ABSTRACT
Cruise tourism is a modern high-end tourism product. Under the background of the public health emergency response brought about by the outbreak of coronavirus disease 2019, there are some dilemma in cruise tourism, such as the insufficient of doctors and medical services on cruise ships. It is known that the international treaties or rules on the provision of medical equipment formulated by relevant international organizations have not yet been able to meet the needs of cruise passengers in terms of medical treatment. Based on this, this article compares and analyzes the differences between China and the United States in the medical services provided on cruise ships, the judicial practice of medical disputes arising from cruise ships, and the legislation related to the provision of operating doctors on board. According to the characteristics of disease transmission on cruise ships, it is suggested that by reference to the relevant international treaties and the effective practices of the United States, various measures should be taken to solve the problems of insufficient doctors and insufficient medical services provided on cruise ships in China, such as improving domestic relevant legislation, advocating cruise passengers to increase their awareness of purchasing insurance related to cruise travel, clarifying the obligation of doctors on board, the qualifications of the doctors and related responsibilities. The cruise industry association should play an active role in this issue.
ABSTRACT
In February 2012, an outbreak of respiratory illness occurred on the cruise ship MSC Armonia in Brazil. A 31-year-old female crew member was hospitalized with respiratory failure and subsequently died. To study the etiology of the respiratory illness, tissue taken at necropsy from the deceased woman and respiratory specimens from thirteen passengers and crew members with respiratory symptoms were analyzed. Influenza real-time RT-PCR assays were performed, and the full-length hemagglutinin (HA) gene of influenza-positive samples was sequenced. Influenza B virus was detected in samples from seven of the individuals, suggesting that it was the cause of this respiratory illness outbreak. The sequence analysis of the HA gene indicated that the virus was closely related to the B/Brisbane/60/2008-like virus, Victoria lineage, a virus contained in the 2011-12 influenza vaccine for the Southern Hemisphere. Since the recommended composition of the influenza vaccine for use during the 2013 season changed, an intensive surveillance of viruses circulating worldwide is crucial. Molecular analysis is an important tool to characterize the pathogen responsible for an outbreak such as this. In addition, laboratory disease surveillance contributes to the control measures for vaccine-preventable influenza.
Em fevereiro de 2012, durante a temporada de verão no Brasil, um surto de doença respiratória ocorreu no navio de cruzeiro MSC Armonia. Mulher de 31 anos, membro da tripulação, foi internada com insuficiência respiratória e morreu. Com o objetivo de estudar a etiologia da doença foram investigadas necrópsia de tecido do caso fatal e secreções respiratórias de 13 passageiros e membros da tripulação com sintomas respiratórios. O teste de influenza por RT-PCR em tempo real foi realizado e o gene completo da hemaglutinina (HA) das amostras positivas foi sequenciado. O vírus influenza B foi detectado em sete indivíduos, sugerindo-o como a causa do surto de doença respiratória a bordo do navio. A análise da sequência do gene da HA indicou que os vírus estão fortemente relacionados com o vírus B/Brisbane/60/2008, linhagem Victoria, componente da vacina de influenza para 2011-2012 no hemisfério sul. Uma vez que a composição da vacina foi alterada para uso na temporada de 2012-2013, é essencial a vigilância ativa dos vírus circulantes em todo o mundo. A análise molecular é uma ferramenta importante para caracterização do patógeno responsável pelo surto. Além disso, a vigilância de doenças baseada em dados laboratoriais contribui para as medidas de controle da influenza, uma doença imunoprevinível.