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

The last several articles on this blog have involved gastrointestinal (G.I.) virus outbreaks on cruise ships.

The cruise ships involved are Holland American Lines’ Volendam and Veendam, (HAL ships, historically, are the most likely to be contaminated with norovirus), the Discovery cruise ship which was held up in Liverpool for what the cruise lines describe as “enhanced cleaning,” and most recently the Celebrity Millennium which arrived in Alaska with a bunch of sick passengers who went ashore and coughed all over the city of Seward.

These ships join the list of other sick cruise ships this year. There are seven official reports of G.I. cases so far this year documented by the U.S. Centers for Disease Control and Prevention (CDC). But the list is incomplete. The CDC requires cruise lines to report outbreaks only when a certain percentage (more than 3%) of the passengers become ill. If the cruise ship does not call upon a U.S. port, then the CDC has no jurisdiction and there is no obligation to report any G.I. cases to the U.S. federal government.

Most countries around the world don't require reporting of cruise G.I. cases. So when you read the CDC database of G.I. outbreaks on cruise ships, remember that this is only those cruises which dock at a U.S. port and where at least 3% of the passenger report to the infirmary.

My partners at my law firm ask me why I blog about G.I. cases because our firm rarely handles such cases. Why don’t we handle G.I. cases? For a couple of reasons:

It is usually impossible to prove where the virus originated. The CDC and the Food and Drug Administration (FDA) concluded long ago that most norovirus outbreaks are due to contaminated food and water. No, not due to the dirty hands of the cruise passengers as the cruise lines want you to believe, but noro-laden food or contaminated water.

But general propositions are no help in a particular case. The CDC makes no real effort to pinpoint the epicenter of the outbreak on the cruise ship.

The CDC usually can figure out the causative agent (i.e., noro, e-coli, etc.) but that’s where the federal agency’s inquiry ends. The CDC has but a few hours to board the cruise ship and conduct its investigation once the ship returns to a U.S port. It does not have the time or the resources to perform a full blown epidemiology assessment during the limited time the ship is in port.

Was the water well used to irrigate the potatoes or lettuce which were loaded onto the cruise ship contaminated by noro-infected swine feces that leeched into the well supplies? You will never know because no one is doing any investigation to find out.

The cruise lines don’t want such sophisticated analysis either, because the most likely cause of norovirus outbreaks is not bad passenger hygiene but contaminated food and water. It’s bad for cruise business for an official U.S. agency to point the finger at contaminated water or infected food, or to conclude that food handlers worked while infected with noro and, in turn, contaminated 150 plates of salad consumed by the passengers.

Illnesses due to e-coli or norovirus are nasty. You’re afraid that you are going to die and then you’re afraid that you’re not going to die, the joke goes. But it’s no joke. Sick passengers do die, particularly elderly passengers with suppressed immune system and especially those who are ignored by the ship doctors or those who receive bad care while on the cruise ship.

The rights of ill or dying passenger infected with norovirus on cruise ships are limited. The Death on the High Seas Act (DOHSA) prohibits the recovery of damages for elderly retirees. Their deaths are financially meaningless if they become sick during a cruise and then later die either on or off of the cruise ship. Cruise lines love DOHSA. Also, sick passengers who receive bad medical care by the ship doctors usually have no recourse against the cruise lines because the ship doctors are legally considered to be “independent contractors” for whom the cruise lines have no responsibility. And neither the cruise lines nor the CDC or FDA are trying to find out where the norovirus came from in the first place.

Cruise lines are cutting back on the testing of water, placing increasing demands on its crew members who often work while sick, hiding dirty galley equipment from CDC inspectors, and pushing their ships and staff past reasonable limits leaving little time and resources to maintain a clean and hygienic environment. 

It’s easier for the cruise lines to blame the passengers for poor hygiene and then stand behind the CDC’s and FDA’s indifference and archaic laws like DOHSA which have insulated the cruise industry from the consequences of their negligence and recklessness for decades.

In a nutshell, we don’t handle G.I. virus cases because the deck is stacked against the cruise passenger. Cruise passengers typically don’t know when they board a noro-infected ship that they have few rights and that the cruise line will blame them if they get sick. We blog about the problem because it is an insight into the way which the cruise industry operates its business and treats its customers.

The cruise lines say that the “health and safety of cruise passengers are its highest priorities.” That’s not true. We prefer that the cruise passengers understand that before they walk up the gangway into a noro-contaminated ship.

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

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

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

Photo Credit: Wikimedia / Captain-Tucker

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

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

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

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

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

As usual, the cruise company also blamed the passengers: 

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

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

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

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

Photo Credit: Wikipedia / yeldark

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

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

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

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

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

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

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

Photo Credit: Wikipedia / Barek

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A Carnival cruise ship has become the sixth cruise ship this year to flunk a sanitation inspection by the Centers for Disease Control and Prevention (CDC).

The Carnival Fascination failed the surprise inspection with a score of only 84. You can read the report from the CDC here.  It's full of dirty and unsanitary conditions in the galley and food serving areas, as well as problems with the recreational water supplies.

The Fascination had a problem which we are hearing about more often, that is when crew members are experiencing acute gastrointestinal illness but keep working. This substantially increases the chances that they will infect other crew members and the passengers that they come into contact with. The problem is particularly critical when the infected crew are food handlers. 

Five other cruise ships have failed CDC inspections this year.

Two weeks ago we wrote about the Celebrity Summit, the Golden Princess, the Sea Dream Yacht Club's Sea Dream, and the Caribbean Fantasy operated by America Cruise Ferries all of which flunked the CDC inspections. You can read our article: Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections

A week ago, we wrote about another Celebrity Cruises ship, the Celebrity Century, which also failed the inspection.

Read the U.K.'s Daily Mail article:  Carnival Fascination Fails Health Inspection After Dead Flies, Leaking Brown Material and Cockroach 'Nymph' Found on Board

Photo Credit: Wikipedia / Jonathan Schilling

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Those of you who read this blog regularly know that I find lots of information about things that the cruise lines would prefer you not know on Professor Ross Klein's website called CruiseJunkie.com.  A silly name I know, but the information is quite serious if you are interested in accurate information about cruise passengers and crew who disappear under mysterious circumstances, fires and collisions, and disease outbreaks on the high seas.  There is no other credible website like this anywhere which tracks such information in the cruise industry. 

Yesterday Professor Klein's website contained information about a gastrointestinal illness (GI) outbreak aboard the Celebrity Infinity cruise ship. He linked to the CDC Vessel Sanitation website which contained a report that 101 of 2086 passengers (4.84%) and 17 of 927 crew (2.05%) have reported ill with gastrointestinal illness. Two CDC Vessel Sanitation Program environmental health officers and an epidemiologist boarded the ship on arrival in Fort Lauderdale on April 1, 2013 to conduct a targeted environmental health assessment and evaluate the outbreak and response activities. 

But when I clicked on the link to the CDC information, the website said:

"The page you requested cannot be found at this time. It may be temporarily unavailable or it may have been removed."

So what happened?  I don't know. 

Professor Klein questions whether this is a mistake of some sort or whether there is a cover-up at play.

Again I don't know. But I do know after being a lawyer for 30 years that there is a very cozy relationship between the cruise lines and federal agencies like the CDC whose surprise inspections are hardly a surprise. And last year it became obvious that after Congress passed a law requiring the cruise lines to report crimes to the FBI which had to post the data on a Coast Guard website for the public to view, these federal agencies worked behind the scenes with the cruise lines to cover the crime statistics up.  

So what's up with the CDC posting a GI outbreak and then the information disappearing?

Celebrity has had difficulties with its shipboard sanitation this year with the Summit and the Century failing CDC inspections for health and sanitation.  

Is the removal of the report of the outbreak aboard the Celebrity Infinity a mistake or is something else more sinister going on?

I'd like to hear from passengers and crew members whether there was a recent gastrointestinal illness or norovirus outbreak on the Celebrity Infinity?  Please let us know.

Am I being overly-suspicious? Maybe so. But I'd rather be paranoid than a naive sap who looks the other way while another federal agency and a cruise line play games behind the public's back.

April 7 2013 9:30 PM: The CDC report on the Celebrity Infinity has reappeared. Here it is.  Celebrity Cruises has the dubious distinction of 2 failed CDC inspections and a GI outbreak for 2013.

Photo Credit: Celebrity Infinity  - Wikipedia / Yankeesman312

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According to the Centers for Disease Control and Prevention (CDC), another Celebrity Cruises ship flunked a surprise inspection.

The Celebrity Century failed the CDC inspection, receiving a score of only 78.

Last week we reported that another Celebrity cruise ship, the Summit scored, flunked an inspection with a score of only 81. Three other cruise ships received failing scores as well.  So far this year there have been five cruise ships with failing grades. Read our article: Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections.

The most disturbing finding was not just that the Century was dirty with contaminated food debris, but that crew members worked while ill with gastrointestinal sicknesses. Several of the ill ship employees worked in the galleys or interacted with passengers while ill.  The other cruise ships who flunked the inspections earlier this year also had ill crew members who worked with food and around passengers as well.  

These findings are significant because the cruise lines always blame the passengers when there are norovirus outbreaks and accuse the quests of not washing their hands.  The outbreaks may be due to ill employees who may be contaminating the food and infecting passengers.  

You can read the report of the Century here. 

The report indicates that two cruise ship cook worked while ill before reporting to the ship's medical infirmary.  A sick hair stylist worked all day around passengers before going to the medical center. And an ill gift shop attendant worked before going to the medical center and continued working after he was suppose to be in isolation.

A particularly disgusting finding was that the toilet intended for galley workers was found locked when the galley was in service, and when the inspectors opened the door, the bathroom had no toilet paper.

And you wonder why there are norovirus outbreaks on cruise ships?

Leave a comment below or join the discussion on our Facebook page.

Photo Credit: Celebrity Century Cruise Ship - Wikipedia / Emesbe

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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ABC News aired a video look tonight at the recent spate of multiple norovirus outbreaks on cruise ships, focusing on the most recent outbreaks spreading to passengers and crew aboard the Queen Mary 2 and the Emerald Princess cruise ships. 

You can read about our articles about the Emerald Princess and the QM 2.

Watch the video below with ABC's Matt Gutman reporting:

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

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

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

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

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

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

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

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

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

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

December 26, 2012 Update: The Global Dispatch states:

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

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

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

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

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

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

Norovirus is spread person to person particularly in crowded, closed places. Norovirus is typically spread through contaminated food andwater, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea.

Photo Credit: Wikipedia (Holger.Ellgaard)

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

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

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

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

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

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

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

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

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

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

Photo Credit: Centers for Disease Control

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A Galveston television station reports that a Princess Cruises' ship, sailing from Venice, Italy with a final destination in Galveston, has stricken nearly one cruise passengers with the dreaded norovirus.

KHOU states that the 20-day cruise turned out to be the "trip from hell" for dozens of passengers who fell ill. Ninety six passengers and six crew members on the Crown Princess became ill with the highly contagious norovirus.

With passengers stricken with nausea, vomiting and diarrhea, a spokesperson for Princess Cruises responded that the cruise line took "extra precautions" with sanitation such as disinfecting "high-touch surfaces like railings, door handles and elevator buttons, encouraging passengers to use correct hand washing procedures and enhancing this with the use of hand sanitizing gels placed throughout the ship." 

Like all other of the many cruise norovirus cases, there will be no effort to scientifically determine the cause of the outbreak and try and track it down to either hand-to-hand contact from a passenger or crew member or from contaminated food or water.  Yes the enhanced cleaning is appropriate but won't do too much good if the nasty bug is in the food and/or water.  

The Crown Princess cruise ship left Venice on December 2, 2012 and is scheduled to arrive in Galveston on Saturday.

The Crown Princess experienced several bouts of norovirus earlier this year resulting in hundreds sick and one cruise to be cut short.

The first outbreak struck on the ship's January 28, 2012 cruise cruise and again on the February 4, 2012 cruise with several hundred passengers and crew members becoming ill. After the second outbreak Princess brought the ship back to Fort Lauderdale two days early for an “enhanced cleansing protocol.”

The Crown Princess also had some nasty noro outbreaks in December 2011 which you can read about here and here.

Anyone with info about this latest outbreak please leave a comment below. Or please leave a comment on our facebook page about this story.

December 22, 2012 Update: I am informed that there was a "red alert" for disease outbreak aboard the Crown Princess throughout the Atlantic crossing.  The cruise ship is now in Galveston (as you can see from the ship's bridge cam) and the CDC will board.  If you were on the cruise, how do you think the cruise line handled the outbreak?  Is around 100 sick passengers an accurate number of guests affected by the norovirus?  

Don't forget to read: "Why Do the Cruise Lines Always Blame the Passengers When Norovirus Breaks Out?"

Photo credit:

Top: AP via Fox News

Middle: WPTV

Bottom: Princess Cruises

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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.

It 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Art credit: Chan Lowe / Sun Sentinel

Chart Credit: Friends of the Earth

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

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

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

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

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

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

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

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

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

How did the cruise line handle this latest outbreak? 

Photo credit: Wikimedia Commons (Megadri).

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When passengers fall victim to norovirus while cruising, cruise lines typically blame the passengers for bringing the virus aboard and sickening the ship and crew. But if this Canadian news report is correct, its looks like the table has been turned on one cruise line which allegedly sickened people ashore in the port of Halifax with the dreaded "cruise ship virus."

According to CTV News, the Carnival Glory which stopped in Halifax about two weeks ago is the suspected source of an outbreak that shut down two restaurants on the waterfront this week. Two waterfront restaurants, The Bicycle Thief and Ristorante a Mano, had to close after at least 26 staff and customers became ill with what appears to be the norovirus. 

Other business owners complained that Carnival cruise passengers came through their shops and sickened the employees and customers.  

Some locals commented that they intended to avoid waterfront businesses out of fear that the virus from the cruise passengers might infect them.

We commented on the puke fest on the Carnival in a prior blog.  

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

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

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

There are 1,970 passengers aboard the Island Princess. 

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

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

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A reader of Cruise Law News in the U.K. alerted me to an article in the Daily Echo that one of Royal Caribbean's cruise ships based in the U.K. has been hit with a break out of norovirus: 

"Thousands of holidaymakers due to set sail on board a Southampton-based cruise ship were hit by delays yesterday after norovirus hit 117 passengers and three crew on the liner’s previous cruise.

They were delayed boarding Royal Caribbean ship Independence of the Seas until 3pm so that her cabins and the cruise terminal could be sanitized.

She set sail just after her scheduled 7 PM departure."

Were you on this cruise?  How did the cruise line handle the outbreak?  

Please leave a comment below.

March 7, 2012 Update:

Professor Ross Klein's website has this quote from a passenger:

"We have just returned today 06.03.12 from an 11 day cruise on Independence of the Seas.  We were asked to check in late (15.30), by email.  We were left standing in corridors, the check in lounge and even outside for about three hours. They kept apologising for the delay over and over again.

While we were on the ship the staff were constantly sanatizing all handrails chairs and tables, the shops were sprayed every night.  Each time someone entered the toilet a voice would say"Stop don't forget to wash your hands."  When you sat down to dinner then someone would announce that we were on a high state of alert for Norovirus and to please wash your hands. We were handed wipes each time you entered a venue. We were not allowed to put condiments on our food the waiters etc had to do it for you. They even had to put the milk in you coffee and handed you sugar packets with tongs. We felt like lepers and it spoiled the whole holiday.

must say that the crew had to work extra hard but they always had a smile for us, but they must all be shattered."

Photo credit:  Daily Echo

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A number of cruisers have been contacting our office asking about a sickness outbreak aboard the Celebrity Cruises' Constellation cruise ship. 

The Centers for Disease Control ("CDC") officially placed the Constellation on its vessel sanitation list of ships with sickness.  The Constellation sailed on January 28th from Fort Lauderdale and returned yesterday, February 11th. 

95 out of 1,992 passengers reported being ill during the voyage (4.77%).  12 crewmembers reported being ill. The sick passengers and crew reported symptoms of vomiting and diarrhea.

Only cruise lines calling on U.S. ports are required to report disease outbreaks to the CDC.  Cruise lines are required to make the report only when 3% or more of passengers or crew reported symptoms of diarrheal disease to the ships medical staff during the voyage.  Under-reporting occurs regularly because many passengers can't make it away from their toilets due to diarrhea, and some passengers don't want to be confined to their cabins. 

This is the fifth "official" cruise ship sickness outbreak which has found its way onto the CDC database which lists the Celebrity Silhouette, Celebrity Constellation, Royal Caribbean Voyager of the Seas, Princess Cruises' Crown Princess and P & O Cruises Aurora cruse ships.  The CDC data does not include the outbreak on Princess Cruises' Ruby Princess, which we reported on last week. 

The CDC has confirmed norovirus only on the Crown Princess and Aurora.  It is disappointing that the CDC can't figure out the type of disease on the other ships.  In no cases did the CDC pin-point the cause of the outbreak, to either a virus brought on the cruise ships by a passenger, or unsanitary handling of food by a crew, or infected food and/or water.  If the CDC can't figure out how the outbreak occurred, it seems hard to respond to the problem and eradicate the causative factors.

There has been a lot of criticism on how Celebrity Cruises handled the latest outbreak on the Silhouette.  You can read the comments by passengers here.   

How did Celebrity Cruises handle the outbreak on the Constellation?  If you were on the cruise, please leave her comments below, pro or con.

November 5, 2012 Update:

News sources are reporting that the Constellation suffered another outbreak of norovirus, this time during a 12 day cruise which just returned to Southampton.  BBC reports that 350 passengers became ill with vomiting and nausea. Read our article: Cruise Puke Fest: Norovirus Strikes Celebrity Constellation. if you were ill on that cruise please leave a comment at the end of that article.    

Photo credit:  Getty

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In a responsible step to sanitize its cruise ship following an outbreak of what appears to be norovirus, Princess Cruises decided to end the current cruise of its Crown Princess cruise ship after consulting with the Centers for Disease Control (CDC). 

Nearly 400 passengers and crew on the last cruise became sick due to gastrointestinal illness, which is suspected to be norovirus as we reported over the weekend.   The current cruise out of Fort Lauderdale has seen 114 passengers and 59 crew members become ill, continuing an outbreak that began last week. 

Princess states that it will offer full refunds to the over 3,000 cruise passengers on the current cruise.  It will also assist the passengers in arranging flights home from Ft. Lauderdale.  Princess is providing hotel accommodations for affected passengers, if needed, and will provide all passengers a 25% cruise credit toward a future cruise.

Compare this proactive move to the debacle Celebrity Cruises faced in 2010 when four consecutive sailing of the Celebrity Mercury where hit by norovirus.  Celebrity kept reloading the cruise ship and sickening subsequent passengers until the CDC ordered the Celebrity Mercury to be shut down.

It's nice to see the cruise lines act responsibly like this.  The official statement from Princess is below:

Princess Cruises' Statement on Gastrointestinal Illness Aboard Crown Princess - February 7, 2012

The increased incidence of gastrointestinal illness that occurred during the previous cruise of Crown Princess has reappeared on the current voyage which departed Saturday, February 4, despite rigorous sanitization measures.

In consultation with the US Centers for Disease Control (CDC), who has informed us that there are widespread outbreaks of Norovirus occurring in the US, it was agreed that the best course of action to stop the spread of the illness is for the ship to undergo a two-day extensive sanitization. To accomplish this, Crown Princess is now returning to Fort Lauderdale where the cruise will end on Thursday, Feb. 9. The ship was scheduled to return on Saturday, Feb. 11.

We sincerely regret having to cut short our passengers’ cruise vacations because of this highly-unusual situation. We will, of course, be refunding their cruise fare, arranging flights home, including covering change fees if air was not booked through Princess, providing hotel accommodation if necessary, and offering a 25% future cruise credit.

Crown Princess departed February 4 on its scheduled Southern Caribbean cruise after a comprehensive disinfection of all cabins and public areas, which was overseen by the CDC together with our public health, medical and onboard departments.

On the current sailing 114 passengers (3.70% out of 3,078) and 59 crew (5.01% of 1,178) have reported gastrointestinal illness. On the previous cruise, 364 passengers (11.73% of 3,103) and 30 crew (2.57% of 1,168) were affected.

At the first sign of increased cases of gastrointestinal illness, we immediately initiated additional enhanced sanitation procedures to interrupt the spread of illness for both passengers and crew members. Our sanitation program has been developed in coordination with the CDC and includes such measures as disinfection of high-touch surfaces; encouraging correct hand washing procedures and enhancing this with the use of hand sanitizing gels placed throughout the ship; isolating ill passengers and crew in cabins until non-contagious; encouraging passengers to use their own cabin’s bathroom facilities; and providing regular verbal and written communication to passengers about steps they can take to stay well while onboard.

The enhanced disinfection of the ship in Fort Lauderdale will include bringing aboard additional cleaning crew to assist with a thorough sanitization of all public spaces and surfaces including soft furnishing and carpets, railings, door handles and the like. The staterooms will be sanitized multiple times before making up the rooms with fresh linens and towels on Saturday morning, just prior to passenger embarkation.

We continue to work closely with the CDC to determine the cause of the illness, which is suspected to be the easily-transmitted Norovirus, which is so widespread that only the common cold is reported more frequently.

Following this additional sanitization of Crown Princess, we expect that the next cruise on February 11 will depart as scheduled.

The current seven-day Caribbean sailing of the ship was scheduled to visit Curacao and Aruba, but we regret that the early return to Fort Lauderdale has necessitated cancellation of these calls.

# # #

What is Norovirus?

Norovirus is so widespread that only the common cold is reported more frequently. The CDC estimates that there are 23 million land-based Norovirus cases each year in the U.S., affecting one in 12 people, or 8% of the population. In contrast, the number of cruise passengers affected is .028% of the 8 million cruising population, or 1 in 3,600 of those who vacation aboard ships. Symptoms of Norovirus include mild stomach upset with vomiting and diarrhea, usually lasting between one and three days. The illness generally resolves without treatment or long-term consequences.

Health officials recommend that the best way cruise passengers can protect themselves from getting ill is to wash their hands frequently and thoroughly.

Further information about Norovirus is available through the below links to the CDC and Cruise Lines International Association (CLIA).

http://www.cdc.gov/nceh/vsp/pub/norovirus/Norovirus.htm
http://www.cruising.org/regulatory/cruise-industry-policies/vessel-sanitation

Contact: Karen Candy (661) 753-1540 Julie Benson (661) 753-1530
kcandy@princesscruises.com jbenson@princesscruises.com

Photo credit:  Wikimedia Commons (Cliff)
 

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While reports of five hundred sick passengers aboard two of Princess Cruises' ships sailing to Fort Lauderdale (Ruby Princess and Crown Princess) dominate the news here in South Florida, a newspaper in New Orleans is reporting that over 200 passengers were stricken with norovirus on a Royal Caribbean cruise ship this weekend.

This means around 700 people on these three cruise ships are battling diarrhea and vomiting.

The norovirus outbreak aboard Royal Caribbean's Voyager of the Seas caused delay of the cruise ship's departure from New Orleans   According to WDSU.com, 20 of the over 200 affected passengers on the ship were quarantined in the port as a result of their illness.

The delay was around two hours Saturday evening as cleaning crews tried to sanitize the cruise ship.  It is impossible to adequately sanitize a ship this large in such a short turn around, assuming the norovirus is not in the cruise ship's food or water.

Yesterday we reported on norovirus outbreaks on the Ruby Princess and Crown Princess.

Last year, there were 14 sickness outbreaks on cruise ships calling on U.S. ports.  So far, in the first five weeks of this year, there are already five outbreaks.

With the Costa Concordia disaster and several other overboards, deaths and shipboard rapes, the cruise industry is off to a rough start in 2012.

Were you on the Voyager of the Seas?  Please leave a comment below and let us know how the cruise line handled the outbreak. 

November 11, 20122 Update:  Passengers report a large norovirus outbreak on the Voyager of the Seas as it sailed to Australia.

November 23, 2012 Update: The norovirus continues to infect unsuspecting passengers aboard the Voyager of the Seas in Australia. This time throughout the November 5 tp 23, 2012 18-night sailing returning to Sydney.

Photo credit: Kerry Maloney  / NOLA.com / Times Picayune

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Two cruise ships operated by Princess Cruises are sailing into South Florida have well over 200 passengers experiencing norovirus like symptoms - nausea, diarrhea and vomiting.

The Crown Princess arrived in Port Everglades today with 140 ill passengers and an additional 18 sick crewmembers.

Tomorrow, the Ruby Princess will arrive at port in Fort Lauderdale with 90 infected passengers and 13 sick crewmembers.

The "official" reported cases are usually far less than the actual number of cases, we have found.

PR people for Princess, as usual, are talking about subjecting the cruise ships to "enhanced cleaning" of  "high-touch surfaces like railings, door handles and elevator buttons" and "encouraging passengers to use correct hand washing procedures and enhancing this with the use of hand sanitizing gels placed throughout the ship."

At this point, there is no indication whether ill passengers boarded the cruise ships and sickened others, or whether ill crew handling food sickened the passengers, or whether the food or water sickened the passengers and crew.

The other month I was interviewed in a travel publication and discussed the problem of norovirus on cruise ships in an article entitled "When Bugs Swim."  Cruise lines Ike Princess always blame the passengers and suggest that they need to wash their hands more or use hand sanitizers which are not effective at combating norovirus.  

Cruise lines never admit that their own crew, or the the cruise food or water, may be the culprits.  Many attempts at cleaning by the crew actually make the problem worse, particularly when the source of the virus is the cruise line's food and water and then the vomitted norovirus is spread by rags which the crew rub all over the ship. 

This is the fourth sickness outbreak reported on a cruise ship this year, according tp the CDC.

If you were on these cruises, please leave a comment below and let us know how the cruise line handled these two outbreaks.

February 5 2012 Update:

CNN reports that the number affected on these two cruise ships is around 500.

Meanwhie, in New Orleans:

 Norovirus On Royal Caribbean's Voyager of the Seas Sickens 200 Passengers - Fifth Cruise Ship Sickness Outbreak This Year!

Photo Credit:   CBS-12

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The popular cruise blog written by Gene Sloan for the USA Today newspaper published an article yesterday entitled "Outbreaks of Illness on Cruise Ships at Multiyear Low."

CruiseLog cites statistics from the U.S. Centers for Disease Control ("CDC") of 11 outbreaks of illnesses so far in 2011, down from 14 in 2010 and 15 in 2009.  It concludes that this reflects a "downward trend that began several years ago as the industry increased prevention efforts."

But looking at the data at the CDC website, you can see that the "trend" is actually flat, with 14 to 15  outbreaks reported to the CDC for each the past 3 years (2008, 2009 and 2010).  This year will probably end up with the same number of reported incidents.

There has been an additional outbreak reported to the CDC just since the CruiseLog article was published yesterday.  HAL's Ryndam cruise ship has reported that more than 5% of its passengers reported to the ship's infirmary complaining of vomiting and diarrhea. You can read about this latest outbreak here.  The cruise ship is returning to Tampa tomorrow.

Unfortunately, there seems to be an outbreak or two over the Christmas and New Year sailing somewhere each year, so we should reasonably expect there to be the usual number (14 to 15) this year as in past years.

My real criticism of the CruiseLog article is not whether the number is actually 15 versus 11.  It is that the article really doesn't explain that the cruise ship outbreaks reported to the CDC are probably less than 50% of the actual number of incidents which occur around the world each year.  Remember that cruise lines do not report sickness outbreaks to the CDC if the cruise does not call on a U.S. port.  This is significant because many cruise lines re-positioned a greater number of their cruise ships to Europe and Asia in recent years compared to five years ago

Although it is difficult to track the incidents outside of the U.S., we have reported on a number of incidents this year. 

For example, in September, norovirus broke out on Celebrity's Eclipse sailing out of Southampton, England. Royal Caribbean's cruise ships sailing out of this U.K. port remained on heightened alert for months.  You will find no mention of this is in the official CDC database.  The cruise lines certainly will never voluntarily disclose this.

In November, we reported on one death and 80 sick passengers on HAL's Veendam which experienced a sickness outbreak as the cruise reached in Rio de Janeiro.  

The other issue that the CruiseLog does not explain is the cruise lines report disease outbreaks only when 3% of passengers are afflicted based on the number of ill passengers who appear in the ship infirmary.  This is significantly less than the true number of those afflicted with viral illnesses.  Many sick passengers know that they will be quarantined in their cabins or they simply do not want to wait in the long lines outside of the ship infirmary. 

The Clinical Infectious Disease Journal reported earlier this year that 40% of passengers with a viral infection did not report being sick to the ship medical staff.  If these passengers were included in the sickness count, then the number of CDC reportable cases would surely increase.   

CruiseLog also points to Carnival as not reporting a single outbreak this year.  Does that mean that Carnival has a vaccine against the cruise ship bug?  Hardly.  Consider the following comments by cruise passengers on the CruiseJunkie website about the Carnival Conquest last week:

"From a passenger: There was an outbreak of something vomiting and diarrhea starting on Tuesday of the cruise (4-11 Dec). My husband got sick on Thursday morning and was asked to stay in cabin on isolation. On Friday I came down with vomiting and diarrhea. We were told there were lots of people sick.

Another passenger writes: On our final day at sea suddenly all the crew was wearing gloves and none of the passengers were allowed to get their own plate or food at the buffet.  Everything had to be served by the staff and they were constantly wiping down everything and making announcements about hygiene.  We asked if something was going on and we were told no however by that night 3 of the seven people in our party were very sick and once we walked in on an employee in the bathroom vomiting very badly.  A casino employee told us that night many of the crew and passengers were very sick. 

When we were getting off the boat Sunday we saw stacks and stacks of mattresses in plastic they were loading on the ship.  We still have people from our group sick and I wish we had been told something.  We received no information and since I was traveling with two children and my seventy year old father I continue to be concerned." 

Families intending to cruise and worried about norovirus should read news sources like CruiseLog with a grain of salt.  There is no empirical evidence that norovirus and other cruise ship sicknesses are on the decline. 

Regarding cruises not calling on a U.S. port, the best sources of information are anecdotal, like cruise community forums and websites not beholden to the cruise lines like Professor Ross Klein's CruiseJunkie.

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

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

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

It has been our experience over the years that the "official" CDC numbers of ill passengers and crewmembers is usually less than the true number of those afflicted with viral illnesses.  This is because many sick passengers know that they will be quarantined in their cabins or they simply do not want to wait in the long lines outside of the ship infirmary.  Often, sick crewmembers are pressed to work notwithstanding their sicknesses.  

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

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

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

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

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

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

Photo credit:  Examiner

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

There may be hope for you.   

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

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

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

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

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

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

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

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

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

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

Cruise Ship Norovirus - Clean the Damn Toilets!

Cruise Ship Norovirus - Something in the Water? 

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

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

Photo credits:

Top:  Reuters via Mail Online

Middle & Bottom:  CruiseCritic

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