Norovirus on the Coral Princess

Coral PrincessThe Coral Princess arrived in Fort Lauderdale this weekend with 157 of 2,016 cruise passengers aboard the Princess Cruises' ship stricken with nausea/vomiting and diarrhea which the Centers for Disease Control and Prevention (CDC) suspect are symptoms related to norovirus.

The noro-infected passengers comprise 7.79% of the total passenger population on the ship. 25 of 881 (2.84%) crew members are also infected.

The CDC was unable to conclude where the norovirus came from. I am not aware of a single instance when the CDC has pinpointed the cause of a cruise ship disease outbreak. Unfortunately, the public is often left with the "blame game" of wondering whether the cruise ship food or water was contaminated (which the CDC and FDA generally say are the most likely causes of gastrointestinal outbreaks), or the outbreak was caused by a sick galley worker, or was brought aboard by sick passengers, and then spread because of inadequate hygiene and poor cleaning procedures.

Several years ago, Time magazine published an article titled 13 Worst Norovirus Outbreaks on Cruise Ships. The overall winner of Time's top 13 list was Princess Cruises which had five outbreaks on its brand alone: Crown Princess (January 2010) with 396 ill; Crown Princess (February 2012) - 363; Ruby Princess (March 2013) - 276; Coral Princess (February 2009) - 271; and Sun Princess (July 2012) - 216.

The last norovirus outbreak involving the Coral Princess was in April 2015.

Have a thought? Please leave a comment below or join the discussion on our Facebook page.

Photo credit: Roy Luck - CC BY 2.0, commons / wikimedia.

Hat tip to the popular Crew Center blog which first covered the outbreak. 

Norovirus on HAL's Oosterdam Sickens Passengers and Crew

HAL's OosterdamPassengers aboard a Holland America Line (HAL) cruise ship have fallen ill with symptoms consistent with norovirus on an approximately two week trans-Atlantic cruise that departed from Civitevecchia, Italy on November 3rd and arrived today in Tampa, Florida.  

According to the Centers for Disease Control and Prevention (CDC), the November 3 - 18 cruise aboard the Oosterdam sickened 86 of 1,843 passengers (4.67%) and 18 of 796 crew members (2.26%) who exhibited symptoms of vomiting and diarrhea. 

The link to the CDC about this outbreak is here. There has been no official determination of the cause of the outbreak although norovirus is suspected.

According to the CDC and the FDA, the most common cause of norovirus is contaminated food or water. Of course, like land-based restaurants, ill food handlers often transmit the virus. Passengers can also obviously bring the disease aboard which can spread due to unhygienic conditions caused either by the passengers and/or the cruise line.

Before there can be a scientific determination as to the actual cause of the outbreak, there must first be a serious epidemiology assessment of the ship which the CDC rarely performs due to the quick turn-around of the cruise ship. Unfortunately, in this case HAL immediately argued that norovirus is allegedly "circulating throughout North America and can be easily transmitted if personal hygiene is not maintained," according to a statement that it released to the Tampa Bay Times.

The CDC says that there have been 13 GI outbreaks this year, mostly involving norovirus with two e-coli outbreaks. 

The cruise ship says that it performed enhanced cleaning and left today for the Caribbean.

Photo credit: Sebastian Wessels wikipedia / commons, CC BY 2.5.

Lawsuit: Passenger Contracts Legionnaires' Disease on Royal Caribbean's Majesty of the Seas

Majesty of the SeasA passenger from Ohio who sailed aboard the Majesty of the Seas last November and developed Legionnaires' disease has filed suit against Royal Caribbean. The passenger alleges that only after he boarded the cruise ship in Miami, and the ship had set sail, did the cruise line notify him, via a notice placed under his door, that Legionella had been discovered in the ship's water system on prior cruises.       

Legionnaires' disease is one of the most serious diseases a passenger can contract on a cruise ship. Legionnaires’ disease is a severe pneumonia caused by inhalation or possibly aspiration of warm, aerosolized water containing Legionella organisms. According to the Centers for Disease Control (CDC), contaminated ships’ whirlpool spas and potable water supply systems are the most commonly implicated sources of shipboard Legionella outbreaks. Symptoms include a cough, shortness of breath, high fever, muscle aches and headache. Although prompt antibiotic treatment can kill the bacteria, 5% to 30% of people infected with Legionella will die from the infection.  

After the cruise ended on November 13, 2015, Royal Caribbean sent an email to the disembarking passengers, stating that they may have been exposed to Legionella during the cruise. It stated that if passengers become ill, they should seek medical attention and undergo testing for Legionella. 

Royal Caribbean stated that two passengers had been confirmed to be infected with Legionnaires' disease from the cruise ship, and that one person was possibly infected. One person was infected during a cruise in July 2015 and one other person was infected during a cruise in October 2015. The email stated that Royal Caribbean had shut down the whirlpools on the ship after it confirmed the first case of Legionnaires' disease associated with the July sailing. The cruise line claimed that it treated the ship's water supplies with extra chlorine (the email mentions "two rounds of treatment with chlorine"), but water samples taken from showers confirmed the presence of Legionella.

Royal Caribbean also sent the email to those people who had booked cruises on the Majesty on future dates, advising that the risk of illness is "low but not zero" and suggesting to future cruisers that they may want to reschedule their cruises for a later date depending on their individual risk factors.       

A few days after returning home, the passenger began experiencing symptoms consistent with Legionnaires' disease. He visited his doctor on an urgent basis and he was immediately hospitalized. His lawsuit lists kidney, heart and pulmonary failure among other complications which he suffered as a result of the disease which he contracted on the cruise ship. 

The lawsuit alleges that Royal Caribbean was on actual notice of Legionella on its ship but notified the passengers only after Majesty sailed and was at sea. In addition to alleging that the cruise line was negligent, the lawsuit states that the cruise line "acted with deliberate and wanton recklessness" in refusing to advise passengers of the Legionella prior to the cruise. Royal Caribbean, the lawsuit alleges, acted in "callous disregard" of the dangers to the passenger's health in order to promote its economic interests.

The lawsuit seeks punitive damages, in addition to compensatory damages, due to the cruise line's intentional misconduct.  

The lawsuit was filed by Miami maritime lawyer Domingo Rodriquez

There was a discussion regarding Legionnaires' disease and this particular cruise last year on the Cruise Critic boards. If the comments are accurate, some of the passengers apparently were not notified of the Legionella on the ship during the cruise but were notified only after the cruise was over. At least one person commenting said that he sailed on the cruise ending November 13, 2015 but never received an email from the cruise line. One poster mentioned that a family member who was on the cruise was allegedly admitted to the hospital with Legionnaires' Disease. She stated at the time: "we did not get the email about the ship being contaminated until the afternoon of Nov. 13, after we had just gotten off the ship . . . This was very irresponsible and unethical on Royal Caribbean's part."  

In my opinion, it is outrageous that Royal Caribbean kept sailing the Majesty if it knew that the ship's water supply was still contaminated with Legionella after multiple "extra-chlorine" treatments. It is Legionellaprobable that some of the passengers or crew members would become sick because, obviously, passengers are going to shower during cruises. Unfortunately, we have seen this cruise line take the "show-must-go-on" attitude to extremes over the years, whether it is recklessly sailing into hurricanes or repeatedly exposing its passengers to noro virus on successive cruises.

There have been a number cases of Legionnaires' disease on cruise ships over the years. The most infamous case involved the Horizon cruise ship operated by Royal Caribbean's sister cruise line, Celebrity Cruises (before it was purchased by Royal Caribbean), back in 1994.

Following a deadly shipboard outbreak which caused Celebrity to cancel cruises and fly passengers back from Bermuda, passengers sued Celebrity alleging that the company defrauded them by refusing to disclose that Legionella was present on the cruise ship. An Associated Press writer wrote that: "on Saturday passengers on the cruise ship Horizon were told the risk of contracting Legionnaires' disease on board was low. On Tuesday they were hustled off the ship in Bermuda as a precaution." (Numerous passengers were nonetheless infected). The AP quoted passengers as saying at the time: "everyone is entitled to a worry-free vacation and this has been anything but that" and "the people who operate this line should be chastised" and "what they did to the passengers is unconscionable."

Celebrity subsequently sued the manufacturer of the ship's pool and whirlpool equipment, alleging that extensive press coverage of the disease outbreak stigmatized the company, thus hurting its reputation and reducing its profits. Celebrity obtained a $193 million verdict, although an appellate court subsequently reduced the verdict.

Regarding the recent outbreak, if Royal Caribbean was uncertain whether the Majesty of the Seas still had Legionella in its water system, merely warning future passengers that the risk of illness was "low" but not canceling cruises was, at a minimum, irresponsible. Not informing passengers who cruised on the ship of the disease until after they sailed is truly reprehensible conduct. 

Have a thought? Please leave a comment below or join the discussion on our Facebook page

Photo credit: Top -  CC-BY-SA-3.0/Matt H. Wade at Wikipedia; bottom - By CDC (PHIL #1187) - CDC Public Health Image Library, Public Domain.

Legionella Royal Caribbean Email

Legionella Royal Caribbean Email

 

Empress of the Seas Flunks CDC Sanitation Inspection

Empress of the SeasAccording to the Centers for Disease Control and Prevention (CDC), Royal Caribbean's Empress of the Seas flunked a surprise sanitation inspection conducted in early June. The Empress of the Seas scored a failing score of only 80.  You can read the report here. A score of 85 or lower is considered a failure.

The Empress of the Seas underwent an extended period of renovations in Spain and later in Freeport, Bahamas when the ship was transferred back from Pullmantur. Royal Caribbean canceled a total of thirteen cruises scheduled for earlier this year. The first sanitation violation related to the renovation and involved a bathroom for the medical staff which could be used only for storage and was "heavily soiled." Back in April of this year, Royal Caribbean told the Miami Herald that “as work has progressed, we learned that more significant infrastructure and physical improvements across the ship’s multiple galleys and provisioning areas were needed to meet our high standards.”

I was contacted previously by crew members, during the renovation period, who complained  of unsanitary conditions on the ship. There was talk that the CDC had inspected the ship and initially had not given the ship a passing score, although there was nothing officially posted on the CDC website. Several crew members said that the ship had fallen substantially in disrepair while operated by Pullmantur and had a major problem with pests.    

It is apparent, however, that once back in the Royal Caribbean fleet, the Empress failed to meet high standards. The report regarding the June inspection details forty four CDC violations, ranging from improper procedures to monitor acute gastrointestinal illness cases to incorrect potable water and swimming pool/whirlpool testing.   

The report included numerous references to live and dead flies and cockroaches around refrigerators, buffet lines and other areas used for food storage. The ships was also in violation of the CDC's requirement to use rat guards, and was utilizing rat guards on only one out of six mooring lines while the ship was in port.

A crew member states that the Empress was reinspected earlier this month, on July 10th, and received a score of 97.  If such an inspection took place, the CDC has not posted that inspection yet.  

Royal Caribbean, including its Celebrity brand, has failed other inspections in the past.  In 2013, the Celebrity Century scored only a 78.  The same year, the Celebrity Summit scored only a 81. The Monarch of the Seas scored a 85 in 2011. 

Two years ago, Market Watch published the 5 Most Hygienic Cruise Lines and concluded that Costa and Disney and three other smaller lines had never failed a CDC inspection. Since then, the Disney Wonder experienced a gastrointestinal outbreak in April of this year.    

We last mentioned the Empress of the Seas three weeks ago when it experienced problems with one of its engines, causing Royal Caribbean to alter the cruise ship's itinerary.

Photo Credit: By Jsausley - Own work, CC BY-SA 4.0.

Outbreak on the Silver Spirit Found to be Caused by E. Coli

A gastrointestinal sickness outbreak on the Silver Shadow in March was found by the Centers for Disease Control and Prevention (CDC) to be caused by Enterotoxigenic E. coli (ETEC).

The outbreak occurred during a cruise from March 3 - 21, 2016. The outbreak sickened 37 people according to the CDC report on the incident. The CDC concluded that 24 of 388 (6.19%) passengers and 13 of 366 (3.55%) crew members fell ill due to the disease.

Outbreak News Today said that "according to the Centers for Disease Control and Prevention (CDC), Silver SpiritETEC is a major bacterial cause of diarrhea among travelers and children in the developing world. ETEC is increasingly recognized as an important cause of foodborne illness in developed nations, such as the United States. Infection occurs when a person eats food, or drinks water or ice contaminated with ETEC bacteria. Human or animal wastes (e.g., feces) are the ultimate source of ETEC contamination."

Silversea Cruises was last in the news several years ago when the USPH caught crew members hiding perishable food and galley equipment in crew quarters on the Silver Shadow and flunked the cruise line. CNN covered the scandal. You can see the video here

The Silver Shadow failed another USPH inspection last year as well. 

The Silver Spirit, on the other hand, has always scored highly by the USPH (93-100) in the last 6 years, and it scored a 98 during the last inspection in January. However, in a lawsuit filed by a Silversea crew member (aboard the Silver Spirit and Silver Wind) in 2011, the crew member alleged that his employment as a bartender was terminated after he complained that he was required to fill expensive, premium top-shelf brand liquor bottles with cheaper brands and to fill empty expensive French champagne bottles with cheaper Italian sparkling wines. The case is Marin Asenov v. Silversea Cruises, Ltd., Case No. 0:11 CV 62360 WJZ. You can read the allegations in the lawsuit here.   

Photo credit: This image photographed by Brian Burnell with permission was uploaded to Commons by George Hutchinson. CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15252523

P&O Oceana Flunks CDC Sanitation Inspection

P&O OceanaA month ago, a crew member aboard the P&O Oceana notified me that the cruise ship failed a sanitation inspection by the enters for Disease Control and Prevention (CDC) while the ship was in port in Charleston, South Carolina.  Oceana received a score of 82; 85 or lower is considered a failure.

I have been checking the CDC's online inspection scores since then. I have been asking the CDC when it will release its report on the Oceana.

The report was finally released today. You can read the report here. The report indicated that several back-flow prevention devices, to prevent the contamination of potable water, did not have test results and appeared not to be tested. The ship's Riviera swimming pool and Crystal whirlpool did not have adequate levels of chlorinated and bromine, failed to have hair and lint strainers / filters and were not disinfected. The inspector closed the recreational water facilities on the ship.   

The report also revealed that a food handler had an onset of Acute Gastroenteritis (AGE) and exhibited symptoms at 9:00 A.M. in the morning but did did not report to the medical center until 11:20 A.M. A review of the crew member's work history indicated that this crew member worked, notwithstanding his illness, from 7:30 A.M. until 10:30 A.M.

The ship's galley appeared dirty. There were comments like "the tile grout in this area was soiled and in disrepair."  "The deck below under counter refrigerator . . . had a significant buildup of more than a week's accumulation of food debris, dirt, equipment parts, and what appeared to be insect remains." Food service equipment was broken or out of service and many operational ovens and ice-makers were overflowing their drip pans and/or leaking onto the floor.

Oceana has not prepared a "corrective action report" in response to the failed score, as required by the CDC.

In an era when cruise lines are quick to blame every single norovirus outbreak on the passengers, this CDC report provides an insight into how deficient water sanitation and disgusting food handling practices by a cruise line can jeopardize the health of the traveling public.  

Have a thought? Please join the discussion on our Facebook page

April 4, 2016 Update: The CDC vessel sanitation inspectors inspected the P&O Oriana in February.  Although the cruise ship passed with a score of 90, there were several significant sanitation problems including dirty and out of service galley equipment.  Also food handlers working while ill with gastrointeritis: "A Chef de Partie experienced onset of GI symptoms on 20 January 2016 at 6:45 am. This crew member worked from 7 am to 11 am, took lunch at the crew mess, then returned to work from 1 pm to 5 pm. The chef reported his symptoms to the medical center at 6 pm."   You can read the report here

April 5, 2016 Update:  Cruise Law News was quoted today in the Southampton's Daily  Echo and the U.K.'s Daily Mail.  

Fortune magazine also covered the story, writing that it "raises questions about the industry’s squeaky-clean image, and indeed, that there may be more unreported cases that were either ignored or dismissed by the sickened passengers or the cruise lines themselves."

April 6, 2016 Update:  FoxNews covers the story today - Health inspectors find cockroaches, 'potentially hazardous' food aboard two luxury cruise ships.  The Cruise Line International Association (CLIA) interjects the blame-the-passenger-wash-your-hands excuse but ignores the fact that crew members were handling food while contagious and the ship's galley was found to be unsanitary and potentially hazardous to the guests' health. 

Photo credit: Piergiuliano Chesi, CC BY 3.0, commons / wikimedia.

CDC: 137 Sick with Norovirus on Norwegian Gem

Norwegian GemEarlier this week, we reported that health officials banned the Norwegian Gem from calling on St. Maarten because a number of passengers were ill with a gastrointestinal illness. The NCL cruise ship then sailed on to Tortola where it called on the port there.

The Centers for Disease Control and Prevention (CDC) is now officially reporting that 128 of 2,882 cruise passengers (4.44%) and 7 of 1,100 of crew members (0.64%) on the Gem have been ill during the cruise with norovirus. 

Although it was suggested on the cruise ship that the cause of the outbreak may be contaminated water, there has been no information released to the public confirming or excluding this possible cause. Norovirus is primarily a food-borne disease. Outbreak News Today correctly states that "norovirus is typically spread through contaminated food and water, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea."

Unfortunately, the CDC has limited resources and does not attempt to conduct an epidemiology assessment regarding the source of the norovirus outbreak.    

Photo credit: Corgi5623 at English Wikipedia, CC BY-SA 3.0.       

Another Gastrointestinal Outbreak on Leading GI-Outbreak Cruise Line, Princess Cruises

Ocean PrincessThe Centers for Disease Control and Prevention (CDC) reported that there is a gastrointestinal outbreak on the Ocean Princess cruise ship, with 43 of 603 (7.13%) of passengers ill during the cruise and 5 of 387 (1.29%) crew members sick.

The Princess cruise ship is currently sailing on a February 13 - March 7, 2016 itinerary. The cruise ship is scheduled to go into dry dock on March 7th. 

Princess has 50% of the four cruise ship norovirus that meet the CDC's criteria so far this year. This should be no surprise to anyone who follows gastrointestinal outbreaks on cruise ships.

As I pointed out in my last article about a gastrointestinal outbreak on a Princess cruise ship (the Crown Princess), during the six year period from 2010 to the current date, Princess Cruises experienced the most norovirus outbreaks on its cruise ships calling on a U.S. port, according to the CDC. Including this most recent outbreak, Princess has reported twenty (20) cases to the CDC during this time period.

In contrast, Carnival cruise lines reported just two (2) cases during the same time period.

Celebrity Cruises reported 15 cases (and Royal Caribbean reported 9). HAL also reported a high number (12) during the 2010 to 2016 time period. Cunard reported 4; NCL -3; Oceania - 3; and Crystal - 2. 

Anyone have an explanation why there have been 10 times as many CDC-reported GI outbreaks on Princess cruise ships compared to Carnival cruise line ships?

 Photo Credit: Pjotr Mahhonin - CC0, Wikipedia

CDC Expands Zika Travel Warning

Zika VirusThe U.S. Centers for Disease Control and Prevention (CDC) added eight (8) more destinations to its recent Zika virus travel alert yesterday.

In addition to the 14 countries already on the CDC list (Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti , Honduras, Martinique, Mexico, Panama, Puerto Rico, Paraguay, Suriname, and Venezuela), the CDC added these 8 more countries:

Barbados, Bolivia, Ecuador, Guadeloupe, St. Martin, Guyana, Cape Verde, and Samoa.

The Center for Infectious Disease Research and Policy (CIDRAP) states that the move to add countries where a traveler could be injected "follows the CDC's initial Jan 15 travel advisory recommending that pregnant women and those trying to become pregnant consider postponing travel to countries where Zika virus is circulating, and if they must travel to the destinations they should follow strict steps to avoid mosquito bites."

As we explained in our first article, there is a risk of to pregnant women of having a baby with a small, underdeveloped heads (microcephaly).

This latest development comes at a time when "three travellers who returned to the UK from South and Central America have been diagnosed with the Zika virus."

So far, we have heard of some cruise lines which are cruising to one of the countries subject to the CDC warning are refusing pregnant women to cancel their cruises.  We do not know whether those travel insurance companies are providing coverage when a pregnant cruiser cancels and submits a claim.

The CDC's Recommendations for Pregnant Women Considering Travel to an Area of Zika Virus Transmission

Because there is neither a vaccine nor prophylactic medications available to prevent Zika virus infection, CDC recommends that all pregnant women consider postponing travel to areas where Zika virus transmission is ongoing. If a pregnant woman travels to an area with Zika virus transmission, she should be advised to strictly follow steps to avoid mosquito bites. Mosquitoes that spread Zika virus bite both indoors and outdoors, mostly during the daytime; therefore, it is important to ensure protection from mosquitoes throughout the entire day. Mosquito prevention strategies include wearing long-sleeved shirts and long pants, using U.S. Environmental Protection Agency (EPA - registered insect repellents, using permethrin-treated clothing and gear, and staying and sleeping in screened-in or air-conditioned rooms. When used as directed on the product label, insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant women. Further guidelines for using insect repellents are available online (http://wwwnc.cdc.gov/travel/page/avoid-bug-bites).

January 26, 2016 Update: The CDC added  the United States Virgin Islands and the Dominican Republic to the list of destinations with Zika virus disease outbreaks.

Photo Credit: "Aedes aegypti CDC-Gathany" by James Gathany - PHIL, CDC. Licensed under Public Domain via Commons Wikipedia

Bahama Mama Flunks CDC Sanitation Inspection

Bahamas MamaThe  Bahama Mama cruise ferry, operated by Balearia Bahamas Express, recently failed a bi-annual sanitation and health  inspection conducted by the Centers for Disease Control and Prevention (CDC).

I first read about the Bahama Mama flunking the CDC inspection in an article by Theresa Norton Masek in Travel Pulse titled Bahama Mama Ferry Fails CDC Inspection.

The official CDC report chronicles a disgusting list of filthy conditions (with the requisite dead flies and crawling insects) on the ship as well as disturbing failures to comply with health procedures designed to avoid food contamination. The report indicates that the ship did not even have acute gastroenteritis surveillance logs for each voyage, although there were ill crew members on the ship.

You can read the report here.

The ship has not complied with the CDC and submitted a corrective action report. 

The ship sails between Port Everglades and Freeport, Bahamas. 

Have a thought? Please leave a comment below or join the discussion on our Facebook page

Photo credit: Vicens Gimenez / © Vicens Gimenez via Sun Sentinel

Noro on the Princess Cruises' Star Princess

News sources in Hawaii are reporting that dozens of Princess cruise ship passengers have been quarantined on Maui after a norovirus outbreak.

Newspapers are saying that Princess Cruises' Star Princess is ported at Lahaina. According to the local health department, around 30 people are quarantined in their rooms. Health officials report that the virus originated in San Francisco. 

Princess Cruises notified the Centers for Disease Control and Prevention (CDC).  

There is no official CDC information  because there is no need for the CDC to make a report to the public unless 3% or more of the cruise passengers or crew are ill. 

This week 8 Canadian doctors published a blockbuster article confirming that norovirus can be transmitted in an airborne form.

Unfortunately, given the short time that cruise ship are in port, no health officials ever determine whether the outbreak is caused by contaminated food and / or water versus a sick food handler versus poor hygiene practices by the cruise ship or passengers. I expect the cruise line will still publicly blame the passengers, whatever the true cause. 

Have a comment? Please leave one below or join the discussion on our Facebook page.

Star Princess Noro Virus

Photo Credit: Jim Walker in Seattle

 

Silver Shadow Fails CDC Sanitation Inspection Again

The Centers for Disease Control and Prevention (CDC) flunked Silversea's luxury cruise ship, the Silver Shadow, for unsanitary conditions. 

The Silversea cruise ship received a failing score of only 82. The inspectors determined the ship had improper medical protocols for crew members with acute gastroenteritis. The inspectors found 40 unsanitary conditions such as improper temperatures for stored food, improper sneeze guards at the ship's buffet stations, and unsanitary whirlpools.  

Incredibly, Silversea refused to submit a corrective action report.

Two years ago, this cruise ship engaged in an intentional, calculated scheme to hide food and galley equipment in crew cabins.Crew members on the ship alerted our firm that they (galley workers) were being ordered by their supervisors to take trolleys of perishable foods (eggs, fish & cheese) to the crew quarters and hide the food from inspectors during bi-annual CDC inspections. We advised the "whistle-blower" crew members to notify the CDC. As a result of a surprise inspection, the CDC discovered that the cruise line hid "over 15 full trolleys" of food and food equipment, pans, dishware and utensils to "over 10 individual cabins"  in order to avoid scrutiny of vessel sanitation inspectors. It flunked Silversea with a score of 82.

We were interviewed by CNN regarding Silversea's scam.

We found Silversea Cruises to have acted deliberately and unethically. It was obviously not committed to safe food practices, a conclusion which is reinforced by this latest series of violations.

Unfortunately, the CDC can't enter significant sanctions against renegade cruise lines like this even when the cruise ships intentionally violate CDC sanitation protocols. Our government should impose meaningful monetary sanctions and shut cruise ships down when they threaten the health of passengers. 

Have a comment? Please leave a comment below or joint the discussion on our Facebook page.

The CNN video of the last CDC failed score is below:

 

GI Outbreak on the Celebrity Infinity

Celebrity InfinityThe Centers for Disease Control and Prevention (CDC) reports that at least 95 passengers and 5 crew members have been sickened with a gastrointestinal illness (GI) while aboard the Celebrity Infinity.

The Infinity is on a two week cruise that started on March 29th and will end on April 13th in San Diego, CA.

We have received emails from sick passengers on the ship.

The CDC hasn't figured out whether the outbreak is due to norovirus yet. 

The CDC will send two employees (an environmental health officer and epidemiologist) to the cruise ship when it reaches San Diego April 13th.

The Infinity suffered through a norovirus in 2013

This is the fourth GI outbreak on a cruise ship calling on a U.S. port which has been reported to the CDC this year. The last one involved NCL's Norwegian Pearl.

April 13 2015 Update: A passenger contacted me today saying that there was an outbreak the cruise before which sailed from South America and returned to Ft. Lauderdale at the end of March. She said that her husband became ill with noro-like symptoms and the ship had been fumigated during the cruise.   

Leave a comment below or join the discussion on our Facebook page.

Photo Credit: WikiCopter

Gross! Watch Undercover Cruise Ship Inspection

The NBC Today Show aired a special this morning on cruise ship germs titled Cruise ships may carry unwelcome passengers: Germs.

An undercover team went on an unidentified cruise ship (looks like a Royal Caribbean ship) to the Caribbean to find out "where germs may lurk aboard cruise ships."  They used test swabs and a bacteria meter. Any reading over 100 on the bacteria meter is a "fail." Several readings were acceptable but here are examples of failed scores:

  • Slot machine handle - 373;
  • Elevator buttons - 370; 
  • Lounge chair by the swimming pool - 773; and
  • Serving spoon at buffet - 2,102. 

The team sent the buffet spoon swabs to a certified lab. The team interviewed a emergency room doctor who said "It's very bad. . . they make you really sick."

The doctor suggested that cruise lines utilizing someone with gloves doing the serving instead of a self-serve arrangement. That's "the best way of preventing the spread of infection," he said. 

The Cruise Line International Association (CLIA) dismissed the results, referring to the inspection as a "clandestine demonstration."

 

Visit NBCNews.com for breaking news, world news, and news about the economy

Did the Freedom of the Seas Fail a USPH Sanitation Inspection?

On November 27, 2014, I received a communication directly from a Royal Caribbean crew member indicating that the United States Public Health (USPH) conducted a surprise health inspection of the Freedom of the Seas on November 23rd. The crew member said that the USPH flunked the cruise ship for being unsanitary.  

The crew member, who is still working on the ship and wishes to remain anonymous, said that the USPH gave Royal Caribbean a failing score of "84" (85 or below is a failing grade).

A failed USPH score is a big thing. Only two major U.S. based cruise ships (the Ocean PrincessFruit Flies and Silver Discoverer) failed such an inspection this year. It's embarrassing to the cruise line. It has sometimes ended a F&B (food & beverage) manager's career.  

Since communicating with the crew member, I have checked the Centers for Disease Control and Prevention (USPH) database daily for the official report.

Today, the CDC report was finally released. To my surprise, the official score was an "86," one point above failing.  So what happened between November 23rd and today?

The crew member's account of the inspection seems credible to me. The crew member indicated that there was a great deal of controversy over the failed inspection when the government inspectors left the ship. The crew member mentioned particular aspects of the failed inspection. I tend to believe the account.

Did the inspectors reconsider and change the score after leaving the ship? If so, why? Was this a good faith reconsideration and recalculation based on objective criteria? Or were there behind-the-scenes shenanigans and arm-twisting that resulted in the score being changed to a passing score? There can be no doubt that Royal Caribbean has a cozy relationship with the federal agencies; it routinely hires from the CDC, USPH, FBI and USCG.

So what does the official report say? Here are a few of the findings:

  • Two crew members working with symptomatic acute gastroenteritis;
  • Improper cooling logs for food, risking illness;
  • Cases of food stored on heavily soiled decks;
  • Trolley with plates stored in elevator lobby;
  • Food soil in Sorrentos galley; and
  • Live fruit flies in Windjammer buffet, Chops galley, Windjammer pot wash, Sorrentos bussing station, Cafe Promenade bar, Diamond Lounge buffet, and Crown Viking bar.

The last cruise ship I recall flunking a USPH inspection for fruit flies was the old Monarch of the Seas

If the Freedom's score was not really a "F," it sure sounds like a solid "D-."  

 

Have a thought?  Please leave a comment below or join the discussion on our Facebook page.

Photo Credit: Batzner Pest Management

Ebola on the High Seas: Will the New Cruise Health Questionnaire Work?

The cruise industry finally instituted Ebola-specific protocols after the highly publicized incident yesterday when a healthcare worker from Dallas was discovered to be on a Carnival cruise to the Caribbean. 

TravelPulse published an article discussing the new protocols Cruise Industry Adopts Stricter Ebola Screenings.

Cruise lines like Carnival are finally asking cruise passengers whether they have come into contact with an Ebola patient or worked at a healthcare facility where such a person was treated, within the Cruise Ebolalast 21 days. Cruise lines are also finally inquiring whether the passengers have visited Guinea, Liberia or Sierra Leone within the last three weeks.  It was a glaring error not to have such a basic protocol before yesterday.    

But there is a problem with the questionnaire. It doesn't address what happens if a passenger checks "yes" to these questions.  

Obviously the questions are designed to bar the passenger and his companions from traveling on the cruise ship. The issue remains will the passenger's cruise fare and travel expenses be refunded? Will the cruise passengers receive a full cruise credit?

We know from norovirus cases that many cruise passengers, although they are symptomatic, refuse to disclose that they have a fever and a runny nose. They then get on the cruise ship and infect others. 

Many passengers are inherently selfish. They have planned the cruise far in advance. They have obtained vacation time from work and blocked a week of "family time." They have looked forward to the cruise for many months. They have flown or driven long distances to the cruise port at considerable expense. They realize that they will be barred from embarking and their vacation will be ruined if they provide full and complete answers about their health.  

Cruise lines are inherently selfish too. Although they collect literally billions and billions each year and pay no U.S. income tax, cruise lines are notoriously stringent in not permitting cruise vacationers to cancel if they experience last minute medical emergencies or even deaths in the family.  There is great debate about the need for travel insurance. The attitude toward people who don't purchase insurance and then suffer a medical problem is often "screw 'em." 

The result is that cruise passengers are often not honest about their health and the cruise lines are often unreasonable in not permitting their guests to reschedule and issue them a cruise credit.

So they sneak aboard, already infected with the nasty norovirus.

But unlike the noro bug, Ebola is deadly. The consequences of carrying Ebola aboard a cruise ship packed with 5,000 passengers and crew members is too great. 

The health questionnaire should include language which states that if you checked "yes" to any of the Ebola questions, don't worry. No you won't be able to cruise, but you are entitled to a full refund and your travel expenses will be refunded as well.  

Cruise Critic posted an article today about the new questionnaire. The articles states: "Notably, cruise lines rely on passengers and crew to provide honest and accurate answers in health screenings and on health questionnaires. CLIA said intentionally providing false or misleading answers is a criminal offense and is subject to prosecution."

Threatening cruise passengers with criminal prosecution is ridiculous. It's the wrong idea. First of all, there is no criminal law which applies and no prosecutor will ever take such a case. You can't scare a consumer into doing the right thing. 

Instead, the cruise industry has to anticipate that cruise passengers will be less than candid. Cruise lines need to provide an incentive by way of a refund. You can call it the "Ebola refund."

This will require a substantial change in the greedy attitude of the cruise industry. But it's absolutely necessary to prevent what happened yesterday on the Carnival Magic.Cruise Ebola Questionnaire

 

Cruise Industry Fabricates and Distorts Norovirus Information

Christine Duffy, the CEO of the cruise industry trade group Cruise Line International Association (CLIA), has authored an article entitled "CDC report debunks norovirus cruise myth."

The article was first issued as a press release and later picked up by cruise cheerleaders like Cruise Critic. Travel Weekly is the latest travel publication to publish the misleading article. 

Ms. Duffy fabricates and distorts information in her article. 

Christine DuffyShe compares norovirus outbreaks on cruise ships with norovirus outbreaks on land. But her method of doing so is inherently flawed and misleading. 

She says that In 2013, a little over 10 million people embarked on a cruise from a U.S. port. She claims that there were only 4 norovirus outbreaks, involving around 834 passengers, in 2013. That turns out to be approximately 1 in 12,000 cruise passengers who are affected by the nasty bug, she concludes.

Meanwhile, the CDC estimates that norovirus affected 20,000,000 ashore. With a population of some 318,000.000 U.S. citizens, that turns out to be 1 in 15 people who contract norovirus on land every year.

However, to make a meaningful comparison, you have to compare the U.S. population with the average population of the cruise industry at any given point. There are around 250,000 people cruising at any given time world wide from the major CLIA lines, with around 125,000 sailing from U.S. ports. You don't compare the U.S. population to the total number of travelers. That's like comparing apples to oranges.

A typical cruiser may spend anywhere from 3 days to a week or perhaps 2 or 3 weeks a year cruising. They are not on the cruise ship 52 weeks a year obviously. So it is highly misleading to compare the U.S. population with the total numbers of travelers. It skews the number from 125,000 to over 10,000,000. It understates the likelihood of contracting norovirus on a cruise ship by a factor of 80 or so.

In addition to the flawed methodology, Ms. Duffy's numbers regarding the incidents of cruise norovirus cases are flat-out wrong. She says there were only 4 outbreaks affecting only 834 passenger in 2013. 

But the CDC data shows that there are in fact thousands of passengers who are sickened on cruises every year. From February 25, 2013 to February 22, 2014, for example, the CDC reported that there 13 outbreaks totaling 2,468 passengers. So to make a correct statistical comparison, the land-based outbreaks must be compared to 2,468 incidents in a total cruise population of 125,000 (not 834 incidents out of over 10,000,000 people).

Remember that the CDC data is limited. It doesn't include outbreaks when the cruise ship doesn't return to a U.S. port. Even when a U.S. port is involved, it doesn't even record incidents when less Norovirus Cruise Shipthan 3% of the total number of passengers become sick. So that means that 175 passengers could become ill with norovirus on the Oasis of the Seas and the CDC would ignore it. The CDC data reveals only a fraction of the actual number of cruise norovirus victims. Plus it's well known in the cruise industry that many passengers don't report their sicknesses to the ship infirmary because they don't want to be quarantined.  

During many of the Congressional hearings on cruise ship crimes over the last few years, the cruise industry offered similarly misleading comparative data. It would provide crime statistics using the total U.S. population compared to the total number of passengers who travel on cruise ships. This skewed the statistics wildly in favor of the cruise industry. It made it appear that fewer crimes occur on cruise ships. Congress chastised the industry for providing such misleading comparisons.

Senator Rockefeller criticized Ms. Duffy for not being truthful when she testified before a Senate subcommittee on cruise ship safety in 2012. 

It's a shame that travel publications like Travel Weekly publish such rubbish. It's a disservice to the U.S. public who deserve honest numbers and meaningful analysis.   

Grandeur of the Seas is Still Sick: Cruise Industry Heading Toward Record Breaking Year for Virus of the Seas

The Centers for Disease Control and Prevention (CDC) has documented passengers sailing on Royal Caribbean's Grandeur of the Seas out of Baltimore have been sickened on two consecutive cruises. 

The CDC website reflects that 97 passengers and 8 crew members on the Grandeur of the Seas became ill with vomiting and diarrhea. It left April 5 for a seven-day cruise and returns to Baltimore today.

Royal Caribbean Cruises notified passengers who will be boarding today to arrive late at the port Grandeur of the Seas - Baltimore - Noro Virusbecause the cruise ship will undergo another round of the so-called "enhanced cleaning."

The Associated Press indicates that Royal Caribbean believes norovirus to be the cause.

As is the situation with virtually all gastrointestinal outbreaks on cruise ships, the CDC has not announced an explanation how the outbreak took place. Contaminated food? Contaminated water? Sick crew members working while ill in the galley or dining rooms? Cruise passengers not washing their hands? (the cruise lines' usual excuse). Your guess is as good as mine.  

This is the second consecutive cruise on the Grandeur with a illness outbreak, The CDC reported that 111  passengers and 6 crew members became ill with norovirus on the Grandeur during its cruise from March 28 to April 5. You can read our report here.

The CDC has documented a total of 8 gastrointestinal illness outbreaks on cruises returning to a U.S. ports so far this year. (There was also a norovirus outbreak aboard the P&O Oriana recently). There were just 9 outbreaks in all of last year. Norovirus is cited as one of the reasons the public has less confidence in the safety and reliability of cruising, especially from people who have never cruised before.

This week we were contacted by many cruise passengers asking whether they could cancel the cruise which leaves today because of the ongoing outbreak. Unfortunately the cruise lines hold all of the cards in cases like this.  Fear of becoming sick is not a legally recognized reason to cancel a cruise and expect a refund. However, it all depends on the goodwill of the cruise line. A FOX News report indicates that the spokesperson for Royal Caribbean, Cynthia Martinez, said "if passengers don't want to take Saturday's cruise, Royal Caribbean staff will help them reschedule." 

You can contact Ms. Martinez on Twitter - @CrisisCommChick / telephone (305) 982-2458 / email cynthiamartinez@rccl.com

Suing a cruise line for compensation when exposed to a gastrointestinal virus is a losing proposition because the CDC does such a poor job trying to determine the cause of the outbreak. In this most recent case the CDC has not determined the type of virus much less how the virus came on the cruise ship.

The last message we received was last night: "I will be traveling on the Grandeur this Saturday as well and our check in time was delayed 4 hours! I will be bringing my own bleach wipes on board. Wish us luck!"

Good luck!

Photo Credit: WBAL Baltimore

Have a thought about this story? Please leave a comment below or join the discussion on our Facebook page.

The Norwegian Star Flunks Sanitation Inspection: Is There a Correlation Between Failed CDC Cruise Ship Inspections And Norovirus?

The first official norovirus outbreak on a cruise ship this year involved the Norwegian Cruise Line (NCL) Norwegian Star

The outbreak occurred during a cruise from January 5-19, 2014. The virus sickened 130 of 2318 cruise passenger (5.61%) and 12 of 1039 crew members (1.15%).  You can read the CDC report here.

The CDC concluded that the virus in question which sickened the 142 or so people was norovirus. This was the "causative factor" in CDC parlance. The CDC can usually figure out the "causative factor" and NCL Norwegian Starmost of the time norovirus is the culprit. But I have never seen a CDC report in the last 10 or 15 years where the CDC figured out how the norovirus came aboard the cruise ship.

The cruise lines always blame the passengers. Sometimes the blame is direct with a cruise line public relations representative pointing the finger at their guests. Sometimes it is more subtle with no blame assessment but in the form of "passengers-need-to-wash-their-hands" type of admonishment. 

Determining the cause of a norovirus outbreak is a scientific process to be made by epidemiologists and doctors, not cruise line PR people.

The CDC is severely limited by the few inspectors and epidemiologists who are assigned to the cruise ships. The cruise lines are also eager to re-load their cruise ships and begin another cruise as soon as possible. Our federal government and the cruise lines work together to keep the cruise industry moving. No one wants to inconvenience the next round of passengers and hold a ship in port. Unfortunately, no one is advocating a more comprehensive (and slower) methodical analysis of data. 

My suggestion is that any time there is an outbreak, the CDC should automatically conduct a sanitation inspection as soon as the ship returns to port pursuant to its vessel sanitation program (VSP). The inspectors should determine whether the cruise ship's food or water supplies are contaminated. Medical literature indicates that many outbreaks are due to noro-laden food or water. Particular attention should be focused on the crew members' medical records, particularly the logs indicating whether food handlers (cooks and waiters) have reported to the ship infirmary with acute Cruise Ship Norovirusgastrointestinal symptoms of cramping, diarrhea and nausea.  

Yes, it will take greater resources from the CDC to accomplish this but it is worth it. The "enhanced cleaning" that takes place after an outbreak is "hit or miss." No one figures out what caused the outbreak. The ship is just pressing everyone to work overtime and spray and wipe everything in sight.

There was no CDC sanitation inspection on January 19th when the Norwegian Star returned to port. I would have liked to see the food handler's medical logs for the preceding two weeks in order to determine whether there were complaints of nausea, diarrhea, cramps, fever and headaches.  How did the cruise line handle the illnesses? Did they log all of the complaints and quarantine the sick crew members?  Did they interview the crew members' cabin mates to determine whether they were ill too?

The Norwegian Star underwent a CDC sanitation inspection on February 16th. The results were disgusting. Many crew members worked while suffering from acute gastrointestinal illnesses, threatening the health of passengers, and then appeared in the ship infirmary after working. The cruise line failed to properly document and log many of the sicknesses and report them to the CDC.  For the January 19th to February 2nd 2014 cruise, the number of sick passengers reached over 2% but the cruise ship did not notify the CDC. Many of the cabin mates of the sick crew members were not interviewed by the ship's medical staff, as required by the CDC protocols.  

The following violation was typical:

"Violation: On 28 January, the medical notes indicated a food worker had an illness onset at 0600 with Cruise Ship Food Handlers - Norovirusfour episodes of diarrhea, abdominal cramps, and a headache, but the AGE surveillance log indicated these symptoms started on 28 January at 1315. On the same day at 1315, this person had their last AGE symptom. There was no documentation indicating how long this person was isolated. This individual had four roommates, but there was no documentation the 48 hour interviews were conducted for three of the four roommates."

The CDC flunked the ship with a score of 82. You can read the CDC report here. In addition to the problems with the sick crew members, parts of the galleys and restaurants were filthy.

Does the CDC employ epidemiologists to study the results of vessel sanitation reports to look for trends to explain why gastrointestinal outbreaks occur?  Correlating the medical records of sick food handlers and their cabin mates with outbreaks may be a good idea. A scientific analysis of medical records and logs of crew members with GI problems would certainly be a better use of time than having to listen to the cruise line always blame the passengers for not not washing their hands. 

 

Photo Credit: Top: Wikipedia / Pjotr Mahhonin; bottom: Centers for Disease Control & Prevention

Centers for Disease Control Confirms Gastrointestinal Outbreak Aboard HAL's Massdam

HAL MaasdamTen days ago we wrote about a gastrointestinal outbreak on the Holland America Line (HAL) Maasdam which was sailing routes in South America. 

Passengers were stating that numerous people are sick with nausea, vomiting, diarrhea and other noro virus like symptoms. 

Some passengers complained that they became tired of the HAL captain blaming them for the outbreak.

The public relations people at HAL and parent company Carnival Corporation ignored our requests for information.

The Maasdam finally returned to Fort Lauderdale and the CDC boarded. The CDC is now reporting that 65 of 1096 passengers (5.93%) and 8 of 569 crew (1.41%) were ill with an unspecified gastrointestinal illness.

You can read the CDC report here.

 

Photo Credit: Wikipedia / Andrew J Bryson

Disease Outbreak on HAL Veendam

The Centers for Disease Control and Prevention (CDC) report that there has been a disease outbreak on the  M/S Veendam operated by Holland America Line (HAL)

The CDC states that the Veendam cruise ship has returned after a a 14 day cruise from February 8-22, 2014 with 114 of 1273 (8.96%) passengers suffering from norovirus-like symptoms of vomiting and diarrhea. 10 of 575 (1.74%) crew members are reportedly ill.

The CDC has not figured out the type or cause of the disease outbreak.

Veendam Cruise Ship - NorovirusThe CDC has confirmed four disease outbreaks on cruise ships so far this year.

The story was first mentioned by the Cruise Fever blog.

The HAL Veendam was last infected with e-coli last year. You can read about that outbreak here: Gastrointestinal Virus Plagues Passengers Aboard HAL's Veendam Cruise Ship.

The Veendam has experienced problems with cleanliness and Illnesses over the years.

In 2012, this HAL cruise ship flunked a health inspection. That's hard to do. Read our article: Gross! Holland America Line's Veendam Flunks Health Inspection.

The Veendam also sickened 80 and killed one passenger during a gastrointestinal outbreak in November of 2011.

Over the years, HAL has one of the worst records with disease outbreaks.

 

Photo Credit: Wikipedia / Djheini

Norovirus on Explorer of the Seas: More Sick than Reported

Explorer of the SeasCNN interviewed a family who became sick with gastrointestinal illness while sailing aboard Royal Caribbean's Explorer of the Seas.  

These passengers (Mom, Dad and two kids), made some interesting comments. They disputed the official statistics reported by the cruise line to the Centers for Disease control (CDC) indicating that only 20% of the passengers were infected.  

They believed that a more reasonable estimate is that 80% were infected and 20% were not infected. At some point, they say, the cruise ship's medical infirmary was over-run with sick passengers. The facility could not process and treat the hundreds of people becoming ill. 

The family also said that the cruise line medical personnel "told us to stop coming down" (to the infirmary).

Watch the video below. 

Photo Credit: Roberto Schmidt / AFP / Getty

 

Blame Game: Princess Accuses Passengers of Starting Norovirus Outbreak on Caribbean Princess

Last night the Caribbean Princess cruise ship returned early to Houston, Texas with passengers and crew members suffering from a gastrointestinal illness (GI) outbreak. There are around 173 people officially reported to be ill on the ship, mostly passengers. A Houston news station says the outbreak was caused by norovirus.

Determining the type of GI outbreak and the origin of the outbreak is a deliberate, scientific process that is the work of trained and experienced expert epidemiologists.  

The experts at the Centers for Disease Control and Prevention (CDC) have not yet determined either the type or the origin of the virus.  The outbreak could be attributed to contaminated food, or contaminated water, or galley or food handlers working while ill, or the ship failing to clean up after the last cruise when passengers became ill, or new passengers with the virus who were not properly Caribbean Princessscreened. But whatever the potential cause and origin, it's important to determine what the CDC says about the outbreak.

Princess Cruises, however, has already blamed its guests.  Princess PR spokeswoman Julie Benson tells CBS News that "the pattern suggests the illness was brought on board by passengers." Ms. Benson is not an epidemiologist of course. She has no medical or scientific education or training. Princess Cruises didn't fly a team of epidemiologists into the Gulf of Mexico and lower them down from a helicopter to the cruise ship to conduct tests and make a analysis.

Ms. Benson's comments, in my assessment, are a PR stunt. This is right out of the cruise industry's playbook of how to manage a crisis when a cruise ship sickness epidemic breaks out. Rule number 1: Blame the Passengers!

Cruise lines like Princess don't want the public to think that their cruise ships or crew members are the problem. To divert attention from the possibility of bad food or contaminated water or sick crew members, the cruise lines point the finger at their customers and accuse them of bring the virus aboard or having poor hygiene.

But could it be bad hygiene of the crew? The CDC has found crew working while ill before. That's why the public has to rely on the education and experience of the experts and not PR cruise line people.

Yesterday we wrote that there were passengers sickened during the last cruise. Did the ship clean up the contaminated surfaces and test the food and water after the last puke fest? How many people were sick last week?  Perhaps Princess will tell us? Perhaps not. 

I have mentioned before that cruise lines often don't want the CDC to make any conclusions about the cause or origin of widespread viral outbreaks. Why? So the PR people can spin the story for marketing purposes.

Princess would rather protect their own reputation and blame the sick passengers than wait for the CDC to finish its investigation. 

 

Photo BCredit: Mayra Beltran/Houston Chronicle

Norovirus Outbreak on Caribbean Princess Cruise Ship

Diamond Princess NorovirusThis morning I received an email from a reader of Cruise Law News who said that the Princess Cruises' Caribbean Princess cruise ship will be arriving in Houston tomorrow night 36 hours or so early due to a norovirus outbreak. 

This evening the Centers for Disease Control and Prevention (CDC) reported that the Caribbean Princess has suffered an outbreak affecting the following people infected during its current January 25th - February 1st cruise:

  • 162 of 3102 passengers (5.22%); and
  • 11 of 1148 crew members (0.96%)

The CDC has not yet announced the type of pathogens involved in this latest cruise ship infection.

A Houston newspaper said the virus was norovirus.

The newspaper also said that Princess Cruises issued a statement today saying "that the trip was cut short by one day because of thick fog expected over the weekend."

Yeah, right.

Princess Cruises was recently featured in Time Magazine's Top 13 Worst cruise Ship Norovirus Outbreaks.  

Princess Cruises had five of the worst outbreaks: Crown Princess (January 2010) - 396; Crown Princess (February 2012) - 363; Ruby Princess (March 2013) - 276; Coral Princess (February 2009) - 271; and Sun Princess (July 2012) - 216.

The last gastrointestinal illness outbreak on a Princess cruise ship involved the Diamond Princess just two weeks ago.

How is Princess handing this latest outbreak? Leave a comment below or join the discussion on our Facebook page.

January 30, 2014 Update:  Cruise expert Professor Ross Klein received information from cruise passengers indicating that there were problems with norovirus on the prior cruise:

"From a reader: Passengers have been notified that during the current cruise there has been an increase in the number of cases of gastrointestinal illness amongst passengers caused by Norovirus. In response, we have arranged for the ship to undergo a prolonged and additional disinfection in Houston on Saturday, January 11, 2014. As a consequence, cruise check-in and embarkation will be delayed until 2:00 pm.

This was also noted by a passenger who just disembarked the ship who said, "Cabins on both sides of us had to be sanitized due the passengers being sick."

January 31, 2014 Update: "Blame Game: Princess Accuses Passengers of Starting Norovirus Outbreak on Caribbean Princess."  "Not our fault" says the PR people at Princess Cruises. How about letting the experts conclude their investigation first?

 

Photo Credit: Wikipedia / Yankeesman312

A Royal Mess: Sick Count Increases to Over 600, Cruise Ends Early

The Centers for Disease Control and Prevention (CDC) has stated that over 600 people have been sickened by the gastrointestinal illness outbreak on the Royal Caribbean Explorer of the Seas, CNN reports.

The Royal Caribbean cruise ship left Cape Liberty, New Jersey on January 21, 2014 for a 10 day cruise through the Caribbean. The ship missed a stop at its private stop in Labadee Haiti after the outbreak. It sailed to San Juan to be cleaned. 

The CDC initially stated that over 300 people (281 passengers and 22 crew members) were ill. (Its official report is here with the new statistics). However, over the weekend we began to hear reports from passengers that the number Royal Caribbean Cruise Explorer of the Seas Norovirusof people suffering from nausea and diarrhea had increased to to over 450 and, now, to over 600. 

CNN quotes a spokeswoman with the CDC that more than 600 people on the ship have become ill, reporting vomiting and diarrhea. The CDC spokeswoman said 564 passengers and 47 crew members reported being ill.

Royal Caribbean is ending the cruise two days early. The cruise line will "use the extra time to sanitize the ship even more thoroughly." 

We have been contacted by guests on this ill fated cruise as well passengers from the prior cruise who became ill. 

Passengers who contacted Royal Caribbean say that the cruise line is not considering refunds of any type.

We previously reported on the incident in our article: Puke Fest Aboard Royal Caribbean's Explorer of the Seas.

There has been no official word from the CDC whether this is in fact norovirus, although the symptoms are consistent with the virus. The cruise lines invariably blame the passengers, but the CDC has never in my experience ever pin-pointed the exact source of an outbreak like this.

NBC News raises the issue whether the outbreak on the Explorer is linked to a nasty new type of norovirus known as the GII 4 Sydney strain which caused an outbreak on the Queen Mary 2.

Join our discussion on Facebook about why norovirus outbreaks occur on cruise ships

 

Puke Fest Aboard Royal Caribbean's Explorer of the Seas

The Centers for Disease Control and Prevention (CDC) announced that there is an outbreak of gastrointestinal sickness of a large percentage of cruise passengers aboard Royal Caribbean's Explorer of the Seas cruise ship.

The CDC indicates that 281 passengers (9.21% of total passengers) are suffering from norovirus type of symptoms. The symptoms include vomiting, nausea, headaches and diarehhea. You can read the report here

The pro-cruise site Cruise Critic calls the problem a "small outbreak" but the truth is that 9% is a high percentage.  It is not unusual for passengers not to report the illness in order to avoid being Explorer of the Seasquarantined in the cabin or for crew members who rely on tips to keep working after they are ill. The total numbers are often under-reported.

In addition to sick passengers, 22 crew members are reportedly ill according to the CDC. 

The CDC website states that an environmental health officer and an epidemiologist will board the ship in St. Thomas, USVI on January 26, 2014 to conduct an epidemiologic investigation. 

It may be possible to determine whether the outbreak is in fact related to norovirus. But the CDC will not have any success is determining why and how the virus came aboard. There is not enough time for the CDC to conduct an exhaustive scientific analysis and, as usual, the ship will not sit idle waiting for the test results. The cruise ship will continue to sail whether the CDC determines if it is norovirus or exactly why it is on the ship. 

Earlier this week, cruise expert Professor Ross Klein indicated that the CDC reported 130 passengers and 12 crew members became ill with gastrointestinal illness while cruising aboard the NCL Norwegian Star

The Majesty of the Seas returned to Miami a week ago with 70 people reported ill with gastrointestinal illnesses.

Were the outbreaks on the Royal Caribbean and NCL ships caused by the passengers not washing their hands? That's always what the cruise lines say.

Or was it due to crew members who kept working after they became sick and causing the outbreak? Or was it contaminated food or water, which is a common cause?

We will never know. The cause of gastrointestinal outbreaks is usually a mystery on cruise ships.

 

Have a comment? Please leave a message below or join the discussion on our Facebook page - what's the most common cause of norovirus on cruise ships?  

Photo Credit: Wikipedia / Emma Jones

G.I. Blues: Over 300 Sick on the Celebrity Summit

Celebrity Summit Cruise ShipCruise expert Professor Ross Klein reports that the Centers for Disease Control (CDC) indicates that 307 of 2112 passengers (14.5%) and 14 of 952 crew (1.5%) aboard the Celebrity Summit have reported sick with "gastrointestinal illness."

You can read about the outbreak on the CDC website here.

There is no indication whether the illness is due to norovirus, e-coli or some other virus or bacteria. 

The CDC is working with Health Canada officials as the cruise ship sails in Canada on its way to Bayonne, New Jersey,  The cruise ship will arrival in Bayonne on October 5, 2013.

The CDC will send an epidemiologist and an environmental health officer to meet the ship and conduct an epidemiologic investigation and environmental health assessment, and monitor the sanitation procedures onboard prior to the embarkation of new passengers.

Over 14% of the passengers being sick with gastrointestinal illness is a very high percentage.  

In the past week, we have reported about cruise ship norovirus outbreaks on two Fred Olsen cruise ships, the Black Watch and the Boudicca.

 

Photo Credit: Wikipedia / Yankeesman312

Caribbean Fantasy Flunks Sanitation Inspection - Why Doesn't the CDC Shut Nasty Ships Like This Down?

Professor Ross Klein's website reports that the Caribbean Fantasy, operated by American Cruise Ferries, failed a surprise inspection by the Centers for Disease Control and Prevention last month.  

The Caribbean Fantasy received a failing score of 81. The CDC report is, in a word, gross.

The CDC discovered major problems with the maintenance of the ship's potable water tanks and bunkering system. 

The most disgusting findings were the discovery of "numerous food safety violations" where the ship's American Cruise Ferries Caribbean Fantasystaff used storage lockers to improper store food and galley equipment and utensils.  CDC inspectors found "pests" in the storage lockers which started to be cleaned only during the CDC inspection. 

The CDC found a refrigerator out of order, an oven in the galley out of order, a door to another oven broken, and a dishwasher broken.

Among other disgusting findings by the CDC:

"Multiple condiments and salt and pepper shakers stored among soiled pots and pans."

"Numerous large plastic containers, pots, pans, baking sheets, and coffee carafes were stored as clean but still soiled with food remnants."

"Different sizes of live nymph cockroaches were under the shelves where galley equipment was stored."

Pest management receiving logs had prefilled comments, including "All deliveries free of infestation."

Some "rat guards were not installed."

You can read the report here.  

Earlier this week, we mentioned that the Centers for Disease Control Prevention (CDC), as past of its Vessel Sanitation Program, gave failing scores to two cruise ships following inspections this summer. The cruise ships involved were Regent's Seven Seas Navigator and Un-Cruise Adventures' Safari Endeavour. Both ship flunked the CDC's sanitation inspections.

The Seven Seas Navigator scored a 79 and the Safari Endeavour scored a 81.

These dismal scores of supposedly luxury lines come at a time when the Silver Shadow failed in a highly publicized and spectacular fashion when the CDC caught the crew hiding 15 trolleys of meat, fish, cheese and other perishable items in crew quarters this summer. The CDC concluded that the Silver Shadow intentionally hid food outside of the galley as part of a scheme to obtain high CDC inspection scores.       

Time for the CDC to shut some of these dirty cruise ships down.

 

Photo Credit: acento.com.do

Two More Cruise Ships Flunk CDC Food Sanitation Inspections

Navigator Seven Seas Navigator Cruise ShipThe Centers for Disease Control Prevention (Vessel Sanitation Program) has given failing scores to two cruise ships following inspections this summer.  

The Regent's Seven Seas Navigator and Un-Cruise Adventures' Safari Endeavour flunked the CDC's sanitation inspections. 

Regent's Seven Seas Navigator scored a dismal score of 79.  You can read the report here.  

The Safari Endeavour scored a failing score of 81.  You can read the report here.

These failed scores are even worse than the humiliating failure of the Silver Shadow.

The CDC caught the Silver Shadow cruise ship hiding trolleys of meat, fish, cheese and other perishable items in crew quarters this summer after a surprise inspection. 

Silver Shadow Sanitation Scandal: Silversea Cruises Finally Speaks, But is It the Truth?

The cover up is always worse than the crime, the saying goes.

When we first contacted SilverSea Cruises earlier this month, we asked the cruise line for an explanation regarding the Silver Shadow's failed CDC sanitation inspection. This was before the CDC report was issued and before the CNN story aired. We specifically asked for a comment about the tactic of hiding food and pot & pans in the crew quarters, which we learned from a number of different Silversea crew members.

We received no response, of course, just like crew members who had directly notified senior Silversea management ashore of the unsanitary ship practices long before contacting the CDC in frustration.    

Silversea's first public response was rather tepid, indicating only that that the cruise line was Silver Shadow - Silver Shadow CDC"disappointed" in the failed score. But Silversea offered neither an apology nor an explanation regarding who ordered the food and galley equipment to be hidden in the cabins or what steps it took in respond to the serious violations of the USPH standards and the public's trust. 

It was not until CNN aired a special program about the mess aboard the Silver Shadow (watch video here), did Silversea finally release more detailed statements on its Facebook page about what happened.  

Are these statements truthful? Was this really just an isolated event, or part of an ongoing systemic scheme to trick the USPH inspectors?   

Let's consider a couple of Silversea's claims:

The cruise lines says:

"Silversea Cruises has fully investigated this matter and the accusations of a previous crew member."

Is the public to believe that only one single former crew made the accusation which resulted in the verification by the CDC that food and galley equipment from fifteen trolleys were hidden in several cabins shared by 10 crew members?

Before we first broke the story two weeks ago, we had communicated with several crew members who informed us that the "hide & seek' games were widespread, not only on the Silver Shadow but other Silversea cruise ships as well. Some crew members showed us emails sent to the upper management complaining abut the situation long before the CDC inspection. After the CNN took the story to an international audience, additional crew members contacted us and verified the complaints. And remember, the Silversea crew member interviewed by CNN is not one of the crew members who first contacted us or reported the disgusting circumstances to the CDC in the first place.    

The cruise line also says: 

"The unannounced inspection on June 17 occurred at the end of the breakfast period where pots, pans and utensils were on working stations and items to return to the galleys were on Shilver Shadow Cruise Ship CDCtrolleys as were stores from the fridges ready for use. It is clear that when the galley staff heard that inspectors were on board, instead of continuing their work in the understanding that they were in the middle of a meal service, they tried to quickly remove all trolleys and any items not in the fridges and place them in cabins out of the way."

This is an absolutely fantastic claim. Silversea blames the galley cooks for deciding to hide the food without any instructions from their supervisors?  We know this to be untrue based upon what both low level crew members and managers tell us.

Silversea's tactic of throwing the lowest level ship employee under the bus reveals that instead of being transparent, the cruise line chose to bamboozle the public.  Isn't this exactly what got Slversea in trouble in the first place?

One other thing to keep in mind is that the photographs which CNN aired (and which are on our Facebook page) were taken by several different Silversea crew members on various occasions in 2012 and early 2013. They are not photos of the failed inspection in June 2013.  

After the crew members sent the photos to the CDC this year, a CDC epidemiologist thanked the crew members and wrote:

"The pictures and information you provided were very accurate and reflected what was seen and experienced by the inspectors yesterday on the ship . . ."    

If photographs taken in 2012 accurately reflect what the CDC inspectors discovered 6 to 12 months later, the unsanitary practices clearly date back at least a year.

Silversea wants you to believe that just a few panicked cooks took it on themselves to push fifteen large trolleys out of the galley, through the hallways, down the elevator, and hid food under bunk beds in the bowels of the ship without any order to so so. Do you believe that this was just a secret, spontaneous, isolated event?

Other crew members obviously witnessed this circus parade of food and cutlery and pots & pans clanking on trolleys which rumbled through the hallways.  And security officers and guards could not help but to observe this Silversea Cruises Silver Shadow CDCspectacle which was captured on closed circuit television cameras throughout the ship. This was no aberration; this was business as usual.   

I just returned from Washington D.C. where I attended the eighth Congressional hearing about the cruise industry since 2005. This hearing was called for by Senator Rockefeller who has studied the industry and judged it not to be trustworthy of cruise passenger safety.  

For the first seven hearings, I watched and listened to the cruise lines executives say that crime is rare and the lines transparently report all crimes committed against passengers. But Senator Rockefeller is no fool. He issued a report at this latest hearing which revealed that only 3% of crimes on cruise ships are reported to the public. 97% of cruise ship crimes are hidden. 

Hiding food and galley items in crew member cabins may seem unbelievable to the American public, but as many crew members may tell you, it's a part of "ship life."  And lying when caught is another part of a cruise line culture which has never been broken.    

 

Photo Credit:

Top - Wikimedia / Petey21

Middle and bottom - Silversea crew members 

CNN Covers Silver Shadow Cover Up of Nasty Sanitation Practices - While Silversea Cruises Refuses to Talk

Yesterday CNN aired a special program about the "hide and seek" games which crew members were ordered to play on the Silver Shadow cruise ship, where the ship routinely hid trolleys of food items in crew members cabins to avoid detection by sanitation inspectors of the U.S. Public Health Department.

Our little blog was the first to cover the story ten days ago in our article Silver Shadow Fails Sanitation Inspection After Caught Hiding Filthy Conditions from Health Inspectors

You can see the photos of the cruise line's filthy practice on our Facebook page here.

Silver Shadow Silversea Cruises SanitationBefore we published our article, we contacted several people at Silversea Cruises to discuss the matter but no one would respond.  Its seems like the cruise line thought it could just ignore the problem and it would go away. Quite frankly this is the holier-than-thou attitude of many cruise lines which think that they can do anything with impunity.

The story was mentioned extensively not only on CNN, but is being discussed on other networks (Peter Greenberg was talking about the issue on CBS this morning) as well as being mentioned in newspapers and online travel travel boards. 

The comments to the CNN article are spilling over from Silversea Cruises to the cruise industry at large.

The story comes at a key time while the Senate debates enacting legislation to more aggressively regulate the cruise industry. Yesterday Senator Rockefeller convened a hearing where he announced that he is enacting legislation to provide consumers greater protection while on cruise ships. 

Watch the video below.  Its disappointing to see that the cruise line faced no real consequence after the CDC caught it intentionally gaming the system. Remember it was crew members who exposed the cover up, not the CDC by itself. And the CDC really didn't do anything except tell the cruise ship not to do it again.

Why wasn't the ship detained in port?  Why wasn't the cruise line fined?

 

CDC Releases Report on Silver Shadow's Disgusting Sanitation Problems

Last week we published an article that Silversea supervisors forced crew members aboard the Silver Shadow to hide trolleys of food in the crew quarters to avoid detection by USPH inspectors: Silver Shadow Fails Sanitation Inspection After Caught Hiding Filthy Conditions from Health Inspectors

Today the Centers for Disease Control (CDC) published its report.

It's damning to Silver Shadow's sanitation practices. Quite frankly, it's worse than I expected. The final score is 82 (it was initially 84). Here's a portion of the report:

Silver Shadow Sanitation CDCSite: Other-Galley Crew Cabins

Violation: An organized effort was made to physically remove over 15 full trolleys of dry foods, spices, canned foods, cooked foods, milk, raw meats, pasteurized eggs, cheeses of all types, baking goods, raw fruits, raw vegetables, and a variety of both hand held and counter model food equipment, pans, dishware and utensils to over 10 individual cabins shared by two or three galley crew members in order to avoid inspection by VSP staff. All the out of temperature potentially hazardous foods were discarded along with most other foods that were not canned or in original containers. The lead VSP inspector poured concentrated chlorine liquid over all the discarded foods as they were dumped into garbage bags to ensure they would not be used again

You can read the report here.

The report contains no photos, but you can see some of the photos we posted last week on our Facebook page.

We also asked crew members from other cruise lines whether cruise ships playing "hide and seek" from the USPH is a common practice in the cruise industry.  Its not a scientific poll, but around 90% of crew members said "yes."  Take a look here.

On Wednesday, Senator Rockefeller oversees another Senate hearing into whether cruise passengers need greater protection from the cruise industry's bad consumer practices.  I'm sure this issue will come up.  I look forward to hearing the cruise industry's response.

 

Silversea Cruises Sanitation Failure: How Many Cruise Lines Play Games with USPH Inspectors?

Last Monday I published an article about the U.S. Centers for Disease Control & Prevention (CDC) failing the Silver Shadow cruise ship following a surprise inspection last month when the ship was calling on Skagway, Alaska. The article is entitled: Silver Shadow Fails Sanitation Inspection After Caught Hiding Filthy Conditions from Health Inspectors

Former Silversea Cruises employees contacted me earlier this year and complained that they were ordered to take trolleys of pots and pans, cutlery and food items from the galley and hide them away from the U.S. public health inspectors in the crew cabins and hallways. We told them to report this practice to the CDC which later boarded, inspected and flunked the Silver Shadow. 

The reaction to the story has been mixed. Passengers who learned of the failed score and the alleged CDC Inspection - Silver Shadow Cruise Ship"hide and seek" tactics of the cruise ship appear to be upset not only with the unsanitary practice but with what they characterize as dishonesty and a lack of transparency by the cruise line. You can see this sentiment in a series of comments on the popular Cruise Critic boards.

Silversea will not respond to inquiries from our firm, but suggests in a PR statement it released that the incident is an aberration, pointing out that the scores on its previous inspections throughout its small fleet of cruise ships have been in the high 90"s and it also recently scored a perfect 100.

This argument, in my opinion at least, seems to be no different than a student caught cheating on a test who defends his failed score by pointing out that he received straight A's on all of the previous tests. The student's dishonesty is surpassed only by his disingenuity.   

The other reaction to the story is that this is "business as usual." This sentiment is being expressed by crew members. We have heard from crew members over the last 20 years who have told us of similar stories of the lengths to which some cruise lines go to obtain a passing USPH score. The comments to our article on Facebook, by crew members at least, are to the effect that this practice is wide spread on other cruise ships. It was back luck that Silversea got caught.

You can see similar comments by crew members about how cruise lines cheat on USPH inspections which were posted to a similar story I wrote in December. 

My Cruise Law News Facebook page has over 60,000 followers, and the majority are crew members from all over the world.  The consensus seems to be that all cruise lines engage in this practice to one extent or the other. I'd like to flush this issue out further. So I will post a simple question on my Facebook page:

Do cruise lines hide pots & pans, galley equipment and food from USPH inspectors?  You can click on the link and see what the crew members have to say about the issue.

Whereas passengers may be disgusted by this practice, I suspect that most crew members will yawn and say that this is business as usual.

July 22, 2013 Update:  CDC just released its official report. It's nasty. Here's our article.  You can read the official CDC report here.

CDC Failed Inspection - Silver Shadow

 

Photo Credit:  Former Silver Shadow crew member.

Silver Shadow Fails Sanitation Inspection After Caught Hiding Filthy Conditions from Health Inspectors

Last December, I wrote an article about the practice of certain cruise lines which hide dirty pots & pans and cooking equipment from U.S. health inspectors. The article, which focused on the MSC Poesia, is entitled "Hide & Seek" - Cruise Lines Play Games With USPH Inspectors.

After I published that article, several former crew members from Silversea Cruises left comments alleging that the Silver Shadow also played "hide and seek," concealing food and galley items in crew hallways and cabins, away from the sanitation inspectors in the galley.

The Centers for Disease Control and Prevention (CDC) Vessel Sanitation Program (VSP) conducted a surprise inspection of the Silver Shadow on June 17th while it was in a port in Skagway, Alaska. The inspectors found the food and galley equipment in crew quarters as described by the former Silversea ship employees.  The CDC flunked the cruise line, issuing a score of 84. 

Silversea Silver Shadow Sanitation CDCThe inspection occurred after former Silversea Cruises' crew members contacted our office and, in turn, complained to the CDC about disgusting conditions aboard the Silver Shadow cruise ship.

The crew members complained that the cruise line forced the crew to hide food, cooking utensils, cutlery, and pots and pans in their cabins to avoid detection by U.S. health inspectors.

Crew members aboard the Silver Shadow allege that were forced to store raw meat, salami, fish, cakes, and every kind of culinary preparations in their cabins and remote hallways to avoid inspections by the U.S. Public Health (USPH). The crew members claim that they had to sleep with the food and galley items in cabins with no windows or operational air conditioning. According to crew members, some spoilable food items were kept out of the refrigerator in cabins and hallways but were served the following day to the cruise passengers. 

Other complaints included the alleged use of out-of-date ingredients which were served to the guests, according to the former crew members. The crew also complained that they were forced to Silversea Silver Shadow Cruise Shiphide food infested by flies and insects in cabins where the toilet flush was out of order for days.

We received photographs (above and below) from the crew members which they state were also sent to the CDC. You can see additional photographs on our Facebook page.  

An epidemiologist at the CDC thanked the crew members for the information, writing: "The pictures and information you provided were very accurate and reflected what was seen and experienced by the inspectors yesterday on the ship . . . Thank you for passing along all of this information and protecting the health of passengers and crew on the ship. We appreciate your help!"  

Although the failed inspection occurred one month ago, the CDC has still not posted the failed score or its report of the inspection on its internet site.  

Silversea Cruises holds itself out to the public as a premiere "ultra-luxury" cruise line and charges correspondingly high fares to its cruise passengers.

One former crew member stated that the crew on the Silver Shadow were forced to use tap water to top off expensive bottled water.  

These claims are similar to the allegations in a lawsuit filed by a Silversea crew member (aboard the Silver Spirit and Silver Wind) in 2011 that his employment as a bartender was terminated after he complained that crew members were required to fill expensive, premium top-shelf brand liquor bottles with cheaper brands and to fill empty expensive French champagne bottles with cheaper Italian sparkling wines. The case is Marin Asenov v. Silversea Cruises, Ltd., Case No. 0:11 CV 62360 WJZ. You can read the allegations in the lawsuit here

The Silver Shadow cruise ship has always scored high on the CDC's Vessel Sanitation Program. Its scores have ranged from 92 to 99 (out of 100) since 2000.  

This latest news brings into question whether the Silver Shadow's high scores over the years may have been a result of the cruise line playing hide and seek with the sanitation inspectors at the USPH.

We reached out to Silversea Cruises and asked for the cruise line's comments about the failed inspection. We have not received a response. 

Have a thought about this issue? Please leave a comment below or join the discussion on our Facebook page.  

July 17, 2013 Update: Silversea Cruises just issued this PR statement which was posted on the Cruise Critic site:

Silversea Cruises Statement

On June 17, Silversea’s Silver Shadow received an atypical score of 84 during the Vessel Sanitation Program (VSP) inspection in Skagway. Silver Shadow has scored in the high 90s on its previous VSP inspections where the maximum achievable score is 100. Silversea is deeply disappointed by this specific and only unsatisfactory score and has taken immediate measures to address the issues identified in the inspection report.

The company takes very seriously its responsibility to maintain the highest standards in all areas of its operations. Silversea has an excellent track record when it comes to sanitation, which can be verified on the CDC's website. Silversea ships have achieved perfect scores of 100 on several VSP inspections, including Silver Spirit's most recent inspection in April, which is testament to the company's commitment in this area.

Following a thorough review of Silver Shadow's procedures, we have taken the necessary measures to ensure that the standards are the best in the industry. All Silversea ships have comprehensive policies and rigorous training programs in place to make certain its staff and crew implement best practices to ensure shipboard safety. Silversea is sincerely sorry for the shortcomings in Silver Shadow's evaluation and is committed to ensuring that future inspections result in higher scores in line with the usual Silversea standards.

Saul Fonseca | Area Sales Director

July 21, 2013 Update:  Read our article:

How Many Cruise Lines Play Games with USPH Inspectors? 

And don't miss the results of our Facebook poll: Do cruise lines hide pots & pans, galley equipment and food from USPH inspectors?

Of the first 100 crew members who answered the poll (admittedly unscientific), around 90% said yes, cruise lines hide galley items from inspectors. One crew member said: "There will be more equipment in the crew cabin during the inspection then in the galley that's for sure!!!" 

July 22, 2013 Update:  The CDC finally released its report on the failed Silver Shadow inspection. Here is our article.  You view the official CDC report, click here.

Silversea Silver Shadow CDC Vessel Sanitation Inspection

The Cruise G.I. Blues: Why We Don't Handle Gastrointestinal Virus Cases

The last several articles on this blog have involved gastrointestinal (G.I.) virus outbreaks on cruise ships.

The cruise ships involved are Holland American Lines’ Volendam and Veendam, (HAL ships, historically, are the most likely to be contaminated with norovirus), the Discovery cruise ship which was held up in Liverpool for what the cruise lines describe as “enhanced cleaning,” and most recently the Celebrity Millennium which arrived in Alaska with a bunch of sick passengers who went ashore and coughed all over the city of Seward.

These ships join the list of other sick cruise ships this year. There are seven official reports of Cruise Ship NorovirusG.I. cases so far this year documented by the U.S. Centers for Disease Control and Prevention (CDC). But the list is incomplete. The CDC requires cruise lines to report outbreaks only when a certain percentage (more than 3%) of the passengers become ill. If the cruise ship does not call upon a U.S. port, then the CDC has no jurisdiction and there is no obligation to report any G.I. cases to the U.S. federal government.

Most countries around the world don't require reporting of cruise G.I. cases. So when you read the CDC database of G.I. outbreaks on cruise ships, remember that this is only those cruises which dock at a U.S. port and where at least 3% of the passenger report to the infirmary.

My partners at my law firm ask me why I blog about G.I. cases because our firm rarely handles such cases. Why don’t we handle G.I. cases? For a couple of reasons:

It is usually impossible to prove where the virus originated. The CDC and the Food and Drug Administration (FDA) concluded long ago that most norovirus outbreaks are due to contaminated food and water. No, not due to the dirty hands of the cruise passengers as the cruise lines want you to believe, but noro-laden food or contaminated water.

But general propositions are no help in a particular case. The CDC makes no real effort to pinpoint the epicenter of the outbreak on the cruise ship.

The CDC usually can figure out the causative agent (i.e., noro, e-coli, etc.) but that’s where the federal agency’s inquiry ends. The CDC has but a few hours to board the cruise ship and conduct its Cruise Ship Norovirusinvestigation once the ship returns to a U.S port. It does not have the time or the resources to perform a full blown epidemiology assessment during the limited time the ship is in port.

Was the water well used to irrigate the potatoes or lettuce which were loaded onto the cruise ship contaminated by noro-infected swine feces that leeched into the well supplies? You will never know because no one is doing any investigation to find out.

The cruise lines don’t want such sophisticated analysis either, because the most likely cause of norovirus outbreaks is not bad passenger hygiene but contaminated food and water. It’s bad for cruise business for an official U.S. agency to point the finger at contaminated water or infected food, or to conclude that food handlers worked while infected with noro and, in turn, contaminated 150 plates of salad consumed by the passengers.

Illnesses due to e-coli or norovirus are nasty. You’re afraid that you are going to die and then you’re afraid that you’re not going to die, the joke goes. But it’s no joke. Sick passengers do die, particularly elderly passengers with suppressed immune system and especially those who are ignored by the ship doctors or those who receive bad care while on the cruise ship.

The rights of ill or dying passenger infected with norovirus on cruise ships are limited. The Death on the High Seas Act (DOHSA) prohibits the recovery of damages for elderly retirees. Their deaths are financially meaningless if they become sick during a cruise and then later die either on or off of the cruise ship. Cruise lines love DOHSA. Also, sick passengers who receive bad medical care by the ship doctors usually have no recourse against the cruise lines because the ship doctors are legally considered to be “independent contractors” for whom the cruise lines have no responsibility. And neither the cruise lines nor the CDC or FDA are trying to find out where the norovirus came from in the first place.

Cruise lines are cutting back on the testing of water, placing increasing demands on its crew members who often work while sick, hiding dirty galley equipment from CDC inspectors, and pushing their ships and staff past reasonable limits leaving little time and resources to maintain a clean and hygienic environment. 

Cruise Ship NorovirusIt’s easier for the cruise lines to blame the passengers for poor hygiene and then stand behind the CDC’s and FDA’s indifference and archaic laws like DOHSA which have insulated the cruise industry from the consequences of their negligence and recklessness for decades.

In a nutshell, we don’t handle G.I. virus cases because the deck is stacked against the cruise passenger. Cruise passengers typically don’t know when they board a noro-infected ship that they have few rights and that the cruise line will blame them if they get sick. We blog about the problem because it is an insight into the way which the cruise industry operates its business and treats its customers.

The cruise lines say that the “health and safety of cruise passengers are its highest priorities.” That’s not true. We prefer that the cruise passengers understand that before they walk up the gangway into a noro-contaminated ship.

Carnival Fascination Cruise Ship Flunks Health and Sanitation Inspection

A Carnival cruise ship has become the sixth cruise ship this year to flunk a sanitation inspection by the Centers for Disease Control and Prevention (CDC).

The Carnival Fascination failed the surprise inspection with a score of only 84. You can read the report from the CDC here.  It's full of dirty and unsanitary conditions in the galley and food serving areas, as well as problems with the recreational water supplies.

The Fascination had a problem which we are hearing about more often, that is when crew members are experiencing acute gastrointestinal illness but keep working. This substantially increases the Carnival Fascination Cruise Shipchances that they will infect other crew members and the passengers that they come into contact with. The problem is particularly critical when the infected crew are food handlers. 

Five other cruise ships have failed CDC inspections this year.

Two weeks ago we wrote about the Celebrity Summit, the Golden Princess, the Sea Dream Yacht Club's Sea Dream, and the Caribbean Fantasy operated by America Cruise Ferries all of which flunked the CDC inspections. You can read our article: Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections

A week ago, we wrote about another Celebrity Cruises ship, the Celebrity Century, which also failed the inspection.

Read the U.K.'s Daily Mail article:  Carnival Fascination Fails Health Inspection After Dead Flies, Leaking Brown Material and Cockroach 'Nymph' Found on Board

 

Photo Credit: Wikipedia / Jonathan Schilling

Report of Gastrointestinal Sickness Outbreak on Celebrity Infinity Disappears: Honest Mistake or Diabolical Cover-Up?

Those of you who read this blog regularly know that I find lots of information about things that the cruise lines would prefer you not know on Professor Ross Klein's website called CruiseJunkie.com.  A silly name I know, but the information is quite serious if you are interested in accurate information about cruise passengers and crew who disappear under mysterious circumstances, fires and collisions, and disease outbreaks on the high seas.  There is no other credible website like this anywhere which tracks such information in the cruise industry. 

Yesterday Professor Klein's website contained information about a gastrointestinal illness (GI) outbreak aboard the Celebrity Infinity cruise ship. He linked to the CDC Vessel Sanitation website which contained a report that 101 of 2086 passengers (4.84%) and 17 of 927 crew (2.05%) have reported ill Celebrity Infinity Cruise Shipwith gastrointestinal illness. Two CDC Vessel Sanitation Program environmental health officers and an epidemiologist boarded the ship on arrival in Fort Lauderdale on April 1, 2013 to conduct a targeted environmental health assessment and evaluate the outbreak and response activities. 

But when I clicked on the link to the CDC information, the website said:

"The page you requested cannot be found at this time. It may be temporarily unavailable or it may have been removed."

So what happened?  I don't know. 

Professor Klein questions whether this is a mistake of some sort or whether there is a cover-up at play.

Again I don't know. But I do know after being a lawyer for 30 years that there is a very cozy relationship between the cruise lines and federal agencies like the CDC whose surprise inspections are hardly a surprise. And last year it became obvious that after Congress passed a law requiring the cruise lines to report crimes to the FBI which had to post the data on a Coast Guard website for the public to view, these federal agencies worked behind the scenes with the cruise lines to cover the crime statistics up.  

So what's up with the CDC posting a GI outbreak and then the information disappearing?

Celebrity has had difficulties with its shipboard sanitation this year with the Summit and the Century failing CDC inspections for health and sanitation.  

Is the removal of the report of the outbreak aboard the Celebrity Infinity a mistake or is something else more sinister going on?

I'd like to hear from passengers and crew members whether there was a recent gastrointestinal illness or norovirus outbreak on the Celebrity Infinity?  Please let us know.

Am I being overly-suspicious? Maybe so. But I'd rather be paranoid than a naive sap who looks the other way while another federal agency and a cruise line play games behind the public's back.

April 7 2013 9:30 PM: The CDC report on the Celebrity Infinity has reappeared. Here it is.  Celebrity Cruises has the dubious distinction of 2 failed CDC inspections and a GI outbreak for 2013.

 

 

Photo Credit: Celebrity Infinity  - Wikipedia / Yankeesman312

Another Celebrity Cruise Ship Flunks Health & Sanitation Inspection

Celebrity Century Cruise Ship - Failed CDC ScoreAccording to the Centers for Disease Control and Prevention (CDC), another Celebrity Cruises ship flunked a surprise inspection.

The Celebrity Century failed the CDC inspection, receiving a score of only 78.

Last week we reported that another Celebrity cruise ship, the Summit scored, flunked an inspection with a score of only 81. Three other cruise ships received failing scores as well.  So far this year there have been five cruise ships with failing grades. Read our article: Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections.

The most disturbing finding was not just that the Century was dirty with contaminated food debris, but that crew members worked while ill with gastrointestinal sicknesses. Several of the ill ship employees worked in the galleys or interacted with passengers while ill.  The other cruise ships who flunked the inspections earlier this year also had ill crew members who worked with food and around passengers as well.  

These findings are significant because the cruise lines always blame the passengers when there are norovirus outbreaks and accuse the quests of not washing their hands.  The outbreaks may be due to ill employees who may be contaminating the food and infecting passengers.  

Celebrity Cruise Ship - Failed CDC ScoreYou can read the report of the Century here

The report indicates that two cruise ship cook worked while ill before reporting to the ship's medical infirmary.  A sick hair stylist worked all day around passengers before going to the medical center. And an ill gift shop attendant worked before going to the medical center and continued working after he was suppose to be in isolation.

A particularly disgusting finding was that the toilet intended for galley workers was found locked when the galley was in service, and when the inspectors opened the door, the bathroom had no toilet paper.

And you wonder why there are norovirus outbreaks on cruise ships?

Leave a comment below or join the discussion on our Facebook page.

 

Photo Credit: Celebrity Century Cruise Ship - Wikipedia / Emesbe

Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections

Centers for Disease Control - Cruise Ship CDC Cruise Critic is reporting that three cruise ships recently failed inspection by the Centers for Disease Control and Prevention (CDC).

The cruise ships are the Celebrity Summit, Princess Cruises' Golden Princess and the SeaDream II.  

Take a moment and read the actual CDC reports of these ships. They are disgusting.

You can understand how easily norovirus and other gastrointestinal viruses can spread after reading about cooks and food handlers working while they are suffering from acute gastrointestinal symptoms. The monitoring of water treatment on some of these cruise ships is spotty and there was even one ship using a reverse osmosis system (which is suppose to be used only when the ship is underway) that was sucking up nasty water in the ports.    

The report for the Celebrity Summit is here. You will read about several crew members, including food handlers, who were suffering from acute gastrointestinal (referred to as AGE) symptoms but were still working, including handling food. The gastrointestinal surveillance logs were not being completed. There were widespread dirty and greasy conditions with flies and insect droppings in the bars and galleys.

The report for the Golden Princess is here. The Princess Cruises ship also had crew members with acute gastrointestinal symptoms continuing to work throughout the day even though they were Celebrity Summit Cruise Shipobviously ill in the morning.  An assistant buffet steward was suffering from GI problems but worked the buffet from 9:30 Am and did not report to the ship infirmary until 4:00 PM. There were inadequate reports regarding potable water facilities.  The ship had dirty and soiled areas, including the signature Princess restaurant Sabatini's.        

The report for the Sea Dream Yacht Club's Sea Dream II is here. This is the ship that was operating its water system continuously, including at port, and had been doing so for years. There were also dirty and unsanitary conditions noted.

The next time there is a norovirus outbreak and the cruise line instantaneously blames the passengers for not washing their hands, there may be a lot more to the story.

March 27, 2013 Update: In reading cruise expert Professor Ross Klein's website, I realized that Cruise Critic omitted another failed CDC score by the Caribbean Fantasy operated by America Cruise Ferries. You can read the report here. The deficiencies include failing to maintain acute gastrointestinal sickness logs, potable water deficiencies, galley and potwash cleaning shortcomings, and the failure to maintain cleaning equipment in proper order including several dish-washing machines and conveyors which had been not in proper condition for over a year. 

 

Photo Credit:

Celebrity Summit - Wikipedia / Yankeesman312

Norovirus Outbreak on Rhapsody of the Seas in Fiji - Cruise Ship Quarantined

Cruise Norovirus - Rhapsody of the SeasThe Fiji Broadcasting Corporation (FBC) reports that a Royal Caribbean cruise ship berthed at the Suva Wharf in Fiji was quarantined today by authorities following what is described as an outbreak of norovirus. The Health Ministry in Fiji reportedly confirmed 51 cases of the contagious virus on board the Rhapsody of the Seas which is carrying around 2300 passengers and 870 crew.

The FBC states that affected passengers have been isolated and no one is allowed to enter the quarantined area on the ship except the medical response team. 

The cruise ship will leave Fiji for Noumea, New Caledonia later tonight.

Because this outbreak occurred on a cruise ship which did not call on a U.S. port, it will not be reported to the Centers for Disease Control (CDC).

You can get norovirus from an infected person, contaminated food or water, or by touching contaminated surfaces.

The Rhapsody of the Seas experienced a norovirus outbreak the last week of August when 53 of 2,129 passengers (7.19%) experienced vomiting and diarrhea.

October 31, 2012 Update: Cruise ship under quarantine leaves Fiji.

Small Cruise Ship Sanitation Blues: Grand Mariner Flunks the Fed's Galley Inspection

Cruise Ship SanitationCruise Critic reports today that just one month after HAL's Veendam flunked an inspection by the Centers for Disease Control (CDC), the Blount Small Ship Adventures Grand Mariner's 100 passenger cruise ship also failed a CDC inspection: 

"Moldy ice-cubes, inadequate monitoring of food temperatures, raw meat stored with nonmeat items, ingredient containers left open, dirty dish-washing sinks" and 31 other violations earned the ship the failing score of 75 out of 100.

Wow.  Sounds like the kitchen in my college apartment.  And people pay money to cruise and eat on these ships? 

HAL's Veendam Flunks Health Inspection

Below is a CNN video regarding the 16 year old Holland America Line's Veendam cruise ship which failed an inspection conducted by the Centers for Disease Control.

We blogged about this incident last week in our article:

"Gross! Holland America Line's Veendam Flunks Health Inspection."

CNN described the ship conditions as "really gross:"

 

 

Gross! Holland America Line's Veendam Flunks Health Inspection

Dirty Cruise Ship - CDC - Failed InspectionFlies. Dirty and malfunctioning ice machines, refrigerators & dishwashers. More flies. Dust, dirt, food residue, and debris. Flies and more flies. Flies where food is prepared. Flies where food is stored. Ugh. These unsanitary problems are part of a ridiculously long list that the U.S. Centers for Disease documented during a surprise inspection last month aboard the Holland America Line's Veendam cruise ship.

You can read the gross report here.

The inside word is that most "surprise" inspections are not surprises at all.  Most of the time the cruise lines are tipped off and immense pressure is suddenly applied on the crew to bring the ship up to standards. But here, at least, there was no advance warning. And this is what you get.  

The last cruise ship to fail such an inspection was the Monarch of the Seas last December - Dirty Dishes & Fruit Flies Flourish on Royal Caribbean's Oldest Cruise Ship. That was pretty gross too. 

 

Norovirus Update: Celebrity Constellation Cruise Ship is Latest to Join List of Sick Ships

A number of cruisers have been contacting our office asking about a sickness outbreak aboard the Celebrity Cruises' Constellation cruise ship. 

The Centers for Disease Control ("CDC") officially placed the Constellation on its vessel sanitation list of ships with sickness.  The Constellation sailed on January 28th from Fort Lauderdale and returned yesterday, February 11th. 

95 out of 1,992 passengers reported being ill during the voyage (4.77%).  12 crewmembers reported being ill. The sick passengers and crew reported symptoms of vomiting and diarrhea.

Only cruise lines calling on U.S. ports are required to report disease outbreaks to the CDC.  Cruise Celebrity Cruises' Constellation Cruise Ship - Norovirus?lines are required to make the report only when 3% or more of passengers or crew reported symptoms of diarrheal disease to the ships medical staff during the voyage.  Under-reporting occurs regularly because many passengers can't make it away from their toilets due to diarrhea, and some passengers don't want to be confined to their cabins. 

This is the fifth "official" cruise ship sickness outbreak which has found its way onto the CDC database which lists the Celebrity Silhouette, Celebrity Constellation, Royal Caribbean Voyager of the Seas, Princess Cruises' Crown Princess and P & O Cruises Aurora cruse ships.  The CDC data does not include the outbreak on Princess Cruises' Ruby Princess, which we reported on last week

The CDC has confirmed norovirus only on the Crown Princess and Aurora.  It is disappointing that the CDC can't figure out the type of disease on the other ships.  In no cases did the CDC pin-point the cause of the outbreak, to either a virus brought on the cruise ships by a passenger, or unsanitary handling of food by a crew, or infected food and/or water.  If the CDC can't figure out how the outbreak occurred, it seems hard to respond to the problem and eradicate the causative factors.

There has been a lot of criticism on how Celebrity Cruises handled the latest outbreak on the Silhouette.  You can read the comments by passengers here.   

How did Celebrity Cruises handle the outbreak on the Constellation?  If you were on the cruise, please leave her comments below, pro or con.

November 5, 2012 Update:

News sources are reporting that the Constellation suffered another outbreak of norovirus, this time during a 12 day cruise which just returned to Southampton.  BBC reports that 350 passengers became ill with vomiting and nausea. Read our article: Cruise Puke Fest: Norovirus Strikes Celebrity Constellation. if you were ill on that cruise please leave a comment at the end of that article.    

 

Photo credit:  Getty

Dirty Dishes & Fruit Flies Flourish on Royal Caribbean's Oldest Cruise Ship

Cruise Ship - Centers for Disease Control - CDCIn a story widely reported in the national media, the Centers for Disease Control failed Royal Caribbean's Monarch of the Seas after conducting a surprise vessel sanitation inspection last month. 

On November 18, 2011, CDC inspectors boarded the Monarch of the Seas, which is the cruise line's oldest vessel, and found numerous public health risks and violations if the CDC's sanitary standards.

The popular online cruise community, Cruise Critic, first reported on the nasty situation, followed by the USA Today cruise blog, CruiseLog.  

The CDC found a whopping 43 unsanitary conditions and "deficiencies" in the cruise ship's procedures which were in violation of the CDC's Vessel Safety Program (VSP) manual.  Included in the report were the following:

  • Dish-washing equipment in poor condition;
  • Improper cooling temperatures for stored provisions;
  • Improper cooking temperatures for cooked food;
  • Accumulations of food debris in wash and rinse areas;
  • "Clean" plates soiled with food residue;
  • Soiled plates stacked with clean plates;
  • Waiter stations, food preparation counters, slicers, and strainers soiled with dirt and food particles;
  • Live and dead fruit flies on food preperation surfaces throughout the galley; and 
  • Improper procedures for public toilets, shower-head disinfection, and disease outbreak and prevention.   

You can read the complete inspection report here

Cruise Ship Fruit FliesIt is rare for a cruise ship based in the U.S. to fail a CDC inspection.

For a cruise line which spent billions on its gigantic new Genesis class cruise ships the Oasis and the Allure of the Seas, it looks like its oldest cruise the Monarch is showing significant signs of neglect which risk sickening its passengers. 

Anyone who sailed recently on the Monarch care to leave a comment?  

Photo credit: amNY Photo Illustration

 

CruiseLog's Article on Cruise Ship Sickness Misses the Boat

The popular cruise blog written by Gene Sloan for the USA Today newspaper published an article yesterday entitled "Outbreaks of Illness on Cruise Ships at Multiyear Low."

CruiseLog cites statistics from the U.S. Centers for Disease Control ("CDC") of 11 outbreaks of illnesses so far in 2011, down from 14 in 2010 and 15 in 2009.  It concludes that this reflects a "downward trend that began several years ago as the industry increased prevention efforts."

But looking at the data at the CDC website, you can see that the "trend" is actually flat, with 14 to 15  outbreaks reported to the CDC for each the past 3 years (2008, 2009 and 2010).  This year will probably end up with the same number of reported incidents.

There has been an additional outbreak reported to the CDC just since the CruiseLog article was published yesterday.  HAL's Ryndam cruise ship has reported that more than 5% of its passengers reported to the ship's infirmary complaining of vomiting and diarrhea. You can read Cruise Ship Sicknessabout this latest outbreak here.  The cruise ship is returning to Tampa tomorrow.

Unfortunately, there seems to be an outbreak or two over the Christmas and New Year sailing somewhere each year, so we should reasonably expect there to be the usual number (14 to 15) this year as in past years.

My real criticism of the CruiseLog article is not whether the number is actually 15 versus 11.  It is that the article really doesn't explain that the cruise ship outbreaks reported to the CDC are probably less than 50% of the actual number of incidents which occur around the world each year.  Remember that cruise lines do not report sickness outbreaks to the CDC if the cruise does not call on a U.S. port.  This is significant because many cruise lines re-positioned a greater number of their cruise ships to Europe and Asia in recent years compared to five years ago

Although it is difficult to track the incidents outside of the U.S., we have reported on a number of incidents this year. 

For example, in September, norovirus broke out on Celebrity's Eclipse sailing out of Southampton, England. Royal Caribbean's cruise ships sailing out of this U.K. port remained on heightened alert for months.  You will find no mention of this is in the official CDC database.  The cruise lines certainly will never voluntarily disclose this.

In November, we reported on one death and 80 sick passengers on HAL's Veendam which Holland America Line Veendam Cruise Ship Norovirus?experienced a sickness outbreak as the cruise reached in Rio de Janeiro.  

The other issue that the CruiseLog does not explain is the cruise lines report disease outbreaks only when 3% of passengers are afflicted based on the number of ill passengers who appear in the ship infirmary.  This is significantly less than the true number of those afflicted with viral illnesses.  Many sick passengers know that they will be quarantined in their cabins or they simply do not want to wait in the long lines outside of the ship infirmary. 

The Clinical Infectious Disease Journal reported earlier this year that 40% of passengers with a viral infection did not report being sick to the ship medical staff.  If these passengers were included in the sickness count, then the number of CDC reportable cases would surely increase.   

CruiseLog also points to Carnival as not reporting a single outbreak this year.  Does that mean that Carnival has a vaccine against the cruise ship bug?  Hardly.  Consider the following comments by cruise passengers on the CruiseJunkie website about the Carnival Conquest last week:

"From a passenger: There was an outbreak of something vomiting and diarrhea starting on Tuesday of the cruise (4-11 Dec). My husband got sick on Thursday morning and was asked to stay in cabin on isolation. On Friday I came down with vomiting and diarrhea. We were told there were lots of people sick.

Another passenger writes: On our final day at sea suddenly all the crew was wearing gloves and none of the passengers were allowed to get their own plate or food at the buffet.  Everything had to Cruise Ship Norovirusbe served by the staff and they were constantly wiping down everything and making announcements about hygiene.  We asked if something was going on and we were told no however by that night 3 of the seven people in our party were very sick and once we walked in on an employee in the bathroom vomiting very badly.  A casino employee told us that night many of the crew and passengers were very sick. 

When we were getting off the boat Sunday we saw stacks and stacks of mattresses in plastic they were loading on the ship.  We still have people from our group sick and I wish we had been told something.  We received no information and since I was traveling with two children and my seventy year old father I continue to be concerned." 

Families intending to cruise and worried about norovirus should read news sources like CruiseLog with a grain of salt.  There is no empirical evidence that norovirus and other cruise ship sicknesses are on the decline. 

Regarding cruises not calling on a U.S. port, the best sources of information are anecdotal, like cruise community forums and websites not beholden to the cruise lines like Professor Ross Klein's CruiseJunkie.

Norovirus Aboard Celebrity Solstice Kills Father of Eight

Courthouse News Service reports that a lawsuit has been filed against Celebrity Cruises for the death of a father of eight after he died from incompetent medical care for norovirus he contracted during a vacation cruise aboard the Celebrity Solstice

The lawsuit alleges that Joseph Gavigan Jr., from Orleans, Massachusetts, embarked the Solstice cruise ship in January of this year in Fort Lauderdale, Florida.  During the cruise, a norovirus outbreak occurred and Mr. Gavigan contracted the illness.

The lawsuit alleges that Celebrity failed to take adequate precautions to screen passengers and crewmembers, failed to sanitize and disinfect the cruise ship and disinfect plates, cups, food trays, Joseph Gavigan Jr. - Norovirus - Celebrity Solstice Death utensils, ice machines and drinking fountains, failed to quarantine infected passengers and crewmembers and failed to warn Mr. Gavigan about the virus. 

The lawsuit also alleges that Celebrity provided negligent medical care to Mr. Gavigan, and negligently selected the cruise ship medical staff who held themselves out as agents of the cruise line.

A copy of the lawsuit is available on line and can be viewed here.  The lawsuit was filed by attorney Keith Brais, a very experienced maritime lawyer who used to be a defense lawyer for Celebrity Cruises and other cruise lines.  

The Centers for Decease Control and Prevention reports that 118 cruise passengers and 10 crewmembers reported ill during the voyage.  You can read more about the CDC's report for this voyage aboard the Solstice here.  

The popular on line community Cruise Critic contains Celebrity's official press statement about the norovirus outbreaks (which preceded Mr. Gavigan's cruise) as well as the accounts of unhappy cruisers some of whom felt that the medical staff was incompetent and the cruise line was trying to cover-up and down-play the outbreaks. 

An on line obituary indicates that Mr. Gavigan, nicknamed "Junior," is survived by 21 grandchildren and 17 great grandchildren in addition to his 8 children and companion.

 

Photo credit:  Dockray & Thomas Funeral Home

New Study Reveals Little New About Norovirus on Cruise Ships

The medical journal "Clinical Infectious Diseases" published an article entitled "Disease Transmission and Passenger Behaviors During a High Morbidity Norovirus Outbreak on a Cruise Ship, January 2009."

Of some 1842 passengers on the cruise ship, 1532 (83%) returned questionnaires provided by the researchers.  236 (15%) met the norovirus definition.  

Cruise Ship Norovirus This particular cruise had a passenger vomit in a public area during boarding, as well as 7 other incidents where passengers vomited in public.  The Centers for Disease Control ("CDC") investigators concluded that some sick passengers may have been infected by the vomit (through aerosolized vomit or by touching contaminated surfaces) or they were infected by person-to-person contact, particularly by an ill cabin mate. 

The CDC investigators also concluded that some of the public toilets on the cruise ship were out of hand soap and paper towels and dish washing machines did not do an adequate job sanitizing eating utensils.  These shortcomings might have contributed to the outbreak.

Nothing new with these conclusions.

The two interesting points in my opinion revealed in the study:

Of the 236 ill passengers, 95 (40%) did not report to the infirmary.  We have been told by many passengers on cruises plagued by norovirus that the actual number of sick passengers reported by the cruise lines to the CDC was far less than the actual number of passengers with norovirus.  Cruise lines report only the number of passengers who report to the ship infirmary.  This is a problem we have discussed before - Is Celebrity Cruises Under-Reporting Sicknesses to the CDC?

Perhaps the most interesting statistic is that 62% of ill passengers did not decrease their participation in public activities.  Over 200 passengers ill with norovirus walking around the ship?  Yuck.  This undoubtedly led to the spread of the outbreak.

But most outbreaks of norovirus on cruise ships are no so clear cut.  There appears to be no effort to scientifically determine the source of norovirus outbreaks.  

As we have reported in prior blogs,  the U.S. Food and Drug Administration (FDA) concludes that whereas "person to person" transmission of norovirus has been documented, "norwalk gastroenteritis is transmitted by the fecal-oral route via contaminated water and foods."  The FDA reports that "water is the most common source of outbreaks and may include .  .  . water stored aboard cruise ships."

When will the CDC conduct a recent study analyzing the potable water and food products after an outbreak?  Compare this study with a study by the CDC in 2002 which the CDC "suspected that initial infection among passengers on cruise 1 originated from a common food or water source and then continued to spread from person to person" and "we identified that eating breakfast at restaurant A on day 2 of the cruise was associated with illness . . ."  Or consider "Characterization of a variant strain of Norwalk virus from a food-borne outbreak of gastroenteritis on a cruise ship in Hawaii" (pin-pointing fruit at a buffet as the likely culprit).
 

Read some of our other articles about cruise ship norovirus:

Cruise Ship Norovirus - Clean the Damn Toilets!

"Cruise Ship Sickness" - Is Norovirus In The Food and Water?

Cruise Ship Norovirus - Something in the Water?

March 24, 2011 Update:  USA Today's CruiseLog has a story today about this study, indicating that the study involved Celebrity Cruises' Mercury cruise ship in January 2009.  As we pointed out in an earlier blog, the CDC investigated outbreaks on the Celebrity Mercury in  January and February 2009. 

The interesting thing about the Mercury was that it experienced four cruises a year later, in 2010, with repeated outbreaks of norovirus until the CDC took the unprecedented step of issuing a no sail order, an event we covered last March: Centers for Disease Control: "Shut Mercury Cruise Ship Down!"   It would have been interesting for the CDC to have studied the cause of the norovirus on this cruise ship for months in early 2010.  Why did this particular cruise ship experience so many problems with norovirus?  Certainly it was not just because a passenger puked on embarkation in January 2009?

Royal Caribbean's Radiance of the Seas - First Sick Cruise Ship of 2011

The Centers for Disease Control and Prevention (CDC) has listed Royal Caribbean's Radiance of the Seas as the first cruise ship in 2011 to suffer gastrointestinal illness affecting more than 2% of the vessel's passengers.

The CDC's Vessel Sanitation Program website has indicated that 150 of 2336 (6.42%) of the Royal Caribbean passengers reported being ill during the cruise on the Radiance from January 3 - 8, 2011.  The CDC information on the Radiance can be seen here

Radiance of the Seas - Norovirus? - Tampa Local 13-News station has the headline "Sick Cruise Ship Docked at Tampa Port," indicating that vacationers on board suffered from vomiting and diarrhea. The illnesses will delay the ship from returning to sea later today. The station indicates that the cruise ship's departure will be delayed approximately five hours, until 9:30 p.m., "so crews can sanitize the vessel."

The cruise line is advising cruise passengers who have recently experienced gastrointestinal illness should reschedule their cruise.  The CDC is reporting that the cruise line's response to the outbreak is "increased cleaning and disinfection procedures." 

The CDC at this point has not determined whether norovirus is causing the outbreak, nor the source of the "causative factor."  If norovirus is involved, most outbreaks of norovirus are from food and water, not by person to person contact as the cruise lines claim. 

As we have reported in prior blogs,  the U.S. Food and Drug Administration (FDA) concludes that whereas "person to person" transmission of norovirus has been documented, "norwalk gastroenteritis is transmitted by the fecal-oral route via contaminated water and foods."  The FDA reports that "water is the most common source of outbreaks and may include water from municipal supplies, well, recreational lakes, swimming pools, and water stored aboard cruise ships."

When stories like this occur, the cruise lines blame the passengers and tell them to wash their hands. The cruise ships then spray cleaning fluids everywhere.  But no one ever reveals whether the ship's food and water have been tested and the results of the tests.

The Radiance of the Seas had norovirus outbreaks before.  One passenger took this video of nasty looking tap water on the Radiance on a prior cruise.  An equally disgusting video of brown water on a Carnival cruise ship is here.  

But the winner of the gross-cruise-tap-water award goes to Carnival and is shown here.

Does anyone have video for this cruise?

Were you on the cruise?  How did Royal Caribbean handle the situation?

January 8, 2010 Update:

Passengers on the cruise arre beginning to leave comments, below, that the ice may have been contaminated, that this was a "vacation from hell," and there were way more than 150 passenger  sick.  A few passengers say they still had a great time . . .  

 

 

Photo credit:   Tampa's 13-News Station

Video credit:  ABC News

Norovirus Update on Celebrity's Mercury Cruise Ship - March 21st Sailing

A local news station in Charleston South Carolina is reporting that passengers aboard the Mercury cruise ship on the March 21st sailing are ill.  The story is entitled  "Five Cases of Norovirus on Celebrity Mercury Cruise Ship."

The article suggests that the information came from the cruise line, although I do not see a quote or a press release from Royal Caribbean / Celebrity.  The article is rather vague, as I'm sure it's more accurate to say that some passengers have norovirus-like symptoms.  Stool samples have to be taken and analyzed ashore before anyone can conclude that norovirus exists. (There is still no official determination regarding the cause of the last round of sickness on the Mercury).  

Mercury Cruise Ship - Celebrity Cruises - Norovirus?If this information is accurate, five cases of gastrointestinal sickness is not particularly significant.  The Centers for Disease Control (CDC) "Vessel Sanitation Program" does not require the data to be reported until at least 2% of the passengers are affected (around 37 passengers).

It is possible that all five passengers were infected before they boarded the cruise ship, because there are reports of norovirus ashore of course.  It is also possible that they contracted a virus after they boarded.

We have received a number of calls and emails asking for information about the Mercury's March 21st sailing.  Here are some suggestions:

The Cruise Critic message board has a posting "People are Sick Again on the Mercury," where there is mention of a small number of passengers who may be ill.  The cruise community message boards are sometimes a good source of information, particularly when the cruise lines are not forthcoming with information.

I have found that the CDC eventually responds to e-mails and telephone calls.  The email for the CDC is cdcinfo@cdc.gov - be sure to include "Celebrity Mercury Cruise Ship - March 21st sailing" in the title of your email.  The telephone number is 800-232-4636.

The PR person at Royal Caribbean who handles crisis management statements, including norovirus outbreaks, is Cynthia Martinez.  Her email is CynthiaMartinez@rccl.com  I would be interested if anyone receives a response. 

We often hear from passengers directly from the cruise ships.  If we hear something, we will update this article.

March 27, 2010 Update:

The Charleston Regional Business Journal reports that the Mercury has only 6 sick passengers -"Celebrity Mercury Sees Huge Dip in Sickness After Extra Cleaning Measures."  Good news for Celebrity Cruises and the next round of passengers who will be sailing this Monday, March 29th. 

 

Credits:

Photograph         Directory of Charleston

Celebrity's Mercury Cruise Ship - Free of Norovirus?

So far, no one is reporting an outbreak of sickness aboard Celebrity Cruises' Mercury cruise ship for its latest - March 21st - sailing.  This is good news after the last three disastrous cruises.

Today's South Carolina Post and Courier newspaper runs the headline "Mercury Appears Free of Norovirus" in which the newspaper reports: "after several days at sea, the Celebrity Mercury seems finally free of a stomach bug that afflicted nearly 1,000 passengers on its previous three voyages Norovirus - Cruise Ship - Contaminated Food, Water - Infected Food Handler? from Charleston." 

The Cruise Critic message boards for the Mercury also seem to suggest that there is not a problem with gastrointestinal sickness, yet.  

The question remains what was the cause of the last illness outbreak on the Mercury?  Was it norovirus?  Was it transmitted due to contaminated water or food?  An infected food handler?  

So far the Centers for Disease Control (CDC) have not said.

Let's hope that the cruise ship passengers do not get sick for the remainder of the cruise.    

If you are on the cruise and know otherwise, let us hear from you.  Otherwise, enjoy your cruise! 

 

Credits:

Chart        Virginia Bioinformatics Institute, Virginia Tech

Is Celebrity Cruises Under-Reporting Sicknesses to the CDC?

The Centers for Disease Control (CDC) reports that 406 of the 1829 passengers (22.1%) aboard Celebrity's Mercury cruise ship have reported fever, vomiting, and/or diarrhea.  These CDC statistics are based entirely on the information provided by the cruise line.

In the past week, we have received information from crew members that although they were sick, they were required to continue working.  This raises the issue whether the cruise line is not reporting all ill crew members to the CDC.

We just received the following comment from a passenger, who suggests that you can't trust the official CDC numbers:  

"We just got back from this cruise March 18th (one day early) and we were ready to come home. Don't believe the official count of sickness on this boat, I became ill on the second night out around 2 AM. At around 8 AM, my wife called for medical attention and was told they would be to see us in our cabin. We waited. At 5 PM, my wife called medical again and were told they had no record of our calling earlier but the medical crew was on its way around the ship and they would be to our cabin soon. As of today, March 19th., no one from medical has seen me yet unless they saw me passing in the hallways. I heard of many others who were sick and were not seen as well.

My suggestion if you decide to go, carry your own medication with you and be prepared to quarantine yourself to protect others while you are sick if you do get sick. Room service is good."
 

Celebrity's Mercury Hit By "Cruise Ship Sickness" Again

Celebrity Cruises' disastrous string of "diarrhea-cruises" out of South Carolina continues with the cruise line's decision to return the Mercury to port in Charleston a day early.

USA Today's Cruise Log reports that sickness has marred three straight voyages in "Celebrity to End Cruise Out of Charleston Early as Outbreak Continues."  Royal Caribbean indicates that 342 of the 1,829 passengers on the cruise ship became ill since the cruise began.  The article mentions that the cruise ship will skip its scheduled stop in Tortola British Virgin Islands and head straight back to the U.S.  The cruise ship will arrive in Charleston on Thursday.

Celebrity Mercury Cruise - Sick Ship?This is now the third cruise on the Mercury where passengers have become sickened with a gastrointestinal sickness.  

The USA Today article reads not unlike the typical cruise line press release - mentioning that norovirus is the most common cause of stomach illness in the U.S. and breaks out regularly in schools, nursing homes, and hospitals.  But the article does not inquire into the specific cause of this outbreak, nor question why three straight cruises have sickened passengers.

The report from the Centers for Disease Control (CDC) on the Mercury's last cruise does not even contain a conclusion regarding the "causative agent" for the sickness and is a week out of date.  If the CDC can't pinpoint the type of virus or pathogen from last week's cruise - why does anyone think that another round of "top-to-bottom" cleaning will make a difference?  

As we have reported in prior blogs,  the U.S. Food and Drug Administration (FDA) concludes that whereas "person to person" transmission of norovirus has been documented, "norwalk gastroenteritis is transmitted by the fecal-oral route via contaminated water and foods."  The FDA reports that "water is the most common source of outbreaks and may include water from municipal supplies, well, recreational lakes, swimming pools, and water stored aboard cruise ships."

What are the test results of the cruise ship's water supplies?  The Mercury is one of Celebrity's oldest cruise ships, and is scheduled to leave the Royal Caribbean - Celebrity fleet later this year. Is there something wrong with this ship?  Is this a sick ship?

 

For prior articles:

Stomach Bug Hits Celebrity's Mercury Cruise Ship Again

Will the Celebrity Mercury Infect Another Round of Passengers?

Celebrity Cruises Postpones Cruise From Charleston After Massive Norovirus Outbreak On Mercury Cruise Ship

Can Sick Cruise Ships Cause Norovirus Outbreaks in Ports?

Additional Passengers Sickened on Mercury Cruise Ship

Celebrity Cruises' Mercury Returns to Port with 182 Sick Passengers - Sailing Postponed

"Cruise Ship Sickness" - Is Norovirus In The Food and Water?

 

Here is a statement from Celebrity Cruises / Royal Caribbean issued today:

During Celebrity Mercury’s current sailing, a number of guests onboard experienced a gastrointestinal illness, thought to be a norovirus.  Over the course of the sailing, crew onboard has been conducting enhanced cleaning, to help prevent the spread of the illness. 

While there was a decline in the spread of the illness during the sailing, in an abundance of caution, and in order to prevent additional guests and crew from becoming ill, we have decided to bypass Celebrity Mercury’s port of call today to Tortola, British Virgin Islands, and return to Charleston a day earlier than originally scheduled.  Celebrity Mercury will now arrive in Charleston early Thursday morning.  The enhanced cleaning of the ship, all of which is being done in close coordination with the U.S. Centers for Disease Control and Prevention, will continue until the ship arrives in Charleston.

“I would like to apologize for the inconvenience this modified itinerary will cause our guests currently on Celebrity Mercury,” said Daniel Hanrahan, president and chief executive officer of Celebrity Cruises.  “I have made this decision to delay the sailing because we want to maintain our high health standards onboard our ships, while providing our guests with the best cruise experience possible.  The extra time we are taking to sanitize the ship will help prevent any additional guests from becoming ill.”

March 15, 2010 Update:

Centers for Disease Control: "Shut Mercury Cruise Ship Down!"

"Cruise Ship Sickness" - Is Norovirus In The Food and Water?

The Centers for Disease Control (CDC) reports numerous outbreaks of norovirus on cruise ships operated by Celebrity Cruises, Cunard, Holland American Lines, and Royal Caribbean. 

Every time there is an outbreak, the cruise lines blame the passengers who board the cruise ships.  The media picks up in this theme and often reports that the problem is not with the cruise ships but the passengers who board the ships already infected with norovirus.  For example, in a recent article in the New York Times Travel Section "Stomach Bug Hits Cruise Ships," respected journalist Michelle Higgins writes " . . . the contaminated ships have since been disinfected  . . .  but Norovirus - Cruise Ship - Contaminated Water?such measures can’t prevent a sick passenger from coming aboard and infecting others."  Ms. Higgins suggests that " the best defense is simple: wash your hands."

Unfortunately, the issue is not so simple.

According to the U.S. Food and Drug Administration (FDA), whereas "person to person" transmission of norovirus has been documented, "norwalk gastroenteritis is transmitted by the fecal-oral route via contaminated water and foods."

Contaminated Water Supplies On Cruise Ships?

The FDA indicates that contaminated water is one of the most likely causes of norovirus.  The FDA reports that "water is the most common source of outbreaks and may include water from municipal supplies, well, recreational lakes, swimming pools, and water stored aboard cruise ships.

So whereas you always hear reports of extra cleaning of the bathrooms and cabins on infected cruise ships, there is never a mention of whether the potable water is tested and the results of the testing.

Contaminated Food Supplies On Cruise Ships?

In addition to water supplies on cruise ships being a potential source of the virus, food supplies on cruise ships can also sicken the passengers.

The FDA reports that "shellfish and salad ingredients are the foods most often implicated in norwalk outbreaks. Ingestion of raw or insufficiently steamed clams and oysters poses a high risk for infection with Norwalk virus. Foods other than shellfish are contaminated by ill food handlers."

It would be interesting to determine the job positions of the crew members infected with norovirus.  For example, the CDC reports that sixty-nine crew members were reported ill on Celebrity's Mercury and Millennium cruise ships during recent cruises.  How many of these crewmembers were cooks, waiters or food handlers?  

Norovirus - Cruise Ship - Contaminated Food?The issue of eating oysters and other shellfish on cruise ships presents a double whammy.  Cruise ships dump sewage 12 miles from shore, and the fecal material can contaminate shellfish which filter-feed.  Both cruise passengers and people ashore can then be infected by eating contaminated shellfish. 

Uncertainty Regarding Cause of Virus and Transmitting Agent

Although the CDC tries to determine the "causative agent" of the outbreak, this means that they are trying to determine the nature of the pathogen (i.e., whether it is norovirus or some other virus).  But the CDC does not report whether the virus came from a person boarding the cruise ship or, the more likely scenario if the FDA is correct, from contaminated food and water on the cruise ship.

The issue arises where do the cruise lines obtain their potable water?  From U.S. based vendors or from the Caribbean islands?  What testing is done at the ports before the water is brought aboard?  Where do the food products come from?  Is any of the food inspected by the FDA before it is loaded on the cruise ships?  

The CDC reports that around 600 passengers became ill on Celebrity's Mercury cruise ship on the last two cruises alone.  Are we to believe that all 600 people simply failed to wash their hands?  Or is there something in the food and water? 

Cruise lines should be required to publicly report the test results of the cruise ship's water samples, so that the U.S. public can determine the true cause of cruise ship illnesses.

If contaminated water is the culprit, all of the external cleaning of cruise ship surfaces is not going to solve the problem.   

Additional Information: 

Passengers can track the reported outbreaks on the CDC web page which tracks "Outbreak Updates for International Cruise Ships."  Not all norovirus outbreaks are required to be reported to the CDC and the CDC website is incomplete. 

A good source for additional information is found on "Illness Outbreaks on Cruise ships."  We have reported on numerous cases of cruise line illnesses in prior articles

Celebrity Cruises' Mercury Returns to Port with 182 Sick Passengers - Sailing Postponed

The Centers for Disease Control (CDC) reports that Celebrity Cruises' Mercury cruise ship has returned to Charleston, South Carolina with 182 ill passengers. 

According to its web page "Investigation Update on the Mercury,"  t'he CDC reports 182 of 1749 passengers (10.41%) are ill with diarrhea and vomiting, and 14 of the 850 crew (1.65%) are sick.

With the sick passengers disembarking, another 1,800 passengers are boarding.  (I wonder whether the cruise ine discloses to the new passengers which cabins had sick passengers in them?) 

Cruise Ship Norovirus

The Mercury has experienced more than its fair share of problems in the last month.  There was a report of carbon monoxide poisoning on February 13th when the cruise ship returned to Baltimore.  After the ship re-positioned to Charleston, its inaugural cruise from that port resulted in over 400 passengers coming down with the dreaded norovirus

The ship was delayed a day until February 26th for what the cruise line calls "enhanced cleaning," and we questioned "Will the Celebrity Mercury Infect Another Round of Passengers?"

Now close to 200 people another passengers and crew have fallen ill.   

The most troubling information is that the CDC reports that the "causative factor" (i.e., whats causing the sickness) is "unknown." 

Norovirus can be caused by sick passengers coming aboard, or sick crewmembers greeting the passengers or, more concerning, infected food and/or water supplies.  The cruise supporters always blame the passengers for not washing their hands - which may be the case.  But the issue whether there is a problem with the cruise ship cannot be excluded.  Many people refer to Cruise Ship Sickness - Norovirus - Ill Passengers - Sick Crew norovirus as the "cruise ship sickness."

If the potable water or food have norovirus particles, all of the external cleaning in the world is not going to make a difference.  It only takes a few fecal particles in the food, drinking water or shower.

USA Today reports that the Mercury's departure today is delayed for another round of "enhanced cleaning."  

But without determining the "causative factor" and determining whether the passengers, the crewmembers, or the food and water supplies are spreading the virus - it seems like the cruise line is shooting into the dark.

Stay tuned. 

 

Health Tips: @OrlandoChris has some helpful precautions to help prevent the spread of the infection.

 

Credits:

Cruise desserts     nbnpress.com

 

Additional Passengers Sickened on Mercury Cruise Ship

Celebrity Cruises is again reporting that at least 55 passengers have fallen ill on its Mercury cruise ship with norovirus-like symptoms. 

In a prior article we questioned: Will the Celebrity Mercury Infect Another Round of Passengers?

Here We Go Again

A local news source in South Carolina, the Palmetto Scoop, reports on the latest cruise Cruise Ship Norovirus - Sick Passengersship sickness in an article entitled "Sickness Again Plagues Charleston Cruise Ship:" 

The crew of the Celebrity Cruises “Mercury” ship, which docks in Charleston, thought they had thoroughly sanitized the vessel after nearly one-quarter of the 1,800 travelers came down with a norovirus-like illness on their last voyage. 

Turns out they didn’t do a very good job.

The Mercury ship set sail from Charleston on Saturday and within days, dozens of passengers became sick.  As of Friday, 55 of the 1,880 travelers had fallen ill with the norovirus stomach bug.

Norovirus is a disease common to cruise ships because it is highly contagious and affects confined communities. The unpleasant disease usually runs its course after a day or two and spreads through food, water, or person-to-person contact.

Celebrity Cruises has based the Mercury in Charleston, South Carolina where officials have reported twice as many cases of norovirus as normal this winter. The Associated Press reports that the virus may have come aboard the cruise ship by passengers, crewmembers or infected supplies.

 

 

 

 

 

Celebrity Cruises is owned by Royal Caribbean Cruises whose cruise ships have experienced a large number of norovirus cases this season. 

Other Royal Caribbean Cruise Ships Experiencing Widespread Illness

The Huffington Post reports that at least 310 passengers were sickened aboard Royal Caribbean's Vision of the Seas. A spokeswoman for the Brazil's National Agency for Sanitary Vigilance stated that the sickness was caused by "some kind of food poisoning aboard"  the cruise ship.  Earlier this week, Brazil ordered all 1,987 passengers and 765 crew members to remain on the ship anchored near Rio de Janeiro.  The passengers were just recently permitted to leave the ship. 

Royal Caribbean's Jewel of the Seas and Celebrity Cruises' Millennium cruise ships have also reported of a large number of ill cruise passengers. According to the Centers for Disease Control (CDC) 102 passengers and 14 crewmembers suffered gastrointestinal illness on the Jewel of the Seas, and 157 passengers and 23 crewmembers became ill on the Millennium

You can track cruise norovirus cases via the CDC has a web page which tracks "Outbreak Updates for International Cruise Ships," although not all cruise illnesses are required to be reported to the CDC.  For example, the recent outbreak of illness on the Vision of the Seas was not reported to the CDC. 

For other information about norovirus on cruise ships, consider reading Cruise Ship Norovirus - Clean the Damn Toilets!

 

Video:          WCSC (AP)

Cruise Ship Norovirus - Clean the Damn Toilets!

The Clinical Infectious Disease Journal issued a report yesterday after studying why norovirus infection outbreaks occur frequently on cruise ships. 

The results were quite telling. Cruise lines always blame the passengers whenever a norovirus outbreak sickens a cruise ship. Some cruise lines know when they have a "sick ship" on their hands. Yet, the cruise line's PR department or sales team will issue a report, exculpating the vessel and crew, but blaming some poor bastard who had the misfortune of buying a cruise ticket and sitting on a dirty toilet seat on the cruise ship.

Well finally we have a credible report.  Not some pile of propaganda from the PR people at the Cruise Line International Association, whose "facts" are usually dubious, but from highly trained health care professionals. The medical and hygiene experts covertly evaluated the thoroughness of disinfection cleaning on fifty-six (56) cruise ships over the last three years

The professionals (Philip C. Carling, Lou Ann Bruno‚ÄźMurtha, and Jeffrey K. Griffiths) are tops in their fields.  They are from highly respected universities, including Boston University School of Medicine, Harvard Medical School, and Tufts University Schools of Medicine, Nutrition, and Engineering.

These experts secretly tested whether objects with high potential for fecal contamination, such as toilet seats in cruise ship public restrooms, could be a cause of norovirus breakouts.

The experts' objective tests revealed that only 37% of selected toilet area objects on cruise ships were cleaned on a daily basis. Such low scores may explain why certain cruise ships are prone to infect passengers with norovirus. 

The experts' recommendation?  "Enhanced public restroom cleaning." 

Let's keep it simple, stop blaming the passengers - and clean the damn toilets!