DANGERS AT SEA
It’s the dead of winter, and there’s no better time for a refreshing and relaxing cruise. Let the kids enjoy rock climbing, surfing, zip lining, ice skating and swimming while you savor crisp blue skies, warm sea mists and wine coolers on your balcony as you cuddle together and scan the whitecaps for a glimpse of an acrobatic whale. A lush buffet dinner awaits you all in a couple of hours; until then, there are many options for fun on your personal vacation menu. Unfortunately, although a cruise ship may seem like a getaway from daily life and its stressors, potential dangers lurk in every passageway and on every promenade.– By Linda Reid
A cruise vacation may seem like a great way to relax, but it just might cost you your health.
DANGEROUS FELLOW PASSENGERS
“People assume that a cruise ship is a safe cocoon and get a sense of overconfidence,” says Charles Lipcon, a cruise-line maritime attorney in Miami and author of “Unsafe on the High Seas.” “Their ‘antennas’ get turned off. But a cruise ship is like a big city. Would you let your 15-year-old run around New York City alone at 2 a.m.?” Lipcon’s cases have included gang rapes of young girls and date-rape drug use. Reported sexual assaults on ships number in the dozens each year, and poorly trained or unqualified cruise-line security guards are often the only investigators after a crime has occurred.
“Passengers think they’re in the United States, but they’re in the country of the vessel’s flag and under that country’s laws,” Lipcon adds. The FBI does have jurisdiction over crimes upon American citizens “on the high seas,” but it often has no evidence to work with. Cruise-line personnel, Lipcon says, typically “make no effort to preserve the crime scene. They vacuum the room and steam-clean the sheets.” The result: Many perpetrators remain unidentified – and unprosecuted.
UNHEALTHY EATING AND DRINKING
Taking precautions is important to stay safe on a cruise — but also to stay healthy. “But health-conscious travelers face an environment filled with excess,” says Ellen Bauersfeld, a registered dietitian in Northridge, Calif. “24/7 meals, hundreds of items on a buffet line – most of which are high in fat, salt and sugar. Even with good intentions, many fall prey to overeating.
”Unhealthy foods trigger addictive changes in brain chemistry, Bauersfeld explains, adding: “Recent research has revealed the dopamine spike that sugar creates in our brains. Dopamine is a feel-good hormone that affects our reward/pleasure center a little like a drug. Unfortunately, it only feels good while we’re eating, which is why – as David Kessler, M.D., reported in his book, “The End of Overeating” – we want more and more and more.” Additionally, Bauersfeld warns, “Mixed specialty drinks are in abundance on cruise ships. Not only are they high in calories, but, after a few drinks, impulse control and making good food choices become more challenging.”
FOOD POISONING AND NOROVIRUS
The Centers for Disease Control estimates that food poisoning affects about one in six Americans each year. “Symptoms of food poisoning include fever, abdominal pain, nausea, vomiting and diarrhea,” says Dr. Samia Boctor, who has a certification in travelers’ health from the American Society of Tropical Medicine and Hygiene. “If travelers consume contaminated food or water or touch surfaces contaminated by fecal material or vomitus, they can get infections with salmonella, shigella or E. coli. And norovirus needs special mention. These strains cause severe outbreaks that can send travelers to the hospital.”
According to the CDC, more than 90 percent of outbreaks of diarrhea on cruise ships are caused by norovirus. In 2014, nine norovirus outbreaks were reported through the CDC’s Vessel Sanitation Program. “Norovirus is easily spread, especially in crowded environments,” Boctor warns, “even by sharing food or eating utensils with someone who is ill.”
MECHANICAL DIFFICULTIES AND THEIR CONSEQUENCES
Mechanical difficulties and fires on cruise ships have made headlines; thousands of passengers have been stranded for hours or even days at sea, often without power to support effective refrigeration, food preparation or sewage disposal. Backed-up toilets and leaking human waste can easily spread infections such as E. coli or norovirus. “Because of multiple routes of transmission, it is difficult to contain outbreaks,” Boctor says.
To reduce the risk of infections, Boctor advises that “special attention should be taken while removing vomitus and fecal material; surfaces should be cleaned and disinfected, and cleaners should be wearing protective equipment including, gloves, masks and gowns.” Norovirus can be resistant to common disinfectants. The CDC recommends that cruise-ship passengers wash their hands with anti-bacterial soap after using the toilet and before eating or drinking, in order to prevent the spread of bacteria and viruses.
The ship’s infirmary may be staffed by an earnest health-care provider in a starched white coat, but there’s no guarantee that the “doctor” on duty is licensed to practice medicine in the United States – or anywhere at all.
“Historically, doctors were signed up to work for three to six months at a time, paid a salary and part of the proceeds of what was sold in the ships’ infirmaries,” attorney Lipcon says, “and they could be licensed anywhere, including in the country of the ship’s flag. The cruise line is not responsible for bad medical care as long as they hire a qualified physician.” Lipcon has even seen cases where the ship’s doctor didn’t have a license but was “just a graduate of a medical school in the Dominican Republic.”
TOO MUCH FUN IN THE SUN
We’ve all heard that it’s important to wear sunscreen outdoors, especially during the peak sunlight hours between 10 a.m. and 3 p.m. Dr. Ramin Ram of Beverly Hills, Calif., a fellow of the American Academy of Dermatology, says: “UV rays are what cause skin damage and burning, not the sun’s heat. Unfortunately, you’re exposed to UV rays even during cloudy and cooler days. Sunburns are associated with higher risks of melanoma, which can be fatal if not detected and treated in its early stages.”
Diving into the pool doesn’t protect you. “Although a cold pool or seawater may soothe the skin,” Ram says, “its ability to reflect the UV radiation can even double the initial amount of direct UV light your skin receives. It gets worse when you are near sandy beaches, since the sand also may reflect UV light, even while you are under the water.”
Ram suggests “aggressive and generous applications of water-resistant sunblock reapplied every two hours and after the skin gets wet.” Ram also recommends wearing clothing with SPF protection “while you are in the water, which may significantly decrease your exposure to the UV light.”
CRUISES ROCK – AND ROLL
Cruises may be pleasant when the weather cooperates, but a quiet sea voyage can quickly turn into a nightmare when a ship is battered by a storm. Ross Klein, a professor at the Memorial University of Newfoundland and publisher of the website CruiseJunkie.com, cites multiple reports of winds over 50 knots causing ships to buck and list. Damage reported includes separation of ship panels, destruction of balcony railings and tossing of heavy furniture such as tables and TV sets across cabins and larger rooms or decks, making injuries more likely.
Rough weather also can make passengers seasick, with nausea, vomiting and dizziness. “If you get seasick, talk to your doctor before your trip about ways to prevent symptoms,” Boctor says. “There are over-the-counter and prescription medicines that might help you, though most can make you sleepy and you shouldn’t use them if you’re drinking alcohol.”
YOUR BED MIGHT BUG YOU
Retreating to your bed is always an option if you’re under the weather. But uncomfortable mattresses are among the top five cruise complaints, Lipcon reports.
Even worse, unwanted guests in your bed, such as bedbugs, can ruin your trip at sea – and can follow you home. Bedbugs are insect parasites that can grow to a quarter-inch long, hide during the day near sleeping areas in mattress seams, bedframes and headboards, and are found even in clean and luxurious environments. “Bedbugs don’t transmit disease,” Boctor says, “but their bites can cause discomfort, irritation and allergic reactions that can lead to itching, excessive scratching and skin infections – and disrupted sleep.”
NOTHING TO SNEEZE AT
Allergic reactions can also be triggered by dust and mold. Mold microorganisms and fungi grow in moist environments and on wet surfaces. According to the Environmental Protection Agency, molds produce substances that can commonly cause allergic reactions, as well as irritants and toxins. Allergy symptoms include sneezing, runny nose, red eyes, skin rashes and asthma attacks. Allergic individuals may also react to dust mites and to fabrics and other components of pillows and mattresses. Avoiding these allergens is the best way to prevent symptoms, but antihistamines and prescription medications may reduce symptoms if environmental controls are not possible.
MENTAL HEALTH CHALLENGES
Cruises are filled with social activities in a party atmosphere, but not everyone feels like the life of the party. “Even in the confined space of a cruise ship, surrounded by people determined to connect and have fun, a passenger might still feel lonely, isolated and downhearted,” says clinical psychologist Anthony Johnson. “We constantly compare ourselves. A downhearted person might conclude, ‘I can’t talk to people. I can’t even have fun. I’m not like others. I can’t do anything right. Why go on?’” Mental health challenges such as depression can be exacerbated by loneliness and social isolation aboard ship, as well as by the absence of counseling resources and social safety nets. Klein’s CruiseJunkie.com reports that 22 cruise-ship passengers went overboard in 2014 – including a number of alleged or observed suicides.
HOW TO HAVE A HAPPY, HEALTHY CRUISE
As an experienced maritime attorney, Lipcon has dealt with many cases of accidents, sexual assaults, missing people and infections, but he acknowledges that 12 million people take cruises every year and that, fortunately, most have a wonderful time.
“Cruise Junkie” Klein concurs, advising cautious travelers to “treat a cruise ship as any large city. Don’t assume safety and security. Wash your hands frequently, avoid uncooked and undercooked foods if possible, and take caution with drinking water. Use bottled water if you want to be entirely safe.”
Other tips for a safe cruise, Klein says, include having all of your prescription medications with you, and enough for the entire cruise. “Also, be prepared to give a medical history in case there is [an] emergency requiring medical intervention. Have your medical insurance information with you; buying trip medical insurance is a good idea.“
Bring sun block and use it, and don’t forget to drink lots of water … and avoid overindulgence of alcohol, and of fatty and high-caloric foods; the average passenger gains seven pounds or more on a one-week cruise.” The best advice for sea travelers, Lipcon adds: “Don’t leave your common sense behind when you board.”
This article was originally posted on MSN Health & Fitness.