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most often responsible for such infections are in the
staphylococcus and bacillus groups. The toxins made
by staphylococcus and bacillus bacteria are formed
in situations where refrigeration is inadequate or
food is left out for prolonged periods, as occurs with
salad bars, condiment bars and buffets. Bacteria also
produces the less-common but well-known botulism
toxin. Symptoms from ingesting these preformed
toxins usually manifest in the upper GI tract (as
nausea and vomiting) and typically begin soon after
ingestion of the tainted food. Foods notorious for
this type of infection are creams, soups and desserts.
Symptoms in the lower GI tract may follow the
period of nausea and vomiting. The illness is self-
limited, and only symptomatic treatment is needed.
TRAVEL MEDICINE
Less common but more severe infectious diseases
include hepatitis A, malaria, yellow fever and dengue
fever. Of those, only the hepatitis A virus can be
spread from person to person. While this can be
a serious disease, the symptoms do not usually
occur until after the afflicted person returns home
from a trip. Malaria, yellow fever and dengue fever
are commonly encountered medical problems
associated with traveling, but they are transmitted
by mosquitos and typically acquired during
excursions away from the dive boat or cruise ship. A
wise traveler will check appropriate travel-medicine
websites to ensure he or she is prepared to enter
areas where these tropical diseases are common.
For the most part, preventive measures such as
mosquito repellent and prophylactic medications
such as Malarone will do the trick. Symptoms may
not occur until long after the traveler returns home.
As mentioned previously, treatment for the GI
illnesses commonly encountered during dive travel
boils down to supportive care — relieving the
symptoms of vomiting or diarrhea while ensuring
adequate intake of fluids. Acetaminophen (Tylenol®)
may be used to combat the fever and muscle aches
that often accompany viral illnesses. In vulnerable
populations and extreme cases where there is
concern for severe dehydration, intravenous fluids
and/or prescription medications to combat the
nausea may be required. In the worst cases, patients
will need to be evacuated to shore-based medical
facilities for treatment.
PREVENTION
Not contracting a communicable disease in the first
place is of course preferable to needing treatment.
Prior to leaving your home country, ensure all of
your vaccinations are up to date, including those
for tetanus and hepatitis A. It is also good practice
to obtain the annual flu vaccination. When living in
tight quarters, whether on cruise ship, a liveaboard
dive boat or at a dive resort, wash your hands with
soap frequently. Avoid foods that are likely to
encourage growth of toxin-producing bacteria; these
include meats, sauces or pastries that are left out
for prolonged periods, and items on soup, salad and
dessert bars that aren’t kept hot or cold. The water,
and therefore the ice, on cruise ships is generally
safe for drinking and brushing teeth, but the same
cannot always be said for the water at some resorts
and other public places on shore.
By taking these general precautions you can
avoid becoming a victim of some common diseases
during your time onboard. No one wants to spend
thousands of dollars on a trip only to be confined to
his or her cabin or, worse yet, sick bay. After all, the
goal is to enjoy the underwater world and dive some
sites worth talking about during the next trip.
AD
STEPHEN FRINK
ISTOCKPHOTO.COM
