Escaping NH's Winter With A Cruise. How to stay healthy.
Has the latest weather and snow storm have you thinking of a cruise vacation?
With so many people sharing the same cruise ship, communicable diseases can easily be spread amongst passengers. These diseases can be spread from person to person or through contaminated food, water, air or environmental surfaces. Cruise crew can remain on board and can transmit illness from one group of travelers to the next. Pregnant women, the elderly, and immunocompromised people are the most at risk. Most frequent outbreaks are the flu, and Legionnaires disease, norovirus,and rubella and varicella.
Most cruise ships have medical facilities, but these can vary greatly depending not the size of the ship, the itinerary, length of cruise, and passengers. In most cases these are similar to ambulatory care centers. There is no official regulatory agency that governs their practices. A study from 2013 did show that most provide emergency medical care for passengers and crew, can stabilize patients, and begin diagnostic testing and treatment. They can help with evacuation for patients seriously injured or ill. About 5% of illnesses on board require evacuation. Half of those who seek care aboard are over the age of 65 with majority looking for medications, then respiratory illnesses, followed by gastrointestinal issues.
10-25% report seasickness and injuries (slips, falls, trips). Death rates are most often from cardiovascular events and range from 0.6 to 9.8 deaths per million passenger nights.
Before you go check the CDC Traveler's Health Website for updates and health notices. If you are ill before you go, delay your travel until you are no longer contagious. If you become ill during your trip, go to the ship's infirmary to be assessed and treated. This is helpful in reporting and limiting the spread of infections.
Norovirus happens the most often and account for 90% of GI outbreaks on ships and is easily spread. Wash your hands often, especially before and after using the bathroom and before eating.
The flu seasons in the northern and southern hemispheres are opposite times of the year and crew and passengers are from all over the world, the flu can be spread on cruise ships any time of the year. One key to prevention of this is to get your annual flu vaccine. If you have chronic health conditions discuss starting antiviral medications with the medical staff on board.
Legionnaires is a severe type of pneumonia from inhaling aerosolized water containing the bacteria. Symptoms start 2-3 days after exposure. The redesign of ships and water disinfection systems have greatly reduced this form of pneumonia.
Make sure you have immunity from measles, mumps, rubella, and chicken pox before you go. This may be done through a blood test to check your immunity or by giving you required vaccines.
Traveler's should look at their ports of calls and shore excursions to determine risks of mosquito related infections such as dengue, chickuguanya, malaria, zika, etc and take necessary measures. Depending on where you are going Yellow fever should be considered and may be required. Use appropriate mosquito avoidance measures. Think of the safe involved in any activity you do off the ship.
If you have special needs, such as oxygen, dialysis, speak with the cruise ship and make arrangements in advance to ensure your needs are met. Make sure to bring enough medications and supplies for the duration of your trip and a little extra in case there are delays. Carry copies of prescriptions, medical records, tests, etc in case your condition becomes unstable during travel.
Lastly use sunscreen, make sure your teeth are problem free before you go, and if sexually active, practice safe sex practices.
