"Virus From Hell" - Gastroenteritis Strikes Passengers on Sea Princess

MSN / Ninesman reports on a viral outbreak aboard a Princess cruise ship cruising from Australia which sickened "hundreds" of passengers this week.

A passenger who was interviewed by MSN refers dramatically to being inflicted by a "virus from hell" with sounds of "vomiting echoing down the hallways."  The Sea Princess left Fremantle on August 18th and was heading, eventually, to Singapore. This was reportedly not the first outbreak.  New passengers who boarded in Singapore were not warned of the outbreak and were described by one passenger as "lambs being Sea Princess led to the slaughter . . . they just didn't know what they were in for."

The virus was allegedly on the cruise ship "for months." One passenger says that some of the bar and wait staff were already sick, when some passengers boarded, with gastroenteritis and influenza.  The passenger said that the sick crew members were afraid to report to the infirmary out of fear of losing their jobs. In our experience, some crew members who rely on tips keep working after they are ill.

MSN says that around 500 people were affected; however, Princess claims that this was not a major outbreak with only around 100 passengers becoming ill.  Princess confirmed to a newspaper in Australia that 100 passengers were sickened by what it innocuously referred to as a "tummy bug."

Princess is declining to compensate passengers for the outbreak and will not be reimbursing them for the shipboard medical treatment needed on the ship. 

We asked Princess for a comment but have not heard back from the cruise line.  

Photo Credit: Wikipedia / Bahnfrend Creative Commons

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

Read about cruise norovirus cases from Barfblog.

September 11 2014 Update: We just received a couple of comments from passengers on the ship (below), stating that the story is over-dramatic and the criticism of Princess is overblown.

September 12 2014 Update: Passengers who were struck down by the gastro-intestinal virus have disembarked at Fremantle this morning, according to abcnet.au. One passenger said he "was compensated for his bad experience. We got a special on our next cruise deal and the compensation was a couple of dollars as well, so they looked after us." Another passenger said "they were not told about what had happened but believe they should have been."

September 13 2014 Update: PerthNow reports that passengers said up to 400 people were ill on the ship which many are nicknaming “Pandemic Princess” and “Purgatory Princess.” Princess is sticking with its story that only a “small percentage” of passenger were affected. Passengers were offered a 50 per cent refund to be discounted from their next cruise. One retiree said that a "nice glass of brandy every night” kept him from becoming sick. 

Cruise Industry Fabricates and Distorts Norovirus Information

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

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

Ms. Duffy fabricates and distorts information in her article. 

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

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

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

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

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

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

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

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

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

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

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

Norovirus Aboard Crown Princess Sickens 66 Passengers & 17 Crew Members

Multiple news sources are reporting that an outbreak of a gastrointestinal illness has stricken "at least 66 passengers and 17 crew members" aboard Princess Cruises' Crown Princess.

A spokesperson for Princess Cruises says that the nasty digestive bug is likely norovirus. 

There have been 6 prior gastrointestinal outbreaks on cruise ships calling on U.S. ports this year. There were just 9 in all of last year.

We have been contacted by passengers complaining that passengers were sick and there was a strong smell of vomit in the hallways.

Norovirus has plagued the image of the cruise line. There was a massive outbreak aboard Royal Caribbean's Explorer of the Seas in January. A recent Harris Poll revealed that norovirus was one reason why the public does not perceive cruising as safe or reliable.  

We previously reported on a norovirus case involving the Crown PrincessHere We Go Again: Norovirus Sickens 100 Passengers on Crown Princess Sailing to Galveston

April 10 2014 Update:  The infected count is now at 104 passengers and 25 crew members on the Crown Princess. 

 

 

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

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

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

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

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

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

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

You can read the CDC report here.

 

Photo Credit: Wikipedia / Andrew J Bryson

Princess Cruises' Defense Every Time Norovirus Strikes: "The Passengers Bring It With Them"

This morning I wrote an article about Princess Cruises immediately blaming the sick passengers for what appears to be the latest norovirus outbreak aboard the Caribbean PrincessBlame Game: Princess Accuses Passengers of Starting Norovirus Outbreak on Caribbean Princess. Princess's PR spokesperson Julie Benson accused the passengers of bringing the virus with them when they boarded the cruise ship.

She didn't mention that the virus was wreaking havoc during the prior cruise.

Blaming the passengers is part of the PR strategy of Princess and the cruise industry.  

This afternoon I remembered reading a book by cruise expert Professor Ross Klein about this public Cruise Ship Squeezerelations defense strategy by Princess. The book is called "Cruise Ship Squeeze."  Professor Klein has been recognized as an expert regarding cruise line issues by both the House of Representatives and the Senate before whom he has testified several times.

I suggest reading Chapter 8 of Dr. Klein's book. At pages 179 - 183, you can read about the cruise industry and Princess blaming the passengers. Eleven years ago during a 2003 cruise, passengers were stricken with a gastrointestinal illness. Princess accused their cruise passengers sick with norovirus of "bringing it with them." But the truth is that during the prior cruise, the cruise ship had experienced passengers sickened with the same sickness. 

No scientists arrived at this conclusion. And there was nothing remotely scientific about what Princess represented to the public. 

Ever since then Princess says the same thing over and over every time norovirus sickens the guests. 

Who needs epidemiologists when the cruise line PR team has already figured out what to say?

Norovirus on Explorer of the Seas: More Sick than Reported

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

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

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

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

Watch the video below. 

Photo Credit: Roberto Schmidt / AFP / Getty

 

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

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

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

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

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

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

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

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

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

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

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

 

Photo BCredit: Mayra Beltran/Houston Chronicle

Norovirus Outbreak on Caribbean Princess Cruise Ship

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

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

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

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

A Houston newspaper said the virus was norovirus.

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

Yeah, right.

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

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

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

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

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

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

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

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

 

Photo Credit: Wikipedia / Yankeesman312

Will the Explorer of the Seas Be Ready to Safely Sail Tomorrow?

Explorer of the Seas Norovirus CleaningThe Explorer of the Seas arrived back in port in New Jersey yesterday.

ABC news interviewed some of the sick passengers. Its video below shows one passenger being taken away in an ambulance. ABC calls the incident a "horrific outbreak at sea." 

Incredibly, even though this is the largest gastrointestinal illness outbreaks on a cruise ship in 20 years, the Centers for Disease Control and Prevention (CDC) still has not officially announced what is causing the widespread illnesses.  In addition, the CDC has not declared how the virus came on the ship. It is an impossible task for a single epidemiologist to make such a determination. Without figuring out where and how the virus started, it seems difficult to take steps to eradicate the virus and make certain that the ship is safe to sail on.

The cruise line crew members are busy spraying, wiping and scrubbing. The ship sets sail again tomorrow. I say good luck to the next round of guests. 

 


 

Chart Shows Massive GI Outbreak: Explorer of the Seas Returns to New Jersey with 684 Sick People Aboard

Explorer of the SeasThe noro-stricken Explorer of the Seas has returned to New Jersey filled with 684 ill passengers and crew members. This is reportedly the largest gastrointestinal illness outbreaks on a cruise ship in twenty years.

A gastrointestinal illness (GI) chart from the Royal Caribbean cruise ship shows that the outbreak became obvious on Tuesday, January 21, 2014 when nearly 150 passengers reported that they were sick. By the next day, Wednesday. January 22, 2014, over 300 additional passengers suffered from the onset of the illness. You can track the outbreak affecting both passengers and crew on the chart below.

The chart does not have data included from yesterday or today.

The latest data from the Centers for Disease Control and Prevention (CDC) reveals that there are 684 ill, with 630 passengers and 54 crew members affected. 

It will be interesting if Royal Caribbean will produce a (GI) chart showing the number of patients who suffered from GI during the prior cruise.

Royal Caribbean Cruise Explorer of the Seas Norovirus Chart 

  Photo Credit: Explorer of the Seas - Thomas Layer / AP Photo 

Norovirus on the Explorer of the Seas: Why No Compensation for Crew Members?

Crew members work hard on cruise ships. Waiters and cabin attendants earn wages from Royal Caribbean of only $50 a month. That's right. $50 a month. That's something like $1.67 a day. They depend almost exclusively on tips from the passengers to support their families back home.

Utility cleaners are not entitled to tips, and they earn around only $545 a month. That's around $18.30 a day. 

Crew members work a minimum of 12 hours a day, sometimes more.

Norovirus Explorer of the Seas - Royal CaribbeanThey work 7 days a week. Every single day of the month. For 8 months.

When a norovirus outbreak occurs, they are pressed into duty to try and sanitize the huge ship. That involves hours and hours of extra spraying and wiping and scrubbing everything in sight.

I cannot imagine the extra work required of the cabin attendants who clean as many as 18 cabins and bathrooms a day. I don't know how these men and women clean so many cabins and bathroom when there's no gastrointestinal illness outbreak. But when noro virus strikes and the puking and diarrhea starts, there are literally millions and millions of noro infected microbes floating around in an aerosolized form. The microbes can fall into the fabric of the furniture, the duvet covers on the bed, into the carpet fibers, and all the tiny nooks and crannies of the bathroom tiles.  

When the passengers leave the cruise ship at the last day of this cruise from hell, will they tip these hardworking crew members?  Many passengers are mad and feel ripped off. They didn't obtain the vacations which they paid for with their family. They want their money back from the cruise line. Are they going to track down the public bathroom cleaners responsible for sanitizing all of the public restrooms and give them a $50 tip?

Today Royal Caribbean announced "compensation" for the passengers: a 50% refund and a 50% future credit. Is that fair? Some will accept it. Others will think that they are being mistreated again. Some people were sailing on the Explorer as a replacement cruise after the Grandeur of the Seas caught on fire last year. Are they interested in testing their luck one more time? 

Whatever you think of the cruise line's offer of compensation, remember one thing. The crew is not getting a nickel extra from the cruise line. So if you are a passenger and want to bitch, whine, moan and complain, don't forget about all of those crew members you left behind. Remember that they were the ones cleaning up all of your vomit and removing your bio-hazard bags. They are not receiving any compensation at all.  They are busy trying to get the cruise ship in shape for the next 3,000 guests who will soon board.

Explorer of the Seas Norovirus

Photo Credit: Top - Getty Images

Time Magazine: The Top 13 Cruise Ship Norovirus Outbreaks

With the Explorer of the Seas sailing back to New Jersey with almost 650 victims of norovirus related nausea and diarrhea, Time magazine just published the article Cruise Out of Control: The 13 Worst Norovirus Outbreaks on Cruise Ships.

The worst outbreak is, of course, Royal Caribbean's Explorer but the cruise line and its sister line Celebrity Cruises have the top three worst outbreaks and five of the top 13 worst outbreaks.

The passengers and crew aboard the Celebrity Mercury suffered through outbreaks on five consecutive  sailings back in 2000, including 443 sick in February 2000 and 419 in March. The Centers Norovirus Cruise Shipfor Disease Control and Prevention finally issued a rare no-sail order because the ship kept infecting the passengers and the cruise line wouldn't stop sailing.

The overall winner of Time's top 13 list is Princess Cruises which had five outbreaks on its brand alone: Crown Princess (January 2010) - 396; Crown Princess (February 2012) - 363;  Ruby Princess (March 2013) - 276; Coral Princess (February 2009) - 271; and Sun Princess (July 2012) - 216.

The disturbing thing about the list is that the Centers for Disease Control were unable to publish a single conclusion about where the norovirus came from. The public is left with the "blame game" of wondering whether the cruise ship food or water was contaminated, or the outbreak was caused by a sick galley worker, or was brought aboard by sick passengers and then spread because of inadequate hygiene.

When Norovirus Strikes, Cruise Line Cheerleaders Run & Hide

The news of 600 passengers and crew members stricken with what appears to be norovirus is dominating the cruise news today. The story broke on Friday with the Centers for Disease Control (CDC) announcing that a little over 300 passenger and crew aboard the Explorer of the Seas were suffering from nausea and diarrhea. 

The number rose to over 450 by the weekend. This morning the CDC raised the number of sick people to over 600.

This story came on the heels of another Royal Caribbean norovirus case last week. The Majesty of the Seas returned to Miami the other week with passengers and crew sickened by norovirus. The story Explorer of the Seas Noroviruswas heavily reported as well.

The cruise norovirus stories seem to bring the disgusting Triumph "poop cruise" stories back to life. Hundreds of people floating around on a nasty ship jammed with people who wanted off the cruise and away from all of the vomit and diarrhea.

This morning around 4:00 AM I published my second article ("A Royal Mess") on the outbreak. I then went to the airport in Miami at 5:30 AM to meet a client. A CNN special about the Explorer's gastrointestinal illness (GI) outbreak was on a flat screen television positioned above one of the baggage carousels. Hundreds of people who had just flown into Miami watched the television as they waited for their bags. I watched them either shake their heads in disgust or laugh, perhaps nervously, as the CNN anchor interviewed a Royal Caribbean passenger who described the widespread illnesses on the sick ship.

I was familiar with this particular passenger's plight because we had exchanged tweets on Twitter about the cruise ship GI outbreak. Passengers tweeted over the weekend to anyone and everyone who would listen to stories about the ordeal. I could see that reporters from ABC, CBS and other major networks were sending messages to anyone they could find on Twitter looking for a live voice to tell the story. Reuters reported that one passenger wrote on Twitter: "I've been sick and quarantined... Everything I touch goes in a biohazard bag." A newspaper in the U.K., the Daily Mail, embedded tweets from some of the sick passengers, including a couple of tweets that I shared with one ill passenger.

The puke-fest-on-the-cruise-from-hell-story was growing and growing. It became clear that far more than 300 people were sick. The story would shortly become viral.

As usual, CNN beat their competitors in covering the story with a couple of video interviews of passengers on the stricken ship. One passenger was angry about the cruise line's disorganization. He said his last cruise with Royal Caribbean also involved widespread gastrointestinal illnesses. Another passenger complained that no one in the ship's room service would answer his calls for water, and no one told him when the quarantine was lifted.     

Where were the public relation representatives of Royal Caribbean protecting the crew's and cruise line's reputations? Where were the PR experts for the cruise industry? Royal Caribbean finally sent out a formal statement to the press but there was no one on the cruise line's twitter feed interacting contemporaneously with the sick and suffering on the cruise ship. 

The trade organization for the cruise line, Cruise Line International Association (CLIA), was asleep. Indeed, a check of the CLIA Twitter feed (@CruiseFacts) shows no tweets since December 18, 2013 - over a month! That's an eternity in the fast paced world of social media.

The CEO of CLIA, Christine Duffy, was no where to be seen. She needed to present the cruise industry's side of the story. She last tweeted on Thursday, the day before the outbreak from her handle @CLIACEO. Ironically, she last tweeted about a "great column" in Travel Weekly about the "new wave of attacks on the cruise industry" which featured a travel agent's criticism of me. (You can read my response here).

This shows a problem with the cruise lines' PR. The cruise industry PR is always late and in reaction to bad press. The cruise industry seems to be always complaining about CNN and the bad press, but it doesn't bother to interact with its aggrieved customers in real time. By the time it finally responds to bad news, there are other stories bringing even worse news. The travel writers will be pleased to write a puff piece whenever CLIA wants one, but the coverage is strictly after-the-fact. It lacks spontaneity and genuineness. There are no travel writers fast and nimble enough to react immediately when trouble comes.  

When disaster strikes, whether it's a fire, a capsizing, or just the latest norovirus outbreak, the cruise lines don't know what to do. Their twitter and Facebook pages are silent. Their executives go to the Miami Heat games. The travel agents and travel publications run and hide.

A crisis management expert, Rich Klein, just wrote a blog about the predicament facing Royal Caribbean. With the headline "Honesty Remains Lonely Word," he writes that the cruise line has active Twitter and Facebook pages "but 24+ hours into their respective crises, only customers are reporting the obvious news while the companies offer little insight into what happened."

As sick passengers lamented their cruise-from-hell on Twitter and aggressive news reporters brought their stories to an international audience, Royal Caribbean and CLIA were enjoying their weekend. No one had their hands on the wheels of the PR machine. When genuine sympathy and a quick refund were in order, the cruise industry engaged in slow motion corporate talk. Royal Caribbean has still not even mentioned whether or how it intends to compensate its sick guests for the unpleasant, aborted cruise. 

 

Photo Credit: Thomas Layer / AP Photo

Puke Fest Aboard Royal Caribbean's Explorer of the Seas

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

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

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

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

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

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

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

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

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

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

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

 

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

Photo Credit: Wikipedia / Emma Jones

Celebrity Summit "Cruise From Hell:" Another Passenger Speaks Her Mind About Norovirus

Celebrity Summit Cruise ShipLast week we published an article which featured a comment by a passenger aboard the noro-infected Celebrity Summit cruise ship. 

A number of people commented or contacted our office about the comment, both pro and con. 

We rarely handle norovirus cases, but the discussion around the subject, we think, is still important. How the cruise industry treats gastrointestinal infection cases reflects the cruise lines' standards for hygiene and the cruise companies' attitudes toward their customers.

Here's the latest comments about the situation on the Summit:     

We too were on the Summit recently. We reported how dirty our Royal Suite was. They said they cleaned it, but the only evidence was that they used epoxy on the dining area parkay floor. The smell was horrendous.

I had allergic reaction tongue swelled, face, nose, eyelids and had hives on face and upper body. The doctor on call would not acknowledge this and commenced to tell me that I was having an allergic reaction to blood pressure and cholesterol medications I have been on for years. He told me to stop taking these medications and he filled new prescriptions together with benedryl. They put in a IV to rehydrate me two times.

At the end of the cruise I was taken off the ship in a wheelchair. I had been sick the entire second week. Our butler was under orders to charge us for all the bottle water we needed. They clean the suite with a dirty rag and some kind of spray they use in all the rooms and hallways. It's disgusting! You wouldn't use someone elses used tissue. How sanitary is that?

They charged our ship account $600 for the doctor and pills (that I didn't use except for the benedryl). When we questioned the charge even though we had bought the travel insurance, the Concierge said we "must read the fine print." Three days after my allergic reaction, my disabled husband got the norovirus. Through all of this the doctor refused to come to our suite. They said we needed to come to the doctor office.

This trip was from hell!

Have a comment? Leave your thoughts below or join the discussion on on our Facebook page.

Norovirus Outbreak Aboard the Celebrity Constellation

We received information that the Celebrity Constellation has been hit with a norovirus outbreak during the September 25, 2013 to October 7, 2013 cruise.

A passenger informed us:

Just off the Celebrity Constellation Black Sea cruise Sept. 25th - Oct. 7th. Over 300 sick with Norovirus etc . . . Crew did their best but the sickness progressed rapidly . . . no time to really get rid of the problem between cruises. Expensive problem for passengers traveling from far Celebrity Constellation Norovirusaway places and not being warned prior to boarding the ship. This produces lots of anxiety for all who look forward to a wonderful time. Celebrity should do better for their loyal customers. 

Cruise expert Professor Ross Klein also commented on his popular web site CruiseJunkie that passengers had complained about the disease outbreak on the Constellation.

This outbreak was taking place at the same time as another norovirus outbreak on another Celebrity cruise ship, which you can read about here:

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

We commented on Celebrity Cruises' problems with norovirus aboard the Constellation last year.

If you were on the Constellation, please leave a comment below regarding how Celebrity handled the situation or join the discussion on our Facebook page.

 

Photo Credit: Getty Images 

Norovirus: What's the Cruise Industry's Priority? Public Relations or Passenger Health?

BBC News has an article about a gastrointestinal virus outbreak sickening passengers aboard a Fred Olsen cruise ship this week.

Last week we reported on the Fred Olsen Black Watch cruise ship (what a dreadful name) which was nicknamed the "Black Death" by norovirus infected passengers who have suffered through three consecutive sailings aboard what some people are also calling the "plague ship."

Around 10% of Black Watch passengers have been infected over the last month.

Fred Olsen Boudicca Cruise Ship - NorovirusBBC News says that the Boudicca is the latest Fred Olsen ship to become sick. The cruise line confirms there has been an outbreak of what the cruise line is saying is a "a gastroenteritis-type illness" on board the cruise ship which left Belfast last week. That means that the cruise line doesn't know exactly what type of sickness it is.

Is it norovirus or a e-coli outbreak? Fred Olsen doesn't seem to know.

This is not the first outbreak this year on the Boudicca this year. Read: Our Plague Ship Diary: After Ten Days on Cruise Hit by Norovirus, Two Friends Present the Holiday Snaps from Hell

What caused the latest outbreak? Contaminated food or water?  Sick crew members?  Fred Olsen is not saying if it knows. Usually the cruise lines are quick to blame everything but the cruise ship and its crew. The "dirty handed passengers" of the nasty passengers are usually blamed. 

What we know from the BBC is that at least 72 Boudicca passengers out of the 760 or so passengers are ill. That's around 9%, which is many times the percentage of sick passengers which the Centers for Disease Control requires to be reported in the U.S. 

The cruise line says that the cruise ship will return to Belfast tomorrow where the ship will be cleaned and sanitized. The ship will then quickly head off on a 12-night cruise to Madeira and the Canaries. 

Cruise lines like Fred Olsen tout that "the health, safety and well-being of all our guests and crew is paramount." But is this true?

A responsible company would make the best effort to find out exactly what type of illness affected the passengers, such as testing the food and/or determining whether food handlers were sick and not properly quarantined (a problem recently noted by health inspectors during U.S. CDC Vessel Sanitation Program inspections).

Right now there are over 70 Boudicca passengers spewing vomit and spraying diarrhea in their cabins and bathrooms. (Watch Vomiting Larry) Many millions of infected particles of some type of virus are covering the floors, carpets, bed covers, and nooks and crannies of these cabins. Yes, the cabins will be cleaned thoroughly (we hope) but will a few dozen infected particles linger to greet a new round of passengers? Its takes just 20 particles or so to get sick.

The new passengers, of course, are not told whether their cabins were the scene of a puke-and-diarrhea-fest just hours before they arrived.

It seems like an impossible task for the poor cabin attendants pressed into action for such a short period of time to try and kill off all of the noro or e-coli in the cabins after such intense purging of the stomach and bowels of the sick people. But what if the culprit is in the food from the galley?  There is no way that the cruise ship will find out in the limited time when the sick disembark the ship and the healthy arrive. There's not enough time to slow down and take an extra couple of days to let the epidemiologists perform their job of finding the causative viral or bacterial agent and determining how it came aboard the ship.    

Instead, we hear cruise lines telling the new passengers: "Trust us. Your health is our highest concern."

"Black Death Plague Ship?" Cruise Ship Sickness Back in the News

The Daily Record reports that the Fred Olsen Black Watch was nick-named "Black Death" after more than 100 passengers were struck down by a norovirus outbreak during a 12-night Scandinavia and St Petersburg cruise. 

The cabins of infected quarantined passengers were marked with crosses to warn cruise staff who wore face masks for protection. Their luggage and bags were was marked with chalk to protect baggage handlers.

An ambulance was waiting in the home port to take a sick cruise passenger to the hospital Black Watch Cruise Ship Norovirusin Dunfermline.

The newspaper reports that the previous cruise also had a norovirus outbreak. The newspaper quoted a passenger on the sickly cruise ship saying:

“The staff marked doors of those infected with a cross. It was like the Dark Ages. Forget the Black Watch – we were on the Black Death plague ship.”

130 out of 778 guests became ill.

Meanwhile a small number (8) cruise passengers aboard the the luxury cruise ship, the Queen Mary 2 (QM2), come down with gastrointestinal symptoms thought to be norovirus, according to the Daily Echo

Norovirus is also commonly known as the "cruise ship sickness."

The cruise industry hates it when people call it that. Cruise lines point out that norovirus is also common in hospitals, nursing homes and child-care facilities. They are right of course. But it's a sad commentary when you have to compare high priced cruise ships to places with ill patients, infirm geriatrics, and kids with poop in their diapers.

Celebrity Millennium Puke Cruise Arrives in Alaska

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

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

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

Photo Credit: Wikimedia / Captain-Tucker

Celebrity Millennium Cruise Ship Norovirus

 

Volendam Norovirus Outbreak Sickens HAL Cruise Passengers

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

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

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

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

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

Yesterday we reported on another HAL disease outbreak on the Veendam

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

 

Photo Credit: Wikipedia / Barek

South Florida TV Station: Cruise Ship Workers Breaking Rules & Making Passengers Sick

Cruise Ship Virus - NorovirusThursday night a news station in West Palm Beach, Florida is airing an expose into passengers who are sickened on cruise ships.

WPTV - 5 aired a teaser video tonight entitled Cruise Ship Workers are Breaking the Rules, and Making Passengers Sick.

It sounds like the TV station will take a look at the outbreak of gastrointestinal viruses which have plagued the cruise industry over the years. It promises to reveal the cruise lines with the most problems (i.e., Princess Cruises and Holland America Line).

Cruise lines always blame the passengers for not washing their hands, and the passengers usually blame the cruise lines for having unsanitary ships.  Meanwhile no one is conducting a scientific analysis to determine exactly where the virus originated.  

I will be watching tomorrow night at 11:00 PM.   

 

 

Why Do the Cruise Lines Always Blame the Passengers When Norovirus Breaks Out?

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

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

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

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

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

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

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

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

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

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

 

Photo Credit: Centers for Disease Control

"Like a Crime Scene:" Passengers Threaten Riot on Sickly Cruise Ship "Vomit Hell"

U.K. and Australian newspapers don't mince words. Unlike the U. S. media which may politely refer to nasty norovirus outbreak on a cruise ship as a "stomach bug," the U.K. press and an Australian newspaper are using some choice words to describe a vomiting virus which has swept through P&O's Oriana cruise ship, sickening many hundreds of passengers.

The P&O crew taped off areas of the ship "like a crime scene" while passengers said the liner reeked of vomit, the British tabloid The Sun reports.  Reports of 300 to 400 ill passengers have come from on board the cruise ship. "There might be a riot because the captain and crew refuse to listen. We'll refuse to disembark unless we get some answers. It's been a cruise to hell," British passenger Dave Stringer, 57, told The Sun as mentions in its article Fury Over Cruise Ship Vomit Hell.

P&O Oriana Cruise Ship NorovirusIt seems that P&O is blaming the passengers for allegedly bringing the virus aboard and then spreading it by not washing their hands - which is the cruise industry's usual defense to a sick ship.

The London Evening Standard reports that the cruise line appears to be involved in a cover-up:

"A spokeswoman for P&O's parent company Carnival said there had been 'an incidence of a mild gastrointestinal illness' among the passengers.

She added that as of today, of 1,843 passengers, 'the number of passengers with active symptoms is six.'

But passenger Paul Gilman, 62, told the Daily Mail: "It has been outrageous from start to finish. People were falling like flies, yet the crew were trying to insist everything was fine.

'Everyone is saying, this is a plague ship. It's a living nightmare.'"

The Oriana returns to Southampton today where, after "enhanced cleaning" takes place, the ship will re-rack with another 1,800 passengers for a holiday cruise.  Stay tuned for more vomit-cruise-from-hell stories.

 

Photo Credit: News Tank

Disease on HAL's Amsterdam Sickens 10% of Passengers

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

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

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

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

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

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

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

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

Holland america Line Cruise Ships - Norovirus

Art credit: Chan Lowe / Sun Sentinel

Chart Credit: Friends of the Earth

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 

Norovirus Outbreak on Royal Caribbean's Voyager of the Seas?

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

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

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

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

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

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

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

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

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

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

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

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

Ruby Princess Latest Cruise Ship to Battle Norovirus

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

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

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

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

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

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

Princess' Crown Princess (two sailings) Celebrity's Silhouette Cruise Sickness - Norovirus

Royal Caribbean's Voyager of the Seas

Princess' Ruby Princess 

P & O Aurora.

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

Only cruise ships calling on U.S. ports are required to report sickness outbreaks to the CDC.  Cruise line are required to make the report only when 3% or more of passengers or crew reported symptoms of diarrheal disease to the ships medical staff during the voyage.

Under-reporting occurs regularly because many passengers can't make it away from their toilets due to diarrhea, and some passengers don't want to be confined to their cabins. Crewmembers often work while sick.

 

Photo credit:  bottom - cheezburger.com

HAL's Veendam: 1 Dead, 80 Sick

Multiple news sources are reporting that an U.S passenger died aboard Holland America Line's Veendam cruise ship that arrived in Rio de Janeiro yesterday.

HAL's Veendam is also the same cruise ship on which approximated 80 passengers fell ill, according to the state-run Brazilian news agency, Agencia Brasil.  The agency refers to the cruise passengers as suffering from "gastro-enteritis."  It is unknown whether there is a norovirus outbreak. 

Forensic doctors are investigating the death of the American passenger.  A CNN article reports that the cruise ship doctors told police that the woman was "elderly and suffered from diabetes and hypertension."  (So much for the confidentiality of a patient's medical information.) 

The Veendam left New York 36 days ago for a South America cruise. The Veendam had stopped earlier in the cruise at ports in Chile, Argentina and Uruguay before reaching Rio de Janeiro.

November 23, 2011 Update: 

HAL claims that the death and the illness of some 80 passengers are unrelated.  HAL issued a statement to Noticias de Cruceros that the passenger died due to a heart condition which had nothing to do with the  gastrointestinal ilnesses.  It's amazing how cruise line PR people suddenly become epidemiologists when someone dies on their cruise ship. 

HAL Veendam - Cruise Cruise Norovirus?But a local newspaper in Brazil, Clarin, has the following account (translated):

An American, 61, died of a suspected food poisoning on a luxury cruise ship which arrived in Rio de Janeiro, from Chile, Argentina and Uruguay, in which 86 other passengers had symptoms such as cramps and vomiting, reported Brazilian authorities, in what is thought to be an outbreak of gastroenteritis due to consumption of bad food and poor hygiene.

The Holland America liner MS Veendam, carrying 1259 passengers, arrived in Rio de Janeiro and was quarantined to be subjected to investigations by the Brazilian Federal Police and the National Health Surveillance Agency (ANVISA) .

Tourism Secretary de Janeiro, Ronald Azaro, said that 79 people have contracted some sort of infection on the trip. When the November 6 cruise departed from Valparaiso, Chile, ANVISA received a warning symptoms of some passengers.  He went to Argentina and Uruguay, having started the journey in New York, USA, with stops in Panama and Colombia, according to the Brazilian press.

The official said the Brazilian Federal Police took over the investigation into the death of the American, identified as Dorothy Philips, age 61, occurred on board as the ship was in the Maua Pier in the city of Rio. 

Sources told the Brazilian media crew that the crew issued a red alert three days ago to take care with hygiene and some food. For now, the pool and the library of the cruise were closed. 

According to the NASS report released last month, 27% of cruise ships passing through the Brazilian coast have health problems than those permitted by the rules in Brazil. Among the problems, according to an official report collection are inadequate food and lack of water conditions offered to passengers. 

ANVISA recalled thatpassengers on the same boat, in March this year, experienced gastroenteritis cruising to  Brazil. At least 43 passengers had symptoms in Belem, capital of Amazon state of Pará.

 

Photo credit:  Michael Penn / Juneau Empire 

New Study Reveals Little New About Norovirus on Cruise Ships

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

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

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

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

Nothing new with these conclusions.

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

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

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

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

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

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

Read some of our other articles about cruise ship norovirus:

Cruise Ship Norovirus - Clean the Damn Toilets!

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

Cruise Ship Norovirus - Something in the Water?

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

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