The Celebrity Summit is the latest cruise ship to experience a gastrointestinal outbreak requiring the involvement of the Center for Disease Control and Prevention (“CDC”) this year. The Celebrity operated cruise ship reported 152 of 2,144 (7.09%) passengers and 25 of 963 (2.60%) crew members experienced gastrointestinal (GI) illnesses . A total of 177 people were sickened on the May 15–May 25, 2023 cruise and experienced symptoms which included diarrhea, vomiting, abdominal cramps, and headaches.
This is the twelfth GI outbreak so far this year, which exceeds the average number of yearly GI outbreaks on cruise ships for the three year period before the industry was sidelined by the coronavirus epidemic. Of course, it is only six months into this year, making the total number of illness cases to be approximately twice the average yearly total of GI cases on cruise ships.
The Washington Post covered this story two week ago in Stomach Viruses Are Back Up On Cruise Ships, With Hundreds Falling Ill by Hannah B. Sampson (formerly one of the better reporters who worked for the Miami Herald before joining the Washington Post). The Post reports that “… so far this year there have been 12 outbreaks of vomiting and diarrhea that have reached the threshold for public notification on cruise ships visiting U.S. ports. The tally has already exceeded each yearly total number of outbreaks reported from 2017 to 2019.”
The cruise industry’s trade association, the Cruise Lines International Association (“CLIA”), says incidents of gastrointestinal illness are “quite rare” on ships. Cruise lines typically say the symptoms are often mild and resolve quickly. Another talking point of CLIA is the argument that GI outbreaks are always caused by guests failing to wash their hands.
The CDC has determined that the cause of the recent GI outbreak on the Celebrity ship was due to norovirus. Despite what CLIA says, the fact of the matter is that both the CDC and the Federal Food and Drug Administration (“FDA”) concluded long ago that contaminated food and/or water are the main explanations for norovirus outbreaks.
Recent federal studies show that sick employees were behind a majority of food contamination and foodborne illness outbreaks in the U.S. The CDC found that among outbreaks where a contributing factor was identified, 41% were caused by food contamination from ill or infectious employees.
“If a food worker stays on the job while sick and does not wash his or her hands carefully after using the toilet, the food worker can spread germs by touching food,” according to the CDC’s website. Norovirus is the leading cause of foodborne illness in the United States.
The CDC report concluded that only around 43% of businesses provided paid sick leave to sick workers, resulting in many employees working while contagious.
In the cruise line context, many waiters and food handlers, who are paid almost exclusively by tips, are often reluctant to go to the ship infirmary when they are ill. No cruise line, to our knowledge, provides paid sick leave to their crew members. Unfortunately, there’s an incentive to work while sick on a cruise ship in order to be paid.
The CDC rarely has enough time to collect stool samples or other data or conduct much of an investigation when cruise ships return after a GI outbreak, and then quickly pick up another round of passengers and leave port. The CDC usually does not even determine the cause of the outbreak in most cases. Of the last twelve illness outbreaks on cruise ships, the CDC was able to conclude the causative agents in only five cases (all involved norovirus).
Expect CLIA and the cruise lines to downplay the foodborne illness explanation for this norovirus outbreak and to encourage cruise fans to think that its actually their unwashed hands which are to blame.
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