Advice for those going on Cruises
Cruises are increasingly popular and allow adventure at the same time as the security of good accommodation, food and other facilities.
Diet and Weight Gain
Food on cruises is frequently excellent and provided in abundance. Many passengers put on a lot of weight even during short cruises.
Ship Movement and Accidents
Ships are inherently unstable due to sea swell and currents and accidents are common due to falls on deck and staircases. Excessive drinking of alcohol is common.
Care must be taken to avoid sunburn and UV light reflection from the water as well as from the sun make this more likely at sea. Dehydration can be prevented by drinking abundant non-alcoholic fluids.
The Elderly and those with medical conditions
Some cruise ships are unsuited for frail, elderly and handicapped travellers and details of facilities should be sought in advance if special facilities are needed. Those with existing illnesses or who are on medication should obtain a summary of their condition(s) and copy of current prescriptions from their doctor before departure. Heart problems as well as accidents may be caused by over indulgence in food and alcohol and this may be combined with a lack of exercise. Over exposure to the sun increases the possibility of stroke. Walking around the ship in rough weather is more likely to lead to injury in old people with poor balance, limited agility and slow reaction times.
Health care is usually available. Regardless of the quality of primary medical care a ships infirmary is often unable to provide immediate backup services such as surgery, blood transfusion, detailed laboratory or radiological investigations. Medical evacuation in emergency is dependent upon the ship’s position at sea, its sailing itinerary and the next port of call. There may be extra costs if evacuation is needed that are not covered by insurance.
Complicated vaccination schedules are usually unnecessary unless overnight stays on shore are anticipated in less than ideal accommodation. However within the confines of a ship outbreaks of respiratory infections can spread rapidly and vaccination against influenza / pneumococcal disease is highly recommended.
Great care is normally taken to prevent outbreaks of food poisoning on cruise ships but rarely contaminated food may be taken on board during stopovers. Those who choose to eat ashore must take care to avoid contaminated water and risky foodstuffs. Because hepatitis A is so easily spread vaccination against this disease may be appropriate for those cruising outside Europe and North America. If a passenger is likely to take risks when ashore, in addition to hepatitis A vaccination, typhoid vaccine and poliomyelitis boosters may be considered as for the country being visited.
Passengers are often asked to obtain a certificate of vaccination against yellow fever by the cruise company. Yellow fever is most unlikely to infect those at sea and those who only visit port cities since they are normally well away from the jungle areas where this disease is usually contracted. However a certificate of vaccination may be required for travellers on ships travelling between ports in South, Central America and Africa and unvaccinated passengers may also not be allowed ashore.
Post-exposure rabies vaccination is usually available on most larger cruise ships for those unlucky enough to have a dog bite while ashore. Verification should be sought from the tour / cruise organizer
The risk of malaria is also usually small but may be significant, for example, when entering ports in sub-Saharan Africa. The risk is small in most ports in Asia, the Caribbean, South and Central America. Passengers should be aware when they may have been exposed, however small the risk, so that they can seek medical attention should any fevers occur.
Mosquito bites should be minimized and prophylaxis may be more important for those with medical conditions or for the elderly when an attack of malaria may be more serious. The new drug atovaquone/proguanil (Malarone) has an advantage in that it only needs to be taken for 7 days after exposure so the scenario of having to take 4 weeks tablets after an overnight stop in, for example, the Gambia is now unnecessary.