Chapter 18 : Infections on Cruise Ships

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 Salmonella 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 Legionella 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.