1887

Chapter 18 : Infections on Cruise Ships

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Infections on Cruise Ships, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815950/9781555814847_Chap18-1.gif /docserver/preview/fulltext/10.1128/9781555815950/9781555814847_Chap18-2.gif

Abstract:

The majority of the diarrheal outbreaks on cruise ships involve the introduction of the pathogen into the food and water supply, with the subsequent breakdown of the food and water sanitation chain. The prevention of gastrointestinal infections on cruise ships involves controlling potential deficiencies in food and water handling as well as in cooking and catering, preventing sewage contamination of the water supply, and isolating sick persons. In the absence of effective vaccines for the prevention of infections by the majority of the above organisms, with the exception of serovar Typhi, these efforts are the primary preventive methods to decrease the burden of gastrointestinal illnesses on cruise ships. A study of the epidemiology of injuries and illnesses among passengers on cruise ships revealed that respiratory tract infections were the most common cause for seeking medical attention by passengers and crew members aboard the ship. Among the bacterial pathogens causing respiratory infections on cruise ships, the most common infections reported have been due to species. There have also been reported cases of vaccine-preventable infections, such as diphtheria and rubella, acquired on cruise ships. The presence of hot tubs and spas and the proximity of individuals on cruise ships can lead to the spread of skin infections among the passengers. The prevention of these infections involves meticulous care of the ship’s sanitary conditions, receiving appropriate vaccinations as necessary, and following basic infection control mechanisms, especially hand washing.

Citation: Kak V. 2009. Infections on Cruise Ships, p 377-383. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch18

Key Concept Ranking

Upper Respiratory Tract Infections
0.47171375
Infectious Pathogens
0.4067252
Infectious Diseases
0.4027419
0.47171375
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of FIGURE 1
FIGURE 1

Transmission electron micrograph of norovirus virions. Noroviruses are nonenveloped, single-stranded RNA viruses that belong to the genus and the family Source: Charles D. Humphrey, CDC (http://phil.cdc.gov/phil/quicksearch.asp).

Citation: Kak V. 2009. Infections on Cruise Ships, p 377-383. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch18
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555815950.ch18
1. American College of Emergency Physicians. 1998. Health care guidelines for cruise ship medical facilities. Ann. Emerg. Med. 35:535.
2. Anonymous. 1999. Influenza on a cruise ship in the Mediterranean. Commun. Dis. Rep. CDR Wkly. 9:209212.
3. Anonymous. 1997. Diphtheria acquired during a cruise in the Baltic Sea. Commun. Dis. Rep. CDR Wkly. 7:207.
4. Bodnar, U. R.,, S. M. Maloney, and, K. L. Fielding. 1999. Preliminary Guidelines for the Prevention and Control of Influenza-Like Illness among Passengers and Crew Members on Cruise Ships. U.S. Department of Health and Human Services, CDC, National Center for Infectious Diseases, Atlanta, GA.
5. Centers for Disease Control and Prevention. 1998. Rubella among crew members of commercial cruise ships—Florida, 1997. MMWR Morb. Mortal. Wkly. Rep. 46:12471250.
6. Centers for Disease Control and Prevention. 20 October 2008, accession date. Outbreak Updates for International Cruise Ships. CDC, Atlanta, GA. http://www.cdc.gov/nceh/vsp/surv/GIlist.htm.
7. Centers for Disease Control and Prevention. 20 October 2008, accession date. Cruise Ship with Inspections with Score of 100. CDC, Atlanta, GA. http://wwwn.cdc.gov/vsp/InspectionQueryTool/Forms/InspectionWith100Score.aspx.
8. Centers for Disease Control and Prevention. 2000. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb. Mortal. Wkly. Rep. 49 (RR-3):138.
9. Centers for Disease Control and Prevention. 1998. Outbreak of influenza A infection—Alaska and the Yukon Territory, June–July 1998. MMWR Morb. Mortal. Wkly. Rep. 47:638.
10. Centers for Disease Control and Prevention. 1998. Update: outbreak of influenza A infection—Alaska and the Yukon Territory, July–August 1998. MMWR Morb. Mortal. Wkly. Rep. 47:685688.
11. Centers for Disease Control and Prevention. 1994. Outbreak of Shigella flexneri 2a infections on a cruise ship. MMWR Morb. Mortal. Wkly. Rep. 43:657.
12. Centers for Disease Control and Prevention. 1997. Update: outbreaks of cyclosporiasis—United States and Canada. MMWR Morb. Mortal. Wkly. Rep. 46:521523.
13. Cramer,, E. H.,, C. J. Blanton,, L. H. Blanton,, G. H. Vaughan,, C. A. Bopp, and, D. L. Forney. 2006. Epidemiology of gastroenteritis on cruise ships, 2001–2004. Am. J. Prevent. Med. 30:252257.
14. Daniels,, N. A.,, J. Neimann,, A. Karpati,, U. D. Parashar,, K. D. Greene,, J. G. Wells,, A. Srivastava,, R. V. Tauxe,, E. D. Mintz, and, R. Quick. 2000. Traveler’s diarrhea at sea: three outbreaks of waterborne enterotoxigenic Escherichia coli on cruise ships. J. Infect. Dis. 181:14911495.
15. Davies,, J. W.,, W. R. Simon,, E. J. Bowmer,, A. Mallory, and, K. G. Cox. 1972. Typhoid at sea: epidemic aboard an ocean liner. Can. Med. Assoc. J. 106:877883.
16. DiGiovanna, T.,, T. Rosen,, R. Forsett,, K. Sivertson, and, G. D. Kelen. 1992. Shipboard medicine: a new niche for emergency medicine. Ann. Emerg. Med. 21:14761479.
17. Edelstein, P. H., and, M. S. Cetron. 1999. Sea, wind and pneumonia. Clin. Infect. Dis. 28:3941.
18. Ferson, M. J., and, K. A. Ressler. 2005. Bound for Sydney town: health surveillance on international cruise vessels visiting the Port of Sydney. Med. J. Aust. 182:391394.
19. Gregory, D. W., and, W. Schaffner. 1987. Pseudomonas infections associated with hot tubs and other environments. Infect. Dis. Clin. N. Am. 1:635648.
20. Jernigan,, D. B.,, J. Hofman, M. S. Cetron,, C. A. Genese,, J. P. Nuorti,, B. S. Fields,, R. F. Benson,, R. J. Carter,, P. H. Edelstein,, I. C. Guerrero,, S. M. Paul,, H. B. Lipman, and, R. Breiman. 1996. Outbreak of Legionnaires’ disease among cruise ship passengers exposed to a contaminated whirlpool spa. Lancet 347:494499.
21. Koo, D.,, K. Maloney, and, R. Tauxe. 1996. Epidemiology of diarrhoeal disease outbreaks on cruise ships, 1986 through 1993. JAMA 275:545547.
22. Lawrence,, D. N.,, P. A. Blake,, J. C. Yashuk,, J. G. Wells,, W. B. Creech, and, J. H. Hughes. 1979. Vibrio parahaemolyticus gastroenteritis outbreaks aboard two cruise ships. Am. J. Epidemiol. 109:7180.
23. Lew,, J. F.,, D. L. Swerdlow,, M. E. Dance,, P. M. Griffin,, C. A. Bopp,, M. J. Gillenwater,, T. Mercatante, and, R. I. Glass. 1991. An outbreak of shigellosis aboard a cruise ship caused by a multiple-antibiotic-resistant strain of Shigella flexneri. Am. J. Epidemiol. 134:413420.
24. Lumish,, R. M.,, R. W. Ryder,, D. C. Anderson,, J. G. Wells, and, N. D. Puhr. 1980. Heat-labile enterotoxigenic Escherichia coli induced diarrhea aboard a Miami based cruise ship. Am. J. Trop. Med. Hyg. 111:432436.
25. Merson,, M. H.,, J. H. Tenney,, J. D. Meyers,, B. T. Wood,, J. G. Wells,, W. Rymzo,, B. Cline,, W. E. DeWitt,, P. Skaliy, and, F. Mallison. 1975. Shigellosis at sea: an outbreak aboard a passenger cruise ship. Am. J. Epidemiol. 101:165175.
26. Miller,, J. M.,, T. W. S. Tam,, S. Maloney,, K. Fukuda,, N. Cox,, J. Hockin,, D. Kertesz,, A. Klimov, and, M. Cetron. 2000. Cruise ships: high-risk passengers and the global spread of new influenza viruses. Clin. Infect. Dis. 31:433438.
27. Minooee, A., and, L. S. Rickman. 1999. Infectious diseases on cruise ships. Clin. Infect. Dis. 29:737743.
28. Neri,, A. J.,, E. H. Cramer,, G. H. Vaughan,, J. Vinjé, and, H. M. Mainzer. 2008. Passenger behaviors during norovirus outbreaks on cruise ships. J. Travel Med. 15:172176.
29. Noel,, J. S.,, R. L. Fankhauser,, T. Ando, S. S. Monroe, and, R. I. Glass. 1999. Identification of a distinct common strain of “Norwalk-like viruses” having a global distribution. J. Infect. Dis. 179:13341344.
30. Peake,, D. E.,, C. L. Gary,, M. R. Ludwig, and, C. D. Hill. 1999. Descriptive epidemiology of injury and illness among crew members of commercial cruise ship passengers. Ann. Emerg. Med. 33:6772.
31. Singal, M.,, P. M. Schanta, and, S. B. Werner. 1976. Trichinosis acquired at sea—report of an outbreak. Am. J. Trop. Med. Hyg. 25:675681.
32. Waterman,, S. H.,, T. A. Demarcus,, J. G. Wells, and, P. A. Blake. 1987. Staphylococcal food poisoning on a cruise ship. Epidemiol. Infect. 99:349353.
33. Wheeler, R. E. 2001. Travel health at sea: cruise ship medicine, p. 275–287. In J. N. Zuckerman (ed.), Principles and Practices of Travel Medicine. John Wiley and Sons, New York, NY.
34. Widdowson, M. A.,, E. H. Cramer,, L. Hadley, et al. 2004. Outbreaks of acute gastroenteritis on cruise ships and on land: identification of a predominant circulating strain of norovirus—United States, 2002. J. Infect. Dis. 190:2736.
35. World Health Organization. 2001. Sanitation on Ships: Compendium of Outbreaks of Food Borne and Waterborne Disease and Legionnaires’ Diseases Associated with Ships, 1997–2000. WHO, Geneva, Switzerland.

Tables

Generic image for table
TABLE 1

Infectious pathogens and diseases of potential risk on cruise ships

Citation: Kak V. 2009. Infections on Cruise Ships, p 377-383. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch18

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error