raw or undercooked eggs” and meat that has not reached an internal temperature of 165 degrees during food preparation. Symptoms of Salmonella include fever, abdominal cramping, and blood-tinged diar- rhea. Symptoms typically begin within a few hours after ingesting the infected food. Symptoms may resolve on their own, but vulnerable populations may require hydration and support through antibiotics or hospitalization.2 As the cruise ship docked in Florida, it is highly likely a few passen- gers showed signs and symptoms of airborne disease as well. Cooped up in cabins with other passengers, there is always a passenger willing to share a rhinovirus via sneezes and coughing (droplets) that land on tactile surfaces where others will pick up the virus and gain more than they purchased for the trip. Although the common cold makes us mis- erable for several days, it is unlikely to make us very ill, unlike more dan- gerous airborne diseases, such as influenza, pertussis, mumps, measles, and anthrax.3 Although we prefer to believe Mumps and Measles are uncom- mon thanks to childhood vaccinations, people in Newark, New Jersey received a bit more than they bargained for on Christmas Eve 2018, as a passenger with full-blown Measles boarded an International plane from Brussels and landed in New Jersey, rash and all at Terminal B! Additional outbreaks have been reported in continental USA during 2018. In the case of Newark, a very watchful eye noticed the passenger’s telltale spots and provided immediate follow-up.1 As you might have realized, the job of a cruise ship director or nurse is hardly an easy task. Knowledge of disease transmission is imperative. Knowing when to contact the Department of Health for contagious outbreaks and knowing when diseases could be harmful to your patient population is of utmost importance. While an airborne outbreak such as a common cold might make passengers cough and sneeze, it would be unlikely to put them at risk. An outbreak of Influenza A or B, on the other hand, could be deadly for elderly passengers, or for very young children. The seasonal influenza virus spreads easily from person to person, and it “continually changes to adapt to the human immune system.” Particles that transmit airborne disease are small enough to hang around in the air, or cling to surfaces in cabins on a cruise ship. They could cling to dust particles, or float in the uncirculated air. They could also transmit disease if someone coughed into their hand and then touched a chair to pull it away from a table. It would be a nightmare for a vessel full of hosts waiting to be infected! Hopefully, many might have received influenza shots that were a good match and this scenario would not occur. But the cruise ship director knows they must be prepared for every eventuality. Transmission of disease isn’t a topic that includes only one or two chapters. The Oasis of the Seas heads to many tropical islands, such as the previously planned trip to Jamaica. While nurses in the United States don’t readily think of vector-borne diseases, those who work in the tropics do. Vector-borne diseases account for more than 17 percent of all infec- tious disease around the globe, which equates to approximately 700,000 deaths annually. Recently, we have begun to hear more about the dev- astating effects of one vector-borne illness (Zika), as the mosquito carrying the disease was identified in Miami-Dade and Dowd counties in Florida, in the continental Although the common cold makes us miserable for several days, it is unlikely to make us very ill, unlike more dangerous airborne diseases, such as influenza, pertussis, mumps, measles, and anthrax. COVER STORY  | 6 INFECTIOUS DISEASE, DISASTER PLANNING & WOUND CARE | 2019 | www.elitecme.com