Blaming consumers: Cruise ship edition

Jim Walker of Cruise Law News writes the Centers for Disease Control (CDC) reports that there was a gastrointestinal outbreak on the Crown Princess during its recent cruise, from October 25th to November 8, 2017. The Princess cruise ship departed Quebec, Canada on October 25th for a two-week cruise to Canadian and U.S. ports. The cruise ship arrived in Fort Lauderdale, Florida on November 8th and will begin its Caribbean season.

According to the CDC report, 184 passengers and 12 crew members became ill with gastro-like symptoms which included diarrhea.  

During the period from 2010 to the current date, Princess Cruises experienced the most outbreaks on its cruise ships calling on U.S. ports, according to the CDC. Princess reported twenty-one (21) cases to the CDC during this time period.

The Crown Princess alone has suffered through six (6) norovirus outbreaks since 2010 to the present. Before the current GI outbreak, the last norovirus outbreak on the Crown Princess was from January 3 – 18, 2016 and, before that, from October 18 to November 16, 2014. Earlier, there was a norovirus and e-coli outbreak from February 5 to 12, 2014. It also experienced back-to-back norovirus outbreaks from January 29 to February 4, 2012 and February 4 to February 9, 2012.

The cruise line with the second most outbreaks is Holland America Line with 18 cases of GI sicknesses reported to the CDC since 2010. HAL suffered norovirus outbreaks on the Nieuw Amsterdam, and two outbreaks each on the Voendam and the Noordam this year.  

So why is Princess Cruises far more prone to norovirus outbreaks than Carnival cruise lines, for example?

The cruise industry always blames the passengers for bringing the virus aboard, rather than its food handlers, or contaminated food or water. So are Princess Cruises customers the sickest and the least hygienic cruisers around? Are guests of HAL the second most unhygienic cruisers? Do they wash their hands the least of any cruisers? This seems like absurd arguments to make.

Whoever is to blame, the crew members, of course, always pay the price, by having to wipe and scrub and spray everything in sight for long 16+ hour days to try to disinfect a ship longer than three football fields.

Irrespective of the blame-game, don’t call us if you get sick on a cruise. Proving where the virus came from, or that the cruise line was negligent, is virtually impossible to prove, especially since the CDC conducts no epidemiological analysis and sometimes can’t even figure out whether the outbreak is due to norovirus, e-coli or something as exotic as Shigella sonnei or Cyclospora cayetanensis.

For example, The New Zealand Herald reports, a passenger on a cruise ship plagued with a vomiting and diarrhoea bug says he only learnt previous guests had been struck down with the same thing once they set sail.

Sydney man Walter Gibian and his wife Elisabeth left Sydney on October 30 on a 12-day Celebrity Solstice cruise travelling from Sydney to Auckland via the South Island so they could see New Zealand. Gibian had worked in New Zealand in 1980s and loved it so booked the cruise to see the East Coast.

The ship had left Melbourne when the captain announced to guests that passengers on an earlier cruise had norovirus and asked guests to take extra precautions including washing their hands regularly and using hand sanitiser.

any notification before they left and by this time it was too late to do anything about it as they were well on their way to New Zealand.

“It think people should be told and given the option that if you don’t like being exposed to this virus you are allowed to get off. But we found out when we were sea.”

Halfway into the 12-day cruise passengers started falling ill and Elisabeth came down with the bug on Saturday night. She was then isolated to her cabin for 48 hours.

“They (passengers) are sick all right. But of course the ship won’t tell us how many are sick, but my wife got sick on Saturday night. They are taking all sorts of precautions but it is still happening. They keep telling me, they are doing their utmost and they are doing their best but the fact is it is not effective.”

252 sick: Noro cruise docks in Maine

Federal health officials say the first cruise ship to dock in Portland, Maine, this season is under surveillance for norovirus.

chapman.vomitThe Centers for Disease Control and Prevention says 27 percent of the passengers aboard the Balmoral — operated by the Fred Olsen Cruises — have gotten sick since the cruise began April 16.

The ship and all aboard have since left Portland, according to police Lieutenant Robert Doherty.

The CDC reports that 252 of the 919 passengers on the Balmoral have fallen ill, as well as eight crew members.

Fred Olsen Cruises did not immediately return a call seeking comment.

So far this year, there have been 10 outbreaks of norovirus on cruise ships, according to the CDC.

Things go bad when Americans try biz in Cuba: Norovirus edition

The first cruise ship to Cuba in decades set sail on its historic voyage a week ago – but it has returned to Florida with a suspected norovirus outbreak on board.

the-godfather-part-iiCarnival Corporation’s Fathom Line ship Adonia left Miami for Havana with just over 700 passengers on board on May 1. 

The ship returned to Miami a week later – around 6.30am on Sunday – but on its journey back to the United States, there were reports that several passengers had fallen ill, CBS News reports.  

Carnival confirmed to the station that 14 passengers were recovering from stomach-related symptoms. 

It is believed that the passengers in question had norovirus, CBS reports, but the cruise line has not elaborated. 

12 sickened: Australian grandmother almost died after contracting Salmonella on cruise

A Perth grandmother has been struck down by a number of illnesses after she was infected with Salmonella while a passenger on an Australian cruise ship.

Sally Faulkin, 90, has spent one month in hospital after she, along with 12 others, came down with Salmonella poisoning on a Cruise and Maritime Voyages ship last month.

Ms Faulkin became so sick she could no longer walk, and her family called a priest, fearing she would need to have her last rites read.

Ms Faulkin’s family said they had made five phone calls and sent nine emails to the cruise company in an attempt to get answers, but haven’t received a response.

Michael Gannon, a spokesman for the Australian Medical Association WA, said cruise ships are a breeding ground for bacteria.

“It’s a completely closed environment where infectious agents can spread very quickly,” he said.

The Australian Medical Association WA is making calls for a quarantine and inspection service to check ships coming in and out of the state, which would bring them in line with NSW.

Cruising and noro

I’ve never been on a cruise. Sometimes we talk about taking one, hopping from island to island and relaxing on the open seas.

And then comes another round of norovirus outbreaks. Lots of news coverage, throwbacks to the poop cruises and pictures of the CDC Vessel Sanitation program officials boarding ships.

Restaurants are linked to 64 per cent of norovirus outbreaks. CDC says that cruise ships get a lot of the attention but only account for only about 1 per cent of norovirus outbreaks.

But not everyone goes on a cruise.

In 2013, according to the Florida-Carribean Cruise Association 11.7 million North Americans (out of a total of ~530 million residents) went on cruises.

In this week’s MMWR, the good folks at the CDC released an analysis of cruise-related noro. MSMajestyOfTheSeasEdit1

From 2008 to 2014, the rate of acute gastroenteritis on cruise ships decreased among passengers from 27.2 cases per 100,000 travel days in 2008 to 22.3 in 2014, while the rate among crew members was essentially unchanged. The rate among both passengers and crew members was higher in 2012 compared with the preceding and following years, likely because of the emergence of a new norovirus strain. Among 73,599,005 passengers on cruise ships during 2008–2014, a total of 129,678 (0.18%) cases of acute gastroenteritis were reported during outbreak and nonoutbreak voyages; among 28,281,361 crew members, 43,132 (0.15%) cases were reported. Only a small proportion of those cases were part of a norovirus outbreak.

Cases of acute gastroenteritis illness on cruise ships are relatively infrequent. Norovirus, the most common causative agent of outbreaks, accounted for 14,911 cases among passengers and crew members during 2008–2014, 0.01% of the estimated number of norovirus cases in the United States during the study period. To further reduce acute gastroenteritis on cruise ships, travelers should practice good hand hygiene, especially after using the toilet and before touching the face or eating; persons experiencing diarrhea or vomiting should promptly report their illness for proper assessment, treatment, and monitoring.

Suspected norovirus outbreak hits Holland America Line’s Veendam

Holland America Line’s Veendam was hit with a possible norovirus outbreak on its December 20-27 cruise, ending in San Diego on Sunday. Fifty-seven of 1,429 passengers or almost 4 percent of passengers were reported ill with vomiting and diarrhea as the primary symptoms, according to the U.S. Centers for Disease Control, which investigates illnesses on cruise ships.

BarfingBarbie.vomitjpgTen of 588 crew members, or 1.7 percent of the crew, also were ill during the cruise. While the CDC lists the causative agent as “unknown,” the reported symptoms mimic that of norovirus, which occurs on both land and sea in places where large numbers of people gather.

In response to the outbreak, the CDC said that Holland America Line and the crew undertook the following action:

Increased the onboard cleaning and disinfection procedures according to their outbreak prevention and response plan;

Collected stool specimens from passenger and crew gastrointestinal illness cases for testing;

Made twice daily reports of gastrointestinal illness cases to the Vessel Sanitation Program (VSP);

Consulted with the CDC on plans for their comprehensive sanitation procedures planned for the voyage disembarkation day in San Diego.

During that disembarkation, Holland America set up a planned staged disembarkation for active cases to limit the opportunity of illness transmission to other, non-infected guests and also sanitized the terminal, to protect those well passengers who were disembarking and others boarding the ship for the next cruise.

‘Floating sick bay’ Australia cruise ship rocked by Norovirus claims

Passengers aboard P&O’s newly-launched cruise liner say it is anything but a Pacific Eden, with a gastrointestinal outbreak affecting at least 60 passengers ahead of its return to Sydney on Monday.

norovirus-2The ship Pacific Eden, which docked in Sydney on Monday morning, has been accused of being a “floating disaster” and some passengers are seeking a refund.

Several passengers have contacted the Herald, claiming a norovirus gastrointestinal outbreak has affected a large number of passengers.

But a spokeswoman for P&O, which owns the ship, disputes the allegations. She said only 11 out of 1500 passengers aboard are ill, including five who were in isolation on Saturday. That number had reduced to two by Sunday.

This is about the same rate as the general population at any time, she said.

The departure of the 55,820 tonne cruise ship from Sydney on December 16 was delayed three to four hours to allow the crew to sanitise the ship after an outbreak of gastro on the previous trip. Yet the spokeswoman said she understood the previous cruise had a similar number of people who were sick with norovirus.

Yvonne Hubscher of the Sunshine Coast said she had seen children running along a deck singing, “We’re all living on a spew ship.”

She said the captain had mentioned that there had been 247 cases of norovirus on the previous trip. Many others had been sick on this trip.

Other passengers also contacted the Herald with similar allegations, including Cherie Butcherine from Dundas Valley.

vomit cruiseThe number affected by the outbreak is far higher than the 11 reported ill by a P&O spokeswoman on Sunday. It was the second outbreak of the Pacific Eden’s short life – she joined the fleet on November 25 after being purchased and refurbished by P&O.

But disease was only one of the young cruise liner’s problems. Guests who spoke to Fairfax Media also complained of mouldy bathrooms, a dearth of toilet paper, flooding, leaks and poor customer service.

“It was worse than a one-star motel, basically,” said Cherie Butcherine, who was travelling with her husband, mother and daughter Alexa. “We were just devastated to have to stay on board.

“There was food all over the floor, the bathroom was absolutely disgusting, it was covered in mould.”

 

182 sick: Barf cruise ship docked in Sydney

The Explorer of the Seas arrived at around 6am on Wednesday with Royal Caribbean confirming 182 cases of a gastrointestinal illness among guests and crew of the 14-night trip.

mr.creosote.monty.python.vomit“Those affected by the short-lived illness have responded well to over-the-counter medication administered onboard the ship,” the statement issued on Wednesday said.

Paramedics were on stand-by as the 3,566 passengers and 1,139 crew members disembarked the Royal Caribbean Explorer, but no patients needed to be transported, am Ambulance NSW spokesman told AAP.

The ship and terminal will undergo enhanced cleaning and sanitisation to prevent any illness affecting future cruises as the ship prepares to depart for its next voyage on Wednesday evening.

With more than three per cent of the ship’s passengers struck down with the stomach bug, it is a legal obligation that health authorities be alerted.

The outbreak started on December 5 and peaked on December 11 and 12, but has since been decreasing, NSW health authorities told AAP.

Cruising: Avoiding Norovirus on the high seas

Experts say to prepare ahead is the best way to keep your health while on vacation. Bring hand sanitizer and wash your hands frequently, according to the New York Daily News. Proper hygeiene can go a long way. Practice your balance because you will want to avoid touching handrails.

cruisingExperts say Norovirus is spread by touching elevator buttons, salt and pepper shakers and anything else that the mass population will also come in contact with on the cruise ship.

According to reports, door handles, toilet seats and baby-changing tables pose a big risk, so proceed with caution! Press the elevator button with a knuckle instead of your fingertips, a trick that women with manicures have known the world over.

Avoid contact with salt and pepper shakers because norovirus is spread by common contact.  If you really need salt or pepper on your food, use a napkin to handle the shakers.

Use a handkerchief or napkin to touch door handles. 

vomit cruiseChange the baby on your cabin bed and use your foot to put down or lift a toilet seat. Handrails are deadly for spreading the virus. 

Avoid contact with the handrails and practice your balance by walking down the stairs in your home or office without using the banister. 

Cruise ship sickness/norovirus outbreaks lowest in 14 years

The number of gastrointestinal illness (GI) outbreaks, including norovirus and enterotoxigenic E. coli, on cruise ships fell to the lowest level in 14 years in 2014.

vomit cruiseThe CDC (Centers for Disease Control and Prevention) website contains detailed reports about the outbreaks on cruise ships from 1994 to 2015. The CDC considers it an outbreak anytime 3% or more of the passengers and crew members report diarrheal symptoms onboard a vessel of at least 100 passengers on sailings that are 3 days or longer.

There were nine reported outbreaks of GI on 7 different cruise ships in 2014, tying 2013 with the lowest number of outbreaks since 2001. When you take into consideration that the number of cruise ships is at a record high, this past year saw the lowest percentage of outbreaks on cruise ships since 2001.