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Are cruise lines really to blame for norovirus outbreaks?

February 4, 2014 Cruise, Headline News 7 Comments Email Email

OLYMPUS DIGITAL CAMERAWith norovirus outbreaks on cruise ships hitting the headlines again, and being an avid cruiser myself, I began wondering if maybe cruise companies and their ships were being blamed unfairly, perhaps receiving flack they really did not deserve and that cruise companies and their vessels may not be really to blame at all.

But first what is norovirus?

A quick search in, what else but Google, tells me that  Norovirus is “a genus of genetically diverse single-stranded RNA, non-enveloped viruses in the Caliciviridae”!

What does that really mean though?

My research goes on to tell me that the known noroviruses are all considered to be the variant strains of a single species called Norwalk virus and are transmitted by fecally contaminated food or water, person-to-person contact and via aerosolisation of the virus and subsequent contamination of surfaces, with noroviruses the most common cause of viral gastroenteritis in humans, and affecting people of all ages.

Explorer of the Seas - RCIIn the UK, norovirus is commonly known as winter vomiting bug  and in the USA winter vomiting virus, because the virus spreads more easily in winter, when people tend to spend more time indoors and near to each other, with outbreaks of norovirus infection often occurring in closed or semi-closed communities, such as long term care facilities, overnight camps, hospitals, prisons, dormitories, and cruise ships, where the infection spreads very rapidly.

The most surprising part is that although many less well informed sensationalist mass and some travel media would have you believe that norovirus, which as we all know is a very unpleasant infection, only occurs on cruise ships.

The reality is that norovirus happens all over the world, affecting around 267 million people and causing over 200,000 deaths each year, although with these deaths usually in less developed countries and in the very young, elderly and immuno-suppressed, … not on cruise ships!

CBS news recently reported that a strain of norovirus that is sweeping the globe, now described as “taking over the USA”, accounting for over 60% of all norovirus outbreaks in the USA, causing around 90% of epidemic nonbacterial outbreaks of gastroenteritis around the world, is thought to be responsible for 50% of all food borne outbreaks of gastroenteritis in the United States , that is in the US … not on cruise ships!

So what can we conclude from all this?

Well, interestingly, the majority of the passengers on board cruise ships, including Explorer of the Seas and Caribbean Princess, that have been recently affected by norovirus, come from countries currently awash with norovirus, aka the winter vomiting bug and winter vomiting virus and where it is winter right now, and as a result, it is very likely that the passengers took the norovirus on board with them!

The real issue why norovirus spreads on cruise ships I believe, is because as any of us that have cruised know, the cruise companies put in place very stringent hand sanitising and other processes, which many passengers simply ignore, plus passengers still cough openly, and do other things that can transit these viruses.

I recently regularly watched passengers failing to sanitise their hands when they entered a food outlet, even if the crew asked them to!

Also, I observed a passenger on a recent cruise serve himself some sauce from a buffet, causing some drips on the edge of the bowl, in which the sauce was located on the buffet, then wiping the drips off the serving bowl with his finger, then putting his finger in his mouth … then did the same thing again and then picked up the spoon again.

If he was infected with norovirus then he transmitted it to the bowl and spoon – simple.

Fortunately, one of the servers saw him do it and immediately removed the bowl and the spoon, which shows how well trained they are in health procedures.

Also while passengers might sanitise their hands, once in the buffet or restaurant they might rub their hands over their mouth or cough and then hold a buffet utensil – then if they are infected they have passed the virus to the buffet utensil and if the next person that uses the utensil goes back to their table and breaks a bread roll in half with their hand and eats the roll, they are infected … simple.

I think that the cruise companies or at least the vessels I have been on are doing what they can to prevent spreading of infections like norovirus and I have also visited the kitchen, servery and crew areas of many cruise ship and believe me they are absolutely spotless, with very strict rules and regulations indeed relating to sanitisation and every possible protection in place.

If you wonder why you do not generally catch bugs like norovirus on an aircraft unless you are very unlucky, the reason is that on good airlines the seats are sterilised and chemically treated very regularly  described by one airline official as – nothing could live on or in those seats – and also aircraft have highly sophisticated air filtering systems that I am told take out 99.999% of all airborne particles and bugs, including norovirus.  It would be very challenging to do that on a cruise ship!

So, I reckon that the cruise companies are doing a pretty good job of putting in place high quality and stringent protective measures and even dealing with outbreaks, as once there is an outbreak, it is very difficult to control, and while passengers might not know if they are infected or not when they go on board, I think they need to be a great deal more vigilant when on board in relation to food and health and santisation processes.

What do you think?

John Alwyn-Jones, Cruise Editor and Correspondent

Currently there are "7 comments" on this Article:

  1. AgentGerko says:

    As a seasoned cruiser, I believe its the kids who are respoinsible. They don’t understand sanitisation and their parents raarely police it. I’m talking kids in the 3 to 8 years bracket. They love to handle things. They stick fingers into every unsanitary place they can find and then into food and on to utensils. Just a few weeks ago I was waiting for coffee when the young girl in front of me in the queue waiting for a free cupcake or cookie, stuck her cabin card in her mouth and then proceeded to wipe it all over the counter of the serving area. The cruise lines really do everything they can. Sorry to sound harsh but you wanna lessen the people getting ill then make all food and drink serving areas adults only. I’m not saying the kids cannot eat or drink there but that only adults should be able to get the food and drink on their behalf. It would most likely be wildly unpopular but ask the people who’ve laid out thousands for a great holiday only to be locked into their cabins what they think of the idea.

  2. This puts into perspective something I have been saying to customers for a long time now. I had a similar but shorter conversation with new cruise customers yesterday that it is people not ships that spread norovirus and to be vigilant onboard with the simple things like washing their hands. It also makes eating in the restaurant rather than the buffet my preferred choice. I will be sharing this with cruise customers and colleagues. Thanks.

  3. Michael Horn says:

    I dont think that anyone blames cruise companies for such outbreaks. The newsworthy part of these stories is that you can’t run away or hide from the ship (and the virus) easily. I recall some old movies where people were trapped on trains, aircraft or, well,cruise ships,and they all divulged in the horror of being caught in a crowd unable to avoid same. A virus needs carriers to spread; the more the faster it will! Friends of mine just cancelled the cruise of a lifetime because they got scared realizing how “helpless” they’d be on high seas.

  4. V. Taylor says:

    Last Princess cruise I was on, there were attendants standing with hand sanitizers ready to assist those who would not use the stationary one outside the Horizon Court. So many just went on their merry way, coughing into their hands and touching all the utensils. When I asked why they didn’t insist on making the passenger use the sanitizer for not only their protection but perhaps the protection of others, they told us the cruise line said ‘not to hassle the pax.’
    Later on, we were having a late night snack when the cruise director arrived. He loudly proclaimed, loudly and indignantly, that hand sanitizers did nothing for norovirus! Couldn’t hurt. It would also be nice to see those sanitizers in what should be obvious spots – entrance/exit to Casino and all elevators.

  5. Hi Guys – thx for your comments.

    I kike the kids idea Agent Gerko and you are spot on, I have seen the same.

    Agree Narelle I nearly always eat in the restaurants as I know the food is freshly cooked and there can also be food heat and cooling maintenance issues in buffets.

    Michael, the cruise companies do get the blame – below is how one of our fellow travel media reported on this yesterday. Pity your friends cancelled the cruise of lifetime, because they were scared – while there are currently two ship affected and were they travelling on either? There are hundreds of ships that are not affected at all!

    Princess gets sick too
    Almost 180 people have been taken ill with a reported outbreak of another gastrointestinal sickness aboard a Princess Cruises ship operating out of Houston.
    The Caribbean Princess was on a seven-day cruise to its namesake region but was cut by one day, although a spokesperson for the cited the cut due to thick fog.
    Officials from the Centre of Disease Control and Prevention met the vessel on its return and have carried out an investigation.
    Princess Cruises said the ship will undergo a full sanitisation course before its next departure.
    All passengers aboard the shortened voyage will receive a 20% discount on their next Princess Cruises booking as well as an allowance to cover one day of meals and ancillary expenses.
    It is the second ship to report cases of gastro after last week’s outbreak on Royal Caribbean’s
    Explorer of the Seas, which affected more than 600 people.

    Pretty average reporting that does not mention the processes the cruise companies have in place as the norm and that it is very likely that the virus was taken on board the ship by a passenger!

    Keep em coming


  6. Judith Phillips says:

    I went down with norovirus on a RCCL cruise to the Eastern Mediterranean and agree with your piece entirely. Although we were stringent about hand washing and sanitising, and the ship’s crew were constantly cleansing surfaces in public
    areas and restrooms, it was common to see people leaving toilets without washing their hands, or failing to use the hand cleanser as they entered dining areas.
    The point about children is valid, but many adults were ignoring hygiene measures too. I lost three days of the cruise because of the illness and was impressed when RCCL made financial recompense for this. All credit to them.

  7. Thx V – the cruise companies need to insist sanitise or no entry to restaurants or buffets and perhaps even post crew in toilets to ensure passengers wash their hands and also have crew around with mobile sanitisers if they see people coughing, go up to them nicely and give them a shot in their hands to sanitise. We carry hand sanitisers in our pockets whenever we travel everywhere! One of the issues is that many of the crew come from countries where they do not like “confrontation” even in its mildest forms, but that also means they can do it in a fun and jocular manner but serious! This may seem over the top, but it is the only way that passengers will begin to understand. The cruise company should also issue flyers in cabins and in restaurants etc explaining why, etc, nicely of course that it is all about making sure passengers have a great cruise and are not ill.

    What that Cruise Director said is nonsense and he should be fired and agree they should be all over the ship and located in such way you cannot avoid them.

    Judith I am so sorry to hear that you went down with norovirus on a RCCL cruise to the Eastern Mediterranean and thank you for your comments.

    I find RCI very good with their cleaning, sanitising, etc, but if the virus is bought on board, then it becomes challenging and they and other companies do quarantine affected passengers.

    I agree it is common to see people leaving toilets without washing their hands, or failing to use the hand cleanser as they entered dining areas and that is not good enough.


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