Whether it is an exotic adventure through the Panama Canal or a relaxing trip up the New England coast to see the colors change, cruises are a popular way of traveling throughout the world. But, many individuals are being forced to go home before they even get on the boat because they don’t have a passport. This may seem odd, especially considering that many cruises only stop at one international port, but a little known law from the late 19th century has made a passport practically necessary for even the most routine cruise.

In 1886, the Passenger Vessel Services Act was passed by Congress requiring that all foreign-flagged vessels (meaning ships constructed outside the U.S., as most cruise ships are) visit one foreign port before they can return to their port of origin. For example, an Alaskan cruise may leave Seattle, go to Juno and Skagway, Alaska, but it would have to visit Vancouver, Canada, before docking back in Washington.

The reasons behind the 1886 act are fairly complicated, but what it means is that all cruise travelers should have a passport before embarking, even if they don’t plan on going ashore in a foreign country. Previous to 2009, a birth certificate or other form of government-issued I.D. was sufficient, but changes to travel regulations have made passports a necessity. In fact, many cruise lines will not even allow you to board the ship if you do not have a passport (and in some cases a visa).

If you are planning a cruise vacation, be sure to have your passport before you go. Passport Health now offers passport and visa expediting services to help you organize all of the documents you may need for your trip. On average, getting a new passport takes four to six weeks, but expediting services can get the passport back to you in as little time as one to three business days.

To learn more about what you will need for your passport application, see our passport requirements page. Or, if you are ready to begin your application, contact us today.

Have you had any experiences with cruises and passports? Let us know on Facebook, Twitter or in the comments below.

As we commemorate George Washington’s birthday today, it is interesting to note a little known fact about the first president: George Washington was one of the first political leaders to recognize the positive impact vaccines have.

A new book titled Gentleman Scientists and Revolutionaries: The Founding Fathers in the Age of Enlightenment by Tom Shachtman explains how George Washington pushed for his soldiers and the population at large to be vaccinated against smallpox during the Revolutionary War. At the time, however, this advocacy represented was a very radical position. There was no traditional vaccine at the time. Instead, a technique called variolation was used to promote disease immunity.

The practice of variolation called for the pus from an infected individual being inserted under the skin of an uninfected person. This would give the receiver a very mild case of the disease and, after surviving the mild case of the disease, the person would then be immune. It was a procedure that many founding fathers had gone through themselves, including Benjamin Franklin and Thomas Jefferson as well as Martha Washington.

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Disasters can strike anywhere around the globe at any time of year. Hurricanes, earthquakes, war and famine are just a few of the natural and manmade disasters that can lead to aid workers being sent to a region. Given the nature of their work, these individuals often face additional health challenges.

According to the Centers for Disease Control and Prevention, individuals considering becoming aid workers or that are traveling to participate in aid work should schedule a visit with a travel health specialist as soon as possible to ensure they are fully prepared for what they may encounter during their mission.

The CDC requires aid workers and disaster responders in the United States, and often internationally, to have received a tetanus and a hepatitis B vaccine before leaving to help. Both vaccines protect against potential exposure to bacteria and viruses that may be present in an environmentally compromised area.

Other vaccines may be recommended on a case-by-case basis if engaging in aid work internationally. These commonly include:

• Hepatitis A– a common foodborne disease
• Typhoid– often found in contaminated food or water, especially if raw sewage is present
• Meningitis– can be spread through multiple vectors including living in close quarters, as one would experience in dorms or tents
• Rabies– spread by bites from infected animals

A Passport Health travel specialist will be able to assist you in identifying which vaccinations are most important and relevant for your specific destination and the type of aid work you will be participating in.

Preparing for your aid trip isn’t just about vaccinations. Most aid workers will need to prepare their bags more thoroughly than other travelers. Often, the areas visited are either less developed or have been severely damaged by weather or other disasters. Plan on bringing the following items in a sufficient quantity to last your entire trip:

• First-aid kit
• Water filter or purification tablets
• Gloves
• Toiletries
• Flashlight
• Candle or matches
• Non-perishable food

Mosquito nets or repellents may also be recommended depending on your destination and the condition of the area.

A Passport Health travel specialist may also recommend a traveler’s diarrhea kit even if you are going to a developed area. CDC data shows instances of diarrhea increase significantly after disasters, even in well developed and industrialized areas.

For more information on the vaccinations recommended, see our vaccinations page. If you are planning an aid trip, contact a Passport Health travel specialist today by calling or book your appointment online.

Have any tips you’d like to add? Let us know in the comments below, on our Facebook page or via Twitter.

Many have never heard of Legionnaires’ disease, but this bacteria-caused illness is making headlines after reported outbreaks in New York City this summer. The disease was blamed for 12 deaths over 119 reported cases until the outbreak was declared over by early August of 2015. However, in October of this year, three Chicago schools shut down due to reports of possibly high risk of contracting the disease. In both cases, the bacteria were traced to cooling towers in the city. In reality, Legionnaires’ disease affects thousands of people annually in the United States.

Legionnaires’ disease is caused by a bacteria called Legionella, which is naturally found in warm waters. Sources include hot tubs, plumbing systems, fountains, and cooling towers. When the bacteria have an opportunity to multiply and grow, outbreaks of the illness can occur. Legionnaires’ disease is spread by breathing in air vapors containing the bacteria – it is not spread person to person. In New York City and Chicago, the disease was spread by bacteria thriving in cooling towers, which are part of air conditioning systems. The bacteria travel in the air and are dispersed through the vents of the buildings. Another example of how Legionnaires’ disease could be spread is breathing in mist rising from a hot tub that was not properly cleaned. A person diagnosed with Legionnaires’ disease is not a threat to others. Instead, it is the source of the bacteria that is a threat, and the situation should be rectified to prevent further cases.

Most people have resistance to the disease and do not develop symptoms. For those that do, symptoms include coughing, fever, general aches and difficulty breathing. The bacteria settle in a person’s lungs and cause symptoms similar to pneumonia. Treatment includes a course of antibiotics and possible hospitalization. Elderly adults and those with compromised immune systems may have complications from this disease. According to the CDC, death is possible in 5 to 30 percent of all cases. Furthermore, more than 20 percent of cases are travel-associated, which indicates the necessity to take precautions against this disease.

The best way to prevent Legionnaire’s disease is to maintain clean and efficient water systems. Large buildings like airports and hotels are more prone to Legionella outbreaks because they have more complex water systems. Keeping water at an appropriate temperature and free of impurities will lower the risk of growing Legionella bacteria.

For individuals, avoid drinking tap or otherwise potentially contaminated water while traveling. Even ice can be a bastion for the bacteria that can lead to Legionnaire’s and other infections. Passport Health stays abreast of any information regarding outbreaks throughout the world and will keep you up-to-date on any Legionnaire’s infections that may occur in the country you are traveling to.

If you are traveling abroad, make sure you know the risks of Legionnaires’ disease in the areas you are visiting. If you develop symptoms, be sure to visit your healthcare provider right away. If you know that you have been exposed to a site with an active Legionnaires’ disease outbreak, continue to monitor your symptoms two weeks after exposure. A visit with a Passport Health adviser before your trip can help ensure you are up-to-date on any information you need to safeguard your health.

Have you had experiences with contaminated water on your trips? We’d like to hear about what happened. Feel free to share your story in the comment section below, on our Facebook page or via Twitter.