Descriptive epidemiology of injury and illness among cruise ship passengers.

STUDY
OBJECTIVE: To provide information, which can be used in the formation of guidelines concerning medical facilities and staff on cruise ships, on the descriptive epidemiology of the medical conditions encountered by cruise ship physicians.
METHODS: A retrospective descriptive epidemiologic study design was used to evaluate patient physician encounters on cruises originating in a calendar-year period for the 4 ships of a major cruise ship line with cruises originating in the United States. Demographic data regarding sex and age of the passengers on these ships were available for each cruise. We collected information on patient age, sex, chief complaint, diagnoses, treatment, and patient disposition recorded in the patients' medical records in the ships' medical logs.
RESULTS: Seven thousand one hundred forty-seven new patient visits occurred in a population of 196,171 passengers and 1,537,298 passenger days; 56.7% of passengers were female, and 60.7% of patients were female; 43.3% of passengers and 39.6% of patients were male. Visits to the ship infirmaries were made for the following reasons: 18.2% of visits were related to injuries, 69.3% were related to medical conditions, and 12.5% were unspecified or other conditions. The most common diagnosis was respiratory tract infection (29.1%); 11% of patients had a serious or potentially life-threatening diagnosis. The most common group of prescription medications prescribed was antibiotics.
CONCLUSION: Many different injuries and illnesses occur on board cruise ships. The spectrum is similar in many respects to the patients presenting to emergency departments. Cruise lines must prepare for the initial treatment and stabilization of patients with serious illnesses or injuries with appropriately qualified and equipped medical personnel and establish procedures for disembarkation of patients to facilities capable of handling such conditions.