Seasick?

How to stay healthy on that summer cruise

Cruise ships promise sun, sea, and no-hassle luxury travel. For the most part, they deliver, showing passengers the world aboard glittering floating cities stocked with every amenity. But on occasion, the very attributes that make ocean liners appealing can send travelers into an extended stay in sick bay.

In 2002, an estimated 1,800 passengers and crew experienced severe vomiting and diarrhea due to an outbreak of Norwalk virus during cruises to Alaska and the Caribbean. The leading cause of gastrointestinal illness in the United States, Norwalk viruses spread through contact with contaminated food and surfaces. Most disturbingly, nearly a third of the cruise ship victims were sickened on ships that had been cleaned and disinfected aggressively after a previous outbreak.

Hundreds of passengers living, eating, and relaxing together in the confines of a cruise liner offer ample opportunity for the microbes to be transmitted from one passenger to another, says Patti Emmett, a nurse and infection control coordinator at Community Hospital. The close quarters, communal meals, and visits to international ports only work in the tiny stowaways’ favor.

All in all, it’s enough to make the hardiest traveler pause before setting foot on a gangplank.

Smooth sailing

The weather service predicted steady winds and smooth water off the coast of Central California, and you went for it. With full sails heeled over in a perfect trim, your vessel was cutting the water at a clip of 10 to 20 knots. Feeling the sun warm your face and the brisk air whip your hair, it was a heady morning at sea. Turning to share a picturesque moment with your first mate, you found her
at the stern, gulping air in a desperate attempt to stem the nausea.

This had nothing to do with the Norwalk virus or being around hundreds of germ-laden cruise ship inhabitants. This was just old-fashioned motion sickness.

Getting fresh air is a good way to relieve this kind of seasickness, but it’s not the only solution. Next time you’re feeling seasick, you might want to sit down long enough to munch a few saltine crackers and sip a little cola while focusing on the horizon to regain your equilibrium. Or, close your eyes.

Send someone else below deck to get your snack; dropping down into that stuffy cabin could be just enough to put you over the edge. And you can forget about the greasy fried chicken and goat cheese you brought for that on-board gourmet lunch. Fortunately, it no longer sounds good, anyway. But if you can get your hands on a little ginger, it’s an herbal remedy known to settle the stomach and available in powder capsules at some health food stores.

While you’re probably thinking you’ll never again venture within a yacht’s length of the water, there are things you can do to plan ahead if you eventually decide on a return trip to sea. There are numerous anti-motion drugs — Dramamine™, for example — that affect the inner ear where motion or seasickness originates before it lands in the stomach. But no single remedy works for everyone, so you might want to consult your doctor. And keep in mind that any of the remedies must be taken before symptoms occur.

An alternative to oral medication is a prescription patch placed behind the ear. Designed for a continuous release of scopolamine, this flat, circular patch is unobtrusive and works for up to three days before it needs to be replaced. As with other medications, though, it may cause drowsiness and should not be combined with alcohol.

To avoid feeling drowsy, ocean-going travelers might prefer acupressure, which exerts a mild pressure between the flexor tendons on the wrist. The popular Seaband™ is a narrow woven cuff with a small plastic knob knit into the fabric, which painlessly presses into the tendon. Some travelers would not set sail
without it; others would rather wear jewelry and a patch behind the ear.

And if all else fails, there’s nothing like a return to shore to anchor an upset stomach. As the British hero Admiral Nelson said, “You’ll feel better if you sit under a tree.”

Tips for a bon voyage

Understanding how illnesses spread on a cruise ship, and avoiding these pitfalls, will help most travelers stay healthy for a lovely vacation.  Community Hospital nurse and infection control coordinator Patti Emmett offers the following tips developed by the Centers for Disease Control and Prevention.

You can plan for a healthy trip long before you pack your bags.

Start by reviewing a ship’s sanitation record before you book the cruise. The Centers for Disease Control (CDC) Web site publishes travelers’ advisories as well as the results of cruise ship health inspections at: www.cdc.gov/travel/cruiships.htm.

Visit your doctor before leaving. Ask which diseases are prevalent in the areas you plan to visit and what vaccinations are recommended for the region. To provide full protection, many vaccinations require a series of shots administered over several weeks. Be sure to get them all done well before your departure date. And ask your physician to prescribe a preventive antibiotic for traveler’s diarrhea; take it at the first sign of gastrointestinal discomfort. Remember, however, that antibiotics can’t cure a viral illness.

Once onboard, the single best way to stave off illness is to wash your hands thoroughly and often. Many diseases are spread through contact with germ-laden surfaces. Make sure your hands are clean before you eat or touch your eyes, nose, or mouth. On shore excursions, bring along a travel-sized bottle of hand sanitizer for times when soap and water aren’t available.

Watch what you eat. Contaminated food is a major source of shipboard illness. “A food handler with the sniffles could easily shed enough virus to infect several diners. So try to select foods that have been thoroughly cooked or that you can peel yourself,” Emmett says. “When you’re looking at that beautiful, mouth-watering gourmet buffet, in addition to the list of what you would like to eat, maybe think about what you would like to avoid, such as raw vegetables or meats.” No matter how amazing the watermelon sculpture appears, skip the fruit salad. It’s not only raw, it has been processed by many people. Opt for a banana or orange that you can peel at your plate instead.

Eat a sit-down meal whenever possible. A buffet line sneezeguard doesn’t provide that much protection; the food in the buffet line comes in contact with far more people than a hot dish served up especially for you.

Apply the same principles to shoreside dining. The aromas wafting through the local marketplace may be enticing, but it is generally wise to avoid food from street vendors if you suspect it hasn’t been well-cooked or well-refrigerated. If you must sample the local specialties, make sure everything you eat is fresh and piping hot.

Whenever possible, drink beverages made from boiled water, such as tea and coffee. Canned sodas and juices, and bottled beverages such as spring water, beer, and wine, should also be safe. And no matter how hot the weather, drink everything without ice, which is only as safe as the local tap water, since freezing doesn’t kill most germs.

Though cruise ships teem with opportunities to mingle with fellow passengers, be prudent about your social contacts. “You may meet new friends who invite you to get together for drinks or dinner. But if they talk about being up ill the previous night, perhaps you should decline,” Emmett says. “Practice common-sense behavior.”