For many centuries seafarers, sea passengers and cargoes, were the major route by which infections such as smallpox, plague, cholera and anthrax were carried around the world. It was in the major port cities, such as Hamburg, London, Liverpool and the Eastern seaboard of the USA that the first hospitals and institutes for investigation of tropical diseases were established and these were always closely linked to the infectious diseases found in seamen. The importance of sea transport as a route of transmission of infection has now diminished, but seafarers themselves remain at risk from a wide range of infectious diseases and have a pattern of work, with worldwide sourcing of crews, periods at sea remote from medical care, port visits and leave periods in home countries that leads to a unique set of challenges for the prevention, diagnosis and treatment of infectious diseases.
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