Welcome to the April 2009 issue of "Smart Traveler". The newsletter with tips and information to help make your traveling smoother.

Top 10 Common Cruise Questions

Cruising newcomers usually have more excuses as to why they've never sailed than there are ships at sea. Often, these excuses are based on misconceptions of what a cruise vacation is really like. If your mental image of a cruise vacation is based on Titanic (snobby rich folks playing shuffleboard and dining each night in gowns and tuxedos) or The Love Boat (lots of shameless hooking up between guests and crewmembers), or if it involves the notion of a floating, nonstop smorgasbord, you clearly need to bring your preconceived notions in line with the reality of modern cruising.

To give you more insight into the contemporary cruise experience, we have answered 10 of the most common questions that we are asked by travelers who've never sailed.

1. Is Cruising Expensive?
The upfront price may seen high, but remember that your cruise fare includes your accommodations, meals in main dining venues, activities (including children's programs), and nighttime entertainment—not to mention transportation from port to port. When you factor in all of the costs you'd incur on a land vacation, as well as the great deals you can currently find on cruise travel, you'll discover that you can actually save money by booking a cruise, as opposed to a land-based vacation.

2. Are Cruises All-Inclusive?
No. Your cruise fare includes a lot (see above), but you'll pay extra for a whole host of amenities. Among them? Alternative restaurants, some coffee and ice cream bars, soft drinks and alcoholic beverages, shore excursions, spa treatments, and gratuities. The luxury lines include more, but even they are never completely all-inclusive. (Drinks and gratuities may be included in fares, but spa treatments and shore excursions won't be.)

3. Are All Cruise Ships Alike?
Cruise ships come in a variety of sizes and personalities. You'll find a myriad of variations: big ships, small ships, explorer-oriented ships, absolutely decadent luxury ships, family ships, sailing ships ... and on and on!

4. Is Cruising Like Going to Vegas or to a Resort?
Well, yes—and no. These days, cruise ships do have all the comforts and luxuries that travelers associate with on-land resorts, as well as much of the glitz and glamour of destinations like Vegas (including bustling casinos and lavish production shows). However—and this may seem obvious, but it needs to be mentioned—you are on a ship. Rough seas can impact your itinerary, you must debark and reboard the ship at specified times, and your cabin will typically be smaller than a hotel room (unless you book the highest level of suites).

5. Isn't Cruising Just for the "Newly Wed and Nearly Dead"?
It used to be, but no way is that true anymore. Cruise ships are increasingly targeting families, offering children's programs and facilities that rival those on land. You'll find onboard water parks, teen discos, video games, and a variety of craft projects and interactive play. Singles can enjoy the camaraderie of communal meals and organized shore tours, special singles' meet-and-greets, and a host of onboard activities. Hip and urban travelers will be pleased to find gourmet dining, high-tech and modern entertainment, and late-night action at onboard bars and clubs. Gay and lesbian cruisers are welcomed onboard with their own meet-ups in ships' lounges. Charter cruises—catering to gay singles, couples, and families—are also offered.
Health-conscious and active travelers should note that midnight buffets have given way to expansive fitness centers, spa cuisine, and an array of active, onboard pursuits like rock-climbing and Pilates classes. And, cruise lines are even offering plenty of shorter-than-usual (three- to six-night) voyages that are marketed to working folks, who simply can't give up two weeks or more.

6. Will I Get Sick or Seasick?
You may have read news articles about outbreaks of norovirus on cruise ships. Norovirus is a stomach bug that spreads easily in contained environments, such as hospitals and schools, as well as ships. You can stay healthy by washing your hands often and using the hand sanitizer lotion found in dining areas and by the ship's gangway.
As for seasickness, most ships are so big and well-stabilized that you can hardly tell you're moving, especially in the calm waters of the Caribbean and Alaska's Inside Passage. Radar helps big ships outrun hurricanes and other bad-weather patches, but if you do happen to pass through some rough water, any queasiness can usually be relieved by an over-the-counter medication like Dramamine or Bonine. If you are very prone to seasickness, ask your doctor before you leave home for the Transderm patch, available by prescription. Alternative remedies include ginger capsules and acupressure wristbands, available at most pharmacies. Also, note that the purser's desks on most ships can provide rations.

7. Is Cruising Safe?
Ships must follow an extraordinary number of rules and regulations that assure passengers' (and crewmembers') safety while onboard. The Coast Guard conducts rigorous, quarterly inspections of all ships that operate from U.S. ports, looking to make sure they comply with emergency-response requirements. Rather than sinking (a la Titanic), fire is the biggest concern, and when it comes to fire safety, ships operate under international rules, known as Safety of Life at Sea (SOLAS). The rules require most ships to have smoke detectors, sprinklers, and low-level emergency lighting for escape routes.
Within the first 24 hours of sailing, everyone on your ship is required to participate in a safety drill that includes trying on a nifty orange life jacket and locating your assigned lifeboat, on the odd (and rare) chance that you need to use it.
However, cruise ships are like mini-cities, and you should take the same general travel precautions you would on land. Keep any valuables in your cabin's safe (or leave them at home), don't open your cabin door without verifying who's there, and give children strict rules about when they can and cannot roam the ship without adult supervision.

8. Will I Be Bored?
No way! You may need a map to navigate around today's big ships, and there's something to do in nearly every corner. For intellectual stimulation, you can listen to guest speakers, participate in Bridge tournaments or attend wine lectures. To get your heart pumping, play some hoops, or visit the ship's gym. There are pools for soaking and swimming, boutiques for shopping and spas for pampering. You can participate in contests, do crafts, watch movies, or simply grab a book and get a tan.
Even on small ships, there's plenty to do during times when the vessels are at sea; most notably, these cruises tend to offer strong enrichment-oriented activities. Plus, remember you're not on the ship all the time—most itineraries include a variety of different ports of call.

9. Won't I Get Fat?
OK, we know the rumor that the average person gains about five pounds on a one-week cruise. But, for those watching calories, be assured there will be low-fat (and often low-carb) options on the menus and some healthy choices at the buffets. Certain ships actually have onboard spa cafes. And, many have simply done away with midnight buffets—those longtime paeans of absolute indulgence. (After-dinner revelers can, instead, partake in hors d'oeuvres, served in late-night venues.)
Aside from eating healthy, you can also burn calories by working out in the ship's gym, speed-walking or jogging around the various decks (or ditching elevators in favor of stairs), and mountain-biking, hiking, and kayaking in port. Some ships have basketball courts, rock-climbing walls, and rollerblading rinks for more onboard athletics.

10. Can I Stay in Touch?
On most ships, you'll get CNN or some other cable news network on your in-room TV. A daily news sheet may also be available, combining wire reports with stories from major newspapers. You can make phone calls from the phone in your cabin (though it's prohibitively expensive), and from your cell phone, as well. (Roaming charges apply.) Most ships have Internet centers and shipboard WiFi, so you can read email and surf the Web.

Concerned About Swine Flu? Read This First!

If you're traveling in the near future, you may be concerned about the recent news regarding swine flu. Luckily, the travel industry has been proactive in regard to the situation, and you should find a more lenient (read: penalty-free) environment if you need to change or cancel your travel plans. If you're still planning on hitting the road or taking to the skies, however, know that proper precautions, common-sense practices, and good judgment can go a long way toward keeping you healthy and disease-free.

Where Are the Current Warnings?At press time, the Centers for Disease Control and Prevention (CDC) has only put out a swine flu warning for travel to Mexico, advising against any non-essential trips there. All other countries are currently classified as safe for travel.

Should You Cancel or Postpone Your Trip?If you want to postpone your trip to Mexico, several airlines are permitting free ticket changes. Currently, the airlines that have announced flexible travel policies include:

If you have booked a trip to Mexico with one of these airlines, you can request a ticket change with no fee. Date policies and restrictions vary by airline; contact your carrier directly to request changes. Additionally, if the virus continues to spread, expect more travel providers to reduce or omit fees or expand the no-penalty policy to include cancellations.

Hotels are also reducing fees for those who need to change their travel plans, with Marriott, InterContinental, and Hyatt among the companies currently waiving change fees. Funjet Vacations, Pleasant Holidays, and United Vacations are also omitting fees for those who want to delay their Mexico vacations.

For cruises, Carnival, Holland America, Norwegian, Princess Cruises, and Royal Caribbean have temporarily decided not to port in Mexico, and other cruise lines will most likely follow their example.

Regardless of which company you booked with, contact your travel agent directly if you need to make a change to your itinerary. Hotels will typically let travelers cancel with a few weeks' notice without penalty; check your hotel's cancellation policy if you are concerned. If you would like to cancel your flight, you may be able to apply the value of a nonrefundable ticket toward another ticket, but there's no guarantee. Again, check with your carrier to find out what the policies are, and if there's any leniency given the swine flu situation.

What You Can Do to Protect Yourself if You Decide to Travel
According to the CDC, travelers should "take common sense steps to protect themselves. Wash your hands, get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food." Additional recommendations include making sure your vaccinations are up to date, packing a travel health kit that includes first aid and basic medical supplies, knowing in advance where any health care centers and hospitals are in the region you are visiting, and checking in with your health insurance provider to ensure you have coverage overseas (if applicable).

Tamiflu and Relenza (both prescription drugs) have shown some effect against swine flu. Speak with your doctor for further details or to obtain a prescription.

Once you're in country, make sure to be vigilant of the situation and those you come into contact with, and be cognizant of any affected areas you may visit. Avoid coming into close contact with sick people; limit touching your eyes, nose, and mouth; and use hand sanitizers and tissues. Be sure to follow local health guidelines wherever you may visit.

The World Health Organization (WHO) has also put together a swine flu resource site that includes updates, FAQs, and more.

What to Do En Route

If you're at the airport, you may be able to request a surgical mask to wear while waiting at your terminal or on the plane. The staff at Mexico City International Airport, for example, has been handing out masks to passengers as a precaution.

Wash your hands frequently at the airport using hot water and plenty of soap. In flight, keep a travel-sized bottle of hand sanitizer with you, and use it when you're not able to wash your hands.

If you're seated next to someone exhibiting flu symptoms, such as coughing, fever, sneezing, and the like, you may be able to speak with a flight attendant and request a transfer to a different seat. Keep those sanitizers handy and drink plenty of fluids.

New drug brings hope for jet lag sufferers

The sleepless nights, the woozy days and the foggy minds of jet lag are the bane of any business traveler's life.


But help may be on the way in the form of a new drug that has proved successful in resetting the body's natural sleep rhythms.

In two clinical trials, the drug tasimelteon helped volunteers whose sleep pattern had been delayed by five hours to fall asleep quicker and to sleep for longer.

The drug mimics the effects of melatonin. Melatonin is a naturally-occurring hormone in humans that regulates the circadian rhythm, or the natural human clock, that is partly controlled by daylight.

When the circadian rhythm is disrupted -- by traveling across time zones or disrupting sleep during shift work -- the most common symptoms are insomnia when trying to sleep and excessive sleepiness while trying to remain awake. This is due to the inability of the body to cope with conflicting time signals.

Melatonin improves the quality of sleep and dulls the awakening signal in the body clock.

The studies on tasimelteon were undertaken by researchers from Brigham and Women's Hospital, Boston, USA and Monash University, Australia.

They conducted two trials with 450 volunteers whose sleep patterns had been disturbed by keeping them awake for five hours longer -- usually the time difference between New York and London.

They compared the sleep patterns of people who had been given different dosages of the drug 30 minutes before sleep and those who had been given a placebo. In both studies, tasimelteon reduced the amount of time it took for them to fall asleep, and increased the amount of time they spent asleep.

Commenting on the results of the trial, published in medical journal The Lancet this week, Daniel Cardinali, from the University of Buenos Aires and Diego Golombek from the National University of Quilmes, Buenos Aires, said the results would be welcomed by "shift workers, airline crew, tourists and football teams."

They added that the drug could be an alternative to addictive sleep therapies such as benzodiazepines. Melatonin-like drugs only exert a "modest sleep-promoting effect." Instead, they wrote, "they amplify day-night differences in alertness and sleep quality." What are your tips for overcoming jet lag? Sound off below.

Melatonin products are already available over the counter in the USA, the researchers pointed out in The Lancet. But they are not recommended because their potency, purity, and safety are not regulated by the US Food and Drug Administration.

The study was funded by Vanda Pharmaceuticals which makes tasimelteon. If approved, the drug could be on the market within three years.

In the meantime,  there are natural ways business travelers can combat the effects of jet lag. Here are some to keep in mind before you travel.

Tips for combating jet lag

Avoid late meals and alcohol

Take cat-naps when you need to

Adjust to your destination as soon as you get on the plane

Eat on local time

Get a good night's sleep before you travel

Go for walks in daytime and get plenty of sunlight

Try to sleep at take-off when gravitational forces and a shortage of fresh oxygen make ideal conditions for dozing off

A break in a long flight can help

Noise-cancellation headphones can block out noise and help you sleep on planes

How to Take On Travel Trouble

Health Care Abroad

No one wants to imagine being sick or injured on vacation -- but if the worst happens, it pays to be prepared. A few minor precautions can save you considerable hassle, time and money, and offer you peace of mind if you encounter health problems while traveling.

Medical practices abroad may be very different than those in the United States. Language barriers and unfamiliarity with your medical history make planning for potential medical care crucial.

The following tips, contact information, medication names and additional resources will help you find health care abroad and deal with medical needs both minor and critical.

Start with the Consular Information Sheets
If you aren't familiar with the country you're visiting, the U.S. State Department's Consular Information Sheets are a good place to start to see what type of medical services will be available to you once you're there. Select your country and look for Medical Facilities and Health Information.

Collect Health Care Contact Information Before You Leave
Write down the following information in your address book, journal or itinerary and keep it with you at all times.

  Your regular doctor's office and home phone numbers in case you need a consultation while traveling

  HMO/insurance company contact information in case you need to get approval for treatment

  Embassy contact info for countries in which you are traveling

Also, ask your doctor for a contact name and number in the event of an emergency that occurs when your own doctor is not available.

All of this information should be with your primary identification in your carry-on luggage, wallet, purse or money belt so that, should you be incapacitated, whoever comes to your assistance will find it. If you have serious allergies or a medical condition such as diabetes, be sure to ask your doctor about medical emergency bracelets.

Know the Generic Names of Your Medications
Common brand names at home may not be available or widely known where you are traveling. Knowing the generic/medical names of common medications may help you find the over-the-counter medications you need, and help you avoid taking the wrong medications.

It's a good idea to pack a range of travel medications in a first-aid kit before you leave. If you need to replenish your supplies while traveling, keep in mind the following generic medication names:

  Advil/Motrin/Alleve = ibuprofen

  Tylenol/Excedrin = acetaminophen

  Bayer, others = aspirin

  Benadryl (antihistamine) = diphenhydramine

  Dramamine, Bonine = dimenhydrinate, meclizine

  Pepto-Bismol = bismuth subsalicylate

  Antacids = calcium carbonate, aluminum hydroxide or magnesium hydroxide

  Imodium = loperamide

Medical Assistance Companies
Membership with a medical assistance company buys you access to an extremely wide range of medical and other services, from the mundane (vaccination recommendations, doctor referrals, legal advice), to the dramatic (repatriation, emergency evacuations, emergency cash loans).

Plans, services and prices can vary widely, so read all information carefully, and compare the various service levels and companies. Two recommended medical assistance companies include:

International SOS
Travel Assistance International

Locating Doctors and Clinics While Traveling Abroad
The U.S. State Department provides a list of doctors and hospitals abroad. Also, check your guidebook -- many include hospital, clinic or doctor recommendations.

Especially at upscale lodgings, ask the hotel concierge for physician recommendations. Some doctors will make "house calls" to your hotel. Alternatively, your best bet may be to contact the nearest medical school, where you will often find English-speaking doctors and students.

The following agencies provide contact information for English-speaking doctors throughout the world. Membership may be required.

International Society of Travel Medicine (ISTM)
(770) 736-7060

International Association for Medical Assistance to Travelers (IAMAT)
(716) 754-4883

Obtain Information at Your Location
If you are sick or injured, ask for complete contact information (including a fax number) of the hospital or clinic at which you're being treated before you call your doctor or insurance provider. Having this information will make it easier for your provider to process your claim and to fax pertinent documentation to your caregivers.

Additional Contact Information
The following government and private agencies provide valuable information for U.S. citizens traveling abroad:

U.S. State Department Overseas Citizens Services
(888) 407-4747 -- from overseas: (202) 501-4444

The American Society of Tropical Medicine and Hygiene (ASTMH)
(847) 480-9592

Centers for Disease Control and Prevention (CDC)
(800) 232-4636

World Health Organization (WHO)
(+ 41 22) 791-2111

Remember: Without a travel agent you're on your own.

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