Healthbeat: Staying healthy on a cruise

For many people, a cruise is an ideal way to relax and see the world. You are surrounded by the gorgeous blue of the ocean, get waited on hand and foot, have activities and events planned for you and are provided with a seemingly limitless supply of food and drinks -- all while having the opportunity to visit multiple countries and destinations.

Although cruising has many obvious pleasures, potential health hazards also are a risk with cruise ship travel. Staying informed and preparing for these potential hazards can help you stay healthy and get the most out of your cruise vacation.

Vaccines

Regardless of your itinerary, you should be up-to-date on routine vaccines, such as measles/mumps/rubella, varicella and seasonal flu. Crew members and fellow travelers often come from countries where these diseases are more common than in the United States and where vaccination is not routine. Consequently, outbreaks of chickenpox and rubella [German measles] have been reported on cruise ships.

Additional vaccines you'll need depend on where you'll be stopping and what you're going to do there. CDC's general vaccination recommendations, by country, can be found on the Travelers' Health destination pages. However, discuss the cruise itinerary and your specific travel plans with your doctor. If you're stopping in a country only for a short time, or if you don't plan to leave the tourist area around the dock, certain vaccines may not be necessary.

Even if you are not at risk for yellow fever during port calls, some countries in Africa and South America may require proof of yellow fever vaccination if you have previously visited a country with yellow fever. Visit the destination pages for a country's yellow fever requirements. Cruise ship companies sometimes have requirements that differ from those of the countries you will be visiting, so be sure to check with the cruise line about those requirements, as well.

Nausea, vomiting and diarrhea

Cruise ship outbreaks of nausea, vomiting and diarrhea, primarily caused by norovirus, have been reported. The best way to prevent illness is frequent hand-washing with soap and water. Wash your hands before eating and after using the bathroom, changing diapers or touching things that other people have touched, such as stair railings; it is also a good idea to avoid touching your face.

If soap and water are not available, alcohol-based hand sanitizer [containing at least 60 percent alcohol] is a good second choice. You will see hand sanitizer dispensers throughout your cruise ship -- use them.

While on shore excursions, especially in developing countries, follow basic food and water precautions: eat only food that is cooked and served hot, drink only beverages from sealed containers, avoid ice and eat fresh fruit only if you have washed it with clean water and peeled it yourself.

If you are feeling sick before your voyage, ask your cruise line if alternative cruising options are available. Consult your doctor to find out whether it is safe for you to sail. If you feel sick during your voyage, report your symptoms to the ship's medical facility and follow their recommendations. For more information about nausea, vomiting and diarrhea on cruise ships, visit CDC's Vessel Sanitation Program website.

Other health concerns

Respiratory diseases also are common on cruise ships. Frequent hand-washing can keep you from getting sick, and coughing or sneezing into a tissue [not your hand] can prevent you from spreading germs. Getting a flu shot is the best way to keep from getting the flu.

Seasickness is a common complaint of cruise ship passengers. If you are [or think you might be] prone to seasickness, talk to your doctor about medicine to decrease your symptoms. Note that many common medications [including some antidepressants, painkillers and birth control pills] can worsen the nausea of seasickness.

Various stressors associated with cruising -- changes in diet, variation in climate, changes to sleep and activity patterns -- can worsen a chronic illness. If you have been diagnosed with such an illness, you should be prepared to monitor your health while on a cruise [for example, frequently testing your blood sugar if you have diabetes]. If you regularly take medicine for a chronic illness, make sure you bring enough for the duration of the cruise, plus extra in case of delays, and take it on the same schedule as you would at home.

For more information on healthy travel, visit www.cdc.gov/travel.

Travel health insurance and evacuation insurance

You should check with your regular health insurance company to see if your policy will cover any medical care you might need in another country or on board the ship. If not, you can purchase travel health insurance to cover you during your trip.

Also, look for gaps in your insurance coverage. For example, your health insurance might not cover medical evacuation if you cannot receive needed treatment where you are. Evacuation by air ambulance can cost $50,000 to $100,000 and must be paid in advance by people who do not have insurance. You can buy medical evacuation insurance to be sure you will have access to emergency care. For more information on travel health insurance, visit http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/travel-health-insurance-and-evacuation-insurance.htm.