Cruise ships bring nearly 700 sick passengers to shore

Between two cruise ships arriving in Florida and one in New Orleans, nearly 700 sick passengers were brought to shore over the weekend. Norovirus, which causes vomiting and diarrhea, hit passengers and crew causing hundreds to become ill, many to be quarantined and sailings to be delayed. Its a common ailment, magnified by the closed environment of a cruise ship, but avoidable for the most part with some basic precautions and help is on the way in the form of a new vaccine.

Investigators with the Centers for Disease Control and Prevention (CDC) went on board Ruby Princess and Crown Princess to monitor cleaning procedures said Princess spokesperson Julie Benson. “We’re working in close cooperation with the CDC to identify the cause,” Benson told CNN after 499 cases occurred between the two ships, both based out of Fort Lauderdale.

In New Orleans, WDSU-TV reported Royal Caribbean‘s Voyager of the Seas returned with 200 cases of the flu-like illness.

“At Royal Caribbean International we have high health standards for all our guests and crew,” said Royal Caribbean in a statement. “During the sailing, we conduct enhanced cleaning on-board the ship, to help prevent the spread of the illness. Additionally, when Voyager of the Seas arrived in New Orleans, Louisiana, this past Saturday, February 4, we conducted an extensive and thorough sanitizing on-board the ship and within the cruise terminal, to help prevent any illness from affecting the subsequent sailing.”

The CDC notified officials in Louisiana Friday that a cruise ship might be coming in with a Norovirus outbreak, state epidemiologist Raoult Ratard said Sunday, reported CBS News. Putting the illness into perspective, Ratard said that on any given day about 10,000 people in the New Orleans area are likely to have diarrhea and about 30 percent of them because of the Norovirus.

“In a closed space like a cruise ship, in a nursing home, in a hospital, you want to be extra careful,” Ratard said.

On the horizon, new a new medical breakthrough might have the answer to cruise passenger concerns over Norovirus incidents.

“It is possible to prevent infection and illness with a vaccine for Norovirus,” Dr. Robert Atmar, a professor of medicine and molecular virology at the Baylor College of Medicine in Houston told Medicine Plus. But many questions remain unanswered, he said. For example, “we have to figure out the best way to give it and how long protection lasts.”

Tested on 98 people who received the vaccine or an inactive placebo, all of the participants tested positive for a gene that makes them more susceptible to the Norovirus. But those who received the new vaccine were less likely to develop the illness than their counterparts who received the placebo, the study showed.

Administered as two doses three weeks apart via a nasal spray, there were no safety issues seen in the study and side effects were minimal.

“Further study is needed to answer questions such as who should get the vaccine and how long the protection lasts,” said Dr. Thomas Hooton, a professor of infectious disease at the University of Miami Miller School of Medicine noting the Norovirus is “a mess and spreads like wildfire.”

When will this new treatment be available?

No timetable has been set but Atmar suggested the likely initial candidates would be people in nursing homes, health-care workers, the military and segments of the food industry.

How to avoid Norovirus while we wait for the new miracle medicine? Here are some tips to maximize your chances of not getting the Norovirus bug while on your cruise:

  • Wash your hands- Like on land, our hands contact all sorts of things and people, many of which may have horrible sicko germs, waiting to attack us. Do you know how to wash your hands? The Centers for Disease Control and Prevention (CDC), the people that police these things, have instructions on how to do it.
  • Don’t count on the hand sanitizers– Those hand sanitizer dispensers all over the ship are mostly for show in the grand scheme of things. They help but there is no substitution for a good hand washing.
  • Avoid touching things– Hand rails on stairs, elevator buttons, walls are all things that some sick person might have touched before you.
  • Don’t pick your nose– I know, gross, but a really good way to get germs on your fingers into your body.
  • Avoid closed spacesCruise ships themselves provide the closed environment that the Norovirus needs to multiply and thrive. Elevators then, are almost like a closed environment within a closed environment and should be avoided. It won’t kill most people to take the stairs and get some extra exercise either.

Flickr photo by SCA Svenska Cellulosa Aktiebolaget

Possible swine flu on Alaska cruise ship

The numbers of cruise ship bookings to Alaska are down this year, and with a possible case of swine flu detected on board one ship in Alaska waters, I’m worried they could very well go down even more.

The Associated Press reports today that “a female crew member of the Serenade of the Seas, a Royal Caribbean ship, became ill May 2 while sailing from San Francisco northward.” Swine flu was suspected, and the Washington State Public Health Laboratory forwarded tests to the CDC, which is validating the results. Meanwhile, state officials in Alaska conducted its own tests in Ketchikan when the ship docked there. The results were negative, though officials note that the patient had been taking Tamiflu and hadn’t run a fever for several days, so the negative results were not surprising.

If this case turns out to be positive for swine flu, it will be the first reported case in Alaska.

UPDATE: Alaska health officials say tests confirmed that swine flu sickened the crew member, but she has since recovered after a course of treatment and a CDC-recommended 7-day period of isolation. However, Alaska health officials argue that the case can’t be considered Alaska’s “first case” of swine flu for several reasons, one being that the woman became ill before entering state waters.


[Via Anchorage Daily News]

Flesh eating bacteria consumes cruise passenger in 24 hours

Have you had your breakfast/lunch/dinner yet? Because this story is bound to upset your stomach.

While on a Mediterranean cruise, 58 year old Raymond Evans hurt his knee during a fall. The injury was nothing serious, but the ships doctor put Mr. Evans on an antibiotic regimen, just to be safe.

Despite the shots, his widow said his condition started to deteriorate, and that the back of his knee was turning black. This developed into a “blotchy blackness” that spread to his chest, elbow and fingers, and he was admitted into the ships hospital.

When the ship docked in Alexandria, Egypt, Mr.Evans was transported to the intensive care unit of the city’s hospital where he died hours later. The total time from noticing the blackness on his knee till death was just 24 hours.

A pathologist told the official inquiry that Mr.Evans had been infected by the flesh-eating bug necrotising fasciitis (warning: graphic images on that page!).

The pathologist concluded that Mr.Evans had not caught the bug during his fall, because the symptoms of the flesh eating bug usually start hours after being infected, so the most probable source was something on the cruise ship that entered through his wounds.

This is of course just another example of the health risks involved with cruise ships. For years, cruise lines have struggled with the norovirus as we previously covered here, here and here. Still, common sense and basic hygiene precautions should help keep you perfectly safe when you get on board.

The cruise ship photo above is for illustrative purposes only – that is not necessarily the ship involved in this incident.


Sickness at water park thought to be virus related

Last week it was reported that 90 people became sick after visiting Six Flags Great Escape Lodge and Indoor Water Park just north of Albany, New York. According to this subsequent report by the New York Department of Health, the number went up to 435 by the time the complaints stopped rolling in. People were suffering from gastrointestinal problems, although, the illnesses didn’t seem to be serious. Officials have found traces of norovirus called Norwalk virus that is passed around from sharing food and drink, touching contaminated surfaces and being in close proximity to people who have the virus. As a result, the employees of the park were giving it a real scrub down. The complaints have since stopped.

With water parks being such a perfect haven from the cold and dreariness of winter, I am surprised more people don’t get sick at them. However, in January, we went to a new water park minutes from Cincinnati with positive results.

When I walked into Coco Key, I noticed the smell of chlorine. It wasn’t overpowering but it was strong. We spent parts of two days floating in the lazy river, hanging out in the hot tub and taking some winding tube slide runs. Because this was during the middle of the week at the tail end of winter break, not many people were there. Getting sick wasn’t something I was thinking about.

Even though you’re surrounded by water at a water park and that might seem clean, following hygiene rules of not sharing food and washing ones hands often are a good idea. And if you have to cough or sneeze, put your forearm over your mouth and nose, not your hand.

Norovirus Strikes Again

I am a seasoned germophobe, so I can tell you that there are two environments where bacteria thrive: elementary schools and cruise ships.* Schools are OK because you can simply bring your sick child home until he gets better. However, if you’re ill and stuck in the middle of the ocean, there’s nowhere to run.

Earlier this week, Centers for Disease Control and Prevention officials boarded the Queen Elizabeth II to investigate an outbreak of stomach flu. The team determined that 278 passengers and 28 crew members were stricken with norovirus. The crew prevented the disease from spreading by instituting disinfection measures such as cleaning casino chips and thickening the buffet sneeze guard. (I may have made that second one up.) Norovirus can be fatal if dehydration occurs, but most infections end after a few days of horrible, horrible intestinal problems.

*This is obviously not a professional opinion, and both places are quite safe. In fact, I’d rather be on a cruise ship to Alaska right now.

Related: Last month, Iva posted about a 380-person norovirus outbreak on the largest luxury liner in the world.