Ship Cough could it be the Air Conditioning

Exaggeration like that is really funny.

You wrote that respiratory illness was "not a big concern" for the CDC. My point was simply that it should be. If no one is monitoring the outbreaks of respiratory illness on cruise ships, the source of the illness can't be known, nor can the number of people with symptoms be known.

 

Passengers and crew are asked to report gastro-intestinal symptoms which is why we have information from the CDC regarding norovirus and other GI pathogens. We do not have the same type of reporting requirements for respiratory illness, so we can't possibly know the cause or extent of outbreaks of respiratory illness on cruise ships.

So everyone that has a cold should be reporting themselves to the infirmary? :confused:

............................SNIP................................

Passengers and crew are asked to report gastro-intestinal symptoms which is why we have information from the CDC regarding norovirus and other GI pathogens. We do not have the same type of reporting requirements for respiratory illness, so we can't possibly know the cause or extent of outbreaks of respiratory illness on cruise ships.

Even if all respiratory illnesses were reported, it still wouldn't give us a cause or the extent of the illness. Why? Because people will bring it with them onto the ship, just as they do with Noro. No one will honestly report illness on the pre-screening paperwork. How will chronic respiratory problems such as COPD, asthma and emphysema be differentiated from the common cough/cold? How will passengers report getting a respiratory illness after returning home? How will the monitors know if it was acquired on the ship, on the plane or on a shore excursion? So, it's not too ridiculous to issue face masks/respirators on boarding.

So everyone that has a cold should be reporting themselves to the infirmary? :confused:

No, but with certain symptoms, people with colds are advised to see a doctor. As one example, here's the Mayo Clinic's advice to people with colds:

When to see a doctor

For adults — seek medical attention if you have:

• Fever of 103 F (39.4 C) or higher
  
• Fever accompanied by sweating, chills and a cough with colored phlegm
  
• Significantly swollen glands
  
• Severe sinus pain
  

For children — in general, children are sicker with a common cold than adults are and often develop complications, such as ear infections. Your child doesn't need to see the doctor for a routine common cold. But seek medical attention right away if your child has any of the following signs or symptoms:

• Fever of 100.4 F (38 C) in newborns up to 12 weeks
  
• Fever that rises repeatedly above 104 F (40 C) in a child of any age
  
• Signs of dehydration, such as urinating less often than usual
  
• Not drinking adequate fluids
  
• Fever that lasts more than 24 hours in a child younger than 2
  
• Fever that lasts more than three days in a child older than 2
  
• Vomiting or abdominal pain
  
• Unusual sleepiness
  
• Severe headache
  
• Stiff neck
  
• Difficulty breathing
  
• Persistent crying
  
• Ear pain
  
• Persistent cough
  

copied from http://www.mayoclinic.org/diseases-conditions/common-cold/basics/symptoms/con-20019062

Wouldn't it make sense for cruise ships to offer some sort of guidance to crew members and passengers about when to report respiratory illness that might be more serious than just the common cold?

Exaggeration like that is really funny.

You wrote that respiratory illness was "not a big concern" for the CDC. My point was simply that it should be. If no one is monitoring the outbreaks of respiratory illness on cruise ships, the source of the illness can't be known, nor can the number of people with symptoms be known.

 

Passengers and crew are asked to report gastro-intestinal symptoms which is why we have information from the CDC regarding norovirus and other GI pathogens. We do not have the same type of reporting requirements for respiratory illness, so we can't possibly know the cause or extent of outbreaks of respiratory illness on cruise ships.

Please see the GeoSentinel Surveillance system of the ISTM and CDC, which specifically tracks travel illnesses, including respiratory illnesses. They rely on doctors to sign up to report travel illnesses, so your own physician may be reporting to them when you go to him/her with a cold, and they ask you what appear to be innocuous questions about what you've been doing lately. http://www.google.com/url?sa=t&rct=j&q=geosentinel&source=web&cd=1&cad=rja&uact=8&ved=0CCgQFjAA&url=http%3A%2F%2Fwww.istm.org%2Fgeosentinel%2Fmain.html&ei=6vhXU6SaDdbMsQSo04KACA&usg=AFQjCNGDXmBC3Qltx3Atzexlbfeg3BvHBw&bvm=bv.65177938,d.cWc

Please also look at the CDC's Yellow Book for International Travelers to see whether or not they are aware of respiratory illness problems, the problems with diagnosing them, and data collection: http://www.google.com/url?sa=t&rct=j&q=cdc%20yellow%20book&source=web&cd=1&cad=rja&uact=8&ved=0CCgQFjAA&url=http%3A%2F%2Fwwwnc.cdc.gov%2Ftravel%2Fpage%2Fyellowbook-home-2014&ei=zflXU6X3K-aosAT_04DoBA&usg=AFQjCNGzsTsJU7hVWphrE_gWLIZybgJMKA&bvm=bv.65177938,d.cWc

Just because all of the CDC's research does not get as much attention in the media as noro, does not mean it doesn't exist. And outside the US, the WHO has similar resources. While CDC information about respiratory illness on cruise ships is not as readily available as noro updates, it is public information, so feel free to contact them to obtain their studies.

What respiratory diseases in particular are you worried about getting from going on a cruise? As is mentioned in the Yellow Book, and as I have mentioned, the primary means of transmission is having a lot of people in close proximity.

And, again, I did not say that respiratory illness is not a big concern of the CDC, what is of minor concern is whether or not the ship is the causative agent, based on their statistical and historical data.

Please see the GeoSentinel Surveillance system of the ISTM and CDC, which specifically tracks travel illnesses, including respiratory illnesses. They rely on doctors to sign up to report travel illnesses, so your own physician may be reporting to them when you go to him/her with a cold, and they ask you what appear to be innocuous questions about what you've been doing lately. http://www.google.com/url?sa=t&rct=j&q=geosentinel&source=web&cd=1&cad=rja&uact=8&ved=0CCgQFjAA&url=http%3A%2F%2Fwww.istm.org%2Fgeosentinel%2Fmain.html&ei=6vhXU6SaDdbMsQSo04KACA&usg=AFQjCNGDXmBC3Qltx3Atzexlbfeg3BvHBw&bvm=bv.65177938,d.cWc

 

Please also look at the CDC's Yellow Book for International Travelers to see whether or not they are aware of respiratory illness problems, the problems with diagnosing them, and data collection: http://www.google.com/url?sa=t&rct=j&q=cdc%20yellow%20book&source=web&cd=1&cad=rja&uact=8&ved=0CCgQFjAA&url=http%3A%2F%2Fwwwnc.cdc.gov%2Ftravel%2Fpage%2Fyellowbook-home-2014&ei=zflXU6X3K-aosAT_04DoBA&usg=AFQjCNGzsTsJU7hVWphrE_gWLIZybgJMKA&bvm=bv.65177938,d.cWc

 

Just because all of the CDC's research does not get as much attention in the media as noro, does not mean it doesn't exist. And outside the US, the WHO has similar resources. While CDC information about respiratory illness on cruise ships is not as readily available as noro updates, it is public information, so feel free to contact them to obtain their studies.

 

What respiratory diseases in particular are you worried about getting from going on a cruise? As is mentioned in the Yellow Book, and as I have mentioned, the primary means of transmission is having a lot of people in close proximity.

I responded to your original statement that respiratory illness "was not a big concern" to the CDC. Now you appear to be saying otherwise. But the fact remains that there is no mandatory reporting of respiratory illness on cruise ships (and just to be clear, as I indicated previously, I am not suggesting that the common cold needs to be reported.) And yes, I think we all understand that the illness spreads quickly in a closed, heavily populated environment. Likewise, we know that there can be other sources of respiratory illness, as has been discussed previously.

I responded to your original statement that respiratory illness "was not a big concern" to the CDC. Now you appear to be saying otherwise. But the fact remains that there is no mandatory reporting of respiratory illness on cruise ships (and just to be clear, as I indicated previously, I am not suggesting that the common cold needs to be reported.) And yes, I think we all understand that the illness spreads quickly in a closed, heavily populated environment. Likewise, we know that there can be other sources of respiratory illness, as has been discussed previously.

Here is my original statement, with your red highlighting added:

That's what I was trying to point out. The reason the USPH/CDC doesn't spend as much time broadcasting respiratory illness on cruise ships as they do noro, is that it is not a big concern for them, at least as far as the ship being a transmission vector.

You will note that I said that it wasn't a concern for them as far as the ship being a transmission vector , meaning that their studies have shown that illnesses caused by the ships are very rare, and that if the ship follows the VSP, it generally can be discounted as a causative agent.

So, if we use your list of symptoms that should be reported to a doctor (pretty common sense), shouldn't the cruise line also provide handwashing instructions and personal hygiene flyers as well? And what would be the outcome? More paper trash. If you can't get people to prevent noro outbreaks by following what your mother taught you at age 2 (wash your hands), do you think that guidelines for passengers to report to medical with fevers will do any good? If you can't get people who are experiencing the unbelievable diarrhea and vomiting of noro to go to medical, because they don't want to be quarantined, do you think someone who is coughing and has a fever would do so?

No, there is no mandatory reporting for respiratory illness on cruise ships, probably because the CDC has found that most are common cold and flu, from their travel medicine studies.

Again, what specific illness or virus do you believe the ship is responsible for cultivating? I'm not being facetious, I'm interested in what your concerns are.

Here is my original statement, with your red highlighting added:

 

That's what I was trying to point out. The reason the USPH/CDC doesn't spend as much time broadcasting respiratory illness on cruise ships as they do noro, is that it is not a big concern for them, at least as far as the ship being a transmission vector.

 

You will note that I said that it wasn't a concern for them as far as the ship being a transmission vector , meaning that their studies have shown that illnesses caused by the ships are very rare, and that if the ship follows the VSP, it generally can be discounted as a causative agent.

 

So, if we use your list of symptoms that should be reported to a doctor (pretty common sense), shouldn't the cruise line also provide handwashing instructions and personal hygiene flyers as well? And what would be the outcome? More paper trash. If you can't get people to prevent noro outbreaks by following what your mother taught you at age 2 (wash your hands), do you think that guidelines for passengers to report to medical with fevers will do any good? If you can't get people who are experiencing the unbelievable diarrhea and vomiting of noro to go to medical, because they don't want to be quarantined, do you think someone who is coughing and has a fever would do so?

 

No, there is no mandatory reporting for respiratory illness on cruise ships, probably because the CDC has found that most are common cold and flu, from their travel medicine studies.

 

Again, what specific illness or virus do you believe the ship is responsible for cultivating? I'm not being facetious, I'm interested in what your concerns are.

You've got a few premises that I do not agree with, but there's no point in going over all that again.

Just to reiterate: That wasn't my list of symptoms that should be reported to a doctor - it was a quote from the Mayo Clinic for those suffering from a cold on when they need to see a doctor. That quote was in response to the question "So everyone that has a cold should be reporting themselves to the infirmary?" (Short answer: no, only when certain symptoms present.)

As far as your question is concerned, I don't know what makes you ask if there is any specific illness or virus that any ship is responsible for cultivating. That would be a very serious accusation - one that would certainly require proof to support such a claim. And since mandatory reporting is limited to gastro-intestinal illness, the origin of which is rarely established, proof of accusations regarding responsibility for origin of disease outbreaks on cruise ships would be darn near impossible. Kind of a Catch 22.

You've got a few premises that I do not agree with, but there's no point in going over all that again.

 

Just to reiterate: That wasn't my list of symptoms that should be reported to a doctor - it was a quote from the Mayo Clinic for those suffering from a cold on when they need to see a doctor. That quote was in response to the question "So everyone that has a cold should be reporting themselves to the infirmary?" (Short answer: no, only when certain symptoms present.)

 

As far as your question is concerned, I don't know what makes you ask if there is any specific illness or virus that any ship is responsible for cultivating. That would be a very serious accusation - one that would certainly require proof to support such a claim. And since mandatory reporting is limited to gastro-intestinal illness, the origin of which is rarely established, proof of accusations regarding responsibility for origin of disease outbreaks on cruise ships would be darn near impossible. Kind of a Catch 22.

I understood where your list of symptoms came from.

The reason I ask is that you seem to be convinced that the ship harbors these viruses more than other locations. The USPH/CDC has determined that one respiratory illness could be caused by poor operational practices on cruise ships, legionella, and have included sanitizing procedures for preventing this. If they have studied this respiratory illness, why do you not think they have looked at other instances, and determined that either there is insufficient evidence that other viruses are more prevalent on cruise ships than in the general public, or that there is no viable means of preventing an aspirated virus on ships (i.e. there is no link to the ship per se, just to the number of people in the environment). Do you advocate mandatory reporting of respiratory illnesses at conventions, resorts, and hotels?

And what do you base the statement "gastro-intestinal illness, the origin of which is rarely determined"? I know that the USPH/CDC are actually very good at tracking GI illness outbreaks back to "patient zero" or to the causative agent (for food borne illness like e coli). This is what they do. How do you think they came up with the protocols to contain a noro outbreak, if they didn't know how and where it is transmitted? One problem they do have, is with the truthfulness of answers supplied on the GI contact interview from patients. The final investigation reports are not published on the website, generally, but are available if you ask for them.

We have always gotten a letter in our cabin from the doctor saying we should wash our hands. On the last cruise, it mentioned this was important to prevent the spread of Noro AND influenza. I never remember them mentioning influenza before. Maybe someone who has saved their letters can check. If this is a new addition to the letters, something has clearly changed.

On our last two cruises, I did get a cough toward the end. In both cases it turned out to be severe. In one case it became pneumonia. I clearly remember someone coughing in my face on the last cruise. This was a 28-day cruise, and towards the end, many people were coughing. This is one reason we prefer to use the stairs and another reason Royal Princess won't work for us.

Recently on an HAL med cruise. I developed a cold 2-3 days after embarkation. I noticed when checking in that some HAL personnel handling paperwork had tissues, blowing noses, etc. I used Purell but still got a cold. Maybe one should take along a small disinfectant spray or something like that to disinfect your documents and room key card.

I am back about a week and a half from the Regal, have my usual post cruise coughing and congestion!

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