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The so-called swine flu, a new strain of the type A H1N1 influenza virus that began in Mexico and has since spread across the world, has had a major affect on cruising. When the flu was centered in Mexico, several cruise lines canceled Mexican Riviera itineraries and replaced them with Pacific Northwest cruises. Once the virus had spread worldwide, ships with suspected cases of the flu onboard were barred from calling in several ports in the Caribbean and Australia.
How will this near-pandemic outbreak impact cruise travelers next? How are cruise lines handling outbreaks and protecting against future ones? Get the basics on the virus, cruise line policies and how to stay healthy on your next cruise vacation.
What is swine flu?
According to the Centers for Disease Control and Prevention (CDC), "Swine Influenza is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs." Recently, a variant of the virus called type A H1N1 has been found in humans. The virus contains gene segments from North American, Asian and European swine viruses, North American bird flu viruses, and human flu viruses.
Where have cases of swine flu been found?
On June 11, 2009, the World Health Organization (WHO) declared the H1N1 influenza virus a pandemic. According to the organization a virus becomes a pandemic when three conditions are present: a new virus subtype has emerged; humans are infected with serious illnesses; and the disease is spreading among humans. At that time, 30,000 cases had been confirmed in 74 countries.
As of mid-August 2009, the WHO reports more than 182,000 laboratory-confirmed cases of H1N1 in 177 countries and territories. In addition, 1,799 deaths have been ascribed to the virus.
What are the symptoms?
Symptoms are similar to any seasonal flu. According to the CDC, they include fever, cough, sore throat, body aches, headache, chills, fatigue, and possibly diarrhea and vomiting. If you already have a chronic medical condition, swine flu may cause that condition to worsen.
How is the flu transmitted?
Swine flu is transmitted from person to person, mainly through the coughing or sneezing of infected people. Spread of the virus is thought to be happening in the same way that seasonal flu spreads. It is not transmitted via food, such as pork or pork products. People infected with H1N1 are contagious from one day before they show symptoms to about five to seven days after.
Pre-existing conditions such as pregnancy, diabetes, heart disease, asthma and kidney disease may put you at greater risk of contracting H1N1. People over the age of 64 are showing fewer cases of the virus, with the highest level of cases found among people under the age of 25.
Is it safe to cruise?
Yes. Cruise lines are no longer cancelling cruises due to swine flu outbreaks. However, it should be noted that individual ports -- including the Whitsundays, Port Douglas and Cairns in Australia, and St. Lucia, Antigua, Grenada and Barbados in the Caribbean -- have turned away cruise ships with suspected cases of the illness onboard.
In addition, cruise lines are adopting measures to prevent the virus from coming onboard or spreading through cruise ships. All cruise lines that are members of the Cruise Lines International Association (CLIA) -- which includes the biggies like Carnival, NCL and Royal Caribbean and smaller lines like AMAWATERWAYS and SeaDream Yacht Club -- have agreed to issue public health questionnaires to all passengers, crewmembers and visitors prior to embarkation and have medical staff screen anyone exhibiting flu-like symptoms. MSC Cruises is even using non-invasive thermal imaging cameras to detect whether embarking passengers have higher-than-normal body temperatures, a possible indication of flu. Passengers and crew on any ship who come down with the flu while the cruise is in progress will be isolated and treated.
In addition, cruise line infirmaries have stocked up on appropriate medical equipment and antiviral medications to effectively treat anyone who comes down with swine flu while onboard. And whenever an outbreak is suspected, cruise ships will undertake an enhanced sanitization and cleansing routine to prevent a further spreading of the illness.
How can I stay healthy?
The best way to protect yourself is to avoid contact with sick people. Be sure to wash your hands thoroughly with soap and water (or alcohol-based cleaners), and avoid touching your nose, eyes or mouth. Should you get sick while traveling, cover your nose and mouth with a tissue when you sneeze or cough, and remain in isolation whenever possible to avoid spreading the flu to other passengers.
Is there a cure?
The CDC is working on a vaccine, which may be ready by fall 2009. Two prescription antiviral drugs, Tamiflu (oseltamivir) and Relenza (zanamivir), have been shown to be effective against the flu.
Should I buy travel insurance?
If you are concerned about getting sick while traveling, you should definitely consider travel insurance, either a regular trip insurance policy or a travel medical plan. Look for policies that cover doctor's visits and medical care outside your home country, trip interruption (if you need to cut short your travels due to illness), emergency medical evacuation and repatriation of remains.
However, if you are currently healthy, note that most insurance policies will not reimburse you should you decide to cancel a trip because you're worried about contracting swine flu. You will only be covered if you purchased a "cancel for any reason" upgrade to your insurance policy.
The so-called swine flu, a new strain of the type A H1N1 influenza virus that began in Mexico and has since spread across the world, has had a major affect on cruising. When the flu was centered in Mexico, several cruise lines canceled Mexican Riviera itineraries and replaced them with Pacific Northwest cruises. Once the virus had spread worldwide, ships with suspected cases of the flu onboard were barred from calling in several ports in the Caribbean and Australia. 
