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Cruise Ship Travel
Approximately 1 in 250 cruise ship passengers will experience an illness while onboard that requires medical attention. To ensure the best possible cruise experience for yourself, it is important to be prepared for cruise ship travel and to know how to prevent illness, especially if you are elderly or have a pre-existing medical condition. Be sure and discuss your travel plans with your travel medicine practitioner well before the time of departure.
Pre Existing Medical Conditions
If you have a pre-existing medical condition or are recovering from a recent health problem, contact the cruise lines medical department prior to travel and verify that they have the staff and equipment you may need. If you are disabled or have trouble walking, you should inquire into the availability of assistance for embarking and disembarking, since not all ports have the necessary equipment. If you are taking medications, be sure to bring an adequate supply with you and provide the ship physician with a list of all current medications and dosages.
Infants And Pregnant Women
For safety reasons, many cruise lines will not accept infants younger than 6 months of age or women who are in the later stages of the third trimester (last 3 months) of pregnancy. Contact your cruise line for more information.
Contagious Health Risks
Influenza
While onboard cruise ships, large numbers of people co-exist in relatively confined spaces and are in close contact with other passengers, which helps spread respiratory infections such as influenza ("flu"). If you are elderly or otherwise at risk from respiratory illness, influenza can lead to serious complications including pneumonia, hospitalization, and even death.
It is also important to know that you may be traveling with passengers from different parts of the world and therefore could be exposed to flu virus at any time of the year, not just during "flu season" in your home area. To best defend yourself against influenza, ask your travel medicine practitioner about risk, symptoms, and whether you should take antiviral medicine to prevent or combat influenza. All passengers, especially the elderly and those with pre-existing medical conditions, should be vaccinated against influenza before traveling.
Medications called "neuraminidase inhibitors" —such as oseltamivir (Tamiflu)— may be helpful in reducing the severity of flu symptoms; the ships medical unit should stock these drugs.
"Norwalk-like" Virus Infections
Norwalk-like virus infection is a very common gastrointestinal virus. Symptoms can include vomiting, diarrhea, abdominal cramps, and low fever. The virus is highly contagious and can be transmitted through improper hygiene, from person-to-person, via contaminated food or water, through contact with contaminated surfaces, or even through particles in the air.
Symptoms usually appear within 12 to 48 hours after you are exposed to the virus, and the illness generally runs its course in 24 to 48 hours. However, persons may remain contagious for up to 72 hours after symptoms have disappeared.
To prevent the spread of the virus, cruise lines may not let passengers with obvious symptoms board the ship. Passengers who become ill are sometimes asked to stay in their cabins and may be asked to leave the ship at the next port. Passengers may be asked not to shake hands at cocktail parties, and the crew may serve foods to you from "self-serve" buffets. Frequent hand washing (every 1-2 hours) helps reduce the spread of the virus.
Legionnaires Disease
Legionnaires disease is a flu-like illness acquired from water systems. Outbreaks of the disease have occurred on cruise vessels due to poor cleaning and maintenance practices of spas, fountains, and showers. However, risk is considered low.
Skin Problems
Skin infections and sunburn are common problems during cruise travel. To help reduce the chance of skin infections, you should disinfect cuts, abrasions, and insect bites. Avoid excessive sun exposure and use sunscreen to prevent sunburn.
Other Hazzards
Malaria
Malaria is a disease caused by the bite of an infected mosquito. A number of cruise ships visit ports in countries where malaria is endemic, particularly on the South American coast and the eastern and western coasts of Africa. Cruise lines commonly offer day trips to local destinations, with passengers returning to the ship in the evening. In this situation, medication to prevent malaria is generally not needed, because you will be on the ship during the evening and at night, when the mosquitoes that carry malaria are most apt to bite and the risk of acquiring malaria is highest.
Before traveling, you should discuss with your travel medicine provider the need for insect precautions and preventive medications if you plan to spend the night on shore or plan to spend more than 1 day in sub-Saharan African ports or other high risk ports. If you have a fever after having visited these areas, be sure to report it immediately to your health care provider (if it occurs after you have returned home) and also tell him where you traveled. If you experience a fever while still on board the cruise ship, report it immediately to the ships medical department.
Travelers Diarrhea
Most cases of acute diarrhea (except diarrhea caused by the Norwalk-like virus) are not contracted on the ship but when passengers eat at native restaurants while in port. Diarrhea can occur 24 to 48 hours after you are exposed. Before you travel, ask your travel medicine practitioner for advice on preventing and dealing with diarrhea in the event that you do become sick. If you experience symptoms, contact the ships medical department for treatment.
Motion Sickness
Most large modern ships have been engineered to reduce motion sickness. Check out Motions Sickness
Vaccinations
Yellow Fever
Cruise ports in countries where yellow fever is endemic do not require yellow fever immunization, with one exception: if you are taking a cruise tour up the Amazon River, you should be vaccinated. In the past, some passengers who were not vaccinated have contracted yellow fever on these cruises. One dose of yellow fever vaccine is given.
Hepatitis A
Hepatitis A infection is not usually a risk to passengers on cruise ships. However, if you who intend to eat at local restaurants while in port, you should be vaccinated against hepatitis A virus before you travel. Two doses of hepatitis A vaccine are given, 6 to 12 months apart.
Pneumococcal Disease
If you are older than 65 years of age or have a pre-existing illness that might make you vulnerable to pneumococcal disease, you should be immunized prior to travel. One dose of the vaccine is given.
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