Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
J Travel Med. 2012 Jul;19(4):233-7. doi: 10.1111/j.1708-8305.2012.00620.x.
Cruise ship outbreaks of vaccine-preventable diseases (VPD) such as rubella and varicella have been previously associated with introduction and spread among susceptible crew members originating from countries with endemic transmission of these diseases.
During February to April 2006, we investigated a cluster of rash illnesses due to measles, rubella, or varicella on a cruise ship sailing from Florida to the Caribbean. Case-finding measures included review of medical logs, active surveillance for rash illness among crew members, and passive surveillance for rash illness in the ship's infirmary lasting two incubation periods from the last case of measles. Passengers with potential exposure to these VPD were notified by letters. All susceptible crew members with potential exposure were administered the measles, mumps, and rubella vaccine after informed consent.
A total of 16 cases were identified only among crew members: 1 rubella, 3 measles (two-generation spread), 11 varicella (three-generation spread), and 1 unknown diagnosis. Of 1,197 crew members evaluated, 4 had proof of immunity to measles and rubella. Based on passive surveillance, no cases were identified among passengers, the majority of whom resided in the United States.
The international makeup of the population aboard cruise ships combined with their semi-enclosed environment has the potential to facilitate introduction and spread of VPD such as measles, rubella, and varicella onboard and into communities. Cruise lines should ensure crew members have evidence of immunity to these diseases. Passengers should be up to date with all vaccinations, including those that are travel-specific, prior to embarking on cruise travel.
此前，与风疹和水痘等疫苗可预防疾病（VPD）相关的游轮疫情暴发与易感染船员有关，这些船员来自这些疾病地方性传播的国家。
在 2006 年 2 月至 4 月期间，我们对一艘从佛罗里达州开往加勒比海的游轮上发生的麻疹、风疹或水痘爆发进行了调查。病例发现措施包括审查医疗日志、对船员皮疹疾病进行主动监测，以及对船上医务室的皮疹疾病进行为期两个潜伏期的被动监测，从最后一例麻疹病例开始。向有潜在接触这些 VPD 的乘客发出了信函通知。所有有潜在接触的易感染船员在知情同意后均接种了麻疹、腮腺炎和风疹疫苗。
仅在船员中发现了 16 例病例：1 例风疹、3 例麻疹（两代传播）、11 例水痘（三代传播）和 1 例不明诊断。在评估的 1197 名船员中，有 4 人对麻疹和风疹具有免疫力证明。根据被动监测，在大多数居住在美国的乘客中未发现病例。
游轮上的人口构成具有国际性，再加上其半封闭环境，有可能在船上和社区内促进麻疹、风疹和水痘等 VPD 的引入和传播。游轮公司应确保船员对这些疾病具有免疫力证明。乘客在开始游轮旅行之前，应接种所有疫苗，包括特定于旅行的疫苗。
