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CONTAGIOUS DISEASES

It is always better to prevent than to cure. Nowadays, we nearly always try to preven diseases and there are fewer places where this is more important than on board a ship.

Conditions at sea are not favourable for one's. The opportunities for recreation, exercise, and a healthy way of life are limited; accommodation is less comfortable and fresh food is harder to come by. The crew are away from land and their families for long periods of time; they spend months in the limited space of their ship with a small number of crewmates around them (always the same ones). These conditions give rise to boredom and stress, which can contribute to the appearance of some illnesses.

In addition, the ports and fishing grounds of many of the countries visited are endemic for many infectious diseases, they do not have adequate health measures in place, and it is easy to catch diseases transmitted by water, food or insect bites.

Contagious diseases are those that can be transmitted by one person (or animal) to another. There could be a direct transmission from one infected person or animal to a healthy person, or it could be an indirect transmission, sometimes through an intermediary (mosquito, rat…) and other times through the environment (air, water, food…).

The organisms that produce illnesses in humans, called infectious agents, belong to different Groups: bacteria, viruses, fungi…, and can penetrate the organism in different ways: digestion, respiration, skin and mucus.

GENERAL NORMS FOR THE PREVENTION OF TRANSMITTABLE DISEASES

The infection chain is made up of the following links:

1. Source of infection: sick humans or animals; contaminated products (vomit, urine, blood, faeces…).
2. Means of transmission of the infection: water, food, dust, air, insects, rodents, soil, objects...
3. A healthy person, where the infectious agent can enter through: digestion, respiration...

Methods of prevention are directed at breaking this chain by acting against one or all of its links:

1. Countering the source of infection: isolation, disinfection and delousing, early treatment.
2. Countering the methods of transmission: personal on board hygiene, disinfection, protecting against insect pests, clearing of rats (see Chapter 13, CREW HYGIENE and Chapter 14, ON BOARD HYGIENE).
3. Human health: vaccination, chemoprophylaxis, gammaglobulin prophylaxis and health education.

In addition, there is an unspecific, though very important, type of prevention to stop infection appearing in the community, such as adequate food and living conditions, make the water drinkable, treatment of residual water… (see Chapter 13, CREW HYGIENE and Capítulo 14, ON BOARD HYGIENE). The appearance and propagation of infectious illnesses on board will be very unlikely, if each crewmember looks after his own personal hygiene, if the hygienic conditions of the vessel are kept minimally acceptable, if water and food are handled and conserved adequately.

We will now move on to isolation, vaccinations, sexually transmitted diseases and human-transmitted diseases, especially concentrating on the prevention of malaria.