Cruise Tips

Visit a travel clinic for a pre-cruise consultation well before you depart. Medical expertise, vaccines and malaria chemoprophylaxis may not be available on cruise ships, and vaccinations may require time to become effective.

During the consultation, the travel doctor will:

• Discuss your itinerary, including the season, duration of travel and onshore activities.
• Review your medical and immunisation history, allergies and special health needs.
• Discuss travel-specific health hazards.
• Discuss immunisations – routine, recommended or required (see vaccination information below).
• Discuss food and water precautions and advise if a medical kit should be taken (see personal medical kit information below).
• Address insect-borne disease and insect bite prevention, and provide malaria medication if required.
• Provide documentation regarding immunisations given and medications supplied.

The travel doctor will advise you to:

• Obtain travel insurance that covers medical evacuation and repatriation should it be required.
• Declare all medical conditions when obtaining travel insurance in order that they are covered if needed.
• Keep your regular medications in your hand luggage in the original containers with a copy of the prescription.
• Obtain a letter from your regular doctor outlining medical conditions, allergies and medications (see regular medications information below).
• Take a copy of a baseline ECG (heart tracing) from your regular doctor if you have a history of heart disease.
• Liaise with the cruise company if you have special requirements (e.g., use of wheelchair or oxygen).
• Check that your CPAP (continuous positive airway pressure) machine is compatible with the electricity provided on the cruise, if required.

Many crew members on cruise ships come from developing countries with low immunisation rates, although each company will have its own vaccination requirements. Like the crew, passengers come from all over the world, increasing the risk of a range of diseases.

Cruise passengers should be up to date with the following vaccinations:

Routine vaccinations (depending on age)

• Tetanus/diphtheria/whooping cough
• Poliomyelitis
• Measles, mumps and rubella
• Chickenpox
• Meningococcal meningitis

Recommended vaccinations

• Influenza (perhaps the single most important vaccination for cruise passengers)
• Hepatitis A (generally indicated if visiting developing countries)
• Typhoid (destination-specific, often optional)

Required vaccinations for specific destinations

• Yellow fever
• Poliomyelitis

Other vaccinations may be indicated depending on your itinerary, specific medical conditions and personal preferences. These include hepatitis B, meningococcal, pneumococcal, Japanese encephalitis and rabies vaccinations.

You should take with you an adequate supply of your usual medications for the entire cruise, as the specific medication (or an appropriate substitute) may not be available on board or in ports. Generally, ships’ doctors do not have prescription authority in local ports. It is almost impossible to obtain controlled medications on cruises.

You should carry in your hand luggage all medications in their original containers, along with a copy (ideally both paper and digital) of the prescription and/or an accompanying letter from your medical practitioner. You should carry a backup supply of critically indispensable medication in your suitcase.

A personal medical kit should be individualised according to each passenger’s medical conditions and itinerary. Recommended essential items in addition to the passenger’s regular medications include:

Non-prescription items

• Oral analgesics
• Anti-diarrhoeal agents
• Rehydration salts
• Antihistamines
• Antiseptic solutions

Prescription items (ideally supervised by the ship’s medical team)

• Antibiotics for bacterial dysentery
• Antibiotics for respiratory infections
• Antiemetics
• Optional:
  • Other antibiotics
  • Antiviral medication
  • Metronidazole (for giardiasis)
  • Antimalarial medications, although the risk is low even when cruising to known malaria-endemic areas. Ships generally leave port at dusk, just when the vector mosquitoes become active. If you are overnighting in port, discuss the need for preventative measures with the doctor. 

This list is not exhaustive. Although passengers are recommended to carry a supply of commonly required antibiotics, empirical self-treatment on a cruise can sabotage efforts to control outbreaks. Ships’ doctors generally prefer pre-travel health providers to instruct passengers not to take antibiotics without direct medical advice; self-treatment of a condition such as norovirus gastroenteritis for two to three days before presentation has the potential to spark a large outbreak on board. You should report any vomiting or diarrhoea to the ship’s medical centre immediately, at any time of the day or night. Please read the Product Disclosure Statement (PDS) carefully before making a decision to purchase a product.

The cost of medical services varies between ships but is generally expensive and is almost never covered by Medicare or private health insurance, even on cruises within Australian waters. All medical expenses are added to the room service bill and are payable before disembarkation. The importance of premium travel insurance cannot be overemphasised, ideally covering any pre-existing medical conditions. Travel insurance that covers medical evacuation and repatriation should be secured.