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Infections on Cruise Ships

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  • Author: Vivek Kak1
  • Editor: David Schlossberg2
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Allegiance Health, Jackson, MI 49202; 2: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec August 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0007-2015
  • Received 11 March 2015 Accepted 14 March 2015 Published 07 August 2015
  • Vivek Kak, Vivek.Kak@allegiancehealth.org
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  • Abstract:

    The modern cruise ship is a small city on the seas, with populations as large as 5,000 seen on large ships. The growth of the cruise ship industry has continued in the twenty-first century, and it was estimated that nearly 21.3 million passengers traveled on cruise ships in 2013, with the majority of these sailing from North America. The presence of large numbers of individuals in close proximity to each other facilitates transmission of infectious diseases, often through person-to-person spread or via contaminated food or water. An infectious agent introduced into the environment of a cruise ship has the potential to be distributed widely across the ship and to cause significant morbidity. The median cruise ship passenger is over 45 years old and often has chronic medical problems, so it is important that, to have a safe cruise ship experience, any potential for the introduction of an infecting agent as well as its transmission be minimized. The majority of cruise ship infections involve respiratory and gastrointestinal infections. This article discusses infectious outbreaks on cruise ships and suggests preventative measures for passengers who plan to travel on cruise ships.

  • Citation: Kak V. 2015. Infections on Cruise Ships. Microbiol Spectrum 3(4):IOL5-0007-2015. doi:10.1128/microbiolspec.IOL5-0007-2015.

Key Concept Ranking

Upper Respiratory Tract Infections
0.52947044
Infectious Diseases
0.4569883
Infectious Pathogens
0.44000086
0.52947044

References

1. Acevedo F, Diskin AL, Dahl E. 2011. Varicella at sea: a two-year study on cruise ships. Int Marit Health 62:254–261. [PubMed]
2. American College of Emergency Physicians. 2013. Health care guidelines for cruise ship medical facilities. Ann Emerg Med 35:535. [PubMed]
3. Centers for Disease Control and Prevention. 2011. Vessel Sanitation Program 2011 Operations Manual. U.S. Public Health Service.
4. Cramer EH, Blanton CJ, Blanton LH, Vaughan GH, Bopp CA, Forney DL. 2006. Epidemiology of gastroenteritis on cruise ships, 2001–2004. Am J Prevent Med 30:252–257. [PubMed][CrossRef]
5. Edelstein PH, Cetron MS. 1999. Sea, wind and pneumonia. Clin Infect Dis 28:39–41. [PubMed][CrossRef]
6. Guyard C, Low DE. 2011. Legionella infections and travel associated legionellosis. Travel Med Infect Dis 9:176–186. [PubMed][CrossRef]
7. Miller JM, Tam TWS, Maloney S, Fukuda K, Cox N, Hockin J, Kertesz D, Klimov A, Cetron M. 2000. Cruise ships: high-risk passengers and the global spread of new influenza viruses. Clin Infect Dis 31:433–438. [PubMed][CrossRef]
8. Neri AJ, Cramer EH, Vaughan GH, Vinjé J, Mainzer HM. 2008. Passenger behaviors during norovirus outbreaks on cruise ships. J Travel Med 15:172–176. [PubMed][CrossRef]
9. Stefanelli P, Fazio C, Neri A, Isola P, Sani S, Marelli P, Martinelli C, Mastrantonio P, Pompa MG. 2012. Cluster of invasive Neisseria meningitidis infections on a cruise ship, Italy, October 2012. Euro Surveill 17(50). [PubMed]
10. Ward KA, Armstrong P, McAnulty JM, Iwasenko JM, Dwyer DE. 2010. Outbreaks of pandemic (H1N1) 2009 and seasonal influenza A (H3N2) on cruise ship. Emerg Infect Dis 16:1731–1737. [PubMed][CrossRef]
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/content/journal/microbiolspec/10.1128/microbiolspec.IOL5-0007-2015
2015-08-07
2017-11-21

Abstract:

The modern cruise ship is a small city on the seas, with populations as large as 5,000 seen on large ships. The growth of the cruise ship industry has continued in the twenty-first century, and it was estimated that nearly 21.3 million passengers traveled on cruise ships in 2013, with the majority of these sailing from North America. The presence of large numbers of individuals in close proximity to each other facilitates transmission of infectious diseases, often through person-to-person spread or via contaminated food or water. An infectious agent introduced into the environment of a cruise ship has the potential to be distributed widely across the ship and to cause significant morbidity. The median cruise ship passenger is over 45 years old and often has chronic medical problems, so it is important that, to have a safe cruise ship experience, any potential for the introduction of an infecting agent as well as its transmission be minimized. The majority of cruise ship infections involve respiratory and gastrointestinal infections. This article discusses infectious outbreaks on cruise ships and suggests preventative measures for passengers who plan to travel on cruise ships.

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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. doi:10.1128/microbiolspec.IOL5-0007-2015.f1

Source: microbiolspec August 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0007-2015
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Image of FIGURE 2
FIGURE 2

Micrograph of bacteria. doi:10.1128/microbiolspec.IOL5-0007-2015.f2

Source: microbiolspec August 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0007-2015
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Tables

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TABLE 1

Infectious pathogens and diseases of potential risk on cruise ships

Source: microbiolspec August 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0007-2015

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