travel on cruise ships, which can have their own disease risks. There have
certainly been outbreaks of gastrointestinal and respiratory illnesses
reported on cruise ships with significant attack rates. The Centres for
Disease Control and Prevention (2004) has an interesting site dealing with
recent hygiene inspections of cruise ships visiting US ports. It makes for
interesting reading for both the traveller and the travel health adviser.
Practical considerations include the risks of seasickness and exacerbation
of illnesses, which may be difficult to manage at sea.