Empress of the SeasAccording to the Centers for Disease Control and Prevention (CDC), Royal Caribbean’s Empress of the Seas flunked a surprise sanitation inspection conducted in early June. The Empress of the Seas scored a failing score of only 80.  You can read the report here. A score of 85 or lower is considered a failure.

The Empress of the Seas underwent an extended period of renovations in Spain and later in Freeport, Bahamas when the ship was transferred back from Pullmantur. Royal Caribbean canceled a total of thirteen cruises scheduled for earlier this year. The first sanitation violation related to the renovation and involved a bathroom for the medical staff which could be used only for storage and was "heavily soiled." Back in April of this year, Royal Caribbean told the Miami Herald that “as work has progressed, we learned that more significant infrastructure and physical improvements across the ship’s multiple galleys and provisioning areas were needed to meet our high standards.”

I was contacted previously by crew members, during the renovation period, who complained  of unsanitary conditions on the ship. There was talk that the CDC had inspected the ship and initially had not given the ship a passing score, although there was nothing officially posted on the CDC website. Several crew members said that the ship had fallen substantially in disrepair while operated by Pullmantur and had a major problem with pests.    

It is apparent, however, that once back in the Royal Caribbean fleet, the Empress failed to meet high standards. The report regarding the June inspection details forty four CDC violations, ranging from improper procedures to monitor acute gastrointestinal illness cases to incorrect potable water and swimming pool/whirlpool testing.   

The report included numerous references to live and dead flies and cockroaches around refrigerators, buffet lines and other areas used for food storage. The ships was also in violation of the CDC’s requirement to use rat guards, and was utilizing rat guards on only one out of six mooring lines while the ship was in port.

A crew member states that the Empress was reinspected earlier this month, on July 10th, and received a score of 97.  If such an inspection took place, the CDC has not posted that inspection yet.  

Royal Caribbean, including its Celebrity brand, has failed other inspections in the past.  In 2013, the Celebrity Century scored only a 78.  The same year, the Celebrity Summit scored only a 81. The Monarch of the Seas scored a 85 in 2011. 

Two years ago, Market Watch published the 5 Most Hygienic Cruise Lines and concluded that Costa and Disney and three other smaller lines had never failed a CDC inspection. Since then, the Disney Wonder experienced a gastrointestinal outbreak in April of this year.    

We last mentioned the Empress of the Seas three weeks ago when it experienced problems with one of its engines, causing Royal Caribbean to alter the cruise ship’s itinerary.

Photo Credit: By Jsausley – Own work, CC BY-SA 4.0.

The Sun Sentinel is reporting that the Fathom Travel’s historical first cruise on the Adonia cruise ship to Cuba may have experienced a norovirus outbreak aboard the ship sickening passengers, according to reports from the captain. 

At around 2:45 P.M. this afternoon, there were at least 14 people on the ship complaining of diarrhea, vomiting and stomach cramps mentioned by the captain according to the Sun Sentinel. With only around 600 people aboard the cruise ship, that’s over 2% of the cruise passengers which is near the threshold where the Centers for Disease Control and Prevention (CDC) become involved.

The photos and video from the cruise ship show crew members already rubbing and scrubbing the surfaces of the ship. Norovirus is primarily a foodborne virus although the virus can last for weeks on contaminated surfaces. It can also be spread by person to person contact. Hand shaking on the ship is apparently discouraged. Self-serve buffets have also reportedly been replaced with service by crew members wearing gloves. 

The cruise ship, of couse, quickly blamed the passengers with the ship doctor writing a letter saying "we suspect that the virus may have been inadvertently introduced on board by embarking travelers, even though the ship had not even performed tests to make such a determination.  One of those sick, a former public health social worker, said "I think it was something I ate." Read Fears of Norovirus mar last day of cruise to Cuba.

You can see a video related to the gastrointestinal virus on the Adonia here

Norovirus on the first cruise to Cuba?  There must be a Jimmy Fallon joke here somewhere. 

May 8 2016 Update:  Spin Masters? Carnival PR team tells the Sun Sentinel that there is no verification that the Adonia guests were sick due to norovirus.

 

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Fathom Travel Adonia Ship Doctor Norovirus

 

https://youtube.com/watch?v=YBeEE9vh8kA%3Frel%3D0

An unsettling development occurring on the Disney Wonder cruise ship was brought to our attention this morning. There has been an outbreak of acute gastroenteritis (AGE) which exceeds the Centers for Disease Control and Prevention (CDC) percentage (3%) of affected passengers and crew members.

The cruise ship still has two more days to finish its current cruise. The next cruise is the "14 Night Panama Canal: cruise which leaves from Miami headed for San Diego, California. 

There was an emergency meeting in the dining room, where crew members were informed that about 99 guests and 10 crew were ill with AGE. (The official report from the CDC estimates that there were 92 of 2679 (3.43%) passenger and 5 of 991 (0.5%) of crew members affected).

A sign was posted for the crew informing them that there is a high level of outbreaks over 3% of passengers"and crews sick on the ship. The Disney Wonder has a capacity of around 2,400 passengers and 945 crew members. This will result in the crew members working longer hours to try and sanitize the ship before the next round of families and kids embarkthe cruise ship in Miami on May 1st.

There have been 9 prior outbreaks on cruise ships calling on U.S. ports this year.  Disney is one of the few cruise lines which do not routinely suffer from gastrointestinal outbreaks. 

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The Disney Cruiseline Blog contains a copy of an email sent to future cruisers on the upcoming cruise.

May 2 2016 Update: The Sun Sentinel, the first major newspaper to report on the outbreak, picks up the story – Nearly 100 sickened on Disney Wonder cruise ship

May 3 2016 Update:  Gobal Dispatch says that "health officials now put the total cases at 145, 131 of 2680 passengers onboard and 14 of 991 crew members" 

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 aFred Olsen Balmoral 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)

    

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P&O OceanaA month ago, a crew member aboard the P&O Oceana notified me that the cruise ship failed a sanitation inspection by the enters for Disease Control and Prevention (CDC) while the ship was in port in Charleston, South Carolina.  Oceana received a score of 82; 85 or lower is considered a failure.

I have been checking the CDC’s online inspection scores since then. I have been asking the CDC when it will release its report on the Oceana.

The report was finally released today. You can read the report here. The report indicated that several back-flow prevention devices, to prevent the contamination of potable water, did not have test results and appeared not to be tested. The ship’s Riviera swimming pool and Crystal whirlpool did not have adequate levels of chlorinated and bromine, failed to have hair and lint strainers / filters and were not disinfected. The inspector closed the recreational water facilities on the ship.

The report also revealed that a food handler had an onset of Acute Gastroenteritis (AGE) and exhibited symptoms at 9:00 A.M. in the morning but did did not report to the medical center until 11:20 A.M. A review of the crew member’s work history indicated that this crew member worked, notwithstanding his illness, from 7:30 A.M. until 10:30 A.M.

The ship’s galley appeared dirty. There were comments like “the tile grout in this area was soiled and in disrepair.”  “The deck below under counter refrigerator . . . had a significant buildup of more than a week’s accumulation of food debris, dirt, equipment parts, and what appeared to be insect remains.” Food service equipment was broken or out of service and many operational ovens and ice-makers were overflowing their drip pans and/or leaking onto the floor.

Oceana has not prepared a “corrective action report” in response to the failed score, as required by the CDC.

In an era when cruise lines are quick to blame every single norovirus outbreak on the passengers, this CDC report provides an insight into how deficient water sanitation and disgusting food handling practices by a cruise line can jeopardize the health of the traveling public.

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April 4, 2016 Update: The CDC vessel sanitation inspectors inspected the P&O Oriana in February.  Although the cruise ship passed with a score of 90, there were several significant sanitation problems including dirty and out of service galley equipment.  Also food handlers working while ill with gastrointeritis: “A Chef de Partie experienced onset of GI symptoms on 20 January 2016 at 6:45 am. This crew member worked from 7 am to 11 am, took lunch at the crew mess, then returned to work from 1 pm to 5 pm. The chef reported his symptoms to the medical center at 6 pm.”   You can read the report here.

April 5, 2016 Update:  Cruise Law News was quoted today in the Southampton’s Daily  Echo and the U.K.’s Daily Mail.

Fortune magazine also covered the story, writing that it “raises questions about the industry’s squeaky-clean image, and indeed, that there may be more unreported cases that were either ignored or dismissed by the sickened passengers or the cruise lines themselves.”

April 6, 2016 Update:  FoxNews covers the story today – Health inspectors find cockroaches, ‘potentially hazardous’ food aboard two luxury cruise ships.  The Cruise Line International Association (CLIA) interjects the blame-the-passenger-wash-your-hands excuse but ignores the fact that crew members were handling food while contagious and the ship’s galley was found to be unsanitary and potentially hazardous to the guests’ health.

Photo credit: Piergiuliano Chesi, CC BY 3.0, commons / wikimedia.

Oceania RivieraYesterday we received information about the current cruise of the Oceania Rivieria which is sailing through the Caribbean (Miami March 20-April 3). "The captain came on the intercom yesterday informing the passengers that a large number of passengers had come down with flu like/gastrointestinal issues and the CDC had been informed. The ship ported at their first stop Santa Marta, Colombia as scheduled today."

The Centers for Disease Control and Prevention (CDC) has now officially reported the third norovirus outbreak on the cruise ship.  

The first recent outbreak was during the November 18 – December 2, 2015 sailing and involved 74 ill passengers. The second outbreak occurred during the  February 12-22, 2016 sailing which had to be ended early and involved at least 124 sick passengers. We wrote about how the crew members had to work overtime, often off the clock and without extra pay, to try and super-clean the cruise ship. 

This latest outbreak involves at least 52 passengers who are ill with norovirus. Zero crew members were reported ill during the current cruise.

Unfortunately, the under-staffed CDC never tries to conduct a meaningful epidemiology assessment to determine whether the outbreak can be traced to a particular type of food contamination, an ill food handler, poor cleaning of the ship or an ill passenger who brought the noro aboard the ship. 

Expect the number of affected passengers to increase during the cruise notwithstanding the extra hours spraying and wiping by the crew. 

So far this year, there have been 8 gastrointestinal outbreaks reported to the CDC by cruise ships calling on U.S ports. 

Photo Credit: Kefalonitis94 CC BY-SA 4.0, creative commons / wikimedia.

Golden Princess9News in Australia reports that the Golden Princess cruise ship docked in Melbourne this morning “after hundreds of passengers were struck down with gastro.”

The newspaper reports that “more than 300 passengers” on-board the cruise ship are believed to have been affected with a gastrointestinal illness.

Princess Cruises spokesman praised the ship’s crew and medical personnel who handled what the newspapers said is believed to be norovirus.

In the last two month, Princess Cruises has experienced a number of gastrointestinal outbreaks, on the Ocean Princess, Diamond Princess, and the Crown Princess.

Princess Cruises has experienced the most gastrointestinal outbreaks in the last decade – over 20.

Norovirus is primarily a food-borne virus which often spreads through contaminated food or water.  It can be spread by food handlers, people who touch contaminated surfaces and from person to person transmission.

Photo credit: Jean-Philippe Boulet, CC BY 3.0.

Norwegian GemEarlier this week, we reported that health officials banned the Norwegian Gem from calling on St. Maarten because a number of passengers were ill with a gastrointestinal illness. The NCL cruise ship then sailed on to Tortola where it called on the port there.

The Centers for Disease Control and Prevention (CDC) is now officially reporting that 128 of 2,882 cruise passengers (4.44%) and 7 of 1,100 of crew members (0.64%) on the Gem have been ill during the cruise with norovirus. 

Although it was suggested on the cruise ship that the cause of the outbreak may be contaminated water, there has been no information released to the public confirming or excluding this possible cause. Norovirus is primarily a food-borne disease. Outbreak News Today correctly states that "norovirus is typically spread through contaminated food and water, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea."

Unfortunately, the CDC has limited resources and does not attempt to conduct an epidemiology assessment regarding the source of the norovirus outbreak.    

Photo credit: Corgi5623 at English Wikipedia, CC BY-SA 3.0.       

Several passengers on the Norwegian Gem have contacted me, saying that health officials in St. Maartan have reportedly prohibited the NCL cruise ship from porting there.

The passengers are saying that there is a gastrointestinal outbreak reported on the Gem, thought to be norovirus.

I have not previously heard there was any type of outbreak on the ship. Anyone have information?

Photo credit: Corgi5623 at English Wikipedia, CC BY-SA 3.0 

March 18, 2016 Update: We are receiving some interesting comments on our Facebook page, including one suggesting that the source of the outbreak may be contaminated port water – rather than the cruise lines’ usual excuse of cruise passengers blamed for not washing their hands.

March 21, 2016 Update: The Gem next called on Tortola. Many local citizens are not happy. VI allows cruise ship to dock despite alleged Norovirus infection outbreak

 

  

Carnival SunshineThe Centers for Disease Control and Prevention (CDC) reports that the Carnival Sunshine is suffering through a gastrointestinal outbreak. This is the fifth GI outbreak of a U.S. based cruise line this year according to the CDC,

The CDC says that 118 of 3,005 (3.93%) of passengers sickened with noro during the cruise in addition to 5 crew members out of 1,142 (0.43%).

As I have mentioned in other recent articles, Carnival cruise lines has reported only three norovirus outbreaks to the CDC for U.S. based cruise since since 2006.  This is to be sharply contrasted with the norovirus outbreaks reported by Carnival owned Princess and HAL which have reported 32 GI outbreaks between them in the last decade.

Photo Credit: Piergiuliano Chesi 3.0 creative commons / wikimedia

March 5, 2016 Update: The CDC reported that the number of passengers sickened during the cruise is 173 with 5 crew members also stricken with noro virus.