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

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

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

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

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

Nothing new with these conclusions.

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

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

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

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

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

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

Read some of our other articles about cruise ship norovirus:

Cruise Ship Norovirus - Clean the Damn Toilets!

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

Cruise Ship Norovirus - Something in the Water?

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

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

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The Observer in St. Kitts-Nevis is reporting that cruise passengers on a tour bus were robbed this morning, apparently during an excursion from a cruise ship  - "Busload of Tourists Robbed at Gunpoint." 

The robbery reportedly occurred in the Sandy Point area on the island.  A "local tour bus of cruise passengers had been robbed at gunpoint along the island’s main road as the bus made its way to Brimestone Hill."

The tour bus is identified as the "Caribbean Journey Masters tour bus," which was being driven by owner Urban Herbert at the time of the incident.  While the tour bus was heading towards a historic site, rocks and branches were strewn across the bus' path.  Mr. Herbert exited the bus to investigate, and the robbers threw a rock into the windshield of the bus. Two armed, masked men rushed from the bushes and entered the bus.

The newspaper reported that seventeen (17) passengers including an infant were aboard the bus at the time of the robbery.  The cruise passengers were robbed of their money, cell phones, jewelry and other personal items.  The police  released a statement that no one was physically injured.

As is often the case, the police did not release the name of the cruise line or cruise ship.  Local police and tourism bureaus in the Caribbean are very sensitive to bad press and avoid embarrassing the cruise lines on which they rely for the U.S. tourist dollar.   

It turns out that the passengers were from the Celebrity Cruises' Mercury cruise ship. 

The St. Kitts police / tourism people claim that crime like this is unheard of; however, another local newspaper SKNVibes reports in an article - "Tourists Robbed at Gunpoint Near Brimstone Hill" - that local taxi drivers state that this is nothing new and security needs to be improved, particularly when cruise ships arrive. 

I have written many articles about the high crime rates in many of the Caribbean islands frequented by cruise lines - Crime in Caribbean Ports of Call Against Cruise Passengers.  Consider the following articles in the last year alone: 

Antigua - Cruise Passengers Attacked & Robbed in Antigua While Cruise and Tourism Officials Meet and Passenger From Star Clippers Murdered in Antigua

Bahamas 18 Passengers From Royal Caribbean & Disney Cruise Ships Robbed By Shotgun in the Bahamas,  Eleven Cruise Passengers Robbed in Nassau, and Cruising To The Bahamas - Is It Safe?

Guatemala - Norwegian Cruise Line Passenger Murdered in Guatemala  

Mexico -  Royal Caribbean and Norwegian Cruise Lines Pull Ships From L.A. Due To Crime In Mexico

St. Lucia - Norwegian Cruise Line Drops St. Lucia and 14 Cruise Passengers Robbed at Anse-La-Raye Waterfall in St. Lucia

St. Thomas - More Caribbean Crime - Carnival Passenger Killed In St. Thomas

Additional information: Tourism and Crime in the Caribbean  

December 3, 2010 Update:

"Visitors Warned About Safety in St. Kitts After Tourist Robbery"

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

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

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

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

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

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

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

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

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

March 27, 2010 Update:

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

Credits:

Photograph         Directory of Charleston

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A local news station in Phoenix, Arizona,  ABC-15 (KNXV), is reporting on the latest efforts by Kendall Carver to protect families who cruise in international waters.

In a video interview entitled "Valley Man Pushes for New Laws after Daughter Vanishes,"  Mr. Carver explains that his 40-year-old vanished on the second day of a seven-day Alaskan cruise aboard Celebrity Cruises' Mercury cruise ship back in 2004.  The cruise ship covered the incident up and then lied to Mr. Carver.

ABC-15 reports that for more than a year, Mr. Carver says the cruise line "provided little information.  He hired private detectives, lawyers and spent quite a bit of money searching for any indication as to what happened.  Eventually, he said they found an employee on the boat who had some information."

"We deposed the steward to find out that he had reported our daughter missing daily for five days on that ship and his supervisor told him to forget it and do his job," said Carver.  "They had not notified the FBI, they had not notified anybody, in fact, they gathered her belongings and got rid of them."

Carver says what many people may not know is that the cruise ship industry doesn't even have to report crimes ranging from theft to a disappearance.

"You can get the crime report for any city in the country, by zip code, by name, but you can't get that for cruise ships," Mr. Carver told ABC-15.

To push for new laws and help victims of cruise ship crimes, Carver formed the organization - International Cruise Victims (ICV).  He has been working on this cause everyday for the past five years.

"We have hundreds of volunteers, with next to no money and as of this week we are now in 20 countries around the world," said Carver.  "It's one of those things as a father I couldn't walk away from, I still want answers and people need to know what's going on."

As a result of the ICV's efforts, a cruise law - called the Cruise Vessel Safety and Security Act of 2009 - passed the House of Representatives last year.  The bill is awaiting a vote in the Senate this year.

"This would make it mandatory that they immediately advise the FBI," said Carver.  "They (travelers) don't realize when they get onto these ships they're going into a foreign country."

To learn more, read about the story of Merrian Carver on the ICV website. Please consider joining  the ICV and making a small donation to keep the grass root organization operating.

The ABC-15 video with Mr. Carver is below:

For additional information about Ken's fight to protect the cruising public, consider reading:

Family Wins Battle Against Cruise Ship Industry After Daughter's Disappearance

Credits:

Photograph of Mirrian Carver        Ken Carver  

Video        ABC-15 (KNXV) Phoenix, AZ  (Christopher Sign reporting)

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

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

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

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

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

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

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

Credits:

Chart        Virginia Bioinformatics Institute, Virginia Tech

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At 8:00 p.m. this evening, Celebrity Cruises' Mercury cruise ship will sail for an eight day cruise to the Caribbean.

The Mercury has been called the "sickest sea at sea."  Even ABC's Good Morning America posed the question: Celebrity Mercury - Sickest Ship At Sea - Can Cruise Ship Be Cured? 

Local South Carolina ABC affiliate WCIV News - 4 is optimistic that the cruise ship has been thoroughly cleaned over the past 72 hours after the Centers for Disease Control (CDC) issued a rare "no-sail" advisory.  The ABC affiliate reports that "officials are now confident the ship is safe."

But I would not be so sure.  Gastro-intestinal illnesses can be caused by contaminated food or water, from fecal-oral transmission from crew member to passenger, or from sick passengers who come aboard and infect others.

And the CDC has not determined the cause of the last sickness outbreak.  The CDC report for the Celebrity Mercury's March 8th -19th sailing indicates that the "causative" agent for the widespread illnesses is "unknown."

Not sure I would set sail on a "sick" cruise ship where the CDC can't exclude contaminated food or water or ill crew members as the causes. 

Let's cross our fingers and hope another round of passengers don't find themselves confined to their cabins.  

March 22, 2010 Update:

According to USA Today, only 1,076 passengers are cruising on the Mercury (which is about 60% full).  Around 800 passengers canceled and obtained what is described as a full refund.

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

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

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

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

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

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

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

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

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

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

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

Here is a recent video from the AP: 

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

Let us hear from you.

Credits:

Video      AP

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

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

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

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

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

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

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

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

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

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

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

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

Credits:

Video              ABC Good Morning America

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

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

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

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

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

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

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

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

March 16, 2010 Update:

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

Credits:

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

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

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

This is now the third cruise on the Mercury where passengers have become sickened with a gastrointestinal sickness.  

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

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

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

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

For prior articles:

Stomach Bug Hits Celebrity's Mercury Cruise Ship Again

Will the Celebrity Mercury Infect Another Round of Passengers?

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

Can Sick Cruise Ships Cause Norovirus Outbreaks in Ports?

Additional Passengers Sickened on Mercury Cruise Ship

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

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

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

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

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

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

March 15, 2010 Update:

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

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

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

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

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

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

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

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

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

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

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

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

Stay tuned. 

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

Credits:

Cruise desserts     nbnpress.com

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

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

Here We Go Again

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

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

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

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

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

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

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

Other Royal Caribbean Cruise Ships Experiencing Widespread Illness

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

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

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

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

Video:          WCSC (AP)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Credits:      

Sick cruise passenger           Bill Mahler's Food Poison Blog

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

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The departure of Celebrity Cruises' Mercury cruise ship, scheduled for today, has been delayed so that the cruise line can make a last ditch effort to try and kill the norovirus which sickened over 20% of the passengers and crew during its last cruise. 

Celebrity is offering vouchers to accommodate the passengers or staying overnight in Charleston.

The ship is now scheduled to depart on Saturday at 5 PM.

A large number of newspapers and blogs are covering the plight of the sick cruise ship.  The highly respected Food Poison Blog by super-lawyer Bill Mahler covers the problem in an article "Over 400 Sickened with Norovirus on Cruise."  NPR (my favorite) has even gotten involved with a story entitled "Stomach Flu Hits Caribbean Cruise Ship."

Celebrity Cruises president Daniel Hanrahan issued a statement: "I would like to apologize for the inconvenience this delay will cause our guests on Celebrity Mercury's next sailing . . . the extra time we are taking to sanitize the ship will help prevent any illness from affecting the next cruise."

Let's hope so.

February 27, 2010 Update:

Passengers who live more than a 2 hour drive from Charleston arte staying in area hotels paid by the cruise line, and credited $50 for expenses incurred.  According to the Post and Courier, the cruise's itinerary was shortened by a day, with a call in Key West canceled. Passengers who sail today will be given on-board credit for two-days worth of their fare and a 25 percent discount on future Celebrity cruise bookings

Read other Cruise Law News articles regarding the sick Mercury cruise ship.

Interested in other cruise - norovirus articles?  consider reading:

Cruise Ship Norovirus - Clean the Damn Toilets! 

Cruise Ship Bathrooms, Norovirus and Medical Care

"Cursed Cruise Ship" Balmoral At Risk of Being Impounded As Hundreds More Suffer Vomiting Bug

U.S. to Block Arrival of Queen Victoria After Norovirus Outbreak?

Credits:

Mercury cruise ship and passengers             AP (Mic Smith) via Washington Post 

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Around 450 passengers and crew are sick with nausea, vomiting and diarrhea aboard Celebrity's Mercury as the ill cruise ship completes its inaugural cruise to the Caribbean from the port of Charleston, South Carolina.  The cause of the illness is unknown.  The cruise ship will sail again from Charleston tomorrow, and many new passengers don't want to set foot on the ship.

This is not what the city of Charleston or the thousands of passengers who paid for a relaxing cruise to the Caribbean bargained for.  

The media is focusing on this nauseating story. The Baltimore Sun has an article "More Than 400 Sick Aboard Celebrity Mercury Cruise Ship" (the comments are brutal).  The Consumerist's headline says it all: "Caribbean Cruise Ship Turns Into Diarrhea Nightmare Vessel." 

In ABC News' story "400-Plus Passengers Get Sick on Cruise," the cruise line's PR spokesperson, Cynthia Martinez, says that the ship doctors are giving passengers anti-nausea and diarrhea medication such as Pepto-Bismol . . . "   

Pepto-Bismol?  

The cruise line is in overdrive trying to clean the cruise ship. The web site of a local news station in Charleston carries the story "Mercury Crews Scramble to Clean Cruise Ship."  The ship's crewmembers are "conducting some 'enhanced cleaning,' according to Ms. Martinez. 

"Enhanced cleaning?"  What the heck does that mean?  And what exactly are they cleaning?

The cruise line has not even established the type of pathogen or virus involved and its source.  Large scale sickness like this on a cruise ship can come from numerous sources - such as a contaminated water supply, improperly prepared food, or norovirus in bathrooms. The Norovirus Blog reports that cruise ship norovirus outbreaks are linked to the ship's bathrooms, and we addressed this issue last year in our blog "Cruise Ship Norovirus - Clean the Damn Toilets!"

But so far, there is no indication that norovirus in the ship's bathrooms is the culprit.  If the ship's water supply is contaminated, all of the external cleaning in the world is not going to eradicate the problem.

And at this point, it does not look like the cruise line knows, or at least it is not disclosing the source of the problem to the public or the next 1,800 passengers who are boarding the cruise ship tomorrow.  Instead, the cruise line is implying that its the passengers who are the problem because they are not washing their hands, rather than the ship which is infecting the passengers.    

This week our office has received a number of inquiries from passengers who are frightened to sail on the Mercury tomorrow.  They wonder whether they can cancel their cruise and get their money back.  Unfortunately, the cruise line's lawyers have spent years crafting terms and conditions in the passenger tickets which protect the cruise line, not the consumer.  And if the passenger has travel insurance, the insurance company probably won't pay if the passengers cancel because they are not sick (yet) and the cruise ship will sail again tomorrow, come-hell-or-high-water.    

The cruise line is promising to give sick passengers a voucher "based on the number of days a guest is isolated divided by the total of cruise fare paid."  Huh?  These nice people are sitting on a crapper in their cabins, vomiting into a waste can on their lap.  All they get is a voucher for partial payment for another cruise?  That's a crappy deal, excuse the pun.

What a predicament for these folks.  Tomorrow, the cruise line will unload the 1,800 passengers from the Mercury and load another 1,8000 back on.  And the Mercury will set sail again, this time for a 10 day cruise to Mexico, Belize, the Bahamas, and Key West. 

We wish the passengers luck.

And don't forget to take a large bottle of Pepto-Bismol with you . . .

February 25, 2010 Update:

The Washington Post reports that the CDC is confirming the presence of norovirus on the cruise shp.  

Our prior article on the Mercury's history of shipboard illnesses: Stomach Bug Hits Celebrity's Mercury Cruise Ship Again

February 26, 2010 Update:

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

March 4, 2010 Update:

The Baltimore Sun reports that "about 55 guests have been treated for gastro-like symptoms" on the Mercury cruise ship.

Credits:

Pepto Bismol     Shakespeare's Monkey (fark.com)

Itinerary                Celebrity Cruises  

• Comments (1)

The Associated Press reports that hundreds of passengers have fallen ill with a stomach ailment aboard the cruise ship Mercury, operated by Celebrity Cruises, which is sailing in the Caribbean.

Over 300 of the 1,800 passengers are experiencing upset stomachs, vomiting and diarrhea. Another 25 or so crewmembers are also ill. The Mercury left Charleston, South Carolina on February 15th and this is the first cruise from Charleston.

The PR person for Celebrity / Royal Caribbean stated that the cruise ship's medical facilities were "overwhelmed" and another doctor and nurse boarded the Mercury in St. Kitts.

The cruise line did not report what virus or pathogen was involved, but the cruise ship dropped samples off in Puerto Rico for testing. The ship is scheduled to return to Charleston on Friday.

The Centers for Disease Control (CDC) recorded two outbreaks of gastrointestinal illness on the Celebrity Mercury last year. The CDC investigated outbreaks on the Celebrity Mercury in  January and February 2009.

The CDC has a web page which tracks "Outbreak Updates for International Cruise Ships."

Celebrity's Mercury was in the news just last week when a Hazmat team and ambulances arrived at the port in Baltimore after 6 crewmembers became ill after inhaling fumes while welding on the cruise ship. The crewmembers may have poisoned due to carbon monoxide as reported in the press, although there was no carbon monoxide detected when the cruise ship arrived in port the following day. The cruise ship then repositioned to Charleston for this cruise.

We reported on the incident - Carbon Monoxide Poisoning Reported Aboard Celebrity's Mercury Cruise Ship.  There has been no follow up stories on the cause of the illnesses or the condition of the sick crewmembers.

February 24, 2010 Update:

Will the Celebrity Mercury Infect Another Round of Passengers?

Credits:

Artwork          Maxim magazine

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Multiple news sources are reporting that six crewmembers on Celebrity's Mercury cruise ship at the Port of Baltimore are being treated for exposure to carbon monoxide. 

Fire rescue officials took the the six crew members  to local hospitals. 

According to WBAL TV in Baltimore, the Baltimore fire department spokesman Chief Kevin Cartwright said crews responded to the scene at about 11:30 a.m. Saturday to treat the victims.

Cynthia Martinez, the PR spokesperson for Royal Caribbean Cruises (the parent company of Celebrity Cruises) issued a statement that crew members were performing a welding operation on board the ship inside the engine room Friday. The members began to report respiratory problems and other medical issues after they completed their work and reported to the ship's medical facility.

A local ABC station reports that "at least 5 medical units, a Hazmat team, and an EMS Commander are currently at the scene treating the victims and taking carbon monoxide readings to determine the air's quality."

The cruise line PR spokesperson also said: "Out of an abundance of caution, the ship staff contacted city fire and rescue, which responded Saturday to treat the 6 crew members and transport them to hospitals."   Ms. Martinez claims that all six crew members were walking when they entered the ambulances to go to the hospitals. 

The TV station in Baltimore also reports that a Hazmat crew is trying to determine where the leak was coming from.

Update February 14, 2010:

One of the writers at the online cruise community CruiseMates.com brought the following article to my attention: "6 Workers Sickened On Cruise Ship In Baltimore" written by the AP and published on the web site of a local CBS affiliate WJZ in Baltimore. The article contained the photo below.  It has  a little more detail and indicates that the Hazmat team did not find carbon monoxide on the ship: 

"Baltimore City Fire and hazmat officials went on the ship and tested for CO and found nothing."

This does not appear particularly surprising, because the testing was done 12 to 18 hours after the suspected exposure.

Cynthia Martinez, the PR spokesperson for the cruise line, is attributed saying that the Mercury cruise ship can hold a couple thousand passengers.  The cruise ship was heading to Baltimore at the time of the incident. She indicated that the six ill six workers had been working in the engine room, welding pipes with welding gear Friday night at the time of the suspected exposure.

There have been no reports by the hospitals or the cruise line regarding the current medical condition of the ill crewmembers.  

The Mercury was cleared to sail to South Carolina and has no passengers are on it until they board in Charlston. 

 

Credit:

Celebrity Cruises' Mercury cruise ship        Baltimore Sun

Hazmat photograph               AP  / CBS Baltimore affiliate WJZ 

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