{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:14:46Z","timestamp":1787238886879,"version":"build-2736575974"},"reference-count":53,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T00:00:00Z","timestamp":1564444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission Second Programme of Community action in the Field of Health 2008-2013","award":["2012 2103"],"award-info":[{"award-number":["2012 2103"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>A literature review was conducted to identify evidence of cases and outbreaks of vaccine-preventable diseases (VPDs) that have been reported from on board ships and the methods applied on board for prevention and control, worldwide, in 1990 to April 2019. Moreover, evidence from seroprevalence studies for the same diseases were also included. The literature review was conducted according to Preferred Reporting Items for Systematic reviews (PRISMA) guidelines. A total of 1795 cases (115 outbreaks, 7 case reports) were identified, the majority were among crew (1466\/1795, 81.7%) and were varicella cases (1497, 83.4%). The origin of crew cases was from sub-tropical countries in many reports. Measles (40 cases, 69% among crew), rubella (47, 88.7%), herpes zoster (9, 69.2%) and varicella cases (1316, 87.9%) were more frequent among crew. Mumps cases were equal among passengers and crew (22\/22). Hepatitis A (73\/92, 70.3%), meningococcal meningitis (16\/29, 44.8%), and pertussis (9\/9) were more frequent among passengers. Two outbreaks resulted in 262 secondary measles cases on land. Review results were used to draft a new chapter for prevention and control of VPDs in the European Manual for Hygiene Standards and Communicable Disease Surveillance on Passenger Ships. Despite past and current evidence for cross-border VPD transmission and maritime occupational risks, documented pre-employment examination of immune status, vaccination of seafarers, and travel advice to passengers are not yet regulated.<\/jats:p>","DOI":"10.3390\/ijerph16152713","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T11:15:56Z","timestamp":1564485356000},"page":"2713","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A Systematic Review for Vaccine-Preventable Diseases on Ships: Evidence for Cross-Border Transmission and for Pre-Employment Immunization Need"],"prefix":"10.3390","volume":"16","author":[{"given":"Varvara","family":"Mouchtouri","sequence":"first","affiliation":[{"name":"Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Hadjichristodoulou","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EU SHIPSAN ACT Joint Action Partnership","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.1708-8305.2012.00620.x","article-title":"Measles, rubella, and varicella among the crew of a cruise ship sailing from Florida, United States, 2006","volume":"19","author":"Mitruka","year":"2012","journal-title":"J. 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