Cruise Ships

Travellers’ diarrhoea is the most common illness affecting travellers. It can be caused by many different bacteria, viruses and parasites, many of which are widespread worldwide. Cholera is very rare in tourists and travellers.

Worldwide Prevalence

There are regional differences in the risk of diarrhoea. Low risk countries include USA, Canada, Australia, New Zealand, Japan, and countries in northern and western Europe. Medium risk countries include those in Eastern Europe, southern Africa, and some Caribbean islands. High risk areas include most of Asia, the Middle East, Africa, Mexico, and Central and South America.

Laboratory reports of gastrointestinal illness by travel history, England, Wales, and Northern Ireland: 1995 – 2004.

The graph shows the total number of laboratory reports of organisms commonly causing gastrointestinal illness and reported to the UK’s Health Protection Agency from 1995 to 2004. It indicates how many cases were acquired during travel, however, the number of reports for which a travel history is known is generally less than 15%.

Cruise Line Infection Outbreaks 2009 / 2010

Risk for Travellers

Travellers’ diarrhoea is the most common illness in those travelling from resource-rich to resource-poor countries and occurs in 20%-60% of travellers. Destination is the most important influence on risk. The standard of hygiene in cafes, restaurants and bars also contributes to diarrhoea risk. Travelling “rough” and being more adventurous in eating habits is likely to increase the risk. The effects of diarrhoea are generally greater in the very young, the elderly and those with special health needs.

Transmission

Norovirus and other diarrhoea causing microorganisms and spread most frequently form person to person or from surfaces to person on hands.

Eating contaminated food and drinking contaminated liquids can also be a way of catching travellers’ diarrhoea. Changes in bowel habit can be caused by stress, unfamiliar food, increased alcohol consumption and hot weather. However most episodes of diarrhoea are caused by infections.

Prevention

The most effective method of prevention is to either wash your hands with soap and water at a sink, and then treating your hands at least once per day (the more often the better) with Q Shield^TM .

Signs and Symptoms

Travellers’ diarrhoea is usually described as passing three or more loose stools in a 24-hour period or any number of unformed stools accompanied by abdominal pain, fever, nausea or vomiting. It usually occurs during the first week of travel and is often self-limiting, lasting three to four days. In a small number of travellers, diarrhoea persists for longer than a month. Some travellers develop a post-infection irritable bowel syndrome.

Treatment

Usually, travellers’ diarrhoea is a short illness only lasting several days.

HPA passenger letter

http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1206520183347