Seventy-five people (65 guests and 10 crew members) were sick with gastrointestinal (GI) symptoms on the Arcadia cruise ship when the P&O Cruises ship arrived in the port of New York this week.
The report by the Centers for Disease Control and Prevention (CDC) indicated that 3.32% (65) of the 1,959 guests and 1.25% (10) of the 799 crew members were sickened. The CDC has not figured out what type of infection was involved.
75% of the outbreaks this year involved highly contagious norovirus. Of the 12 GI outbreaks this year, 9 incidents involved norovirus; one outbreak involved E. coli; and the causative agent for two outbreaks remain unknown.
As usual, the CDC did not arrive at a conclusion regarding the source and cause of the outbreak. The CDC and the Food and Drug Administration (FDA) have long stated that most norovirus outbreaks are caused by contaminated food and/or water. Cruise lines typically blame the passengers for the outbreak despite the lack of technical information supporting such a conclusion.
It is also well established that norovirus can be spread in the air, although no cruise lines respond to an outbreak by dispensing N95 masks.
The usual debate when a GI outbreak is announced involves the public casting blame on uncooked cruise line food and the cruise lines saying that the passengers failed to wash their hands. My thought is that you can wash your hands several times a day but it is not going to prevent you from becoming sick if the food is contaminated by ill food handlers and the virus is being transmitted through the air.
One of the shortcomings of the CDC’s Vessel Sanitation Program (VSP) is that the CDC does not make an effort to determine how GI outbreaks occur. The CDC does not make factual, scientific determinations regarding the actual source of the disease transmission (i.e., a particular type of food and/or water and the location of the initial outbreak). This is probably due to the limited resources of the CDC and the quick turn-around of cruise ships in U.S. ports.
The cruise industry has no interest in actually determining why a specific outbreak takes place. Most cruise lines will always claim that a guest brought the virus aboard the ship and other passengers then failed to wash their hands. Neither the CDC nor cruise lines investigate whether galley staff and/or food handlers were working while infected. There is no analysis what the passengers, who became ill, last ate or were served during the same seating and/or by the same waiters. There is no tracking by cruise lines of illnesses due to the type of food served during the cruise. This is to be sharply contrasted with shore-side major restaurant businesses in the U.S. when a disease outbreak occurs. Chipotle, for example, has a reputation of determining the specific source of an norovirus outbreak and then focusing on the distributor which supplied the particular contaminated sprouts, lettuce or other food item.
Interested in this issue? We suggest reading the article After Years of Decline, Norovirus Outbreaks Surge on Cruise Ships and our article about a GI outbreak on another Princess cruise ship, the Ruby Princess, a little over a year ago:
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September 24, 2024 update:
The CDC updated the number of ill passengers and crew members. 87 of 1,959 (4.44%) of the passengers and 11 of 799 (1.35%) of the crew have reported ill.
Photo credit: Arcadia – Pjotr Mahhonin CC BY-SA 4.0, commons / wikimedia; norovirus – User:Graham Beards at en.wikipedia