Health Advisory for Guests Traveling to Remote Destinations

[Emme1233]

On 9/5/2024 at 9:13 AM, Mary229 said:

If that was 2023 I know that person and yes he had insurance and rejoined the cruise. He was quite pleased with how everything went

No that was probably 8 years ago. This was a woman. 

[Budski54]

12 hours ago, cccole said:

@Budski54  We have used Geo Blue but not sure what Trekker Essential is.  We make sure evacs are in our insurance.  Trip interruption and cancellation is not something we like to insure for, but sometimes it is hard not to include these.  I hope you take this cruise.  Cherie

Trekker Essential is the basic GeoBlue yearly Medical coverage plans. It has $250,000 for Medical Evacuation. It does not cover trip cancelation etc.

[Budski54]

9 hours ago, pmjnh said:

I am on the Jan 28 sailing and never received a letter from HAL as the OP stated. Travel insurance with good evacuation coverage is essential for sure. No vaccines required for the Antarctic sailing. 

 

Antarctica_Information_EN_HAL.pdf

[buffy4454]

Budski we are sailing on the jan 6, 2025 trip.   If you like, there is a really good roll call for this cruise.  Lots of info.   We did not get that notice from HAL but we booked a long time ago.   Hope to see you onboard. 

[VintageCheap]

I always roll my eyes at the article that keeps reappearing online stating that cruise ships are a cheaper alternative  to nursing homes.  If you get seriously ill or shatter your ankle or need to be fed or given your meds they cannot provide 24 hour a day intensive care or surgery aboard and you will be sent away in a local EMS rig and good luck.

[coolbluegreenseas]

On 9/6/2024 at 12:35 PM, Mary229 said:

Take the list to your personal physician.  Those clinics sell vaccines so they will tell you that you need them all. 

That is wrong. Travel medicine is a separate discipline within medicine. They specialize in diseases that are uncommon in the US, but can be encountered in other countries with different climates or infrastructure. I visited Guatemala and India within 6 months of each other and the doctor at the clinic reviewed with me what my plans were, how long I was going to stay and previous vaccine history. There was a longish list of vaccines needed/recommended for each country. Still, I received only a subset because my activities would expose me to somethings but not others. Also, a PCP will probably recommend a travel clinic when asked about foreign travel. To the OP: go to the travel clinic for the best advice.

[Mary229]

6 hours ago, coolbluegreenseas said:

That is wrong. Travel medicine is a separate discipline within medicine. They specialize in diseases that are uncommon in the US, but can be encountered in other countries with different climates or infrastructure. I visited Guatemala and India within 6 months of each other and the doctor at the clinic reviewed with me what my plans were, how long I was going to stay and previous vaccine history. There was a longish list of vaccines needed/recommended for each country. Still, I received only a subset because my activities would expose me to somethings but not others. Also, a PCP will probably recommend a travel clinic when asked about foreign travel. To the OP: go to the travel clinic for the best advice.

I am sorry but we will have to disagree.  Doctors are educated on travel needs of patients and doctors know what might be contraindicated for the particular patient.  There are dangerous consequences for some personal medical conditions.  Of course that presupposes the patient has taken the time in life to have a proper relationship with a physician.  

[TRLD]

3 hours ago, Mary229 said:

I am sorry but we will have to disagree.  Doctors are educated on travel needs of patients and doctors know what might be contraindicated for the particular patient.  There are dangerous consequences for some personal medical conditions.  Of course that presupposes the patient has taken the time in life to have a proper relationship with a physician.  

i would take a bit of a middle position  A good review of vaccinations requirements for the areas you are traveling is a good first step. Most primary care physicians do not keep up to date with all needs in all areas. 

 

For most areas the list is small and the local physians recommendations  would cover. Hep A/B would probably be the most useful in case one eats on shore in many 3rd world countries or on the rare chance that something happens requiring medical treatment.

 

That said once one does their research for the countries they are visiting they should then discuss that list with their physician based upon their own medical history.

[howiefrommd]

When I was in active clinical practice, I relied on the CDC's "Traveler's Health" to assist in identifying potential vaccine recommendations for patients.  Obviously one needs to balance the benefit/risk (especially taking into consideration the current health status of the patient) of vaccines. 

 

For a good part of my professional career, I have been mostly based in research.  I have been lucky to work at a large University based Medical Center in which I have colleagues that travel to some of the most remote distances on earth. We routinely depend on our in-house international travel physician colleagues to guide us.  

 

So what I am trying to articulate it is most beneficial to have guidance with a travel medicine physician (yes that is a specialty) and the primary care provider who has the most knowledge of your medical history.   

Edited September 11 by howiefrommd
Typo correction

[Mary229]

I have never had a physician who did not accurately detail the vaccines I should have for overseas travel.  (Yes, I cross check their advice). And further those physicians have always been able to clearly tell me why I, personally, should or should not have those medications.  I will reiterate : there are dangerous results depending on your medical history.  Sure pick up a pamphlet at the pharmacy but absolutely talk to your own physician.  Again - this assumes you have a thoughtful, mature relationship with your physician.  

[Horizon chaser 1957]

On 9/10/2024 at 6:14 AM, VintageCheap said:

I always roll my eyes at the article that keeps reappearing online stating that cruise ships are a cheaper alternative  to nursing homes.  If you get seriously ill or shatter your ankle or need to be fed or given your meds they cannot provide 24 hour a day intensive care or surgery aboard and you will be sent away in a local EMS rig and good luck.

Me too. Those articles conveniently overlook the ‘nursing’ part of ‘nursing home’.

[TRLD]

1 hour ago, Horizon chaser 1957 said:

Me too. Those articles conveniently overlook the ‘nursing’ part of ‘nursing home’.

More like a cheaper alternative to independent living facilities.

[TRLD]

3 hours ago, howiefrommd said:

When I was in active clinical practice, I relied on the CDC's "Traveler's Health" to assist in identifying potential vaccine recommendations for patients.  Obviously one needs to balance the benefit/risk (especially taking into consideration the current health status of the patient) of vaccines. 

 

For a good part of my professional career, I have been mostly based in research.  I have been lucky to work at a large University based Medical Center in which I have colleagues that travel to some of the most remote distances on earth. We routinely depend on our in-house international travel physician colleagues to guide us.  

 

So what I am trying to articulate it is most beneficial to have guidance with a travel medicine physician (yes that is a specialty) and the primary care provider who has the most knowledge of your medical history.   

Back before I retired we had a company on retainer to keep up with travel destinations, current outbreaks and other relevant information, including vaccination recommendations.  When I would take their recommendations to my physician he would ask for a copy of some sections of the report, because as he put it, it was news to him.  For most areas of the world hep A/B, typhoid, maybe yellow fever and the normal domestic vaccines cover quite nicely.  Some areas in southeast Asia and Africa can be a bit more interesting.

 

These days I use

https://wwwnc.cdc.gov/travel/destinations/list

[jlawrence01]

On 9/10/2024 at 9:02 PM, coolbluegreenseas said:

That is wrong. Travel medicine is a separate discipline within medicine. They specialize in diseases that are uncommon in the US, but can be encountered in other countries with different climates or infrastructure. I visited Guatemala and India within 6 months of each other and the doctor at the clinic reviewed with me what my plans were, how long I was going to stay and previous vaccine history. There was a longish list of vaccines needed/recommended for each country. Still, I received only a subset because my activities would expose me to somethings but not others. Also, a PCP will probably recommend a travel clinic when asked about foreign travel. To the OP: go to the travel clinic for the best advice.

 

Strongly agree.  I met with my internist and my infectious disease specialist, both Filipinos, prior to heading to the Philippines.  They asked me what specific provinces I planned to visit and made vaccine recommendations for my trip.  

[foodsvcmgr]

I have sailed these itineraries twice and am not aware of any vaccines suggested for the average person.

[TRLD]

3 hours ago, foodsvcmgr said:

I have sailed these itineraries twice and am not aware of any vaccines suggested for the average person.

There are several recommended for the countries visited on that itinerary. 

[foodsvcmgr]

But none were required.

Do most get them anyway?

[Mary229]

31 minutes ago, TRLD said:

There are several recommended for the countries visited on that itinerary. 

Notice he said itinerary not country.  That is why you need a physician who will look at the data not just a checklist.  Yellow fever, for example, is only recommended in South America if you are visiting specific regions during an outbreak.  Malaria - ditto.  Additionally Malaria medications can cause severe cardiac conditions.  Always consult your own physician. 

[TRLD]

3 minutes ago, Mary229 said:

Notice he said itinerary not country.  That is why you need a physician who will look at the data not just a checklist.  Yellow fever, for example, is only recommended in South America if you are visiting specific regions during an outbreak.  Malaria - ditto.  Additionally Malaria medications can cause severe cardiac conditions.  Always consult your own physician. 

Yellow fever not on the list unless you are going into jungle areas. Such as a visit to Igauzu falls for example

 

 

On the other hand hep a and b are because you can contract hep A simply by eating in the wrong place on shore. Hep B is more if you have a medical emergency and need treatment on shore or plan to come in contact with bodily fluids. Have been cases of transmission during some medical procedures in SA.

 

Typhoid less necessary unless going and staying in more remote areas

 

Then you have the more normal flu, covid, measles, tetnus, etc.

 

One can choose to get them or not, but suspect most that would recommend Hep A for any travel in South America or for thst matter many places around the world even on ship if one is going on shore and eating there. or in the case of B in case of a medical emergency.

 

For thst matter hep A out breaks happen every so often, even in the US, such as San Diego a couple of years ago.

 

One physician provides the exact application to ones medical history and if they might be some reason not to such ad the age factor if one has never had yellow fever vaccination in the past for example.

 

Spending most time on ship limits potential exposure, but does not eliminate it, especially if one chooses to eat on their own.

[TRLD]

As i said earlier the site provides the list to provide the basis for an informed discussion, the consult with the physician compares that information to ones specific medical history.

[Ray4Fun]

On 9/6/2024 at 5:12 PM, Budski54 said:

I have until October 8 to cancel, so I will give it a lot of thought.  More than likely, I will go on the cruise. 

1. Evacuation Insurance. Worth $100k or more. We carry $250k at all Times. One major flight company is close to our house. Chaperoning school children to them I was made aware just how expensive flight evac. can be. 

2. With regards to being 4 days in around Antartica , yup it is lonely for those few days. 

3. As for Valparaiso, BA , Montevideo, Puerto Montt, Puerto Mardryn and Ushuaia all have fairly modern Hospitals. Yup Ushuaia has a real deal hospital. 

We have done this cruise twice. Fabulous memories. Do It, just carry the proper insurance. 

Edited Monday at 12:53 PM by Ray4Fun