Its been a tough month for Royal Caribbean. More than 200 passengers became ill and five had to be hospitalized after an outbreak on the Ovation of the Seas during a two-week cruise between Sydney and Singapore, according to the Washington Post.

Local newspapers in South Florida are reporting today that the Independence of the Seas which left Port Everglades on Monday, for a Caribbean cruise, and returned to Fort Lauderdale this morning with at least 332 passengers sickened by a norovirus outbreak.

A cruise travel writer, @CruiseNiche, was on the cruise and posted photos on Twitter about the widespread gastrointestinal outbreak.

Independence of the Seas NoroNBC News reports that over 500 Royal Caribbean passengers have been sickened on these two cruises alone.

Last month, there was a gastrointestinal outbreak on the Anthem of the Seas. Royal Caribbean confirmed that “were a total of 98 reported cases of gastro-intestinal illness symptoms, which represents 1.9 percent of the 4,905 guests and crew onboard.”

The CDC’s Vessel Sanitation Plan requires cruise ships to send a separate notification when the GI illness count exceeds 2% of the total number of passengers or crew onboard. Cruise ship outbreak updates are posted on the CDC website only when 3% or more of the passengers and crew report symptoms to the ship infirmary during the cruise. Because there were less than than 2% of the passengers and crew members reported ill during the cruise, the CDC will not list the outbreak on its official cruise ship Outbreak Updates page.

There was also a norovirus outbreak on the Anthem of the Seas at the end of February and early March 2016 which was reported to the CDC.

Norovirus outbreaks are typically caused by contaminated food or water, according to the CDC and the FDA, although most cruise lines automatically blame their passengers for bringing the virus aboard the ship and/or spreading the outbreak by not washing their hands.

From my view, hand-washing can’t hurt, but it won’t help if the food is contaminated by an ill food handler or waiter. And of course, washing your hands won’t protect you if you contract norovirus via airborne transmission. Three years ago, in an article titled Norovirus Spreads by Air on Cruise Ships, I discussed that researchers have concluded that norovirus can spread by air, according to a publication in the highly respected Clinical Infectious Diseases. This is an issue which the cruise lines have never acknowledged.

As we have said in prior articles, don’t call us if you get sick on a cruise. Establishing where the virus came from, or that the cruise line was negligent, is virtually impossible to prove, especially since the CDC conducts no epidemiological analysis and sometimes can’t even figure out the source of the outbreak.

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Photo credit: @CruiseNiche

Independence of the Seas