Illness happens on planes, and when it does it’s miserable.

In 2009 I dealt with campylobacteriosis over a day of travel from Manhattan (Kansas) to Raleigh. In 2013, then four-year-old Jack yacked on a flight which led to a fascinating approach by Delta Airlines involving plastic bags to contain the risk and coffee pods to manage the smell. The flight crew let us off the plane first (although we were in the second-to-last row) as we potentially inoculated the plane and passengers with norovirus.

Maybe the best plane-related outbreak was one reported in Clinical Infectious Diseases a couple of years ago. I’d describe my poop and barf-related imagination as pretty good but I couldn’t have dreamt up the scenario that unfolded on a plane leaving Boston bound for Los Angeles in October 2008.

Members of [the] tour group experienced diarrhea and vomiting throughout an airplane flight from Boston, Massachusetts, to Los Angeles, California, resulting in an emergency diversion 3 h after takeoff.

The problematic flight departed Boston on Oct 8, 2008, heading for Los Angeles and carrying among its passengers 35 members of a leaf-peeping tour group. (Four more members of the group had planned other routes home, while two had been hospitalized in the previous 2 days.)

The outbreak included a passenger with “multiple episodes of diarrhea, with at least 1 occurring in the aisle of the first-class section. The soiled aisle was not cleaned until after completion of the flight.”

As the international discussion of Ebola transmission continues, USA Today writes about bodily fluids on airplanes.

[Linda] Cannon, a teacher from Palatine, Ill., was on a United Airlines flight from Chicago to Las Vegas when she felt something wet on her seat. “I pulled out my hand, which was covered in vomit,” she recalls.

The crewmember cleaned the seat while Cannon changed into some clean clothes. But it didn’t help: Bits of upchuck still coated her seat.

“I sat for 3½ hours with the remnants of vomit on my jeans and underwear,” says Cannon. ” I spent the entire flight with nausea and the woman in the next seat telling me it still smelled.”

The passengers who came into contact with blood, urine and vomit wonder who to blame for the lack of hygiene on a plane, and what they’re doing about it.

The answer is a bit complicated. Of course, airlines are responsible for the cleanliness of their aircraft, and it’s a job they say they take seriously.

At American Airlines, for example, planes are tidied up between flights, which can include cleaning the lavatories, seats and replacing any obviously soiled blankets or pillows.

Overnight, the planes are serviced more thoroughly. The restrooms are serviced, seats and tray tables are wiped down, carpets are vacuumed and blankets and pillows are replaced.

While there have many been plane-linked outbreaks, a quick overnight servicing with a wipe-down could explain reoccurring noro events.