The cruise ship industry has expanded considerably in recent decades. In 2008, 13 million passengers worldwide traveled on cruise ships, by 2016 the number has risen to over 24 million. Cruise itineraries cover all continents including areas that are not easily accessible by other means of travel. The average duration of a cruise is about 7 days, however cruise voyages can last from several hours to several months. A typical cruise ship now carries up to 3,500 passengers and 1,200 crew.
In general terms, there are relatively few health risks associated with cruise ship holidays just as long as the traveler is up to date with routine vaccinations, then no further vaccinations are required. However if there is a possibility that meals will be eaten on shore in a less developed country, vaccination against hepatitis A would be advisable. In 1999, there was an outbreak of typhoid fever amongst a number of cruise ship passengers who dined at restaurant in Papua New Guinea, however the overall risk of contracting such an illness is relatively low.
The main method of protection against food and water borne illness and disease in less developed countries should be through following the rules of eating and drinking safely overseas, including drinking only bottled water and avoiding shellfish and uncooked foods.
Aside from food borne illness, respiratory infections can sometimes spread quickly on cruise ships. It is therefore advisable that passengers be vaccinated with the current flu vaccine before heading off on a cruise.
The risk of malaria and other mosquito borne diseases for passengers on a cruise ship is extremely low, as cruise ships usually moor in port during the day and depart in the early evening. So in most cases, standard mosquito avoidance measures are sufficient.
Sea sickness may present a problem for some passengers and there are a number of measures that can sometimes be adopted to prevent this from occurring including;
Minimizing exposure by locating yourself in the middle of the vessel where there is least movement, and adopt a horizontal or semi recumbent position.
Minimize head and body movements.
Restrict visual activity by fixing vision on the horizon or some other external stable object and avoid fixating on a moving object.
Avoid reading and close your eyes.
Ensure good ventilation in and around yourself.
Engage in distracting behavior.
Avoid large meals by only eating frequent small amounts of food.
There are also a number of pharmacological agents which can be useful in preventing sea-sickness. Anti-histamines have been shown to be effective, but the non sedating varieties tend not work as they do not cross the blood brain barrier. Promethazine theoclate (Avomine) or promethazine hydrochloride (Phenergan) as a single daily dose of 25 mg for adults, is a popular choice. The product can be taken the night before commencing the cruise and perhaps continuing for two or three nights the passenger adapts to the 'motion of the ocean'. An alternative product may include dimenhydrinate (Dramamine) 50 mg two to three times daily.
All cruise ship passengers should take out comprehensive travel insurance in case a significant medical event occurs during the cruise which may require intensive treatment and possible medical evacuation.
For those with concerns, it's may be helpful to know there are a range of global standards regarding ship and port sanitation together with disease surveillance measures, as well as response to infectious diseases.
The average traveler on a cruise line is aged between 45–50 with senior citizens represent about 1/3 of all cruising passengers, those over the age of 60. Cruises of longer duration often attract older travelers and by their very nature, they are a group most likely to have more chronic medical problems such as heart and lung disease.
More than half of all emergency visits to health clinics on board ships are made by passengers who are over 65 years of age with the most common health problems including respiratory tract infection, injuries, motion sickness and gastrointestinal illness.
Extended periods away from home, especially days at sea make it essential for passengers to stock up with sufficient medical supplies before leaving home. Prescription medicines should be carried in the original packages or containers, together with a letter from a medical practitioner attesting to the traveler’s need for those medicines. Cruise ship travelers who may require particular medical treatment should consult their health-care providers before booking.
It is important to view a ship’s medical facility as an infirmary and not as a hospital. Although most of the medical conditions that arise aboard ship can be treated as they would be at an ambulatory care center at home, more severe problems may require the patient to be treated in a fully staffed and equipped land based hospital after stabilization on the ship.
Knowledge of the type and quality of medical facilities along the itinerary is important to determine whether passengers or crew members can be sent ashore for additional care or need to be evacuated by air back to the home port. Most cruise vessels do not have assigned space for a dental office, and very few have a resident dentist.
The rapid movement of cruise ships from one port to another, with the likelihood of wide variations in sanitation standards and infectious disease exposure risks, often results in the introduction of communicable diseases by embarking passengers and crew members.
In the relatively closed and crowded environment of a ship, disease may spread to other passengers and crew members. Diseases may also be disseminated to the home communities of disembarking passengers and crew members. More than 100 disease outbreaks associated with ships have been identified in the past 30 years. This is probably an underestimate because many outbreaks are not reported and some may go undetected.
Outbreaks of measles, rubella, varicella, meningococcal meningitis, hepatitis A, legionellosis, and respiratory and gastrointestinal illnesses among ship passengers have been reported. Such outbreaks are of concern because of their potentially serious health consequences and high costs to the industry.
In recent years, influenza and norovirus outbreaks have been public health challenges for the cruise industry. The following are a number of considerations which should be made prior to departure on board a cruise ship.
Note: The following material has been provided for general informational purposes only. It is not intended to be relied on as a substitute for professional medical advice. No person should act, fail to act, disregard professional medical advice, or delay seeking professional medical advice on the basis of this material. The Travelnanna website, nor its representatives does not guarantee the accuracy, currency or completeness of any of this information and will not be liable for any loss, damage or injury directly or indirectly caused by this material or its use.
If a passenger has specific medical or medical equipment needs contact the cruise line prior to arranging a booking to make and inquire as to the availability of the cruise line to assist or provide such items including those with hearing impairments, limited mobility or the sight impaired.
Safety And Security Ashore
Staying safe is the most important thing especially when traveling ashore for the day. Always remain security conscious and take sensible precautions. Ensure you pack your own luggage and do not ever leave it unattended.
Obey the local laws and understand that the laws and procedures which apply are those of the country you are in, not your home country or those of the cruise ship.
Remember to be respectful and to dress and behave conservatively, in accordance with local customs and sensitivities.
Swim only at safe beaches and only participate in snorkeling or scuba activities if you have received training. Do not scuba within 24 hours of flying. Never dive into water of unknown depth.
Be aware when in the water and do not swim after drinking alcohol.
Keep your wallet light. When going ashore, carry only the minimum amount of cash that is required for that day. Leave valuables, spare cash and credit cards in your cabin's safety deposit box.
No matter how strong a swimmer you are, always wear a life jacket for boating, water skiing and other offshore water sports. Check water sports equipment for quality and safety features.
Stick to what you know. Booking tours outside of any cruise company shore tour program is not recommended as they have not been independently assessed for their standard or safety.
Be careful what of what you eat when onshore, and when out and about throughout the day. It's recommended passengers drink plenty of bottled water, avoid ice and eat only well cooked food only.
Beware of uncooked food including salads and fruit that has already been peeled prior to consumption.
The decks on board any cruise ship can be slippery so low heeled or flat rubber soles shoes are recommended to avoid any slips or miss-steps.
Slip, slop, slap! The sun is bright and sunburn hurts so be sure to frequently apply sunscreen throughout the days on and off the ship.
If you get a little queasy on the water be sure to purchase enough medication before leaving home. Seasickness medication can also be purchased on board, however it can be expensive and may require a trip to see the ship's doctor.
Avoid insect bites by wearing light colored, loose fitting clothing that covers your arms and legs, and regularly apply insect repellent that contains at least 20% DEET.
A stomach bug with vomiting and diarrhea symptoms that can last for one to three days. Protect yourself and others by regularly washing your hands and changing into clean clothes everyday. Avoid contact with surfaces shared with others including railings and lift buttons. Pack sufficient medication to combat an outbreak of diarrhea by purchasing a product such as Gastro-stop from the chemist or drugstore.