Norovirus and Cruises – My Personal Experience

November 24, 2014 - 6 minutes read

Fast-acting crew stymies norovirus threat

Every year about 20 million people in the United States contract norovirus, a very contagious disease that causes vomiting and diarrhea. Most cases are due to eating contaminated food or having close contact with infected people. According to the U.S. Centers for Disease Control and Prevention, about 70 percent of reported outbreaks result from food contamination caused by infected food workers. Outbreaks usually occur in restaurants, nursing homes, schools, daycare centers and cruise ships. There is no known treatment. For some, hospitalization is required. A number of patients do die of this disease every year. Because of the work they do, food service workers who have contracted norovirus have the potential to make many people sick. Due to the close quarters in which passengers and crew congregate, cruise ships often are associated with norovirus outbreaks. But cruise ships account for only about one percent of all reported norovirus outbreaks. (1)

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Memorable for several reasons

Recently I got away for a month-long sabbatical, in celebration of my 50th birthday and my parents’ 50th wedding anniversary. We went on a cruise to the South Pacific (including Hawaii) on board a Princess Cruises ship. It was an absolutely fabulous trip. A lot of new friends were made and memories were collected, even though the 28-day excursion was extended to 29 days, due to a medical emergency on our ship. I never stepped into the role of healthcare professional. I chose to remain as a passenger traveling with my family. Besides, the captain and crew handled the medical difficulties masterfully.

The first 21 days were absolute bliss, with no complications. But then a crew member became very ill, forcing us to return back to French Polynesia before heading back to Los Angeles. On the next day, the crew announced that there was a large number of passengers and crew members suffering gastrointestinal illnesses. One day later the crew confirmed it was norovirus. I am blessed to report that no one in my family was afflicted. But anyone who came down with a fever, nausea, vomiting or diarrhea was told to report immediately to their cabin and to call the 911 service on the ship. They could expect medical professionals to evaluate and quarantine them, and to document the case.

Crew’s actions pristine

Overall, 158 passengers and 11 crew members were diagnosed with norovirus. I am told that every hour, on the hour, crew members cleaned up the cabins occupied by the sick passengers. I give praise to Princess Cruise Lines. They knew exactly what they were doing. The crew’s actions were pristine. They acted quickly, limiting the number of afflicted passengers and crew. Considering that more than 600 people were afflicted by norovirus on another, previous cruise, the outbreak might have been worse, but for the crew’s immediate and effective actions following CDC protocols for cruise ships. They responded appropriately, preventing the possibility of extreme spread on a ship with 3,007 passengers and 1,160 crew members. (2)

For example, my family had a reservation at the chef’s table, a special dinner with the chef in the kitchen. But that was canceled after the outbreak began. After that point, no one except the chef and his crew were allowed in the kitchen. Immediate precautions also were taken elsewhere in the dining areas. Only crew members – wearing gloves – were allowed to serve food to passengers. They manned the buffet tables, increasing the number of people who ate sit-down meals. Also, food was covered with plastic, to prevent further transmission of the virus. Many pieces of furniture, such as chairs and tables, were wiped down with Virucidal, an anti-bacterial and anti-viral solution, to prevent further transmission. Even the silverware was handed out to each passenger by crew members with gloved hands. We could not pick up our own utensils, except while eating. Meanwhile, other areas of the ship were constantly wiped down by crew members, such as elevator buttons, handrails along the stairs and telephones. Passengers were instructed to wash their hands frequently and to try to avoid using restrooms other than the ones in their cabins. As an infectious disease physician, I employed personal precautions, such using my elbows to push elevator buttons and frequently using hand sanitizer. I decreased my buffet use and frequently drank water, making sure I was always hydrated, so that my body did not wear down and become more susceptible to infection. We got back safely, although a day late due to the medical emergency. Even after situations like this, people should not be afraid to take cruises. I would definitely cruise on Princess again, and I am planning to go to Australia in 2016.

References

Preventing Norovirus Outbreaks
http://www.cdc.gov/vitalsigns/norovirus/index.html
Princess Cruises ship docks in San Pedro after outbreak of norovirus
http://www.latimes.com/local/lanow/la-me-ln-norovirus-princess-cruises-ship-20141116-story.html?track=rss

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