You might never leave home again
As I trundled my suitcase toward the ship's gangway, I braced for the line of crew members waiting for me. The inevitable cheerfulness, the "aw, come on's" when they stopped me to take a souvenir photo.
They stopped me, inevitably cheerful, as I tried to skulk by. But they weren't stopping me for a snapshot. They were stopping me for a spritz. They pointed to the automatic dispenser of hand sanitiser I'd passed.
I, for one, was happy to oblige. In fact I appreciated their vigilance - and hoped that with four crew members to welcome us, they wouldn't let even one of the 5,998 potentially germ-ridden hands get by.
Because washing your hands is one of the most effective actions a traveller can take to stay healthy on the road. Not just on cruise ships, but anywhere or way you wander.
In fact, the latest reminder of the potential health risks people face when they travel was when passengers aboard a recent US Airways flight learned that a fellow traveller believed to have tuberculosis had boarded - despite being on the CDC's Do Not Board list.
About 70 people were detained at an emergency landing in Phoenix, waiting to see if they needed to be tested, if they or their children would be sick, if a hospital rather than a beach would be their destination.
Turned out to be a false alarm (oops, he wasn't sick), but the scare underlined just how easily pathogens can get around - they, too, are travellers.
Hotels (where the term Legionnaire's disease was coined at a convention in Philadelphia in 1976) remain another area of risk - along with rental cars, swimming pools and public toilets.
If you really thought about the Petri dish that the traveller must wade through (and I often do, as you'll see below), you might never get past your own front steps.
Travellers run into a variety of opportunities for illness, because we so often find ourselves at a crossroads. New experiences on holiday challenge your mettle; new germs challenge your immune system.
There's nothing quite so frustrating as lying in a bed (a tent, a villa, a stateroom) roiling with fever or running to the bathroom when you should be out there skiing or hiking or swooning (momentarily) over a Rembrandt or a romantic sunset.
And we can improve the odds that we'll remain healthy, notes Rosanne Galle, nurse practitioner at the Enlightened Traveller, a travel medicine program of the Valley Health Medical Group with three locations in North Jersey, USA. "There are some very simple things you can do that make so much of a difference," she said. Hand-washing is No 1, she said. "Using common sense is another."
Here are some other common ways vacationers get sick, and actions you can take to avoid germs while travelling:
Every few years, the question of health comes up in connection with the airplane cabin.
Every time it does, some airline exec will say something like "airplane air is cleaner than hospital air." I wonder how they know that, however, since until recently no agency was charged with officially monitoring airplane air. Or food. Or water. Or the housekeeping practices.
For flight crews, the cabin is their office, and they've been pushing for better oversight and regulation for decades.
They're the canaries in the coal mine, and have a whole laundry list of concerns, among them: oil fumes contaminating cabin air; more and more incidents of people getting hit by carry-on items overloading the overhead bins; and the general lack of oversight and regulations.
And even when there is a regulation - say, telling passengers that their airplane has been recently or will be sprayed with insecticide - it isn't enforced. Since 1975, the FAA has assumed "exclusive jurisdiction" over workplace safety and health aboard commercial flights. OSHA, a watchdog for most workers in the US, was banned from the premises.
The good news is that in August OSHA and the FAA came up with a new policy that gives OSHA clout concerning working conditions aloft - and passengers will be the beneficiaries.
Increasing your odds of staying healthy aloft?
Do your homework. Airline websites are supposed to contain information for the public on every plane that is sprayed with pesticides. See if yours is one of them. Not only does the air get sprayed, but I've been told by flight attendants that they spray the seat cushions as well when they do the spraying between flights. Children and the elderly may be particularly sensitive to chemical residue.
With all those packed planes and quick turnarounds assume your flight hasn't been thoroughly sanitised. Planes, like hotel rooms, are natural repositories for bacteria. We've all read the studies about reused blankets and pillows, for example.
Then there's the dog-eared in-flight magazines and safety cards. That tray table never looks wiped off. And has your forearm ever stuck to the armrest? Bring sanitizer (under 3 ounces!) and wipe off any surface you are in contact with.
"I hate to be the bearer of bad news, but I've seen many poopie diapers changed on the tray tables," says Sara Keagle, a flight attendant and blogger (flyingpinto.com).
BYO pillow and reading material. If you want to be a good flier and look at the safety card, use tongs.
And do not for any reason stick your hand down into the seatback pocket. Flight attendants have found everything from dirty diapers to used vomit bags behind that cardboard pocket, Keagle says.
The Centers for Disease Control heads a Vessel Sanitation Program under the Public Health Service Act, with ship inspections, the monitoring of gastrointestinal illnesses and investigating outbreaks, and posting health inspection scores.
You can find those scores at cdc.gov.
Other actions you can take:
In exotic or sketchy ports of call, get recommendations from the crew on where to eat and drink.
Use those hand sanitizers.
Wear flip-flops on decks.
Sunscreen is essential if you'll be outside.
Drink only bottled water.
You may not have the cleanest house on the planet, but at least you know where the germs came from.
You never know who has stayed, slept, bled, partied, spit, barfed and whatevered in your room before you got there.
And here's a new wrinkle to consider: Nowadays hotels are more aggressively than ever pushing the opt-out option for room cleaning.
And whether you pay a lot or a little for your room matters not. Just because you pay a lot for that hotel room doesn't guarantee it's germ-free.
Studies show that bedspreads, TV remotes, water glasses and ice buckets are all popular places for germs to hang out. Anne LaGrange Loving, a microbiologist and retired professor at Passaic County Community College who has researched the germ factor on everything from communion wine cups to the lemons that someone's perhaps-unsanitised hands have squeezed into your drinks, trusts nothing in a hotel room.
A couple of years ago she even turned her microscope on the strange practice of toilet paper triangling. Is this bit of geometry a sign that housekeeping has rid your bathroom of germs? Seems to me that triangle is a sign that your toilet paper's been handled by someone whose hands are constantly in the thick of dirty hotel rooms.
In the end, though, Loving decided it was pointless to do a whole study on the triangles: "It is inherently disgusting that someone else might have fingered your toilet paper before you (use it)," she said. Disgusting, maybe, though "the likelihood of getting an infection from this would be really remote UNLESS someone purposely went out of their way to get some appropriately infectious agent on the paper."
Still, she recommends hotel guests "pull the paper out a few squares, yank it off, and discard that section before using it."
Other ways to avoid all that potential "germinating"?
Bring antibacterial wipes or sprays, and wipe down the remote control, doorknobs, faucet handles and phone.
Wash water glasses with hot water for at least two minutes. Loving only uses hotel cups if they are disposable and individually wrapped.
Let the shower run awhile before using it, and wear flip-flops to protect your feet. Loving wouldn't even think of using a hot tub - even a nice fancy whirlpool.
Always wear socks or slippers around the hotel room. Loving says, "No bare feet. Ever."
Inspect the sheets, Loving advises. For someone else's hairs, for the telltale signs of bedbugs (too gross to get into here), for ... anything that doesn't seem just-out-of-the-laundry. Don't even waste time with the bedspread: Take it off the bed and don't touch it again.
BYO bedding when you can: While it may be impractical to take along your own sheets, you ought to bring a pillowcase. "After all, you've got seven places, when you lay your head down, where germs can enter your body," Loving says. "The head is the most likely entrance portal for infection."
Self-serve buffets can be a problem, depending on how they are monitored and set up. In fact, hotels and cruise ships are increasingly staffing their buffets rather than leaving them in the hands of their diners to reduce the number of people handling the same utensils. Make sure the buffet has a germ guard.
Avoid raw seafood unless you can confirm how long it's been sitting out.
Make sure hot food is truly hot, as lukewarm temperatures can cause bacteria to thrive.
Make sure food that is supposed to be cold is really cold - e.g., mayonnaise and dairy products. Especially in warmer climates, these can turn quickly.
They say don't drink it for a reason. It's a major carrier of bacteria in countries without proper water and sewage treatment. Most hotels from Europe to Latin America now offer bottled water on a regular basis for guests.
Water itself, in a glass, is only the most obvious water to avoid.
Think before you drink, says Galle, and say no to:
Ice in drinks.
Drinks made with a "splash" of water.
Fruits and vegetables washed in water.
Brushing your teeth with tap water (use bottled water).
When showering, keep your mouth shut, Galle advises.
By the way, Legionnaire's disease thrives in water. It can flourish in hot tubs, showers and even through air-conditioning systems. While you can't avoid the AC, think before you plunge.
We all have our memorable bathroom encounters (I'm saving up for a book - complete with pictures). As a travel writer and germaphobe, bathrooms have been a constant source of adventure, terror and, eventually, good tales.
Sometimes - oh, I remember a time in Thailand, in a hut with a hole in the floor and a basin of mud-water, plus a handy measuring cup beside - I am stunned by what I find.
Whether in the jungle hut or the hoity-toity pink luxury stalls at the Ritz in Paris, Jill's Golden Rule of Filthy Places applies: Touch nothing. Everything is suspect.
Several months ago I discovered, in a bathroom in an airport lounge, a small metal bracket at the bottom of the door.
It came with a little diagram: You put your toe under the metal, and pull - thereby avoiding the germs on the door handle.
More recently, on the MSC Divina, a sign on the door as I exited the bathroom said: "You washed your hands, keep them clean. When exiting public bathrooms, use a paper towel!" with a cartoon hand grasping a door pull with said towelling.
I'd been doing that for years and always figured it was neurotic!
Since my neuroses turn out to be practicalities, other things I do include: using something other than naked fingers to flush the toilet (a wad of toilet paper, an elbow); using a paper towel at the sink to turn off the water (if it doesn't go off itself). In cases where the whole bathroom looks less than well-cleaned, I will forgo the sink if I have my own hand sanitiser with me.
Here are some additional neurotic behaviours that have kept me safe from disease when I travel:
Eschewing banisters when possible.
Cleaning off the steering wheel of a rental car when you first get in it. Also be wary after you get it or your own car back from a garage or parking lot.
Covering your mouth and nose when someone nearby - elevator, restaurant, but especially airplane - sneezes or coughs. Though I'm sure it isn't all that helpful, I imagine myself having a leg up on all those other nearby breathers.
If I'm around someone who's perpetually coughing, sniffling etc. and can't get away from them for say 10 hours, ask them what particular illness they have, so you can cut to the chase when you get to your doctor back home.
Do you have any more tips on remaining disease-free while travelling? Leave a comment below.