Cruise Law News : Maritime Lawyer & Attorney : James M. Walker : Walker & O'Neill Law Firm : Admiralty Law, Cruise Ship Accidents & Injuries

Princess Cruises' Ruby Princess cruise ship experienced a norovirus outbreak with the Centers for Disease Control (CDC) reporting that 129 passengers 9 crewmembers suffered gastrointestinal illness.

The Ruby Princess was on a 7 day cruise from February 26 to March 4, 2012 out of Fort Lauderdale. 

The Ruby Princess suffered another outbreak last month, although the prior sickness was not reported or investigated by the CDC.

The cruise industry has struggled with gastrointestinal outbreaks this year, some outbreaks reported by the CDC, some not, with Princess Cruises and the Royal Caribbean/Celebrity ships leading the cruise puke fest.

Here is a list of cases I have reported on just this year:

Princess' Ruby Princess Royal Caribbean's Independence of the Seas Celebrity' Constellation

Princess' Crown Princess (two sailings) Celebrity's Silhouette 

Royal Caribbean's Voyager of the Seas

Princess' Ruby Princess 

P & O Aurora.

There has been a sick cruise ship virtually every week this year. 

Only cruise ships calling on U.S. ports are required to report sickness outbreaks to the CDC.  Cruise line 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. Crewmembers often work while sick.

Photo credit:  bottom - cheezburger.com

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The Celebrity Mercury cruise ship returned to port in Charleston South Carolina today with over 400 sick passengers.  The Centers for Disease Control (CDC) reports that 406 of the 1829 passengers (22.1%) have reported fever, vomiting, and/or diarrhea.

Unlike the last two cruises where the CDC determined that norovirus caused the outbreak, the CDC has not yet determined the cause of the outbreak.  This is probably one of the reasons that the CDC issues a "no travel" advisory for the sick cruise ship.

The traveling public is faced with a cruise line who blames passengers for not washing their hands - the CDC who does not know what the pathogen is or where it's coming from - and the ugly likelihood that the vessel's food, water, crew or public surfaces could be contaminated.

We have been inundated with calls and emails from concerned Americans who are scheduled to travel on the Mercury over the course of the next several months.  We also have heard from crew members, including some crew members who complain that although they are sick they are required to keep working.  Some of the work includes changing linens, serving food and delivering ice.  Very disturbing information. 

There is a lot of pressure on crew members to keep outbreaks secret.  We recently ran across a blog from a former crew member who wrote:

I worked on a cruise ship at the beginning of 2001 and we had a lengthy norovirus outbreak - interestingly, the ship did not make the CDC list for that year. Perhaps because we were far away in South America? Or perhaps it was because we were instructed to deny, deny, deny when any passenger asked: No sir, you're mistaken - the dining rooms are all closed because all the guests are off on tour...not sick in their beds along with half the staff. (Yeah, I was never able to look anyone in the eye and say that.) I never got it, thank God .  .  . "

Here is a recent video from the AP: 

Were you on the last cruise?  Do you have photographs, video or information which may help explain what is happening on the Mercury?  

Let us hear from you.

Credits:

Video      AP

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ABC's Good Morning America (GMA) discusses Celebrity Cruises' sick cruise ship, the Mercury, in this morning's program. 

The Mercury has been hit with three continuous outbreaks of sickness which has plagued hundreds of passengers.  We have covered the outbreaks in prior articles. 

GMA begins its show by describing the Mercury as the "cruise ship which just can't seem to be cleaned."

The video contains the caption - "Sickest Ship at Sea - Can Cruise Ship Be Cured?" and explains how norovirus can thrive on cruise ships.

The GMA video is below.  One passenger askes: "Why do you keep on letting people on this ship when people continuously get sick?"

ABC interviewed its senior health and medical editor Dr. Richard Besser to explain the norovirus and how passengers are infected on cruise ships: 

"The norovirus is highly contagious and its symptoms include nausea, vomiting, diarrhea, cramps and chills, Besser said.

The illness typically lasts 12 to 72 hours and usually occurs in places where people are in close quarters, such as schools, hospitals, nursing homes and cruise ships, according to Besser. It is the leading cause of foodborne outbreaks of diarrheal disease, accounting for more than 50 percent of these outbreaks

It spreads through food, water, contaminated surfaces and person-to-person contact, Besser said. He added that the reason it could be so hard to get rid of on a cruise ship is because people can also bring it on board and it can live on surfaces for more than a week.

Cruise ships often visit places that have poor sanitation, so passengers can easily catch it from a restaurant they visited at a port, Besser explained.

Additionally, the infection dose of norovirus is very low, Besser said. It takes only 10 particles of the virus to make you stick, as opposed to the 100,000 particles of salmonella you would have to be exposed to in order to get sick."

The Mercury returns to Charleston tomorrow.  The CDC issued a "no sail" advisory for the sick ship.  It will undergo another round of "enhaced cleaning" - as the cruise line calls it. 

Credits:

Video              ABC Good Morning America

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The Centers for Disease Control (CDC) has issued a rare no-sail advisory for Celebrity Cruises' Mercury cruise ship.  The CDC has instructed Celebrity not to sail the sick cruise ship until Sunday in order to permit its inspectors to investigate the ongoing outbreaks of gastrointestinal illness. 

Over the course of the last month, hundreds of passengers have become sick on the Mercury over the course of its last three sailings. 

According to CNN, members of the CDC's Vessel Sanitation Program (VSP) boarded the cruise ship looking for causes of the latest wave of illness.

Although the CDC determined that norovirus was the cause of the outbreaks for the first two sailings, the CDC could not determine the type of pathogen for the latest outbreak on the Mercury.

A no-sail advisory is an extreme step.  Its like a city inspector shutting down a dirty restaurant for code violations which pose a health hazard to the city residents. 

The Mercury has been a sailing nightmare for the past month.  First, a half dozen crew members were sickened in what the cruise line thought was carbon monoxide poisoning -  Carbon Monoxide Poisoning Reported Aboard Celebrity's Mercury Cruise Ship - when the cruise ship returned to port in Baltimore.  After the ship was re-positioned to South Carolina, all cruises have been plagued by what many call "cruise ship sickness."

The Mercury is an old ship and Royal Caribbean / Celebrity will be selling it later this year. 

For a chronology of the diseased ship, read our blogs over the past month regarding the Mercury.

March 16, 2010 Update:

USA Today reports: "Celebrity to Offer Full Refunds to Passengers on Delayed Mercury Cruise"

Credits:

Cruise Cleaners              Telegraph.co.uk  "Cruises: Norovirus Questions & Answers" 

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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.

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!"

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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?) 

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 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

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A headline in the NoroBlog intrigued me - "Cruise Ships Causing Norovirus Outbreaks in Ports?" - indicating that norovirus is "often associated with cruise ship sickness."  The article also raises the question whether cruise ships can infect the local port communities. 

The cruise industry's PR people have been fighting the connection between norovirus and "cruise ship sickness" for many years.

Last week the cruise industry's trade organization, Cruise Line International Association (CLIA), wrote a letter to the Daytona Beach News Journal complaining that a writer made a connection between the virus and cruise ships and concluded that this is an illness that happens "often" on cruise ships.

CLIA's letter to the editor stated: "the overwhelming majority of norovirus outbreaks take place at land-based locations, such as schools, day care centers, hospitals and nursing homes."  The one comment to the letter, from a passenger on the norovirus infected Queen Victoria cruise ships, dismissed the letter as "more cover-up from the cruise spokes people."

CLIA has made the "its-a-lot-worse-ashore" argument before.  But arguing that it has a better record than day care centers and nursing homes seems counter-productive to the cruise line's image.  Of course day care centers with a million kids who have not mastered the art of going to the toilet and washing their hands and then wipe their runny noses all over the toys are going to be a hotbed of viruses.  And anyone entering a nursing home filled with incontinent geriatrics can instantly smell feces entering the facility.

The Food Poison Journal (affiliated with the Noroblog) reports that "outbreaks of gastrointestinal illness, and norovirus in particular, are not new to the cruise industry.  In fact, the phenomenon prompted the CDC to create and oversee a "vessel sanitation program (VSP)." 

Arguing against the label "cruise ship sickness" is a waste of time.  The real debate should be whether sick cruise ships pose a health hazard to the local port communities.

In the past six weeks, the United States considered blocking the arrival of the Queen Victoria because of a norovirus outbreak - U.S. to Block Arrival of Queen Victoria After Norovirus Outbreak?  - and a week earlier the U.K. considered impounding the Balmoral cruise ship because of a similar outbreak -  "Cursed Cruise Ship" Balmoral At Risk of Being Impounded As Hundreds More Suffer Vomiting Bug.

The South Carolina Post and Courier ran an interesting article "Norovirus Confirmed Aboard Mercury" which reported on the concern that the Celebrity Mercury cruise ship - with over 400 norovirus infected passengers - could infect people living in Charleston.  

The newspaper reports that Katie Zimmerman, a project manager with the Coastal Conservation League, received frantic calls and e-mails from residents concerned not only about infected passengers entering the city but also about trash from the ship entering local waters.

Cruise ships like the Mercury can dump completely untreated sewage 12 miles offshore.  Although the article concludes that waste from the Mercury poses no risk to marine life or people who eat local seafood, there is a risk of contaminated water infecting shellfish which filter-feed. 

In this day and age, it is barbaric to think that hundreds of CLIA cruise ships routinely dump human waste into the sea.  Cruise lines dump waste because they register their cruise ships outside of U.S. jurisdiction in places like Liberia and Panama which don't care what the cruise lines do. 

The thought of a cruise ship like the Mercury dumping hundreds of thousands of gallons of norovirus infected feces just 12 miles offshore South Carolina is particularly disgusting. 

Even the worst run child care facilities and nursing homes don't do that.

Credits:      

Sick cruise passenger           Bill Mahler's Food Poison Blog

Cruise Cleaners              Telegraph.co.uk  "Cruises: Norovirus Questions & Answers" 

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