Prevention of infections aboard cruise ships
Spring break is here many Americans will go on vacation and some will take a cruise.
Cruises have become increasingly popular over the years as a form of vacation. Cruise lines have responded to the increased demand by adding larger ships to meet the demand. On the darker side cruise ships have been plagues by risk of infection outbreaks due to the over crowding aboard ships. The cruise lines have appropriately responded to this fear of outbreaks by instituting appropriate precautions without interfering with the vacation mood. In fact we just got back from our own spring break cruise in the Caribbean sea on Royal Caribbean’s Oasis of the Seas, their newest and currently largest cruise ship. I noticed several precautions since the last time we took a cruise several years ago. (BTW:The cruise was fabulous. I highly recommend it!)
From an infectious disease perspective I not only have to congratulate the cruise line on a phenomenal job with the accommodations and entertainment but also the attention to infection control issues.
Most dreaded infection issues are the ones transmitted by either droplet leading to respiratory infections or by contact leading to diarrheal illnesses like norovirus outbreaks that often get media attention that the cruise lines dread.
With regard to respiratory infections the few obvious changes in newer ships is the larger airspaces in common areas. The dining halls, the theaters and the promenade all had higher ceilings than on older cruise ships allowing for greater air exchanges. There was information posted daily about respiratory infections, H1N1 precautions etc.
Diarrheal outbreaks can quickly turn a vacation cruise into a nightmare adventure at sea, especially with the greater number of older persons on cruise ships who may be very susceptible to become very ill. If an effort to control this the cruise ships installed waterless hand sanitizer at the entry points to the ship and to the dining halls. They had staff reminding guests to use them. I was pleasantly surprised to see (non scientific observation) that the compliance rate among passengers was very high. I did not see the opposition from anyone that usually accompanies this kind of added inconvenience. Children, adults all seemed to participate and understand why this is needed. Of course the usual buffet controls were also in place such as sneeze guards, single use of plates and flatware etc.
It is very easy for corporations to go overboard (pun intended) with precautions in a knee jerk effort to control outbreaks at sea. These kind of measures prove to be counter productive in the long run. They create more inconvenience, greater cost, greater customer dissatisfaction without much hard science that they are getting anything for it. I did not see any of these problems on this particular cruise. Whoever is advising them is doing a good job.
All these precautions go a long way in making a successful vacation.
Hats off to Royal Caribbean cruise lines for the effort. We do appreciate it.
Bits & Bugs 
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