Recreational Infections (original) (raw)

most frequently Salmonella and Staphylococcus aureus; however, even cholera has been transmitted in this way. 3 Respiratory infection, including influenza A, H1N1, severe acute respiratory syndrome (SARS) and multidrug-resistant pulmonary tuberculosis, have also been transmitted during aircraft flights. 4,5 An estimated 13 million passengers around the globe travel on cruise ships each year. Cruise ships can be responsible for respiratory and gastrointestinal infections, involving complex patterns of transmission in a closed community. 6 Modes of transmission include person-to-person spread, water-borne, food-borne, airborne, vectorborne and even shore excursions. Historically, a number of bacterial infections including cholera and typhoid have been associated with ship-borne spread. The pathogens most commonly implicated nowadays are norovirus, 7,8 Legionella, Salmonella, Escherichia coli, Vibrio and influenza A and B. 6 There is a well-recognized association between outbreaks of Legionella infection and airconditioning systems in holiday hotels. 9 Western travelers increasingly seek more exotic destinations where, as a result of poverty and poor infrastructure, they may be at risk of infection with common pathogens (particularly of the gastrointestinal and respiratory tracts). They may also be at risk of tropical infections that do not exist in their own country (e.g. malaria). These risks are discussed in detail in Section 6. Zoonoses Zoonoses are infections of animals which can be transmitted to humans. Many leisure activities increase the opportunity for contact between humans and animals, with consequent increased risk of infection. Keeping pet animals is a common recreational pastime and increases risks of zoonotic infection. The UK recently had an outbreak of Hantavirus amongst owners of pet rats. 10 Hiking, camping and caving increase the risk of zoonoses. People may hike in a temperate climate or, increasingly, may choose to trek in a tropical or developing country. These activities increase the potential