Respiratory Infections and Gastrointestinal Illness on a Cruise Ship: a Three-Year Prospective Study

• Published in: Travel medicine and infectious disease 2016-07, Vol.14 (4), p.389-397
• Main Authors: Pavli, Androula, Dr, Maltezou, Helena C, Papadakis, Antonis, Katerelos, Panagiotis, Saroglou, Georgios, Tsakris, Athanasios, Tsiodras, Sotirios
• Format: Article
• Language: English
• Subjects: Abdomen; Acute Disease - epidemiology; Acute respiratory infection; Adult; Aged; Aged, 80 and over; Confined spaces; Crew; Cruise; Diarrhea; Disease Outbreaks - prevention & control; Disease prevention; Dyspnea; Europe; Female; Fever; Gastrointestinal diseases; Gastrointestinal Diseases - epidemiology; Headaches; Humans; Illnesses; Incidence; Infections; Infectious Disease; Infectious diseases; Influenza; Influenza, Human - epidemiology; Influenza-like illness; Male; Middle Aged; Passengers; Prospective Studies; Respiratory Tract Infections - epidemiology; Seasons; Ships; South America; Studies; Time Factors; Travel; Travel medicine; Vaccination; Vaccines; Vomiting
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2016.05.019

Summary Background Cruise ships carry a large number of people in confined spaces providing an environment for transmission of infections. The aim of this study is to estimate the incidence of and describe the spectrum of respiratory infections and gastrointestinal illness among passengers and crew of cruise Ship A. Material and Methods The study was carried out from January 2011 to December 2013 on cruise Ship A, including passengers and crew who presented with symptoms suggestive of acute respiratory infection (ARI), influenza-like illness (ILI) and gastrointestinal illness (GI). Advice about preventive measures of respiratory and gastrointestinal infections and influenza vaccination was given to passengers and crew. Data were collected by using one standardized form per patient. Results The most common destination was Northern Europe (90.7%). The mean duration of cruise was 10.6 days; 440 passengers and 421 crew members who sought medical attention were studied (mean age 72.6±9.5 and 33±7 years, respectively). ILI, ARI and GI were diagnosed in 32.7%, 15.9%, 17% and 10.9%, 80%, 0.2% of ill passengers and crew, respectively. The association of ARI, ILI and GI incidence in passengers was statistically significant with season, destination and duration of travel; the incidence for all illnesses was higher during winter, for travel to South America and for >14 days (p-value