Advice for travellers on cruise ships

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					Advice for travellers on cruise ships
                     Cruising has become an increasingly popular choice of
                     holiday in recent years. In 2006 an estimated 11.7 million
                     passengers worldwide travelled on cruise ships.
                     If you are planning to take a cruise the following advice
                     may help to ensure that you enjoy the experience to the

Temperature changes, weather variations, changes in diet and physical
activities can all impact on your general state of health and wellbeing on a
cruise, particularly if you have a pre-existing illness. Consult your doctor or
nurse before booking your holiday. Some cruise ships may be unsuitable for
frail, elderly and handicapped travellers so check with the cruise line pre-
booking and make sure that any special needs are notified before you travel.

Pre-Travel Health Advice:
Allow plenty of time for a pre-travel consultation with your doctor or nurse.
Book an appointment at least 6-8 weeks before you travel to discuss your
travel plans and assess your specific travel health requirements.

Check that you are up to date with your routine vaccines, including your flu
vaccine if you are in a group for whom annual vaccination against influenza is

Travel vaccine requirements are likely to vary depending on the type of cruise
you are going on, the countries you will be visiting, the time of year and
whether any overnight stays on shore are anticipated. It is therefore
important to take your exact itinerary with you to discuss your travel
vaccine needs.

You may require a valid certificate of vaccination against yellow fever,
which is an immigration requirement if you plan to go ashore in some
countries especially in the Caribbean, South and Central America and sub-
Saharan Africa. Unvaccinated passengers may not be allowed ashore in
these countries so ask your practice nurse or doctor for further advice if you
are unsure about whether you need vaccination against yellow fever for your
chosen cruise.


   •   Most travellers on cruises are only ashore during daylight hours when
       mosquitoes that transmit the disease are not feeding and therefore do
       not require tablets to prevent malaria.

   •   Occasionally this is not the case as some cruises include over night
       stays in areas where malaria is a risk and passengers may be ashore
       or on deck after dusk. For example, the Amazon in Brazil, or the
       Orinoco River in Venezuela. Cruises along the East African coast may
       also include a stop for a night or more in the port of Mombasa, Kenya.
       It is important to discuss your cruise itinerary with your doctor or
       nurse, as it may be necessary for you to take malaria prevention

   •   All travellers should take precautions to avoid insect bites when on
       cruising holidays e.g. insect repellent sprays etc

Care in the Sun:
Extra care must be taken to avoid sunburn when cruising. UV light reflection
from the sun on the water increases the risk of sunburn when at sea.
Remember that it is still possible to experience the damaging effects of the
sun even on cool cloudy days so protect yourself from skin damage at all
times by taking a few simple precautions:
   • Avoid sun exposure when the sun is at its highest point in the sky
       (between 10am and 3pm)
   • Always use a sunscreen with a high SPF (usually 15 or higher).
   • Sunscreen should be applied at least 30 minutes before exposure to
       the sun and reapplied about every two hours, also after swimming and
       vigorous exercise.
   • Wear sunglasses and a wide-brimmed hat to protect the head and
   • Cover as much skin as possible with sun-protective clothing if exposure
       during peak times is unavoidable

Food and Water:
Food and alcohol on cruise ships are generally available in abundance.
Changes in diet and environment are a common cause of gastric upsets when
on holiday, although tempting, try to avoid over indulging.
Eating and drinking on board the cruise ship is often considered safer than
eating and drinking onshore, however outbreaks of gastrointestinal infections
occasionally occur onboard. Gastrointestinal infections (commonly caused by
the norovirus) are highly contagious, you can reduce your risk of infection with
good personal hygiene; wash your hands thoroughly and frequently,
particularly before eating or drinking.

Motion Sickness:
Seasickness or motion sickness is the feeling of nausea and dizziness
associated with the motion of the boat. It is not possible to predict if you will
suffer from seasickness however the risk is higher if you have previously
suffered form motion sickness.
Motion sickness is more common on smaller vessels, larger cruise ships
normally have stabilizers that will eliminate much of the motion responsible for
seasickness however even on big cruise liners and ferries the boat moves in
relation to the horizon or coast line, potentially causing motion sickness.
If you are concerned about motion sickness, talk to your doctor or pharmacist
before you travel about the preventative measures you can take, including
Medical Care Onboard:
Health care is usually available onboard ship however medical facilities may
vary, particularly on smaller ships. Travellers should be aware that
independent operators may have no medical facilities available onboard and
are advised to check with their cruise line before they book. The majority of
illnesses seen on cruise ships can normally be treated successfully but
travellers should be aware that in the event of an acute medical emergency
they may have to disembark at whatever port is nearest whilst repatriation is

Supplies of medication onboard ship are likely to be limited.
If you need to take medication regularly make sure that you have a sufficient
supply to last you for the whole trip.
    • Always keep your medicines in the original labeled container supplied
       by the pharmacist and take a letter with you from your doctor giving the
       name of the medicine (both the brand name and generic name) and
       what it is used for. This may help when passing through customs or if
       you need to seek medical attention abroad.
    • If your medicine has to be stored in a refrigerator, get advice on how to
       store it during travel and while you are away. Your doctor or
       pharmacist should be able to advise you.

Accidents and injury:
Older travellers and young children are more likely to sustain injury while
walking around the ship, particularly in rough weather, since they tend to be
less agile and have slower reactions. Accidents on board ship may also occur
as a result of over indulgence in alcohol.

Make sure that you take out adequate travel insurance. Check that your policy
will cover any pre-existing conditions, including the cost of unexpected
treatments while you are away.

If you are travelling in Europe, make sure you have a European Health
Insurance Card (EHIC). The EHIC entitles you to reduced cost, sometimes
free, medical treatment in most European countries. Please note, you should
still always take out private health insurance, as an EHIC will not necessarily
cover all the costs or your treatment and will not cover the cost of being flown
back to the UK.
The EHIC is available from any post office or online from the Department of
Health website

This leaflet has been prepared by Sanofi Pasteur MSD to give you general information
on issues relating to healthy travel. It is not meant as an alternative to individual
advice and should be used in conjunction with advice provided by a health care

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