The Centers for Disease Control (CDC) recently issued new information about the cause of norovirus, indicating that a leading cause of the nasty virus is infected food handlers who work while sick and don’t regularly wash their hands.
The study and conclusions are of course directly relevant to cruise ship norovirus cases considering that cruise ships are in essence giant floating restaurants.
But the new CDC report tried to be kind to the cruise industry, stating that you are far more likely to catch the noro bug in a restaurant than on a cruise ship. The CDC says that cruise ships account for 1 percent of reported norovirus cases, while the other 99 percent of the other cases occur on land.
A comment to a NPR article "Norovirus: Far More Likely To Come From Restaurant Than Cruise Ship," says that this is misleading. If the average individual who goes on a cruise spends an average of one week a year on a cruise, then 51 out of 52 weeks a year they are not on a cruise. So to state that over a year’s time they are more likely to catch this illness when they are not on a cruise is an underwhelming statement by itself."
The CDC on line information indicates that for cruise ships calling on U.S. ports alone, there have been 47 norovirus outbreaks since January 2011. If you consider that the average population of the cruise ship industry is just 250,000 or so at any one given time, the cruise ship fleet would be one of the sickest locations in the world considering that each outbreak involves at least 100 to 250 people. Earlier this year, some 700 Royal Caribbean passengers fell ill with norovirus.
Considering that there are over 300,000,000 U.S. citizens ashore, there undoubtedly are far more people getting sick with noro from restaurants ashore than on a cruise ship. But getting sick at home has got to be a heck of a lot better than power-puking in a tiny little bathroom in a tiny little cabin on a ship with hundreds of others puking around you on the high seas.
As far as norovirus cases attributable to contaminated food, the CDC points the finger directly at ill cooks and waiters. The CDC reports that restaurant workers account for 70% of norovirus cases involving contaminated food. The CDC says:
- 1 in 5 food service workers report working while sick with vomiting and diarrhea. Fear of job loss and leaving coworkers short staffed were significant factors in their decision.
- Food service workers practice proper hand washing only 1 of 4 times.
The CDC suggests that one way to deal with the problem is "requiring sick food workers to stay home, and considering use of paid sick leave and on-call staffing, to support compliance." A CDC spokesperson say that "we really need to call upon the food service industry to work with public health to help foster an environment where food handlers can stay home when they’re sick."
Of course this is impossible on a cruise ship where galley workers live on the ship and have cabin mates who live in close quarters.
Many of the food workers on cruise ships, like waiters and assistant waiters, earn a basic salary of only $50 a month and depend on tips from the customers. Missing a week because they are sick with noro would result in significant loss of money for these cruise waiters and assistants. Many galley workers keep working while sick.
There is also a dynamic on cruise ships that it you are sick, the attitude of the managers and supervisors is "go home" (i.e., quit, you will be easily replaced). The CDC has previously documented many cases of cruise employees working in the galley who work while ill.
The cruise lines always blame the passengers for not washing their hands, but the culprit seems to lies elsewhere. The new CDC report clearly indicates that eating food in a restaurant, whether on a cruise ship or not, with a sick galley crew that doesn’t wash their hands is a more likely way to get sick.