International Centre for Cruise Research
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---, "Rubella among crew members of commercial cruise ships--Florida, 1997,"  Morbidity and Mortality Weekly Report, 1998, 46:52-53 (Jan 9), 1247-50  (Also Journal of the American Medical Association, 1998, 279:5 (Feb 4), 348, 350)

During April-July 1997, two different commercial cruise lines notified CDC of rubella outbreaks among crew members. In July 1997, CDC initiated an investigation on one cruise ship to determine the extent of and risk factors for rubella infection among crew members and to assess the potential risk for rubella transmission to passengers-particularly rubella-susceptible pregnant women at risk for giving birth to an infant with congenital rubella syndrome (CRS). This report summarizes rubella outbreaks involving two cruise ships and the results of the CDC investigation on one cruise ship, which demonstrate that crew members can serve as a susceptible population for rubella infection and should be vaccinated with measles-mumps-rubella vaccine (MMR) if they are not immune. Although the outbreaks were limited to crew members, cruise ship travel provides an environment conducive to the potential spread of rubella and other infectious diseases among crew and passengers; therefore, women of childbearing age, particularly pregnant women, should be immune to rubella before traveling on cruise ships to reduce the risks for rubella infection and CRS.