Abstract
BackgroundInternational travellers are at a risk of infectious diseases not seen in their home country. Stomach upsets are common in travellers, including on cruise ships. This study compares the incidence of stomach upsets on land- and cruise-based holidays.MethodsA major British tour operator has administered a Customer Satisfaction Questionnaire (CSQ) to UK resident travellers aged 16 or more on return flights from their holiday abroad over many years. Data extracted from the CSQ was used to measure self-reported stomach upset in returning travellers.ResultsFrom summer 2000 through winter 2008, 6,863,092 questionnaires were completed; 6.6% were from cruise passengers. A higher percentage of land-based holiday-makers (7.2%) reported stomach upset in comparison to 4.8% of cruise passengers (RR = 1.5, p<0.0005). Reported stomach upset on cruises declined over the study period (7.1% in 2000 to 3.1% in 2008, p<0.0005). Over 25% of travellers on land-based holidays to Egypt and the Dominican Republic reported stomach upset. In comparison, the highest proportion of stomach upset in cruise ship travellers were reported following cruises departing from Egypt (14.8%) and Turkey (8.8%).ConclusionsIn this large study of self-reported illness both demographic and holiday choice factors were shown to play a part in determining the likelihood of developing stomach upset while abroad. There is a lower cumulative incidence and declining rates of stomach upset in cruise passengers which suggest that the cruise industry has adopted operations (e.g. hygiene standards) that have reduced illness over recent years.
Highlights
Travel by land, air or sea puts the traveller at risk of infectious microorganisms not usually encountered in their home country and brings with it the potential to transport infectious diseases from one area to another [1,2]
Customer Satisfaction Questionnaires (CSQs) A total 6,863,092 CSQs completed from May 2000
The participation rate on flights is not known, these records are thought to represent 3.9% of the estimated 174 million package holiday visits abroad made by British residents during that time [16]
Summary
Air or sea puts the traveller at risk of infectious microorganisms not usually encountered in their home country and brings with it the potential to transport infectious diseases from one area to another [1,2]. Gastrointestinal illness is common in travellers, with one study of package holiday tourists reporting travellers’ diarrhoea in 24% of travellers questioned [3]. This may be even higher in those travelling from high to low income countries [4,5,6]. As well as causing illness and distress for the traveller, and reducing the enjoyment of foreign holidays, travellers’ diarrhoea impacts on the country of residence. International travellers are at a risk of infectious diseases not seen in their home country. Stomach upsets are common in travellers, including on cruise ships. This study compares the incidence of stomach upsets on land- and cruisebased holidays
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