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

A newspaper in the U.K. reports that dozens of passengers were struck down by a "vomiting bug" on board a cruise ship which docked in Southampton yesterday.

The Celebrity Eclipse returned from a two week Mediterranean cruise which departed on May 11th. 

77 passengers and five crew members - 1.8 per cent of those on board the ship - were "laid low" by an illness thought to be the winter vomiting bug norovirus.

A spokesman for Celebrity Cruises said it would undergo an “extensive and thorough” clean now that the vessel had returned to Southampton.

Photo Credit: Wikipedia / Jonathan Schilling 

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The Centers for Disease Control and Prevention (CDC) reports the Celebrity Millennium cruise ship sailed to Seward, Alaska last Friday, May 10th, with an elevated number of passengers and crew with a gastrointestinal illness.  164 of its 1,963 passengers and 30 of its 935 crew members experienced the gastro-illness.

The CDC states that the "causative agent" (type of pathogen) is "unknown," although at least one newspaper, the Seward City News, states that the sickness outbreak is believed to be caused by norovirus.

Comments to the newspaper complained about cruise passengers coughing and hacking in public and the locals having to be on higher alert to wash their hands when cruise ships come into port.  

Photo Credit: Wikimedia / Captain-Tucker

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The Daily Post in the U.K. reports that a gastrointestinal virus outbreak has delayed the departure of a cruise ship from Liverpool.

The cruise ship involved is the MV Discovery which was scheduled to depart on a Norwegian cruise last night at 6:30 PM but was delayed until 10:30 PM while a "deep clean" was performed. 

I have always been skeptical about how a cruise ship can be disinfected in just 4 hours. 

One passenger, who described being treated like a leper, said: "I was on a ship which had norovirus and in the end it took four days to clean it, so I cannot see how four hours will help."

But a representative of the operating company said that 3 hours was "exactly the amount of time needed."  It's hard to fathom how anyone can say that with a straight face, particularly considering that the type of virus is unknown, the source of the virus is unknown, and the precise location of the virus is always a mystery.  

As usual, the cruise company also blamed the passengers: 

Paul Foster, speaking on behalf of Cruise and Maritime Voyages, said: "It’s one of those things that are brought on board by passengers. I always say a ship cannot get a sore throat."

But that simply not true. There are such things as "sick ships."  Cruise ships and their food and water supplies can become contaminated with a wide variety of viral and bacterial diseases such as Legionnaires Disease, norovirus, e-coli, and unspecified gastrointestinal viruses. In fact, the U.S. Food and Drug Administration ({FDA) and the Centers for Disease Control and Prevention (CDC) state that the most likely source of a norovirus outbreak is contaminated food or water. Yes, a virus can be spread by bad hygiene of either passengers or crew, but usually the source of the outbreaks starts with something like noro-laden food or water.

The Discovery was launched in 1972 and is a 40 year old ship. It was formerly the Island Venture, Island Princess, Hyundai Pungak and Platinum

The cause of any particular outbreak is the business of expert epidemiologists - not cruise CEO's or Cruise Directors who are quick to point the finger at the passengers.  

Photo Credit: Wikipedia / yeldark

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A Canadian news source, CBC News, reports that cruise passengers on a 31-day Holland America Line (HAL) cruise returning to Vancouver suffered from the ill effects of a norovirus outbreak. 

The outbreak involved HAL's Volendam.  The cruise line, which has experienced more gastrointestinal outbreaks than any other cruise line in the last decade, drained its pools and hot tubs and emptied its libraries to try and contain the spread of the norovirus outbreak.

HAL reported 28 guests and one crew member (2.37 % of the total 1,222 people on board) were sick over the course of the cruise. At three percent, Health Canada could launch a full investigation but will not because the reported cases did not reach this percentage.

One passenger told CBC that the problem appeared worse to those onboard than just the reported cases: "It had to be quite high, because it seemed like you would never sit at a table at dinner without someone having had it." 

After a few hours of cleaning, the cruise ship sailed on a week-long cruise to Alaska at 5 p.m. on the same day it returned to Vancouver

Yesterday we reported on another HAL disease outbreak on the Veendam. 

The last time we reported on the Volendam, the article involved a crew member fatality when a cable to a lifeboat snapped.

Photo Credit: Wikipedia / Barek

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The Centers for Disease Control and Prevention (CDC) reports that sixty (60) of the 1237 passengers (4.85%) aboard the HAL Veendam cruise ship exhibited symptoms such as diarrhea, nausea and vomiting during the last cruise.

Ten (10) of the 574 crew members (1.74%) also reported ill with gastrointestinal illness.

You can read the report here. 

The ship sailed from April 13 to May 4, 2013.

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

Last year, 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 last decade HAL's cruise ships have experienced the most gastrointestinal illnesses and the Veendam has the third most outbreaks of the hundreds of cruise ships operating out of the U.S.  The only other cruise ships with a worse records are the Ryndam and the Amsterdam, both HAL ships. Read about the problem here.    

Photo Credit:  Wikipedia / Djheini

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CBS (Miami) reports today that  a Royal Caribbean cruise ship arrived back in Port Everglades this morning with an outbreak of norovirus on board

The cruise line has not responded to requests for information, but passengers aboard the Vision of the Seas complained about vomiting and diarrhea. Passengers said more than 200 passengers had to be quarantined due to the outbreak.

“It’s been a hell of an experience,” said passenger Johny Celaire, of the 11-day cruise.  The captain reportedly announced there had been an outbreak of the norovirus on board shortly after the cruise ship departed.

CBS reports that one cruise passenger, Joan Webber was not  quarantined even though her husband was ill.  She is concerned that other passengers infected with the virus will take taxi cabs to hotels and airports where others could be exposed.

“There are people flying out today that are going on an aircraft that have diarrhea so bad they don’t know how they are going to get back up to Canada,” Webber said. “I’m surprised we didn’t go and have the health department talk to us.”

CBS further reports that Celaire said Royal Caribbean’s customer service reps added insult to injury when they called to inquire about the situation.

“She said to me if you had washed your hands you’d be okay,” Celaire said. “I said, ‘How the hell do you know if I didn’t wash my hands?’”

Blaming the passengers is a common ploy by the cruise lines even though the Centers for Disease Control (CDC) state that the most likely cause of norovirus outbreaks is contaminated food or water. 

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Researchers in Europe, Japan, New Zealand and the U.S. have detected a new variation of norovirus which emerged last year.  The virus was and remains particularly prevalent in the United Kingdom where norovirus sickened over 1,000,000 people.  The virus was tracked back to Australia and has spread to a number of countries,  The U.S. Centers  for Disease Control (CDC) documented the new mutant virus to have entered the U.S. last fall.

The researchers' findings and conclusions are set forth in a publication "Indications For Worldwide Increased Norovirus Activity Associated With Emergence of a New Variant of Genotype II.4, Late 2012." The new virus has been labeled "Sydney 2012."

An article in Bloomberg explains that this virus has posed a problem for cruise lines late last year and will continue to plague the cruise industry this year. In "Sydney Vomiting Bug Poses Risk for Cruise-Line Passengers," Jason Gale explains that "new epidemics of acute gastro often emerge on cruise ships, where control is hindered by close living quarters and shared dining areas." 

Gale writes that cruise ships carrying sick passengers have docked in New York and Florida the past three weeks, "heralding a new wave of infections for which there is no specific treatment or vaccine." The article cites a professor of microbiology in Australia, Peter White, who says: “Cruise ships are almost a sentinel sensing system for norovirus. Norovirus is going to wreak havoc in their cruise industry for the next year while this new strain gets a grip.”

Last month we wrote about Cunard's Queen Mary 2 sailing into New York from the U.K. with several hundred passengers and crew members sickened with norovirus, Princess Cruises' Emerald Princess docking in Fort Lauderdale with over 200 ill passengers and crew, and the Princess Crown Princess arriving in Galveston from Europe with hundreds puking from noro. 

The researchers are quoted saying: “Cruise ship holidays create an environment in which norovirus is easily spread and outbreaks readily occur." Professor White, who identified the new mutation, refers to cruise ship passengers and says: “It’s almost impossible for them to protect themselves against a norovirus outbreak once it occurs. The only way you could do it would be to stay in your cabin the whole time and not go out.”

Photo credit: Bsip/Photoshot/UPPA/Zuma Press via Bloomberg

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Cunard's Queen Mary 2 is in the news with reports that over 150 passengers have been stricken with norovirus as the cruise ship sails on a thirteen night itinerary in the Caribbean from New York.

The Daily Mail states that 150 - 200 passengers have fallen ill with symptoms of nausea, vomiting and diarrhea.

There were reportedly norovirus cases on board the cruise ship during the transatlantic crossing to New York. The Daily Mail suggests that the cruise ship may therefore not been properly cleaned prior to this latest cruise.

Some cruise passengers are debating all of this on the Cruise Critic message board with one person speculating that as many as 500 people may have been affected during the cruise.  Carnival, which owns Cunard, said that although 130 passengers were affected only 19 currently have "active symptoms." 

The Travel Mole publication suggests that Cunard has been playing down reports that "hundreds" of passengers have been hit by the virus.    

If you are on the cruise, please leave a comment about how the cruise line has handled the situation.

Photo Credit: Daily Mail

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Miami's WSVM Channel 7 television station is bringing us some bad news this Christmas Eve, reporting that passengers aboard a Princess Cruises cruise ship sailing on the high seas are ill with the dreaded norovirus.

According to News Station 7, more than 150 passengers and crew members reportedly caught the norovirus aboard the Emerald Princess.

This is the second Princess cruise ship in a week to report cases of the contagious virus.  The Crown Princess sailed to Galveston with over 100 cruise passengers and crew members ill with norovirus. You can read several comments by passengers criticizing the food serving and hygiene on the cruise ship  

The news station states that crews will sanitize the ship once it docks at Port Everglades on Thursday, whatever that means.

The sick passengers and crew were reportedly confined to their cabins to prevent a further spread of the disease on the 10-day cruise.

As far as cruise ships calling on U.S. ports, Princess Cruises has by far the most gastrointestinal illness outbreaks - with all of the cases involving norovirus.  According to the data collected by the Centers for Disease Control (CDC), of the total number of 15 outbreaks, this is the ninth sailing with an illness outbreak on Princess cruise ships this year alone:

The Crown Princess suffered two outbreaks in January and February; the Ruby Princess in February; the Sun Princess in July; the Dawn Princess in August and September; the Ruby Princess again in October; the Crown Princess again in December; and now the Emerald Princess.  

As year 2012 ends, Princess has experienced more than 50% of the CDC documented gastrointestinal cases. Considering there are 26 cruise lines associated with the Cruise Line International Association, one cruise line having more than 50% of the sicknesses is quite a feat!

Princess' standard operating procedure is to always blame the passengers for bringing the virus aboard.  Let's wait and hear what Princess says this time. Who wants to make a bet that the cruise line PR representatives point the finger at the poor people spending Christmas Eve puking in their staterooms?

Anyone sailing on the Emerald Princess have comments about the latest norovirus outbreak?  

December 26, 2012 Update: The Global Dispatch states:

The Centers for Disease Control and Prevention (CDC) Vessel Sanitation Program team will be boarding Princess Cruises’ “Emerald Princess” as it arrives in Ft. Lauderdale Dec. 27 to investigate an outbreak of yet unknown etiology, which has sickened nearly 200 passengers and crew.

According to health officials, a total of 166 passengers and 30 crew were sickened with the symptoms of diarrhea and vomiting, resembling norovirus. The voyage dates for the cruise were from Dec. 17 to Dec. 27.

The CDC said the cruise ship took the following actions in response to the outbreak to include cleaning and sanitizing, making announcements to notify passengers and crew and to encourage hand hashing, collecting stool samples for laboratory analysis and reporting twice daily to CDC officials.

This outbreak follows a norovirus outbreak reported aboard a “Crown Princess” cruise destined for Galveston, TX. More than 100 passengers and crew were sickened in this outbreak, according to a Chron.com report earlier this week.

Norovirus is a highly contagious illness caused by infection with a virus of the same name. It is often called by other names, such as viral gastroenteritis, stomach flu, and food poisoning.

The symptoms include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people, the illness is self-limiting with symptoms lasting for about 1 or 2 days. In general, children experience more vomiting than adults do.

Norovirus is spread person to person particularly in crowded, closed places. Norovirus is typically spread through contaminated food andwater, 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.

Photo Credit: Wikipedia (Holger.Ellgaard)

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Yesterday I mentioned that over one hundred people are sick with norovirus aboard the Crown Princess cruise ship which will be arriving in Galveston tomorrow at the end of a 20 day cruise from Italy.  This is the third outbreak of noro on this particular Princess cruise ship this year.

According to the Food & Drug Administration (FDA), although there are cases of noro illness transmitted by hand-to-hand contact, the most likely cause of a norovirus outbreak is contaminated water.  Contaminated food is also a likely culprit.

But if you study the last one hundred cruise ship norovirus cases, one thing is certain - the cruise line will always blame the passengers for bringing the virus aboard.

The New York Times just published a short (three sentence) article about the latest norovirus outbreak on the Princess ship. The newspaper reports that Princess is again pointing its finger at its passengers:

"A spokeswoman for Princess Cruises says more than 100 passengers and crew members contracted a stomach virus on one of its ships, the Crown Princess. The illness struck during a Venetian cruise due to end Saturday at Galveston. The spokeswoman said the cruise line suspects the virus was brought on board by passengers." 

If the cruise lines don't flat out accuse the passengers of being the problem, there will always be an implication that the passengers must not have washed their hands.

The amazing thing about the cruise industry is the frenzy activity when the ships come to port. A tremendous amount of provisions are brought aboard at every port, literally hundreds of thousands of pounds of beef, chicken, pork, fish and shellfish as well as every fruit and vegetable under the sun. Hundreds of thousands of gallons of water are pumped into the ship. The crew members get on and off the ship and of course the passengers do as well.

Was the food and/or water served to passengers on the ship contaminated? Did the passengers or crew eat contaminated food ashore?  Were the hands of a crew member involved in food preparation infected?

Proving exactly how the virus appears on a cruise ship is a difficult scientific process. But no one is engaged in such testing.  Yes, the Centers for Disease Control (CDC) test to determine whether the gastrointestinal illness is due to noro or e-coli, but that's where the testing stops.

So the public is left with the blame game.  The Crown Princess has not even arrived at the port of Galveston where the CDC inspectors are awaiting. But Princess is already telling the New York Times that its contaminated ship is the fault of unidentified guests and their dirty hands.     

Photo Credit: Centers for Disease Control

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Newspapers in Germany report that 67 passengers suffered "heavily illness" on a cruise ship last night aboard the Dutch river ship MS Bellriva. Around midnight the passengers began experiencing what is described as "agonizing nausea, diarrhea and vomiting."  

The cruise ship anchored in the district of Wiesbaden Biebrich on the Rhine River.

The newspapers say that the sick passengers were housed in quarantine in a separate area of the ship during the night. That seems quite difficult because the river ship has only three decks. Some passengers were sent to local hospitals in the morning after experiencing cardio-problems.

There were 188 people on board the ship, including 146 passengers. 

The newspaper state that the passengers were stricken with the dreaded norovirus.

50 members of fire rescue departments showed at the shore up to deal with the many ill passengers.

Videos show many medical responders wearing white hazmat suits standing under a sign on the entrance to the cruise ships saying "Welcome Aboard."   

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The Centers for Disease Control (CDC) reports that 10% of the passengers aboard Holland America Line's Amsterdam cruise ship were sickened by a disease on the ship. It is not yet known whether the disease was norovirus or due to some other causative agent. 

The Amsterdam was in port in San Diego yesterday after a long cruise starting in Sydney Australia on November 11 and arriving in San Diego on December 5, 2012. 81 of 791 passengers became ill. This turns out to be 10.24% of all passengers (assuming all passengers reported their illness and the cruise line accurately reported the outbreak to the CDC). This is an extremely high percentage of affected passengers.

The cruise line's PR department down-played the outbreak saying "a number of guests reported to the infirmary with a common type of gastrointestinal illness."  The popular cruise site Cruise Critic (owned by Expedia travel company) shrugged the illness off as due to a "stomach bug" and repeated HAL's advice to passengers for "extra hand washing."

As usual, there is no discussion regarding the most likely cause of the outbreak. Cruise lines like HAL like to blame the passengers and suggest that they brought the virus aboard and it was then spread because other passengers didn't wash their hands. If this is viral based, due to norovirus, or due to e-coli infection, the real culprit is probably contaminated food or water.

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." 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."

Most of the affected passengers reportedly became symptomatic after the cruise ship left its last port of call (Hilo, Hawaii) on November 29th. Are we to believe that suddenly 10% of the passengers suddenly stopped washing their hands? Or is it more likely that contaminated food or water introduced at the last port of call were the culprit?

The Friends of the Environment (FOE) has an interesting article that the problem is not sick passengers affecting the cruise ship, but sick ships affecting the passengers. FOE tracked the top 12 cruise ships with the most gastrointestinal outbreaks from 2000 to the present, based on the CDC data.

Out of the top 12 sickest ships, HAL operates 5 of them and has the top three sickest ships. HAL's Amsterdam is number 2. The Ryndam is number 1. The Veendam, which recently flunked a CDC health inspection (you can read about the filthy ship here and here), is number 3. The other HAL cruise ships which made the top 12 sickest list are the Volendam (no. 9) and the Zaandam (No. 11).  

Art credit: Chan Lowe / Sun Sentinel

Chart Credit: Friends of the Earth

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The Voyager of the Seas has returned to Australia today after a 18 night cruise.  Like the previous cruise, this cruise aboard the Voyager ended with the cruise ship arriving in port with what appears to be hundreds of cruise passengers infected with norovirus.

We are beginning to receive emails from passengers who were sickened during the cruise (see comments below) and observed "many incidences we saw of poor food handling and personal hygiene practices of both crew members and passengers."

A newspaper in Australia has an article about the problem facing passengers: "Gastro Outbreak Hits Voyager of the Seas Passengers in Sydney Harbour." The article states that the boarding of the "mega liner Voyager of the Seas was thrown into chaos today following an outbreak of a gastrointestinal illness thought to be noro virus." The article mentions that, according to Royal Caribbean, around 135 passengers already aboard the ship were struck by the illness but disembarked in Sydney.

One passenger who contacted us said that around 150 cabins were quarantined which would suggest that Royal Caribbean may have underestimated the number of sick guests.  

According to the newspaper, the lines of passengers at the cruise terminal stretched hundred of meters as frustrated cruisers were left waiting for hours under the sun - many unaware of the cause of the delay. The passengers were required to complete detailed medical forms before they board, but quite frankly it should be the cruise line completing forms detailing the sickness of the cruise ship.  

A cruise line spokeswoman denied any connection between the long lines and the norovirus and blamed "thousands of passengers disregarding allocated staggered boarding times."

Many passengers were upset that the cruise line kept them in the dark. Some others were handed at the port an "information sheet" in which Royal Caribbean said those ill had been limited to ''a small percentage of guests.''

What is missing from the newspaper article is the fact that there was a massive outbreak of norovirus on this cruise ship during the prior cruise. No newspapers in Australia reported on the disease outbreak and the cruise line kept mum too. You can read about the prior cruise and the problem with norovirus in our article: "Norovirus Outbreak on Royal Caribbean's Voyager of the Seas?"

One passenger, Steve, wrote to us displeased that Royal Caribbean had not disclosed that there was norovirus on the cruise ship when he boarded on February 5th: 

"In hindsight if we had been made fully aware through official channels that there was an outbreak on the ship, we would have probably gone home as the last thing I needed was to catch a bout of Norovirus. There needs to be a lot more honesty and openness in this industry, as too many people are vulnerable and gullible when it comes to trusting these big cruise companies who profess to have our best interests at heart. Never again RCCL!" 

If you were on the cruise, please leave us a comment about how the cruise line handled the situation, or leave us a comment on our facebook page.

Any New Zealanders on the cruise? There is a news reporter from New Zealand who would like to speak with you. Please email me at jim@cruiselaw.com and I will place you in contact with the reporter.

Anyone with photos, either of the "enhanced cleaning" or crew members wearing protective clothing, etc.? Send us your photos to jim@cruiselaw.com 

November 24, 2012 Update: New Zealand newspaper picks up the story: "Sickness Stalks Luxury Superliner"  As usual, no one in the media raises the issue of the cause of the outbreak. Contaminated food or water? Sick crew members? Or infected passengers coming aboard?  

Photo credit: 

Bill Hearne - top photos of Voyager of the Seas

Australia's Daily Telegraph - bottom photo of Royal Caribbean letter 

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A number of people have contacted us, including one passenger "Nancy" from Australia, complaining about a recent, major norovirus outbreak on the Voyager of the Seas.  She writes:

"The Voyager of Seas has relocated to Asia Pacific region husband and I sailed on the relocation cruise from Singapore 22nd Oct 2012 to Fremantle Australia. There was Norovirus outbreak around 800 passengers affected undetermined number with chest infection, one Norovirus victim airlifted . . . The ships doctor was swamped with sick passengers couldn't cope turned people away untreated. Cabins were sanitized once during the 14 night cruise and measures taken to fight the infection cabins sanitized as we left the ship ,very hard to fight when there are 3000+ people in one place." 

Nancy also commented on the absence of any mention of the disease outbreak: "The outbreak didn't rate a mention on TV or news papers ($$ damaging to tourist trade)." (The image of the Voyager of the Seas to the left was from an earlier norovirus outbreak when the ship was sailing out of New Orleans in February). 

Another person commented:  "My Mother just went on the Singapore to Perth cruise & many people were quarantined . My Mother got sick the last few days of cruise & is still recovering, vomiting diarrhea etc. . . Virus of the Sea Ship . . ."    

Passenger Nancy appeared sympathetic to the cruise line and thought the outbreak may have been due to the failure of the passengers to wash their hands.

Like most outbreaks, it does not appear that any effort will be made to establish the real cause of the outbreak (i.e., a sick passenger brought the virus aboard, or food and water were contaminated, or a sick crew member spread the virus).

The last norovirus reported to the U.S. Centers for Disease Control (CDC) involving the Voyager of the Seas was earlier this year on a January 28 to February 4, 2012 sailing. 

Royal Caribbean and sister cruise line Celebrity have experienced recent problems with norovirus outbreaks - the Celebrity Constellation sailing out of Southampton reportedly had 350 passengers stricken with norovirus last week, and the Rhapsody of the Seas was quarantined last month while in port in Fiji due to the port's concern that sick cruise passengers may infect the local community.  The U.S. media typically does not mention these type of outbreaks. 

Neither of these latest outbreaks were reported to the CDC because the ships did not call on a U.S. port. 

Can anyone else on the cruise verify the outbreak and comment on how the cruise line handled it?  

Please leave a comment below or follow the discussion on our facebook page about the outbreak.

November 23, 2012 Update: Norovirus Continues to Sicken Cruise Passenger on Latest Cruise

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Yesterday we received an email from a cruise passenger planning to board the Celebrity Constellation, indicating that embarkation would be delayed several hours today because of a norovirus outbreak on the cruise ship.

Today news outlets are reporting that there has been a large outbreak of the dreaded disease on this ship. BBC reports that Celebrity Cruises' Constellation arrived in Southampton at 06:00 GMT at the end of a 12-night cruise. The local port health authority said about 350 passengers had fallen ill with norovirus and were exhibiting vomiting and diarrhea. 

Its departure has been delayed until 20:00 while "deep cleaning" takes place. Of course this type of cleaning is not much good if there is contaminated food or water or a sick crew member in the galley or waiting on tables. 

The BBC report further reports that around 2,200 passengers and 900 crew members had been on a wine cruise around the coasts of France and Spain. Passenger David Mattey said his holiday had been "completely ruined" when he went down with severe vomiting and diarrhea. He said: "The sanitation on that ship is bad."

The U.K.'s Daily Echo mentions that passenger Mattey was bed bound for seven days, and had to go to the medical center several times for an intravenous drip to rehydrate his body. Mattey told the newspaper: “For elderly people to go down with something like this is horrendous. I have never suffered from anything like it before I still feel very weak and I am relieved I am home.”

Celebrity Cruises is quoted telling the newspaper that only "a small number of guests" were affected by the virus. The 350 sickened passengers as reported by the BBC is a very high number to become sick.

This outbreak does not have to be reported to the Centers for Disease Control (CDC) because the cruise ship does not call on a U.S. port. The last outbreak affecting this ship which was reported to the CDC occurred in February this year. 

The last outbreak reported about a Royal Caribbean / Celebrity cruise ship was last month and involved the Rhapsody of the Seas.

The cruise ships ported out of Southampton have experienced problems with norovirus outbreaks in the past which you can read about here and here. 

How did the cruise line handle this latest outbreak? 

Photo credit: Wikimedia Commons (Megadri).

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The 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.

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A puke fest is underway on the Carnival Glory cruise ship, with passengers taking to the message boards at Cruise Critic to comment that passengers are suffering from diarrhea and other norovirus-like symptoms,

The message board states that Carnival prepared a letter to passengers this weekend that passengers on the prior cruise experienced norovirus sickness. Several passengers are stating that the current cruise has been plagued by norovirus as well.  Some comments mention the strong smell of vomit in public areas of the cruise ship.  

One passenger comments that the Centers for Disease control (CDC) came onto the Glory on August 9th.  

There has been no official determination by the CDC yet. According to the CDC, cruise line calling on U.S. ports are required to report the total number of gastrointestinal (GI) illness cases evaluated by the medical staff when the GI illness count exceeds 2% of the total number of passengers or crew on board.

Last year there were 14 official cases of norovirus on cruise ships.

The usual debate is taking place about where the virus comes from, how it's spread and how the cruise lines is handling the outbreak.   The cruise industry bristles at the label "cruise ship virus" and always blames the passengers for not washing their hands and spreading the virus. The fact of the matter is that no one is conducting a scientific analysis to determine the origin of the virus notwithstanding the CDC's findings that the most common cause of norovirus on cruise ships in contaminated food or water.  

Some people are commenting that Carnival is doing a good job dealing with the outbreak, while others are saying that the cruise line is not disclosing the true number of affected passengers to avoid an official determination that the outbreak is norovirus related.

The last norovirus involved the Sun Princess during a July  8 - 21st sailing.  

Augyst 13, 2012 Update: The CDC says that the type of virus is "unknown."   This is the ninth gastrointestinal outbreak aboard a cruise ship calling on a U.S. port this year. 

Photo credit: Mark Davis via Wikimedia

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The Sun Sentinel newspaper in Fort Lauderdale reports that passengers aboard the Island Princess cruise ship are experiencing symptoms of gastrointestinal illness, according to a spokesperson for the Centers for Disease Control ("CDC"). 

The Princess cruise ship is scheduled to return to Port Everglades this morning after sailing a 10 night Panama Canal cruise.

The newspaper reports that the incident is not yet an official “outbreak" which occurs only when at least three percent of passengers experience symptoms such as of the illness, which include vomiting and diarrhea.

There are 1,970 passengers aboard the Island Princess. 

Several Princess cruise ships have experienced problems with norovirus this year, Including the Ruby Princess and the Crown Princess.  

If you were ill on this cruise or have observations regarding how Princess dealt with the issue, please leave a comment below. 

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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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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 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

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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 about 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 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 be 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.

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The Centers for Disease Control ("CDC") report that 118 of the 2,730 passengers aboard the Celebrity Solstice cruise ship have reported to the ship's medical facility with vomiting, diarrhea and other symptoms of gastrointestinal illness.

The Solstice is currently on a 14 day cruise and will return to Fort Lauderdale on December 11, 2011.

Pursuant to the CDC Vessel Sanitation Program, environmental health officers and an epidemiologist will board the cruise ship, once it returns to Fort Lauderdale tomorrow, in order assess the outbreak and the cruise line's response activities.

It has been our experience over the years that the "official" CDC numbers of ill passengers and crewmembers is usually less than the true number of those afflicted with viral illnesses.  This is because 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.  Often, sick crewmembers are pressed to work notwithstanding their sicknesses.  

We wrote about the problem of under reporting last year when the Celebrity Mercury experienced a prolonged outbreak of norovirus: Is Celebrity Cruises Under-Reporting Sicknesses to the CDC?

This is not the first time the Solstice has experienced an outbreak this year.  In January and February, there were norovirus outbreaks on the Solstice with one passenger dying due to exposure to the virus. 

Celebrity Cruises has experienced other bouts of widespread illnesses in 2011.  Over 100 passengers became sick on the Millennium in May of this year. 

Not all gastrointestinal outbreaks are documented with the CDC.  The cruise lines do not have to report the outbreaks when the cruise ship does not call on a U.S. port.  In September, norovirus broke out on Celebrity's Eclipse sailing out of Southampton, England.  You will find no mention of it in the official CDC database.

Earlier this week, we discussed Is there a Cure for the Cruise Ship Virus?

If you were on the Solstice and have something to add to this story, please leave a comment below.  Was the sickness more widespread than reported?  How did the cruise line handle the situation?   

Photo credit:  Examiner

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Afraid of your cruise vacation ruined by a nasty bout of diarrhea and vomiting?

There may be hope for you.   

WebMD and a few other medical journals report that there have been promising results from the tests of an experimental vaccine designed to prevent infection and symptoms associated with  norovirus.

WebMD explains that researchers sprayed the experimental vaccine in the noses of 47 volunteers. They also sprayed a "placebo vaccine in the noses of 43 other volunteers."  The study participants all swallowed a large dose of the norovirus (yuck).

About two-thirds of those who got the placebo vaccine developed gastrointestinal symptoms such as diarrhea and vomiting.  However, only a third of the participants who received the real vaccine developed  symptoms.

The researcher behind the experiment, Dr. Robert Atmar, a professor of medicine and molecular virology at the Baylor College of Medicine, said that the results are very promising, but it will be a few more years of research before the vaccine can be offered to the public.

Although commonly referred to as the "cruise ship virus," the virus also affects nursing homes, hospitals and restaurants.   Over the years, the cruise industry's trade organization, Cruise Lines International Association ("CLIA"), has tried to disassociate itself from this nasty virus.  It often writes to newspapers complaining when norovirus is described in such nautical terms.

When nororvirus breaks out on a cruise ship, you will usually hear the cruise lines and pro-cruise line publications stating that the cruise ship has been subjected to "enhanced cleaning,' whatever that means.  Cruise Critic ran an article earlier this year with a title "Norovirus is NOT a 'Cruise Ship' Virus."   The article showed a couple of photographs of crewmembers spraying down tables, chairs and even the roulette wheel.  Many topical solutions sprayed like this are not effective in killing the virus.  If a towel is contaminated, the wiping down of everything in sight spreads the virus everywhere. 

You will never hear the cruise lines or industry publications mention that the norovirus may not be spread from person-to-person, but  have been transmitted by contaminated food or water.   

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."  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.

Whatever the source of the virus on cruise ships, it is encouraging that there are doctors researching a vaccine against this dreaded sickness. 

For other articles about noro virus on cruise ships, consider reading: 

Cruise Ship Norovirus - Clean the Damn Toilets!

Cruise Ship Norovirus - Something in the Water? 

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

100 Norovirus Victims On Sapphire Princess Cruise Ship - Princess Cruises Blames Passengers

Photo credits:

Top:  Reuters via Mail Online

Middle & Bottom:  CruiseCritic

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