One can imagine life on a cruise ship—perfect for lazy holidays, an azure sky and green sea, not to mention the all-you-can-eat buffet and entertainment. You can travel the world while laying on a sunbed.
However, along with the Broadway showtunes, you might also find food and water contamination, threats of the coronavirus and vector-borne diseases—health hazards all the riskier because of so many people confined in a small area.
The good news is that with a little effort you can have fun and be perfectly safe. The Remedy talked to top doctors and have you covered. Read on to discover the 20 worst health hazards on cruise ships and how to avoid them.
Cruise ship stocks are plummeting as passengers fear contamination. “The coronavirus—COVID-19—like influenza, is spread through respiratory droplets which can be spread from one person to another when coughing or sneezing or through contact such as touching with hands contaminated with secretions,” says Dr. Ko. “COVID-19 may also spread indirectly when people touch surfaces contaminated with the virus and then touch their noses and mouths.”
The Remedy Rx: “The most important precaution is practicing sound hand and respiratory hygiene, which includes frequent hand washing and covering the mouth and nose when coughing or sneezing,” says Albert Ko, MD, a Yale Medicine infectious disease specialist.
“The common cold and more serious respiratory illnesses—such as influenza and coronavirus—are spread through droplets when an infected person coughs or sneezes,” says Dr. Monique May. They are very common on cruise ships.
The Remedy Rx: “Ways to avoid getting sick include an annual flu shot, wearing a respiratory mask, staying three feet away from other people, and washing your hands often,” says Dr. May.
Seasickness is a common complaint of cruise ship passengers. “Increased risk of motion sickness which can cause vomiting and can increase fall risk,” says Dr. Leann Poston.
The Remedy Rx: “Placing a prescription-only scopolamine patch behind your ear at least 4 hours before your cruise leaves helps to prevent sea-sickness,” says Dr. May. “When you are on the deck choose a spot on the horizon to look at to avoid becoming sea-sick. Eating foods low in fat and high in protein and staying well-hydrated (including minimal if any alcohol) will help as well.”
Common gastrointestinal infections on cruise ships are Hepatitis A, norovirus or Norwalk virus, and bacterial infections including E.coli, Salmonella, and Shigella. “They are transmitted by eating foods that have been contaminated by fecal matter, usually prepared under unsanitary circumstances by an infected person (i.e. improper or lack of handwashing),” says Dr. May.
The Remedy Rx: “The only way to protect yourself from food-borne illness is to avoid eating raw or undercooked foods, and avoid foods that have a higher risk for bacterial contamination, such as dairy, eggs, meat, poultry, seafood, or foods containing mayonnaise,” says Dr. May.
A rare neurological disorder—called Mal de Debarquement syndrome—develops after a cruise or some other type of water travel. “Patients feel a persistent sensation of rocking,” says Inna Husain, MD, an otolaryngologist. “Essentially they feel like they’re still on the boat. Some can have difficulty with balance and concentration. Symptoms can last weeks to months after coming off the boat.”
The Remedy Rx: “There is no known cure but often antidepressant or anti-seizure medication can help,” says Dr. Husain. “Some balance or vestibular exercises can help as well.”
“Most cruise ships have pools that increase the risks of drowning, falls and gastrointestinal illnesses,” says Dr. Poston.
The Remedy Rx: Limiting your time relaxing in pools and hot tubs! Be sure to shower afterwards as well.
“Cruise ships are ideal incubators for infectious agents given that passengers spend most of the time outside of their small cabins and have prolonged contact with each other in common spaces while eating or during social events,” says Dr. Ko.
The Remedy Rx: If someone’s sick around you, be sure to wash and sanitize your hands often, and wear a medical mask.
“A delay in debarking from a cruise ship such as due to bad weather, mechanical malfunction, or medical isolation can result in difficulty maintaining refrigeration, adequate freshwater supply, and a functioning septic system,” says Dr. Leann Poston.
The Remedy Rx: “While on shore excursions, especially in developing countries, follow basic food and water precautions: eat only food that is cooked and served hot, drink only beverages from sealed containers, avoid ice, and eat fresh produce only if you have washed it with clean water and peeled it yourself,” advises the CDC.
“Various stressors associated with cruising—changes in diet, variation in climate, changes to sleep and activity patterns—can worsen a chronic illness,” says the CDC.
The Remedy Rx: “If you have been diagnosed with such an illness, you should be prepared to monitor your health while on a cruise (for example, frequently testing your blood sugar if you have diabetes),” says the CDC. “If you regularly take medicine for a chronic illness, make sure you bring enough for the duration of the cruise, plus extra in case of delays, and take it on the same schedule as you would at home.”
“In general, Legionnaires’ disease is contracted by inhaling warm, aerosolized water containing Legionella. Contaminated hot tubs are a commonly implicated source of shipboard Legionella outbreaks, although potable water supply systems have also been implicated,” says the CDC.
The Remedy Rx: “Most cruise ships have health care personnel who can perform Legionella urine antigen testing. People with suspected Legionnaires’ disease require prompt antibiotic treatment,” says the CDC.
A vector is an animal on or in which a small living thing gets transported, an example being a fly or a mosquito. “Cruise ship port visits may include countries where vector-borne diseases such as malaria, dengue, yellow fever, Japanese encephalitis, and Zika are endemic,” says the CDC.
The Remedy Rx: While indoors, remain in well-screened or air-conditioned areas. When outdoors, wear long-sleeved shirts, long pants, boots, and hats.
The cruise ship may dock in places where there is a potential measles outbreak. “Since late 2018, the World Health Organization has reported a resurgence in measles cases worldwide,” says the CDC. “This global trend coincides with declining measles vaccination rates in many countries, which may be contributing to the spread of the disease.”
The Remedy Rx: “Travelers (both passengers and crew) can avoid becoming infected and prevent the spread of measles by being fully vaccinated against measles (2 doses for international travelers at least 28 days apart, at least 2 weeks before travel), or by having other evidence of immunity against measles,” reports the CDC.
“The medical personnel onboard may not speak the same language as you, and therefore it may be difficult to convey information about your illness to them,” says Dr. Leann Poston.
The Remedy Rx: Plan your doctor visits ahead of time!
“Increased access to alcohol and drugs can increase the risk of both falls and crimes,” says Dr. Poston.
The Remedy Rx: Pace yourself. Avoid binge drinking as well, which the CDC defines as five or more drinks on an occasion for men and four or more drinks on an occasion for women.
“The vaccination requirements are not at the same standard across the world. Having people from all over the globe traveling together increases the risk of vaccine-preventable diseases,” says Dr. Poston.
The Remedy Rx: Stay up to date on your vaccinations. Before planning a cruise, do some research about the risks in docking in certain places.
“If you do not have travel insurance, there is the possibility that your medical care may not be covered on a cruise ship,” says Dr. Poston.
The Remedy Rx: Call your insurance company ahead of time and see what they cover.
“Maintaining all of the perks of a cruise ship takes a lot of energy, which can lead to increased pollution levels on a cruise ship which can negatively affect respiratory health. Many cruise ships have diesel engines that emit a high level of pollutants,” says Dr. Poston.
The Remedy Rx: When on your travels, avoid the engine room! If an incident were to happen, try having medical masks on hand.
Traveling on cruise ships involves increased risk of sunburn or heat exhaustion,” says Dr. Poston.
The Remedy Rx: Don’t forget to stock up on sunscreen and wear appropriate clothing when outdoors. And hydrate.
“In the event of an emergency, there may be inadequate preparation by the crew and passengers—i.e. Not knowing the procedure for accessing life vests and evacuation boats,” says Dr. Poston.
The Remedy Rx: Pay attention to the pamphlets and information given to you at the start of your cruise! The information about the boat could come in handy.
“Cruise travelers are often 65+ and dealing with broken down or decayed teeth—or in the midst of complex dental treatment,” says William D. Cranford, Jr., DMD, MAGD. “Dental problems may worsen with eating unusual foods and trying new activities on the ship.”
The Remedy Rx: “Visit the dentist at least one month before your cruise. Schedule treatment to take care of known problem areas that could cause pain or discomfort while you are away.”
And to live your happiest and healthiest life, don’t miss these 60 Secrets Nurses Don’t Want You to Know.