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Preventive Health for Cruise Ship Travelers
Due to multiple port visits and potential exposures, cruise ship
travelers may be uncertain about which prevention medications, immunizations
and behaviors are appropriate for them and for their itineraries.
In general, travelers should inform the cruise line of special medical
needs, such as wheelchair access, oxygen tank, dialysis, etc, in
advance of travel. Adequate medical insurance coverage for receiving
health care overseas and medical evacuation should be ensured. Four
to six weeks before travel, cruise travelers should consult a health-care
provider who can give guidance on appropriate chemoprophylaxis,
immunizations, and health behaviors based on a complete review of
the health status of the traveler, duration of travel, countries
to be visited, and shoreside activities. Clinicians should provide
travelers with
1) destination-specific recommended and required vaccines
(e.g., yellow fever), as well as prevention medication (e.g. malaria
chemoprophylaxis) if needed;
2) routinely recommended age- and medical condition-specific
immunizations, such as MMR and influenza vaccines, if not up
to-date;
3) appropriate options for motion sickness based on the individual’s
medical history and current medications and
4) a written summary of their medical history, including
pertinent diagnostic data such as EKG and chest x-ray, to facilitate
overseas medical care, should it be required. Among cruise ship
passengers and crew members, risk of exposure to infectious diseases
is difficult to quantify because of the broad spectrum of cruise
ship experiences and limited data. Travelers should be given guidance
on good health habits and disease prevention practices during travel
including adequate
1) hand hygiene (i.e., washing hands for at least 20 seconds
with soap and water) or if soap and water are unavailable, using
an alcohol-based product containing more than 60% alcohol
2) respiratory hygiene such as using tissue to cover coughs
and sneezes;
3) food and water intake precautions (i.e., eating foods
that are thoroughly cooked and of appropriate temperate); and
4) mosquito prevention (i.e., using DEET-containing repellents,
bed nets, and clothing that provides more coverage over exposed
areas of the body. Health-care providers can contribute to healthy
environments on cruise ships by questioning ill returned travelers
about recent cruise vacations and promptly reporting any suspected
communicable disease to public health authorities.
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