Chartering locations with an infant?

[lonecapon]

Hey all,

We're planning our annual friend and family cruise and one of our crew just had their first kid. They're excited to go, but want somewhere that is at least reasonably close to a hospital.

I'm headed down to the BVI in a few weeks and I've heard that circling Tortola is a great cruise and would keep us close(ish) to emergency services.

Are there other spots in the Caribbean or Mexico that fit the bill?

[MattL]

I’ve been thinking about this a lot myself recently. I think your primary medical concern sailing with an infant is the presence of emergency medical transportation. The best hospital in the world could be 10 miles away, but if you need to get yourself there on a sailboat, it could take 2 hours. I think what you really want to know is how fast can you get to an adequate medical facility that can stabilize an infant that has suffered some sort of traumatic injury or serious illness. Once stabilized, you can count on your travel medical insurance to airlift you wherever the baby needs to go for further treatment.

So that being said, the BVIs are probably a good option. VISAR has a good record of responding to people in need, and the USCG out of St. Thomas will often step in as well. That means you get people with at least basic EMS training on scene pretty quickly, with a fast powerboat (or maybe even a helicopter) to get you to a hospital in short order (either on St. Thomas or Tortola).

The Spanish Virgin Islands are another option if you want someplace quieter than the BVIs. Not a lot of other boats and not much in the way of facilities, but all within the warm embrace of the US Coast Guard if you need help.

And there are probably plenty of other places that have adequate emergency medical services that I haven’t been to.

Good luck.

[lonecapon]

Thanks for the reply Matt!

Like I said, I'll be down in the BVI in two weeks for some non-infant related sailing, so that will double as a good scouting mission.

The Spanish Virgin Islands are another good one to check out.

[Shrew]

Wouldn't the same apply to anyone, regardless of age? That level of over-worry would lead me to suspect this couple might be too risk averse for the activity.

[lonecapon]

Originally Posted by Shrew

Wouldn't the same apply to anyone, regardless of age? That level of over-worry would lead me to suspect this couple might be too risk averse for the activity.

They're both regular cruisers, but they're new parents. I think this is just new parent anxiety more than anything, especially considering that emergency services would be at least several hours away regardless of location

[Montanan]

Not to rain on your parade, but one has real risks to consider.

How young is the infant?
Has it received all the recommended vaccinations for its young age and have such vaccines [along with the second boosters] had adequate time to provide basic protection?

Then there is the real concern about the various diseases that are specific to the region that one is intending to charter which for the tropic / caribbean including the female mosquito vectored diseases of malaria, dengue, Zika, Chikungunya, or yellow fever which are of risk to the infant but also of grave risk to parents of childbearing age as to the transmission to the next baby that the couple may have. Also typhoid and hepatitis A are of concern.

Think twice before venturing into areas where the diseases could impact your child or your future child.

[tarian]

Originally Posted by Montanan

Not to rain on your parade, but one has real risks to consider.

How young is the infant?
Has it received all the recommended vaccinations for its young age and have such vaccines [along with the second boosters] had adequate time to provide basic protection?

Then there is the real concern about the various diseases that are specific to the region that one is intending to charter which for the tropic / caribbean including the female mosquito vectored diseases of malaria, dengue, Zika, Chikungunya, or yellow fever which are of risk to the infant but also of grave risk to parents of childbearing age as to the transmission to the next baby that the couple may have. Also typhoid and hepatitis A are of concern.

Think twice before venturing into areas where the diseases could impact your child or your future child.

This is great advice , can the child get the vaccinations needed for the area at the age they are at , and all boosters would be prudent , as for hospital transportation , good holiday insurance will allow for good medi care,make sure the insurance company are aware of their infants age

[Auspicious]

Originally Posted by lonecapon

We're planning our annual friend and family cruise and one of our crew just had their first kid. They're excited to go, but want somewhere that is at least reasonably close to a hospital.

Why? How old will the child be? Are there pre-existing conditions?

You're getting reasonable thoughts from people. Here are some more: You're better off doing up and back sir Francis Drake Channel than around Tortola. Every response of substance is going to take hours. USCG response comes from Sector Puerto Rico and they have to get approval from BVI Government. That is reasonably quick during the day, less so at night. If you're worried about the boat why are you not worried about the plane trip down? Are you flying into STT or EIS? If STT why are you not worried about the ferry trip?

If the new parents are this jittery you might consider a Chesapeake or Puget Sound cruise. You're still realistically two or three hours to a hospital even with air evacuation.

The vaccination point is very well taken. Airplanes are incubators for disease. By far the highest risk.

If the child is healthy I wouldn't worry so much. Just go, but stay off any plane I'm on. The screaming puts people off. The kid might be noisy also.

[Montanan]

Cautionary note directed specifically to ladies of childbearing age and also of men who may be partners of childbearing age woman as to traveling in countries with Zika virus exposure potential. [One must assess risks individually as to the specific viruses associated with the region one is visiting, the information posted here is JUST related to Zika and I am not certain if there is more current information recently available] And this specifically relates to the less obvious potential of the man being a carrier / vector of the virus within his ejaculate thereby endangering the fetus. Woman obviously can and are susceptible to being the carrier of viruses of their fetus and woman of childbearing age need to be extra cautious as to choosing to travel to disease exposure countries as the consequences of such travel can be extreme. Guy's be aware and beware; ladies also be aware and beware of you partner's exposure potential. The only certain method of avoiding such consequences is to avoid the potential of being exposed, i.e., don't go / protect you future child. But if you do go take extra precautions as to mitigating exposure and I would recommend being tested for exposure after traveling to ascertain if as a childbearing age woman that you may be a carrier / vector to your baby.

"Guidelines in place for protecting against the sexual transmission of Zika virus may need to be re-evaluated, based on a new study from the U.S. Centers for Disease Control and Prevention.

The CDC currently recommends that men who have traveled to a Zika-active region either use condoms or abstain from sex for at least 6 months.

But that guideline is based on data showing that genetic traces of Zika virus can be found in semen 180 days after infection.

The new data shows that actual infectious Zika particles remain in semen for much less time than those non-infectious genetic traces, said lead researcher Dr. Paul Mead, a CDC epidemiologist in Fort Collins, Colo.

Infectious Zika virus particles are more rarely found in semen, and appear to clear out within a month of infection, Mead said.

"Based on this new information, we certainly will be re-evaluating those guidelines," he added. "We will be looking at it to see whether or not the recommendations should be modified."

Zika virus generally causes a mild flu-like illness, and in one out of five cases goes unnoticed by those infected.

But the virus can cause devastating birth defects when a pregnant woman becomes infected. Most notable are neurological defects and microcephaly, a condition in which the brain and skull are underdeveloped.

Zika is most often transmitted via mosquitoes, but rare cases of sexual transmission have taken place. In 2016, officials noted 45 cases of sexually transmitted Zika infections in the United States, out of 5,168 confirmed infections.

To learn more about how long Zika remains in semen, CDC researchers took 1,327 samples from 184 Zika-positive men.

The investigators used two tests to track the presence of Zika in these samples, Mead said.

"One detects infectious viral particles, and the other looks at the genetic material, the RNA of the virus, which can be found even if the virus is no longer able to cause infections," Mead said.

Zika RNA was detected in about one-third of the men overall, and in two-thirds of those tested within a month of contracting the virus, the researchers reported.

But infectious Zika virus itself was detected in only three out of 78 samples of semen that tested positive for Zika RNA. And, it was only detected in samples obtained within a month of the onset of illness, the findings showed.

For now, the CDC's guidelines remain in place, but the agency is re-evaluating that guidance based on this and other studies, officials said. New guidelines could be released in the next several months.

"This can be a very serious disease in the setting of pregnancy and can have quite devastating consequences," Mead said. "It's important for people to follow the current recommendations for now."

The study was published in the April 12 issue of the New England Journal of Medicine.

The study results show that better technology must be developed to track Zika in humans, said Dr. Heinz Feldmann. He is chief of virology for the U.S. National Institute of Allergy and Infectious Diseases.

"The main issue remains that our diagnostic tools most of the time do not detect infectious virus. It detects genomic presence, and it's hard to determine whether a positive sample by molecular means indicates whether that patient can transmit infectious virus," said Feldmann, who wrote an editorial accompanying the CDC study.

Y'all need to also consider each of the other disease exposure prospects and actions that would be appropriate for each.

Life is full of risks, certain risks can be mitigated or avoided. Live life fully but wisely with caution where cautionary practices can be readily implemented.

Personally I would not bring an infant on a charter, to me that is being a selfish to endanger an infant which infant will NOT enjoy the charter.

[lonecapon]

Originally Posted by Montanan

Not to rain on your parade, but one has real risks to consider.

How young is the infant?
Has it received all the recommended vaccinations for its young age and have such vaccines [along with the second boosters] had adequate time to provide basic protection?

Then there is the real concern about the various diseases that are specific to the region that one is intending to charter which for the tropic / caribbean including the female mosquito vectored diseases of malaria, dengue, Zika, Chikungunya, or yellow fever which are of risk to the infant but also of grave risk to parents of childbearing age as to the transmission to the next baby that the couple may have. Also typhoid and hepatitis A are of concern.

Think twice before venturing into areas where the diseases could impact your child or your future child.

It's not my kid and not my decision. They want to go with their kid and they're looking to mitigate risk (in their eyes). Whether or not they are mitigating risks or not really isn't my call.

I'm just asking if folks have done this kinda thing before because I generally help plan our trips.

[caradow]

Well, really don't see a problem. Other than the immediate need for medical care for anyone aboard your boat and not just an infant. I have intermittently sailed the Caribbean since the late 70's. Raised 3 kids who have been in boats since 5 months of age. I would say my kids have visited probably 70+% of the islands and they are still alive. Infants are easy it's when they become mobile is the problem.
Would suggest let common sense be your guide such as proper skin protection especially just before dark and maybe not anchoring too close to shore in certain places etc.
Yes there are diseases down there but more kids die of Flu right here in the good ole USA than all the scary tropical viruses that have already been named in one of the posts. Add to that Eastern Equine Encephalitis, tick born illness such as Ehrlichia, Babesia and Lyme which are rampant and growing here in the Northeast. Hepatitis exist here as well as MRSA and C Diff plus a whole lot more that are quite scary. There is always something out there to get you and besides the Caribbean are full of children that seem to be doing quite well.
If you still need to be reassured of the relatively best medical care available in the islands from personal experience I would say Nassau if in the Bahamas and for the Caribbean would recommend Cuba, Jamaica, Grand Cayman, Puerto Rico, St. Thomas, Tortola, St. Martin, St. Lucia, and Grenada. You could probably add the bigger French Islands although I have no personal knowledge of those. And note that I did state relatively good care.
The decision obviously rests with the parents ultimately but would not be too concerned if they decide to join you.