ensure passenger health and safety during flights.
Cabin crew medical training
Cabin crew are trained in the use of first-aid equipment and in carrying out basic first-aid and resuscitation procedures. They are also trained to recognise a range of medical conditions that may cause emergencies on board and to act appropriately to manage these.
Medical equipment onboard
The medical kits onboard Malaysia Airlines exceed international regulatory requirements. Equipment carried on an international flight would include:
- one or more first-aid kits, to be used by the crew
- a physician’s kit, to be used by a doctor, to treat in-flight medical emergencies
- an automated external defibrillator (AED) to be used by the crew in case of cardiac arrest
Although Malaysia Airlines cabin crew are trained to handle onboard medical incidents, there may be occasions when an unexpected medical emergency occurs requiring attention outside the realm of their training. This may necessitate our cabin crew making a request for a suitably trained medical professional to voluntarily identify themselves and help in providing medical assistance to an injured or ill person onboard the aircraft.
Passengers who identify themselves as medical professionals will be asked to show relevant identification and/or provide details of medical qualifications to our crew upon request.
To the extent permitted by law, Malaysia Airlines will indemnify the medical volunteer against legal liability that may arise from their assistance or treatment given onboard the aircraft.
WHAT OTHER MEDICAL INFO MIGHT I NEED TO KNOW?
Suffering from acute or chronic diseases
If you have a stable chronic disease (e.g. diabetes), which is well controlled on medication, you do not need medical clearance. You should carry your medications in your hand luggage adhering to the guidelines stipulated under "Travelling with medicines".
Malaysia Airlines appreciates the challenges faced by passengers who suffer from allergic reactions to peanuts or certain type of food.
Malaysia Airlines is unable to guarantee a food allergy or peanut-free environment in its aircrafts or airport lounges. However, Malaysia Airlines will put in place arrangements (as outlined below) to minimize the risk of passengers who are allergic to peanuts or certain type of food suffering an allergic reaction while onboard Malaysia Airlines flights provided advanced written notification has been received by Malaysia Airlines. Specifically, all passengers who are allergic to peanuts or certain type of food are required to submit a 'Release Form' at least three (3) working days before their flight departure. Please see the link to the form and further details at the bottom of this page. If Malaysia Airlines receives the Release Form within the required time, Malaysia Airlines will implement the following measures:
- Peanut snacks are often served on Malaysia Airlines flights. However, Malaysia Airlines will create a 'buffer zone' around the passenger's seat which will include seven entire rows (being the row that the passenger has been allocated to sit in and the three rows in front of and the three rows behind the passenger's allocated row) (Designated Area). Peanut snacks and peanut condiments in meals (such as peanuts that are served on the side to accompany a meal) will not be served to any passengers seated in the Designated Area. The flight crew will use their best endeavours to stop passengers from eating their own peanut snacks in the Designated Area. Please note, however, that peanut-based dishes (such as a satay dish) may be served in the Designated Area.
- Passengers may request via Malaysia Airlines’ reservations a peanut-free meal in advance of their flight's departure. Requests must be made at least 24 hours before their flight's departure. However, Malaysia Airlines cannot guarantee that the meal has been prepared in a peanut-free kitchen or has had no cross-contamination with peanut products within the various flight kitchens and catering services which are used throughout Malaysia Airlines’ network.
- A similar concept of buffer zone will be created for other declared food allergies to an “as low as reasonable practicable” level of risk.
Malaysia Airlines strongly recommends that passengers who are allergic to peanuts or other type of food check their fitness to fly with their physician before travelling. In addition, passengers who are allergic to peanuts or other type of food should:
- Bring their own medication and wear a medical alert bracelet;
- Inform their travelling companion (if any) of how to administer treatment if required;
- If they are a minor, travel with a companion who is sensitive to their medical needs;
- Bring their own food items that do not require chilling or reheating on board (keeping in mind that the food must not violate quarantine laws at the relevant destination point);
- Bring their own sanitizing wipes to wipe down armrests, meal trays and seat back areas;
- Purchase travel insurance which covers anaphylaxis and any other relevant severe allergic reactions;
- Alert an Malaysia Airlines staff member (on the ground or on board) upon feeling the symptoms of an allergic reaction; and
- Inform onward sector carriers of their travelling requirements.
For the comfort of passengers, it is important that passengers inform our Reservation staff of any need for special assistance so that Malaysia Airlines can help to make the necessary arrangements. In particular, passengers who are allergic to certain type of foods or peanuts are required to submit the Release Form to the Malaysia Airlines Reservation/Ticketing Office at least three (3) working days via email or fax before the intended date of travel. For more information, please call 1 300 88 3000 (within Malaysia) or +603 7843 3000 (overseas).
Travelling with medicines
You are advised to carry your medication in your hand luggage, in case you need it. You should also carry a copy of the prescription or a supporting written statement from your doctor in case the medication is lost, additional supplies are needed or security or custom checks require proof that it is for personal use.
Travelling while pregnant
If you are travelling during pregnancy, you will require a letter from your doctor stating the duration of pregnancy and any risk factors. The following are periods not recommended for women to travel:
- After 32nd week of pregnancy for those with multiple pregnancies (e.g. twins) or complicated pregnancies both for domestic and international flights.
- After 36th week of normal pregnancy for domestic and international flights.
- Until seven days after delivery.
Passengers with disability or passengers with a chronic stable disease
If you need mobility assistance (e.g. wheelchair, buggy) at the airport, please contact the Hospitality Desk at the airport, so that transport from the terminal to the aircraft can be arranged.
Immobility and circulatory problems (DVT)
Prolonged immobility, especially when seated, can lead to pooling of blood in the legs, which in turn may cause swelling, stiffness and discomfort. It is known that immobility is one of the factors that may lead to the development of a blood clot in a deep vein, also called "deep vein thrombosis" or DVT. As a precaution, moving around the cabin or doing simple exercises during long flights will help to reduce any period of prolonged immobility. Please refer to Malaysia Airlines’ In-flight Magazine - "Going Places", for simple exercises to follow especially during long haul flights. To reduce the risk of DVT, we recommend the following measures for all our passengers:
- Avoid high consumption of caffeine and alcoholic beverages as these cause dehydration.
- Increase consumption of other fluids, especially water or fruit juices to improve body hydration. In this respect, our cabin staff have been advised to serve water and fruit juices more frequently to passengers.
- Do simple regular in-flight workouts. One such exercise is to raise the buttocks and thighs off the seats while seated and at the same time squeeze the toes and contract the calf muscles. Another exercise is to straighten and bend both legs at the knee while seated. Both these exercises will improve blood circulation.
- Wear loose-fitting comfortable clothing.
If you require more information on deep vein thrombosis (“Travellers’ Thrombosis”), please download World Health Organisation’s “International Travel and Health, Chapter 2” (PDF).
It is safe to fly with a pacemaker provided that your cardiac condition is stable. However, some issues that may be of concern are during the security screening procedures at the airport. Passing through an airport metal detector won't interfere with your pacemaker, although the metal in it may sound the alarm.
Avoid lingering near or leaning against a metal-detection system. If security personnel insist on using a hand-held metal detector, ask them not to hold the device near your pacemaker any longer than necessary. To avoid potential problems, carry an ID card stating that you have a pacemaker. In addition to that general advice, you should check with your own doctor and read the instructions from the manufacturer of your own model of pacemaker to find out whether the pacemaker you have is more sensitive to the metal detection equipment.
Smoking is not permitted onboard Malaysia Airlines flights. Passengers who smoke heavily and regularly may experience stress and discomfort, particularly during long flights. Heavy smokers may benefit from medical advice before travelling. Nicotine replacement patches or chewing gum may be helpful and the use of a mild tranquilliser can be considered.
Travelling with own medical equipment
Medical clearance is required for the use of most medical equipment onboard to confirm that you are fit to fly and to ensure that the medical equipment does not interrupt the avionics of the aircraft. All personal medical equipment should have sufficient battery power to last one and a half times the journey length (150% travel time). Only dry cell or gel batteries are permitted onboard for safety reasons.
All medical equipment that needs to be used onboard will require a Medical Information Form (MEDIF). The MEDIF application form (PDF) should be completed by your attending doctor and submitted to Malaysia Airlines through our ticketing offices or travel agents at least five working days before the intended date of travel.
Approved portable oxygen concentrators (POCs) are permitted on board for use during your flight provided a MEDIF application form (PDF) has been submitted and approved. These do not count towards your carry-on baggage limit. All medical equipment to be used on board will require medical clearance.
The passenger who plans to use the device must provide a written statement signed by a licensed doctor that verifies the passenger's ability to operate the device, respond to any alarms, the extent to which the passenger must use the POC (all or a portion of the flight), and prescribes the maximum oxygen flow rate required.
All POCs approved by the Federal Aviation Administration (FAA) will be accepted onboard. Currently approved POC models are:
- AirSep FreeStyle
- AirSep LifeStyle
- Delphi Central Air
- Devilbiss iGo
- Inogen One
- Inogen One G2
- International Biophysics LifeChoice
- Invacare Solo2
- Phillips Respironics EverGo
- SeQual Eclipse
- Oxlife Independence
Kindly download the MEDIF application form (PDF) and ask your physician to fill it up and submit it to your nearest Malaysia Airlines ticketing office or travel agent. Malaysia Airlines charges for oxygen supplied on international flights.
If you have such medical equipment or oxygen requirements, we strongly advise that you contact 1 300 88 3000 (within Malaysia), +603 7843 3000 (outside Malaysia)or your nearest Malaysia Airlines ticketing office before booking your flight. This is to ensure that you have a safe and comfortable journey with us.
Stress, fatigue and jet lag
Jet lag refers to the disruption of sleep patterns and other circadian rhythms, which result from abrupt changes in time zones. Jet lag may lead to insomnia, indigestion, reduced physical and mental performance and general malaise. The adverse effects of jet lag can be reduced by the use of effective measures. Some of these measures include:
- Be well rested before departure and rest as much as possible during the flight. Ensure that you have as much sleep as possible for every 24 hour cycle when travelling, as you would at home and use opportunities to take short naps regularly. In the case of short trips, it may not always be appropriate to adjust to local time – if in doubt, seek specialist advice.
- Wear loose comfortable clothing.
- Drink plenty of water and/or juices before and throughout the flight.
- Eat light meals. Limit your consumption of tea, coffee and alcohol both before and during the flight.
- Upon arrival, some may find it beneficial to use short-acting sleeping pills to facilitate the adjustment of sleep patterns. However, use these only under medical supervision and ensure that they have been tried and tested at home before you use them on your trip.
- Stay out in the natural daylight or in brightly lit areas to help adjust more quickly to the time zone of the destination.
Travelers who take medication on a strict schedule (e.g. insulin, contraceptive pills) should seek medical advice.
Divers should not fly soon after diving because of the risk that the reduced cabin pressure may lead to decompression sickness (the bends). It is recommended that they do not fly until at least 12 hours after their last dive and this period should be extended to 24 hours after multiple dives or after diving that requires decompression stops during ascent to the surface.
UPDATES FOR TRAVELLERS AND VACCINATION GUIDELINES
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The information provided in this website is for informational purposes only and are not exhaustive. They are not intended in any way to serve as medical advice or its substitute. Please consult your health care professional regarding your health or specific medical questions that you may have. Malaysia Airlines will not be held responsible for any misuse of information or adverse effects of recommendations howsoever arising from or connected with the usage of information as stated in this website.