Preliminary Guidelines for the Prevention and Control of Influenza-Like Illness Among Passengers and Crew Members on Cruise Ships

During the 1972 through 1993 influenza seasons in the United States, an average of 20,000 deaths and more than 100,000 hospitalizations each year resulted from complications of influenza infection. Control of influenza in the general population is based on annual fall vaccination programs, along with education about disease risk reduction, and on administration of antiviral
agents for treatment or prophylaxis. Special vaccination programs traditionally have targeted certain groups of individuals (e.g., those most likely to experience complications or to transmit influenza to persons at high risk for complications). However, influenza vaccination also may have substantial health-related and economic benefits for healthy, working adults. In institutional settings or other semi-enclosed environments, these control measures are supplemented with
surveillance activities, outbreak investigations, and monitoring the results of interventions.

The following preliminary guidelines for the prevention and control of influenza-like illness among passengers and crew members on cruise ships were developed by the Centers for Disease Control and Prevention based on many years of experience in controlling influenza outbreaks in nursing homes and on the experience with travel-related influenza outbreak investigations in 1997 and
1998. While more work is needed to determine the epidemiology of influenza among travelers, these preliminary guidelines are intended to provide a practical approach for influenza prevention and control measures on board cruise ships.