The Fred Olsen Balmoral cruise ship has docked in Norfolk amidst what the Centers for Disease Control and Prevention (CDC) is saying is a norovirus outbreak which has inflicted diarrhea and vomiting symptoms on 153 of 917 (16.68%) passengers and 6 of 518 (1.16%) of crew members, over the course of the two week cruise according to a CDC report.
It is the ninth gastrointestinal outbreak this year involving a cruise ship calling on a U.S. port according to the CDC.
The Balmoral is an old (1987) cruise ship flagged in Nassau which has struggled with gastrointestinal illness outbreaks over the years. 300 passengers were stricken with symptoms when the ship experienced a massive outbreak in May of 2015. The cruise line curtailed the cruise from 8 to 7 days to return to Southampton for "barrier cleaning." In early 2010, a newspaper reported that the Balmoral could have been detained after 250 passengers fell ill with norovirus. In an article entitled "Cursed Cruise Ship Balmoral to be Investigated," the newspaper reported that the sick cruise ship was heading from the Canary Islands to Dover, England. From 2009 to 2010, the number of those affected in three sickness outbreaks on the ship was "541 in under 12 months."
Norovirus is a disease which, although common on shore as well, is a public relations nightmare for the cruise lines. Unfortunately, gastrointestinal outbreaks on the high seas are handled differently than ashore. The cruise lines cast blame on the customers 100% of the time.
Norovirus, according to the FDA and CDC, is primarily a food-borne disease caused by contaminated food or water. It can also be caused by ill food handlers as well as by cruise passengers who come aboard the ship already ill. Chipotle, for example, has taken great responsibility for norovirus outbreaks whenever they occur in one of their stores, by not opening the stores whenever a food handler becomes ill, improving food-handling policies and procedures and carefully scrutinizing food sources to determine whether the outbreak can be tracked down before it infects customers in the stores.
On cruise ships, on the other hand, neither the cruise lines nor the minimally funded and staffed CDC conduct any epidemiology analysis. The cruise lines resort simply to massive spraying, rubbing and scrubbing every surface in sight. But such measures don’t help if the lettuce comes on the ship contaminated or if handled by a sick chef who infects 75 passengers who eat a salad. Crew members are placed under incredible stress and work long hours whenever there is a code red issued. Crew lines automatically blame the personal hygiene of the passengers time after time, ship after ship, no matter the real source of the outbreak and even though no scientific process has taken place to pinpoint the true cause of the outbreak.
I anticipate readers who will respond to this article by posting anecdotal stories of seeing passengers not bothering to wash their hands after they use public bathrooms or not using hand sanitizers, which are largely ineffective against norovirus in the first place.
Chipotle has funded studies to investigate how it can ensure its food quality by improving food handling techniques. It clearly has a commitment to get to the root of the cause of the illness. I know of no commitment by the cruise lines to allocate any of their massive profits to study the problem. Indeed, no cruise line has even acknowledged the studies which indicate that the virus can become airborne when vomited, which seems like a massive problem given the confined space on a cruise ship. (Read: Airborne Norovirus – What Now Cruise Lines?)
So there will be more and more outbreaks, the crew members will continue to be pressed to work longer hours spraying and wiping, the cruise lines will continue to blame the dirty hands of their customers, and no one will figure out the real cause of the outbreak.
Statement by Fred Olsen: The cruise line is already blaming its guests. It cites its alleged compliance with, among other things, the "strict" requirements of the "flag state" (Nassau).
May 8. 2016 Update: The Centers for Disease Control and Prevention says 27 percent of the passengers aboard the Balmoral have gotten sick since the cruise began April 16th. WMTW-TV says that according to the CDC, 252 of the 919 passengers on the Balmoral have fallen ill, as well as eight crew members.
May 11 2016 Update: The CDC says the total number of passengers sickened since the beginning of the cruise has increased to 272 passengers. According to the Evening Standard, Cruise ship Balmoral was infected with vomit bug BEFORE setting sail.
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Photo credit: LesMeloures CC BY-SA 3.0, commons / wikimedia (photo taken 2008 before paint change)