A Sick Ship? Adventure of the Seas Can't Shake the Bug

Earlier this month, we were contacted by passengers aboard the Royal Caribbean Adventure of the Seas because of back-to-back norovirus outbreaks requiring "deep cleaning" of the cruise ship.You can read our article about the situation here

A number of passengers complained of some pretty gross conditions:

One lady said "i was swimming and had to go round feces, which was also in the jacuzzi...it was reported but nothing was said . . . "

Another man said "the most serious issue on board the ship was the failure of its sewage system, a point admitted by its officers during the Q and A session. The ship stank like a Royal Caribbean Cruise Norovirussewage farm throughout the 14 days. We we also found the bed linen in our cabin filthy (pillows were brown and needed to be replaced) . . . This ship has problems!"

And then there was the inevitable debate whether the virus outbreak was caused by the failure of some passengers to wash their hands versus noro-contaminated food or water versus a virus-laden ship itself.

Passengers are now telling us that the norovirus outbreak continues on the third consecutive sailing of the Adventure which is scheduled for yet another so-called "deep cleaning" this weekend. Passengers received an email from the company explaining the the ship will undergo the enhanced cleaning before it leaves Southampton on Sunday, October 26th. Will the next cruise become the fourth consecutive "Norovirus on the High Seas?"

Some of the people who contacted us have small children, elderly parents, elderly grandparents or they are recovering from cancer, or have suppressed immune systems. They are asking whether they can cancel and obtain a refund or reschedule. They are asking us what to do.

Unfortunately the cruise line holds all of the cards in this situation. Royal Caribbean will certainly keep your money if you don't show up for the cruise and it will absolutely not issue you a refund. The only issue is whether the cruise line will permit a few people to reschedule on a case-by-case basis. 

Royal Caribbean just announced yesterday that it made almost $500,000,000 in profits for the third quarter of this year (and pays no U.S. taxes on that loot) so you might think that it has sufficient money to be understanding and reasonable under this circumstances. After all, its ship is sick. Who on earth wants to voluntarily subject their family to disease? But Royal Caribbean has a strict attitude against permitting fearful customers to reschedule even if there's something wrong with its ship. 

One person who contacted us said he was nervous about his family "catching the bug" but fell that he has no chance to reschedule. He said he "will let you know how it went!"

Customers should not become human guinea pigs like this. A good vacation should not depend on the success of another last minute "deep cleaning" of a sick ship which repeatedly failed.

The ship is enormous - 15 decks, 10 pools and whirlpools, 15 bars, clubs and lounges, and thousands and thousands of cabins packed into its 1,000 plus feet. Its an enormous undertaking to clean a ship like this. The chance of a 100% eradication of the nasty bug is slim, no matter how hard the crew is pressed into working overtime.  It takes only a few microbes of noro to sicken the next round of guests. The norovirus could be hidden under the commode seat cover or in the fabric of the duvet covers where the prior passengers were blasting millions of microbes of noro-infected vomit and diarrhea into the bathroom's and cabin's crooks and crannies. 

There are few laws protecting consumers on the high seas. There should be a norovirus policy where a passenger can obtain a hassle-free refund whenever there is a consecutive disease outbreak.  

If you get sick on the upcoming cruise, consider hiring a lawyer. No, not me. There's a good firm in the U.K. which has successfully handled cases this like. You can contact them here.

The cruise line is counting on the hundreds of its customers who fall victim to the pukefest not knowing what to do. After all, you and your family are really not guinea pigs, even if the cruise line treats you like one.   

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

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 is Completely Unprepared for Ebola Outbreak

A week ago, I went to Twitter and complained that the cruise industry had not issued an Ebola-specific protocol for the cruise lines to follow. The threat of Ebola was growing, but the cruise lines seemed asleep at the helm.  Neither the Cruise Line International Association (CLIA) nor its CEO Christine Duffy had even mentioned Ebola.

I had received many inquiries from the public about whether it was safe to cruise. So I tweeted:      

"Passengers fearing #Ebola asking me whether its safe to #cruise / Why no statement byCruise Ebola Scare - Carnival @CruiseFacts or @CLIACEO?"

The popular cruise blog Cruise Hive (@CruiseHive) followed up on the issue and asked via Twitter about the cruise industry's protocols: "I asked the major cruise lines about their Ebola preparation but not one replied! Costa did but no details . . ."

I wrote a short article Ebola on the High Seas: Should Cruise Passengers Worry About Becoming Infected?

CLIA and its CEO didn't tweet or blog or post a story on Facebook about the threat. This is during the heart of the popular CLIA "Cruise Week" when travel agents are in a marketing frenzy to sell cruises. Better-not-scare-the-business-away seemed to be the attitude.

So today we learn that a Dallas health care worker who handled clinical specimens from Ebola-infected Thomas Duncan is on a Caribbean cruise aboard the Carnival Magic.  She apparently went ashore with other passengers in Roatan. When the cruise ship sailed to Belize, the government barred her from going ashore. The government of Belize and the U.S. State Department were in discussions to permit her to board an air ambulance and be flown back to the U.S. When Belize prudently refused, she was stuck on the ship, which sailed on to Cozumel which also barred the ship from port. The Magic is now returning to Texas.

Carnival calls this a "self quarantine." That's hardly true. The U.S. scrambled to fly a jet to medevac her back to Texas. Carnival negligently permitted her aboard in the first place and is not going to let her wander around the ship while she is still within the incubation period.        

Carnival didn't even have a questionnaire to ask passengers whether they had come into contact with an Ebola patient or had worked at a hospital or healthcare facility which treated such a patient in the last three weeks.

Certainly it was easily foreseeable that a nurse might drive down to Galveston for a cheap cruise on a Carnival fun ship.

The reality is that cruise ships are perfect petri dishes for diseases to flourish. 5,000 passengers and crew members are mashed together for a week on the Carnival Magic, using public restrooms and spooning food using the same ladle from gigantic buffets. No wonder in the last ten years we have seen ships plagued not only by outbreaks of gastrointestinal diseases, noro virus and e-coli, but measles & rubella, Legionnaires Disease, Severe Acute Respiratory Syndrome (SARS) and other infectious diseases.

It's outlandish that the cruise industry has no protocols specifically related to Ebola to keep hospital workers who worked around Ebola the heck off of cruise ships.  And if this lack of preparation is any indication, I shudder to think how ill prepared the cruise ships are to respond if an outbreak occurs.

This afternoon, ABC News published a photo taken by a Carnival Magic cruise passenger Jeremy Malone who saw 30 to 40 crew with buckets of disinfectant to deal with the Ebola scare. I think the photo says it all. No protective clothing, no protective boots, no protective masks, etc. Just tired, hard-working, low-paid Filipino crew members assigned yet another extra job without sufficient training or equipment.

Think that the cruise lines' slogan that the "health and safety of our guests is our highest priority" is true regarding Ebola? Think again.

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

 Photo Credit:  Jeremy Malone via ABC News

Texas Hospital Worker Who Handled Ebola Samples is on the Carnival Magic

ABC News reports that a Dallas health care worker who handled clinical specimens from Ebola-infected Thomas Duncan is on a Caribbean cruise aboard the Carnival Magic.

The cruise line says that the female worker is allegedly being "self-quarantined" and is being monitored for signs of infection. She apparently has no symptoms yet. 

She departed on a cruise ship from Galveston, Texas, on October 12th was out of the country before being notified of active monitoring required by the Centers for Disease Control and Prevention (CDC). She works at the Texas Health Presbyterian Hospital, which treated Mr. Duncan (who died) where nurses Carnival MagicNina Pham and Amber Vinson tested positive for Ebola.

The hospital is being roundly criticized for having sloppy and irresponsible procedures to respond to an Ebola patient.

Carnival released a statement, saying:

"We are in close contact with the CDC and at this time it has been determined that the appropriate course of action is to simply keep the guest in isolation on board." 

But there is a dispute whether Carnival had any choice but to keep the worker on the cruise ship. 

Belize (the port of call yesterday) banned the passenger and her traveling partner from entering the country. The ship has already stopped in Mahogany Bay, Honduras on Wednesday and is scheduled to sail on to Cozumel. 

A newspaper in Belize contains dramatic information indicating that the Prime Minister in Belize denied entry into Belize for the "stricken U.S. nationals to be air lifted to the U.S.A. for treatment." 

A news reporter in Belize quotes on her Facebook page an official source in Belize that after talks were concluded between Belize and the US State Department officials, Belize will not be permitting access of the Dallas hospital worker into the country to fly back to the states. 

So it seems unlikely that this case simply involves a situation where the woman is simply "self quarantining" as Carnival suggests. It appears more likely that efforts were unsuccessfully made to get her off of the cruise ship. 

Carnival Cruise EbolaThe cruise lines need to institute a protocol where they simply ask all passengers whether they have worked around an Ebola patient in the last three weeks. The cruise lines should prohibit them from cruising and refund their cruise fare. 

I have written about Ebola and the safety of the cruising public issue last week: Ebola on the High Seas: Should Cruise Passengers Worry About Becoming Infected?

Update: Carnival sent me a statement this morning which you can read here.  Meanwhile, Mexico bars the cruise ship from disembarking passengers.  Over two weeks ago, I was tweeting and asking why the Cruise Line International Association (CLIA) had not issued Ebola-specific protocols. 

ABC News reports that the reaction on the Carnival cruise ships ranges from passengers being completely unfazed sitting by the pool to others being panicked and crying. The news accounts includes a photograph taken by cruise passenger Jeremy Malone who "saw 30 to 40 crew members with buckets of disinfectant who were lined up on along his hallway as they prepared to clean the ship . . . " It looks like these poor crew members not in protective suits were completely unprepared if this was really Ebola.

Carnival Cruise Ebola Scare

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

Update: Cruise Industry is Completely Unprepared for Ebola Outbreak

Photo Credit: Wikipedia / Thomas Doerfer Creative Commons 3.0 (top); Jeremy Malone via ABC News (bottom) 

Ebola on the High Seas: Should Cruise Passengers Worry About Becoming Infected?

I have received a dozen inquiries in the last few days about the chances of contracting Ebola during a cruise. My thought is that the chance is slim that anyone is going to go on a cruise and return home infected with the virus.  But there are some issues that concern me.

For U.S. Travelers, Chances of Infection Are Slim at this Time

From what I have learned, it's very difficult to contract the the virus. A cruise passenger would first have to come into close personal contact with an infected person. The infection could come from contact with the infected victim's bodily fluids (blood, saliva, vomit, feces, urine, or semen) or through contaminated needles. This would first require travel to the affected countries in West Africa (Liberia, Cruise Ship EbolaSierra Leone, and Guinea) and then intimate contact with an Ebola victim.

So far, the only victim in the U.S. is Thomas Duncan who traveled to Dallas from Liberia and since died. There is a chance that the persons who he came into contact with could develop the disease, but the Centers for Disease Control (CDC) is carefully monitoring the health of all persons who possibly could have come into contact with Mr. Duncan.  

Cruise lines are prudently avoiding ports in West Africa. Holland America Line, Seabourn Cruise Line, Regent Seven Seas Cruises and Fred Olsen are dropping West African ports in Ghana, Gambia and Senegal. Princess Cruises is considering rerouting its 30-day "West Africa Adventure," according to the L.A. Times. 

Royal Caribbean does not call on any ports in West Africa, although ironically Royal Caribbean is incorporated in Liberia to avoid taxes and regulations.

Bloomberg says that the Ebola scare has lowered cruise stocks. Carnival's stock price fell 5.5 percent, NCL was down 2.8 percent, and Royal Caribbean fell 5.9 percent even though it doesn't sail near the affected (infected) area.

To my knowledge, there are no cruise lines which routinely hire from Liberia, Sierra Leone, or Guinea. In fact, I have never met or even heard of crew members from these countries. I anticipate that if there are any crew members from these countries, they will not be be re-hired when they return home on vacation. Miami-based cruise lines enacted such hiring freezes on crew members from affected areas during the Severe Acute Respiratory Syndrome (SARS) outbreak in the past.

But I'm Uncertain About the Future

There are some factors, though, that make me nervous about the future.

  • The Centers for Disease Control (CDC) says that as many as 1,400.000 people could be infected with Ebola by January 2015.  
  • The virus will get worse in the West African countries.
  • Experts predict the virus to appear in Europe within the month.
  • There are reports that Ebola can survive on surfaces for anywhere from a few hours to several days, depending on the type of surface, the temperature, and the amount of light. 
  • According to the CDC, the average time for symptoms of Ebola to appear is 8-10 days. 
  • Many travelers don't disclose illnesses either before or during their cruises because they don't want to be barred from the ship or confined to their cabin.   
  • Some employees don't report to the ship infirmary because they don't want to lose their tips.

My concern is that the outbreak will continue and expand. It has already reached Spain. Jacquie Kubin writes in her article Ebola: Lessons Learned from SARS, the Flu, and HIV / AIDS that there is a 75% probability that the virus will reach France by the end of October and a 50% chance that Ebola will migrate to the U.K.

If the virus reaches Europe so quickly, future cruise travelers and employees could become infected. If those infected are booked on cruises, it is foreseeable that an infected person will fail to disclose the early symptoms of Ebola (intentionally or simply because they doesn't know they have been infected) when they appear at the airport or terminal and then embark the aircraft or cruise ship.

We already know from noro virus cases, many cruise passengers are ill when they come to the cruise ship. Unfortunately, they sometimes lie to get on the ship, and they won't stay in their cabins even when they are infectious.

We also know from past experiences that some crew members report to work when they are ill, including food handlers. This is documented in the CDC literature.  

Cruise ships are not prepared to handle a situation with an infected Ebola victim aboard. Any crew Cruise Ship Ebolamembers called upon to clean up the vomit and diarrhea and other bodily fluids of a sick passenger would likely become infected. An infected chef or waiter shedding Ebola would be a disaster and could potentially infect hundreds of passengers.  

We have seen that cruise ships can easily be plagued by outbreaks of diseases which include not only gastrointestinal diseases, noro virus and e-coli, but measles & rubella, Legionnaires Disease, SARS and other infectious diseases.

Unlike noro virus which lasts a few days, Ebola is potentially deadly. The victim needs immediate and specialized treatment that a cruise ship can't provide. An Ebola outbreak on a cruise ship could result in deaths as well as a public relations disaster.

Stay Tuned and Hope for the Best

There currently is no vaccine for Ebola. Clinical trials are just starting.

For the next many months, cruise lines will consider West Africa to be a no-man's land. Until the disease is eradicated, the cruise lines must avoid the ports there. Cruise ships will continue sailing wide of West Africa until the coast is clear. Hopefully the virus will not spread to Europe and find its way onto cruise ships. 

October 17 2014 Update: Texas Hospital Worker Who Handled Ebola Samples is on the Carnival Magic

October 18 2014 Update: Cruise Industry is Completely Unprepared for Ebola Outbreak

 

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

Read circular letter (No. 3484) about Ebola published by the International Maritime Organization.

Photo Credits: Top - Daily Times; Botton - CDC via AP

Are Cruise Ships Vectoring Chikungunya Virus to Florida?

Today I received a comment from a Royal Caribbean passenger who said that he was infected with the dreaded chikungunya virus when he sailed to St. Martin last year on the Oasis of the Seas:

You might need a new cruise category "Disease" as the cruise industry has become a vector for spreading the Caribbean epidemic of Chikungunya Fever virus to Florida . . . I got infected during my Oasis trip to St Martin last Dec - this thing is horrible and can be catastrophic for older passengers - one major "coincidental" cause of increased death among these folks isn't the virus ... it is suicide. 

He also referred me to an article on a local CBS station "Fourth Case Of Mosquito Borne Chikungunya Chikungunya Cruise ShipFever Confirmed In Florida."

The disease is transmitted through infected mosquitos.

The Centers for Disease Control (CDC) says:

"The most common symptoms of chikungunya virus infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Outbreaks have occurred in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. In late 2013, chikungunya virus was found for the first time in the Americas on islands in the Caribbean. Chikungunya virus is not currently found in the United States (no longer true). There is a risk that the virus will be imported to new areas by infected travelers (now true). There is no vaccine to prevent or medicine to treat chikungunya virus infection. Travelers can protect themselves by preventing mosquito bites. When traveling to countries with chikungunya virus, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens."

We have been contacted in the last 6 months by many cruisers concerned about being infected. But this is the first time that someone has contacted us after being bitten by an infected mosquito.

There has been a good amount of chatter on the cruise fan pages about the virus and fears of contracting it while cruising to the Caribbean. 

Some but not all cruise lines warn about the disease.

Do you know someone who has been infected during a cruise to the Caribbean? Does anyone know effective medical treatment to combat the symptoms?  Please leave a comment below or join the discussion on our Facebook page.

Vomiting & Diarrhea Bug Infects Passengers on Grandeur of the Seas

The Centers for Disease Control and Prevention (CDC) reports that 111 out of of 2122 passengers (5.23%) and 6 out of 790 crew (0.76%) have reported ill with gastrointestinal illness involving vomiting and diarrhea. The Royal Caribbean ship was on a 7 day cruise from Baltimore.

You can read the CDC report here. The CDC hasn't figured out yet whether the gastrointestinal outbreak was caused by norovirus. 

Cruise expert Professor Ross Klein reports that cruise passengers have received the following Grandeur of the Seasinformation in an email:

"Hello, this is Royal Caribbean International. We would like to provide you with some important information regarding your Saturday, April 5th, sailing onboard Grandeur of the Seas out of the Port of Baltimore. During the ship's last sailing, a number of guests experienced a gastrointestinal illness. We will conduct enhanced sanitizing onboard the ship and within the terminal to help prevent any illness from affecting your cruise. Therefore, your check-in and boarding will be delayed. Because space and seating in the terminal is limited, we ask that you not arrive to the port before 2:00 PM. Check in will take place between 2:00 PM and 4:30 PM."

I always wonder about the effectiveness of "enhanced cleaning" when the CDC can't determine what the disease is much less how it can aboard the cruise ship.

Any passengers cruising this week please let us know whether the virus was eradicated or whether the outbreak continues.

 

 Photo Credit: Wikipedia / J. Glover

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

Passengers Report Gastrointestinal Outbreak Aboard the HAL Maasdam

Several cruise passengers have informed us that there is a gastrointestinal outbreak on the Holland America Line (HAL) Maasdam which is currently sailing routes in South America.

Passengers are stating that numerous people are sick with nausea, vomiting, diarrhea and other noro virus like symptoms. The number of sick passengers and crew has not been released to the people we have communicated with. 

Today one passenger reported: 

"MS Maasdam has been fighting NOROVIRUS pretty much most of the cruise from Rio to Ft Lauderdale. RED ALERT."

HAL MaasdamAnother passenger reported that he is ill and is tired of being blamed by the ship's captain for the disease:

"I am on the sick Holland America Maasdam which has had Noro virus ever since the departing Rio and won't be scheduled to be back in Fort Lauderdale until the end of the month. I'm getting tired of hearing the Captain blame the passengers for the spread of the disease. As a physician, I've clearly noted that the disease is passed by vectors such as cruise cards, bar staff and wait staff never washing their hands, and the tables and chairs being cleaned with the same rag. Captain it's not the passengers its your staff." 

The Maasdam is on a 26 day cruise, which started in Rio de Janeiro on March 2nd and will be ending in Fort Lauderdale on March 28th. 

We reached out to HAL and parent company Carnival this morning about this reported outbreak but have not yet received a response. Neither HAL nor Carnival responded. 

Are there other passengers or crew members with information about this alleged outbreak?  Please leave us a message or join the discussion on our Facebook page

 

Photo Credit: Wikipedia / Andrew J Bryson

Norovirus Breaks Out On P&O Cruises' Oriana

Oriana Cruise ShipThe British press is reporting that the Oriana cruise ship has returned to port in Southampton with "dozens" of passengers sick with norovirus.

The 19 year-old P&O cruise ship ended its cruise around the Canary Islands early because of propeller problems. The Daily Echo newspaper in the U.K. is calling the ship "cursed" because of the norovirus outbreak.

The Daily Echo says that the ship returned to port on Wednesday due to propeller issues and passengers were permitted to stay on board and using the facility until Saturday. However, 57 passengers on board were then struck down with the highly contagious norovirus.

P&O Cruises offered refunds and credits to passengers, but some passengers said they might sue. 

The cruise line said that it started "enhanced sanitation" protocols.

P&O Cruises also released the familiar PR statement: "the safety and comfort of passengers and crew is always our number one priority.”

 

Photo Credit:  Wikipedia / Pjotr Mahhonin

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

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?

 

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

Salt into the Wound: Royal Caribbean Denies Legionnaires Disease Came from Liberty of the Seas

Last week we reported on an article in the BBC about a former Royal Caribbean captain who died after contracting Legionnaire's disease. BBC's story was entitled Ex-Royal Caribbean Captain Died of Legionella. His widow is now proceeding with an inquest back in the UK.    

This is a disturbing story which we looked into last year: Royal Caribbean Delivers Cruel Blow to Widow of Beloved Captain Tore Myhra.

Royal Caribbean initially declined comment to the BBC saying that it does not comment about pending legal cases, but it looks like the cruise line has changed its mind. Royal Caribbean just sent the BBC a statement saying for the first time that "Royal Caribbean is certain that Mr. Myhra did not contract Legionella while sailing on board Liberty of the Seas."  The cruise line further states that Captain Myhra reported to the Captain Tore Myhraship's doctor only with "flu-like symptoms."

It is interesting to contrast Royal Caribbean's denials today with what the cruise line stated when Captain Myhra fell ill on the cruise ship. Back in December 2009, Royal Caribbean did not deny that the cruise ship had the deadly bacteria. It stated only that ". . . we do not know the source of the guest's legionellosis . . " The cruise line further explained that in response to the legionella-related death it sanitized key areas onboard the ship, including whirlpools and the H2O Zone.  

As we reported in 2009 in our article Former Royal Caribbean Cruise Ship Captain Dies of Legionnaire's Disease After Sailing on Liberty of the Seas, the Miami-Dade Medical Examiner concluded that Captain Myhra became sick on the cruise ship and suffered "nausea, vomiting, diarrhea, respiratory difficulty and dry cough.'' His symptoms worsened and he died of "Legionella pneumophila pneumonia" the day after he departed the cruise ship, on November 1, 2009.

The Miami Herald covered the story and interviewed the Centers for Disease Control: The Herald said that the CDC investigated "five or six cases of Legionnaires' disease aboard cruise ships going in and out of South Florida in the past three months" around the time of Captain Myhra's death.

The South Florida Business Journal reported that during the next cruise, a family on the Liberty of the Seas found the H20 water area and hot tubs were closed six out of seven days of the cruise. A passenger reportedly said "This cruise started off horrible as we were told there had been two cases of Legionnaire's disease on the 11/1 sailing and that Customs was also checking the entire ship . . . " Another passenger mentioned receiving a letter in the stateroom, indicating a passenger on the previous cruise had been diagnosed with Legionnaire's, so the H20 Zone and hot tubs were closed. 

Why is Royal Caribbean now so "certain" that its former captain did not contract the disease on its cruise ship and he had just "flu-like" symptoms?  

It seems like this cruise cruise line will say anything to avoid bad press, even if it means pouring salt into the wounds of Captain Myhra's grieving wife and daughter.  

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

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

Carnival Triumph Cruise From Hell: Here Come the Lawsuits!

Last Friday, the day the Carnival Triumph passengers were finally going home from the "cruise from hell," the first two lawsuits were filed.

The first case mentioned in the press was filed by a Texas lawyer representing a woman from Brazoria County Texas. I printed a copy from the court's online docket to read this weekend. The lawsuit alleges that the passenger was forced to "endure unbearable and horrendous odors on the filthy and disabled" cruise ship.  Because of the "sweltering temperatures, lack of power and air conditioning, lack of running water, and lack of toilets," the woman "feared for her life" and was threatened with Carnival Triumph Cruise Ship Fire"contracting serious illness by the raw sewage" filling the ship. 

The problem with allegations like these is that they are excluded by the terms and conditions of the ticket issued by the cruise line.

Experiencing psychological distress or being afraid of getting sick are not a basis for a lawsuit unless there is a physical injury or actual physical illness.

The lady's lawyer later told the press that his client had a fever and felt nauseous, but notably lacking from the lawsuit or the lawyer's comments were any mention of an actual illness diagnosed by a doctor.  This may be explained by the fact that the woman probably had not been to a doctor yet.        

The other lawsuit was filed on behalf of another Texan passenger by a lawyer here in Miami. As described by USA Today's Cruise Log, the lawsuit alleges that the 42 year old passenger suffered severe dehydration and bruising from aggressive food lines on the crippled ship. Her lawyer said she was so ill from the five-day ordeal that she had to be given intravenous fluids in an emergency room when she returned home to Houston. Severe dehydration may be sufficient to meet the physical injury requirements of the law but it is unknown whether this is just a temporary injury.

I have made my thoughts of litigation in cases like this well know.

Following the last "cruise from hell" engine room fire disaster in 2010 when the Carnival Splendor was stranded off the coast of Mexico and had to be towed back to the U.S., I wrote an article "Three Reasons Why You Will Lose If You Sue Carnival."  The same conclusions I reached two years ago apply to this latest Carnival debacle. 

It's not that I am unsympathetic to the people's plight. But I have represented clients who waved goodbye to family members at the dock and their loved ones either didn't return from the cruise or they returned in a body bag.   

If you are on a cruise ship that catches on fire on the high seas and you return with your family physically uninjured, count your blessings.

Cruise passengers returning from the Triumph need to rest, relax and start trying to recover from the stress.  They should go to a doctor and be checked out. Get your blood tested if you are afraid.  Send the medical bills to Carnival to Carnival to be reimbursed. But filing a lawsuit before going to a doctor puts the cart ahead of the horse. 

Let's hope that no one develops a truly serious and permanent illness from sloshing around in sewage for a week. If the feces and urine cause an innocent passenger to contract hepatitis or Legionnaires Disease or some other debilitating or deadly illness, then the afflicted passenger should sue the hell out of Carnival.

But inconvenience, aggravation, anger and being afraid of disease won't get you very far in a federal courtroom here in Miami.

Update: Triumph Fire:  Here Comes the Lawsuits! (Part 2): Miami Firm Files Class Action Lawsuit!

 

Photo Credit: Fox40

Norovirus Continues to Plague Voyager of the Seas Cruise Ship in Australia

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 Norovirus - Voyager of the SeasVoyager 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."

Royal Caribbean Norovirus - Voyager of the SeasMany 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 

Independence of the Seas - a Dirty Cruise Ship? Sick Passengers Sue Royal Caribbean for £500,000

The U.K.'s Daily Echo reports today that twenty-five ill cruise passengers (and their family members) who sailed aboard the Independence of the Seas filed a lawsuit against the Miami based cruise line, Royal Caribbean Cruises, claiming that the dirty ship conditions and unsanitary galley and food led them to become ill.

The newspaper states that in addition to the unsanitary shipboard conditions, the Royal Caribbean cruise ship had insufficient medical facilities and staff to deal with disease outbreaks during cruises.

The lawsuit is described in the newspaper article as including complaints of "flies in their bathrooms, a waiter blowing (his) nose on a napkin that was then placed on a table and an outbreak of illness Independence of the Seas - Norovirus so severe there were often ambulances waiting for passengers in the ports they visited."

There is no mention where the lawsuit was filed or the name of the passengers' lawyers, but it appears that the case was filed in England. The passengers are seeking £500,000 in compensation from the cruise line. The Independence of the Seas sailed from Southampton England.

The affected passengers sailed on five different cruises over the course of a seven month period from December 2010 through June 2011.  In the U.S. courts, cruise lines like Royal Caribbean have successfully enforced a one year limitations period.  There appears to be a longer limitations period in which to file suit in the U.K.

Royal Caribbean denied the allegations of under-cooked food and poor galley hygiene, stating that it delivered “extremely high” health standards for its guests. During the time period in question, "the ship, Independence of the Seas, sailed on 15 cruises, welcoming over 67,000 guests."

Although the cruise line is down-playing the allegations, the fact of the matter is that Royal Caribbean had a problem with norovirus on this cruise ship notwithstanding its attempts at "enhanced cleaning."  It should be pointed out that if the cruise line really carried some 67,000 passengers in this six month period, it collected well over £100,000,000 as well.    

The last norovirus outbreak we reported on which occurred on the Independence  of the Seas was in March 2012.

Independence of the Seas - Lawsuit - Unsanitary FoodThe cruise lines always blame the passengers for not washing their hands, but there is far more to the story than pointing the finger at the guests. 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 also 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." 

Consider a couple of our articles regarding this subject: 

Cruise Ship Norovirus - Clean the Damn Toilets!

Cruise Ship Bathrooms, Norovirus and Medical Care

It will be interesting how this case turns out! 

 

Photo credits:

Drawing - Maxim Magazine

Independence of the Seas - Echo Daily

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.

Meningitis Afflicts U.S. Passenger Aboard Seven Seas Voyager Cruise Ship

A newspaper in Italy is reporting that a U.S. passenger became sick with meningitis and was taken ashore for medical treatment once the ship arrived at port.

The Corriere del Mezzogiorno newspaper reports that when the Seven Seas Voyager cruise ship arrived at the port of Messina, one U.S. passenger was taken from the cruise ship to a hospital in Gaeta. However, no other passengers were allowed to disembark - apparently out of concern that they may also be sick and infect people ashore.

The newspaper account states that the passengers were given prophylactic medications but must wait at least 48 hours to avoid others from being infected. 

Meningitis is a serious disease affecting the mucous membranes surrounding the brain. It can be spread in the air, person to person and through contaminated food or water. It can be deadly.

Last month four crew members were infected with meningitis while working on the MSC Orchestra cruise. They were hospitalized in a medical facility in Italy.  One crew member died. The frightening thing about that case was that two of the crew members worked in the cruise ship's galley which increased the prospects that the passengers could be infected.

Anyone aboard the Seven Seas Voyager with information to share, please leave a comment below.

October 29, 2012 Update: The Cruise Critic message board has a comment that this was a "suspected" case of meningitis and the Italian Health Ministry indicated that the passenger tested negative for the disease. 

See No Evil, Hear No Evil, Speak No Evil: Cruise Industry & Cruise Fans Quiet After Four Crew Members Develop Menigitis During Cruise

Early this Monday morning I reported on an outbreak of meningitis aboard the MSC Orchestra cruise ship.  Four MSC crew members were hospitalized yesterday in Livorno, Italy once the cruise ship reached this Italian port. Newspapers in Italy, France, Germany and Spain mentioned the disease outbreak.

But no one in the U.S. mentioned the story.

Meningitis is a serious and often deadly disease.  Meningitis developing on a cruise ship filled with several thousand passengers and crew members is a big event, particularly considering that one or more of the crew members worked in the ship's galley and could infect the unsuspecting passengers though saliva from their mouths and/or throats, or coughing and spewing infected mucous on food or into beverages. 

I tweeted my article this morning "Crew Members Aboard MSC Orchestra Stricken With Meningitis."  The cruise community on Twitter operating under the #cruise hash tag is relatively small, with cruise agents, and cruise lines and the cruise trade groups all incessantly and incestuously re-twitting everyone else's tweets about the joys of cruising.  But aside from one travel agent who re-tweeted my article about the MSC meningitis cases this morning, none of the major bloggers or cruise publications tweeted or blogged a word about the disease.

See No Evil - Cruise MediaThe big boys in the world of cruising, like USA TODAY's CruiseLog and the Expedia-owned Cruise Critic, didn't mention a thing. Nor did the Miami Herald or the many travel agent publications or any of the regular cruise and travel bloggers. Instead, we had USA TODAY CruiseLog's last blog about "Princess' Next Ship to Have a Water and Light Show" and CruiseCritic writing about "Work Starts on Biggest P&O Cruise Ship."

Finally late tonight we have CNN reporting the story, commenting that more than 2,800 doses of antibiotics (Ciprofloxacin and Rifampicin) were issued for passengers. CNN repeated the Italian Health Ministry's comments that "the strand was found in the crew that worked in the kitchen and that, therefore, they should not have had continuous and close contact with passengers."  CNN also brought forth the ominous information from the Ministry in Italy that passengers who have disembarked in the past week from the prior cruise should take similar antibiotics.   

This morning I mentioned that the press in Italy reported that some 400 children were aboard the Orchestra and were told to take the antibiotics out of concern of possible exposure to the diseased crew members.  Certainly this is not the type of a cruise story involving at least one or more infected galley workers that only a little blog like mine and a few random twitters should cover and the major U.S. media should ignore until CNN reports on it 12 hours later.

Are the travel publications and major cruise bloggers afraid to offend their friends in the cruise industry?  Are they just trained monkeys who see, hear and speak no evil?    

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:"

 

 

Royal Caribbean Delivers Cruel Blow to Widow of Beloved Captain Tore Myhra

The maritime lawyers here in Miami have been in a state of outrage following a recent decision from an appellate court in the Estate of Tore Myhra v. Royal Caribbean Cruises, Ltd., Case No. 10-15840 (11th Cir. Sept. 21, 2011).

This case addressed the issue of whether a cruise line could legally enforce a "forum selection clause" transferring the lawsuit to a court outside of the U.S., if the effect of the transfer were to limit the cruise line's liability for personal injury or death occurring on cruises.

There is a federal statute which clearly prohibits cruise lines from doing this. 46 U.S.C. section 30509(a) states that attempts to limit liability by contractual terms in cases where the cruise ship calls on a U.S. port are illegal and unenforceable.

In the Myhra v. Royal Caribbean case, a passenger contracted what is described as a bacterial infection on the Liberty of the Seas cruise ship which led to his death. His widow filed suit in Miami where all lawsuits against this cruise line are filed. But the cruise line moved to dismiss the case, citing terms buried deep in the the passenger ticket which specified the U.K. as the location for the lawsuit.

The lawyers for Mr. Myhra's widow argued that the fine print terms in the passenger ticket were not reasonably communicated to Mr. Myhra, and even if they were, because the U.K. adopted the Athens Convention limiting the liability of cruise lines to a maximum of $75,000 (even including death cases), this clause violated 46 U.S.C. section 30509(a).        

But the Eleventh Circuit held that 46 U.S.C. section 30509(a) was not violated. In a tortuously reasoned opinion, it held that because it was not the cruise line limiting its liability, but rather a foreign country (the U.K.) which provided limited damages, the transfer to the U.K. didn't violate 30509(a). This is a rather circuitous argument. After all, it was Royal Caribbean which inserted the U.K. into the ticket as the chosen forum. It did so because it knew that Britain would afford only limited damages to passengers in cases of injury and death.

The South Florida Lawyers blog covered the story. An anonymous reader commented that the decision was "more intellectual dishonesty from the 11th Circuit." Curiously, in a footnote to the decision, the court held that a different result might be reached if the passengers were a U.S. citizen who bought his ticket in the U.S., as opposed to a Brit who bought his ticket in Britain.

Tore Myhra - Royal Caribbean Cruises - Cruise ShipThe case will be remembered as a result-oriented decision where the xenophobic appellate court's priority was to send the case away from the U.S. based on whatever justification it could scrap together.

But there is more to the story. 

Mr. Myhra was not just an average passenger. He was the former Captain (i.e., Master) of several Royal Caribbean cruise ships. He mastered the Monarch of the Seas and was a captain of one of the cruise line's first cruise ships, the Song of America.

By all accounts, Captain Myhra was a skilled mariner, a dedicated Royal Caribbean employee and a well respected captain who was liked by his fellow officers and crew members on the cruise ships on which he served as Master.

In 1998, Captain Myhra bravely sailed the Monarch of the Seas into the harbor in St. Maarten in the middle of the night to bring a sick passenger ashore for emergency medical treatment. But while the cruise ship was sailing out under the command of another officer, the vessel went off course and ran across a reef. The ship sustained heavy damage to the hull and began to take on water. Captain Myhra took command of the ship and ground it to keep it from sinking.

In 1999, Captain Myhra resigned from Royal Caribbean. Even though he was not at the helm when the ship hit the reef, he took responsibility. Thereafter he began a successful camping business called Rose Farm Touring & Camping Park in England with his wife, Susan, and their daughter.

A decade later, Captain Myhra returned to a Royal Caribbean cruise ship not as the captain but as a passenger with his wife aboard the Liberty of the Seas. Captain Myhra was exposed to Legionnaires Disease along with another passenger due to the negligent manner that the cruise line maintained its water supplies.  Although infected, he was kept aboard the cruise ship until the end of the cruise, only to die in a public hospital the next day.

Captain Myhra ended his career with Royal Caribbean trying to help a sick passenger in the middle of the night by diverting the cruise into port for emergency medical care, but ended his life sickened on a Royal Caribbean ship as a passenger.   

But the irony and injustice does not stop there. Captain Myhra and his wife, Sue, a cruise ship purser herself on Royal Caribbean ships, were "Loyal-to-Royal" friends to the cruise line. They were part of the Royal Caribbean "family."  I'm sure CEO Richard Fain knew them both on a first name basis.

But when Master Myhra died due to exposure to Legionnaires Disease on the Royal Caribbean ship, the cruise line treated his widow and child shabbily.  

Royal Caribbean denied liability and tried to place the blame elsewhere. It could have stepped up to the plate and paid Ms. Myhra and her daughter a reasonable settlement and wished its friends and family members well.  But instead, it paid its defense lawyers in Miami a vast sum of money to try and kick the lawsuit, which Ms. Myhra was forced to file, out of the U.S.

In the end result today, Royal Caribbean beat its former captain's widow and child in a court of law. The appellate court pronounced that their lawsuit for the wrongful-death-by-Legionnaire's-Disease-on-a-Miami-based-cruise-ship is somehow not welcome here in Miami where Royal Caribbean is headquartered.

What a sad spectacle. 

Cruise line CEO Fain and President Adam Goldstein earned over $12,000,000 in 2010 while their cruise ships reduced costs across the fleet, including cost reductions due to fewer tests of its potable water on the Liberty of the Seas and other ships. Meanwhile Ms. Myhra is left to seek compensation in the U.K. for her dead husband and the dead father of her daughter.

After attorney fees and costs, the net compensation will turn into peanuts.

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

Passenger With Meningococcal Disease Rescued From P&O Cruises' Pacific Sun Cruise Ship

A "Careflight Rescue" helicopter winched a 48 year-old passenger with a suspected case of the potentially fatal meningococcal disease from a cruise ship off the south-east  coast of Australia. 

P&O Cruises Pacific Sun Cruise ShipSeveral news have reported the incident; however, no one disclosed the name of the cruise ship or cruise line.  The passenger was taken to a hospital in Australia.

ABC News in Australia has finally identified that the passenger was rescued from the Pacific Sun cruise ship (web cam photo left).  The news station reports that the ship is traveling from Sydney to New Caledonia. 

The Pacifc Sun is operated by P&O Cruises in Australia.  Information about P&O Cruises and the Pacific Sun can be read here.

It is not uncommon for the press to try and avoid publishing the name of the cruise line or cruise ship in cases like this.
 

Photograph Credit:  P&O Cruises Pacific Sun webcam

Liberty of the Seas & Legionnaires' Disease - Disease of the Seas?

Legionella - Cruise ShipThe Miami Herald reports today that a tourist from the U.K. who died from Legionnaires' disease had previously sailed on a seven-day Caribbean cruise on Royal Caribbean's Liberty of the Seas.  

The newspaper identifies the English cruise passenger as Mr. Tore Myhra. 

Previously, there was speculation that Mr. Myhra may have contracted the disease at a local hotel here in Miami, the luxurious Epic Hotel & Residences.  However, the U.S. Center for Disease Control ("CDC") said that the hotel was not implicated in his death because another person who died of the same strain of Legionella had not stayed at the hotel. 

The Herald's article today raises the issue whether Mr. Myhra was exposed to Legionella on the Royal Caribbean cruise ship.  The newspaper quotes the medical examiner's report that Mr. Myhra became sick on the cruise ship and suffered "nausea, vomiting, diarrhea, respiratory difficulty and dry cough.''

The newspaper reports that when the Liberty of the Seas ship returned to port in Miami on October 31st, Mr. Myhra was taken to Jackson Memorial Hospital. His symptoms worsened and he died of "Legionella pneumophila pneumonia" on November 1st at the hospital. 

Royal Caribbean's PR spokesperson, Cynthia Martinez, is quoted as saying that the cruise ship "reacted quickly" to the report of the Legionnaires' case.  It is less than clear what this means, Legionella - Cruise Shipbecause the cruise ship kept the sick passenger on the ship and did not request a medevac with the Coast Guard.

The Herald also interviewed a spokesman from the Center for Disease Control.  The newspaper reports that the CDC has investigated "five or six cases of Legionnaires' disease aboard cruise ships going in and out of South Florida in the past three months."

The CDC representative appears to be assisting the cruise line in damage control, based on the CDC's quotes in the newspaper: 

"All appropriate steps have been taken.'' 

"Cruise ships are very aggressive in responding to such outbreaks." 

Cruising is "a very safe endeavor.''

The CDC refused to identify the cruise ships where passengers contracted Legionnaires' disease, which is unfortunate because this should be public information. The obvious question remains - did the Liberty of the Seas have prior cases of Legionella?

It makes me nervous when a Federal agency acts like a cheerleader for the cruise lines while refusing to disclose public information regarding which cruise ships may have Legionella.

UPDATE:

The South Florida Business Journal has an excellent article today "Legionnaire's May Be Linked to Ship."  The articles refers to comments posted on the popular CruiseCritic site that a passenger on the Liberty of the Seas had been diagnosed with Legionnaire's, so the H20 Zone and hot tubs were closed . . .

 Liberty of the Seas

Cruise Ship - Legionella Information:

Legionnaires' Disease During Cruise Linked to Water Supply

Legionnaires' Disease Is Cited in Cruise Death On Celebrity Cruise Ship

CDC: What is Legionnaires' disease?

 

 

Credits:

Legionella cells                     scienceblogs.com

Legionella in lungs               nalcoeurope.com

Liberty of the Seas                hassocka5489 (via wikemedia commons)