Explorer of the SeasThe noro-stricken Explorer of the Seas has returned to New Jersey filled with 684 ill passengers and crew members. This is reportedly the largest gastrointestinal illness outbreaks on a cruise ship in twenty years.

A gastrointestinal illness (GI) chart from the Royal Caribbean cruise ship shows that the outbreak became obvious on Tuesday, January 21, 2014 when nearly 150 passengers reported that they were sick. By the next day, Wednesday. January 22, 2014, over 300 additional passengers suffered from the onset of the illness. You can track the outbreak affecting both passengers and crew on the chart below.

The chart does not have data included from yesterday or today.

The latest data from the Centers for Disease Control and Prevention (CDC) reveals that there are 684 ill, with 630 passengers and 54 crew members affected. 

It will be interesting if Royal Caribbean will produce a (GI) chart showing the number of patients who suffered from GI during the prior cruise.

Royal Caribbean Cruise Explorer of the Seas Norovirus Chart 

  Photo Credit: Explorer of the Seas – Thomas Layer / AP Photo 

Crew members work hard on cruise ships. Waiters and cabin attendants earn wages from Royal Caribbean of only $50 a month. That’s right. $50 a month. That’s something like $1.67 a day. They depend almost exclusively on tips from the passengers to support their families back home.

Utility cleaners are not entitled to tips, and they earn around only $545 a month. That’s around $18.30 a day. 

Crew members work a minimum of 12 hours a day, sometimes more.

Norovirus Explorer of the Seas - Royal CaribbeanThey work 7 days a week. Every single day of the month. For 8 months.

When a norovirus outbreak occurs, they are pressed into duty to try and sanitize the huge ship. That involves hours and hours of extra spraying and wiping and scrubbing everything in sight.

I cannot imagine the extra work required of the cabin attendants who clean as many as 18 cabins and bathrooms a day. I don’t know how these men and women clean so many cabins and bathroom when there’s no gastrointestinal illness outbreak. But when noro virus strikes and the puking and diarrhea starts, there are literally millions and millions of noro infected microbes floating around in an aerosolized form. The microbes can fall into the fabric of the furniture, the duvet covers on the bed, into the carpet fibers, and all the tiny nooks and crannies of the bathroom tiles.  

When the passengers leave the cruise ship at the last day of this cruise from hell, will they tip these hardworking crew members?  Many passengers are mad and feel ripped off. They didn’t obtain the vacations which they paid for with their family. They want their money back from the cruise line. Are they going to track down the public bathroom cleaners responsible for sanitizing all of the public restrooms and give them a $50 tip?

Today Royal Caribbean announced "compensation" for the passengers: a 50% refund and a 50% future credit. Is that fair? Some will accept it. Others will think that they are being mistreated again. Some people were sailing on the Explorer as a replacement cruise after the Grandeur of the Seas caught on fire last year. Are they interested in testing their luck one more time? 

Whatever you think of the cruise line’s offer of compensation, remember one thing. The crew is not getting a nickel extra from the cruise line. So if you are a passenger and want to bitch, whine, moan and complain, don’t forget about all of those crew members you left behind. Remember that they were the ones cleaning up all of your vomit and removing your bio-hazard bags. They are not receiving any compensation at all.  They are busy trying to get the cruise ship in shape for the next 3,000 guests who will soon board.

Explorer of the Seas Norovirus

Photo Credit: Top – Getty Images

The Centers for Disease Control and Prevention (CDC) has stated that over 600 people have been sickened by the gastrointestinal illness outbreak on the Royal Caribbean Explorer of the Seas, CNN reports.

The Royal Caribbean cruise ship left Cape Liberty, New Jersey on January 21, 2014 for a 10 day cruise through the Caribbean. The ship missed a stop at its private stop in Labadee Haiti after the outbreak. It sailed to San Juan to be cleaned. 

The CDC initially stated that over 300 people (281 passengers and 22 crew members) were ill. (Its official report is here with the new statistics). However, over the weekend we began to hear reports from passengers that the number Royal Caribbean Cruise Explorer of the Seas Norovirusof people suffering from nausea and diarrhea had increased to to over 450 and, now, to over 600. 

CNN quotes a spokeswoman with the CDC that more than 600 people on the ship have become ill, reporting vomiting and diarrhea. The CDC spokeswoman said 564 passengers and 47 crew members reported being ill.

Royal Caribbean is ending the cruise two days early. The cruise line will "use the extra time to sanitize the ship even more thoroughly." 

We have been contacted by guests on this ill fated cruise as well passengers from the prior cruise who became ill. 

Passengers who contacted Royal Caribbean say that the cruise line is not considering refunds of any type.

We previously reported on the incident in our article: Puke Fest Aboard Royal Caribbean’s Explorer of the Seas.

There has been no official word from the CDC whether this is in fact norovirus, although the symptoms are consistent with the virus. The cruise lines invariably blame the passengers, but the CDC has never in my experience ever pin-pointed the exact source of an outbreak like this.

NBC News raises the issue whether the outbreak on the Explorer is linked to a nasty new type of norovirus known as the GII 4 Sydney strain which caused an outbreak on the Queen Mary 2.

Join our discussion on Facebook about why norovirus outbreaks occur on cruise ships

 

http://www.cnn.com/video/api/embed.html#/video/health/2014/01/26/intvw-marquez-cruise-ship-illness.cnn

The Centers for Disease Control and Prevention (CDC) announced that there is an outbreak of gastrointestinal sickness of a large percentage of cruise passengers aboard Royal Caribbean’s Explorer of the Seas cruise ship.

The CDC indicates that 281 passengers (9.21% of total passengers) are suffering from norovirus type of symptoms. The symptoms include vomiting, nausea, headaches and diarehhea. You can read the report here

The pro-cruise site Cruise Critic calls the problem a "small outbreak" but the truth is that 9% is a high percentage.  It is not unusual for passengers not to report the illness in order to avoid being Explorer of the Seasquarantined in the cabin or for crew members who rely on tips to keep working after they are ill. The total numbers are often under-reported.

In addition to sick passengers, 22 crew members are reportedly ill according to the CDC. 

The CDC website states that an environmental health officer and an epidemiologist will board the ship in St. Thomas, USVI on January 26, 2014 to conduct an epidemiologic investigation. 

It may be possible to determine whether the outbreak is in fact related to norovirus. But the CDC will not have any success is determining why and how the virus came aboard. There is not enough time for the CDC to conduct an exhaustive scientific analysis and, as usual, the ship will not sit idle waiting for the test results. The cruise ship will continue to sail whether the CDC determines if it is norovirus or exactly why it is on the ship. 

Earlier this week, cruise expert Professor Ross Klein indicated that the CDC reported 130 passengers and 12 crew members became ill with gastrointestinal illness while cruising aboard the NCL Norwegian Star

The Majesty of the Seas returned to Miami a week ago with 70 people reported ill with gastrointestinal illnesses.

Were the outbreaks on the Royal Caribbean and NCL ships caused by the passengers not washing their hands? That’s always what the cruise lines say.

Or was it due to crew members who kept working after they became sick and causing the outbreak? Or was it contaminated food or water, which is a common cause?

We will never know. The cause of gastrointestinal outbreaks is usually a mystery on cruise ships.

 

Have a comment? Please leave a message below or join the discussion on our Facebook page – what’s the most common cause of norovirus on cruise ships?  

Photo Credit: Wikipedia / Emma Jones

This evening we received an email from a passenger on the Sun Princess cruise ship stating that the cruise ship is experiencing an outbreak of what is described as norovirus which is diminishing the cruise experience of the passengers. 

The primary complaint seems to be that the cruise line allegedly knew about the noro outbreak but did not tell the passengers until after the ship sailed. Earlier, on December 26th, we previously posted comments about noro virus on the Sun Princess.  Here’s what we received this evening:

"The Sun Princess is again out in the South Pacific with about 2,000 "Guests," all of whom were boarded without advice that the ship was sailing at ‘RED ALERT’ levels for the NORO virus raging in the vessel. The company is clever at preserving their profits at the risk of passenger health in not advising passengers of the outbreaks until well out on the ocean.

Holiday pleasures diminished, no condiments on tables, no self-service buffers, constant urgings to use expensive bottled water, very expensive medical centre visits, confined to cabins etc. etc. etc This concealment of health risks is deeply concerning and must be addressed by the industry at large right now."

We have written hundreds of articles over the years about noro virus and how the cruise line handle (and don’t handle) the outbreaks. The cruise lines always blame the passengers for not not washing their hands, although the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) have concluded that the most common causative factor is contaminated food and water.

Irrespective of what side you are on in this debate, there are a couple of things that everyone should agree on.

First, there is not enough time during turn-around day for the cruise ships to be adequately cleaned. There is not even enough time to figure out from an epidemiology perspective where the virus came from.  All of the spraying and wiping and fogging are pointless if the water or food are contaminated with the virus. But the cruise lines pressure the crew to madly try and super-clean the ship when it returns at the end of the cruise. 

Secondly, if the cruise line knows that there is a viral outbreak, it should be required to tell the passengers before they embark on the ship. Passengers should not be forced to sail on sick ships.

I for one would hate to take my family into a cabin where just a few hours earlier a sick family was power-puking millions of microbes of noro pathogens everywhere.

Update: Statement by Princess Cruises. Princess provided a statement which reads in its entirety as follows:

"Sun Princess experienced an outbreak of AGE on the prior voyage, however the cause (now known to be Norovirus) was not confirmed until the next voyage began.

During both voyages, the ship increased sanitation procedures, announcements were made by the captain, and letters were distributed to all passengers advising of the situation onboard. We also received verification from New South Wales Health that they were happy with the ship’s actions and response." 
 

Have a thought?  Please leave a comment below or join the discussion on our Facebook page.

Photo Credit: Wikipedia / Lemeki Lenoa

Celebrity Summit Cruise ShipCruise expert Professor Ross Klein reports that the Centers for Disease Control (CDC) indicates that 307 of 2112 passengers (14.5%) and 14 of 952 crew (1.5%) aboard the Celebrity Summit have reported sick with "gastrointestinal illness."

You can read about the outbreak on the CDC website here.

There is no indication whether the illness is due to norovirus, e-coli or some other virus or bacteria. 

The CDC is working with Health Canada officials as the cruise ship sails in Canada on its way to Bayonne, New Jersey,  The cruise ship will arrival in Bayonne on October 5, 2013.

The CDC will send an epidemiologist and an environmental health officer to meet the ship and conduct an epidemiologic investigation and environmental health assessment, and monitor the sanitation procedures onboard prior to the embarkation of new passengers.

Over 14% of the passengers being sick with gastrointestinal illness is a very high percentage.  

In the past week, we have reported about cruise ship norovirus outbreaks on two Fred Olsen cruise ships, the Black Watch and the Boudicca.

 

Photo Credit: Wikipedia / Yankeesman312

The last several articles on this blog have involved gastrointestinal (G.I.) virus outbreaks on cruise ships.

The cruise ships involved are Holland American Lines’ Volendam and Veendam, (HAL ships, historically, are the most likely to be contaminated with norovirus), the Discovery cruise ship which was held up in Liverpool for what the cruise lines describe as “enhanced cleaning,” and most recently the Celebrity Millennium which arrived in Alaska with a bunch of sick passengers who went ashore and coughed all over the city of Seward.

These ships join the list of other sick cruise ships this year. There are seven official reports of Cruise Ship NorovirusG.I. cases so far this year documented by the U.S. Centers for Disease Control and Prevention (CDC). But the list is incomplete. The CDC requires cruise lines to report outbreaks only when a certain percentage (more than 3%) of the passengers become ill. If the cruise ship does not call upon a U.S. port, then the CDC has no jurisdiction and there is no obligation to report any G.I. cases to the U.S. federal government.

Most countries around the world don’t require reporting of cruise G.I. cases. So when you read the CDC database of G.I. outbreaks on cruise ships, remember that this is only those cruises which dock at a U.S. port and where at least 3% of the passenger report to the infirmary.

My partners at my law firm ask me why I blog about G.I. cases because our firm rarely handles such cases. Why don’t we handle G.I. cases? For a couple of reasons:

It is usually impossible to prove where the virus originated. The CDC and the Food and Drug Administration (FDA) concluded long ago that most norovirus outbreaks are due to contaminated food and water. No, not due to the dirty hands of the cruise passengers as the cruise lines want you to believe, but noro-laden food or contaminated water.

But general propositions are no help in a particular case. The CDC makes no real effort to pinpoint the epicenter of the outbreak on the cruise ship.

The CDC usually can figure out the causative agent (i.e., noro, e-coli, etc.) but that’s where the federal agency’s inquiry ends. The CDC has but a few hours to board the cruise ship and conduct its Cruise Ship Norovirusinvestigation once the ship returns to a U.S port. It does not have the time or the resources to perform a full blown epidemiology assessment during the limited time the ship is in port.

Was the water well used to irrigate the potatoes or lettuce which were loaded onto the cruise ship contaminated by noro-infected swine feces that leeched into the well supplies? You will never know because no one is doing any investigation to find out.

The cruise lines don’t want such sophisticated analysis either, because the most likely cause of norovirus outbreaks is not bad passenger hygiene but contaminated food and water. It’s bad for cruise business for an official U.S. agency to point the finger at contaminated water or infected food, or to conclude that food handlers worked while infected with noro and, in turn, contaminated 150 plates of salad consumed by the passengers.

Illnesses due to e-coli or norovirus are nasty. You’re afraid that you are going to die and then you’re afraid that you’re not going to die, the joke goes. But it’s no joke. Sick passengers do die, particularly elderly passengers with suppressed immune system and especially those who are ignored by the ship doctors or those who receive bad care while on the cruise ship.

The rights of ill or dying passenger infected with norovirus on cruise ships are limited. The Death on the High Seas Act (DOHSA) prohibits the recovery of damages for elderly retirees. Their deaths are financially meaningless if they become sick during a cruise and then later die either on or off of the cruise ship. Cruise lines love DOHSA. Also, sick passengers who receive bad medical care by the ship doctors usually have no recourse against the cruise lines because the ship doctors are legally considered to be “independent contractors” for whom the cruise lines have no responsibility. And neither the cruise lines nor the CDC or FDA are trying to find out where the norovirus came from in the first place.

Cruise lines are cutting back on the testing of water, placing increasing demands on its crew members who often work while sick, hiding dirty galley equipment from CDC inspectors, and pushing their ships and staff past reasonable limits leaving little time and resources to maintain a clean and hygienic environment. 

Cruise Ship NorovirusIt’s easier for the cruise lines to blame the passengers for poor hygiene and then stand behind the CDC’s and FDA’s indifference and archaic laws like DOHSA which have insulated the cruise industry from the consequences of their negligence and recklessness for decades.

In a nutshell, we don’t handle G.I. virus cases because the deck is stacked against the cruise passenger. Cruise passengers typically don’t know when they board a noro-infected ship that they have few rights and that the cruise line will blame them if they get sick. We blog about the problem because it is an insight into the way which the cruise industry operates its business and treats its customers.

The cruise lines say that the “health and safety of cruise passengers are its highest priorities.” That’s not true. We prefer that the cruise passengers understand that before they walk up the gangway into a noro-contaminated ship.

The Centers for Disease Control and Prevention (CDC) reports that sixty (60) of the 1237 passengers (4.85%) aboard the HAL Veendam cruise ship exhibited symptoms such as diarrhea, nausea and vomiting during the last cruise.

Ten (10) of the 574 crew members (1.74%) also reported ill with gastrointestinal illness.

You can read the report here

Holland america Line Veendam Cruise ShipThe ship sailed from April 13 to May 4, 2013.

The Veendam has experienced problems with cleanliness and Illnesses over the years.

Last year, this HAL cruise ship flunked a health inspection.  That’s hard to do.  Read our article: Gross! Holland America Line’s Veendam Flunks Health Inspection.

The Veendam also sickened 80 and killed one passenger during a gastrointestinal outbreak in November of 2011.

Over the last decade HAL’s cruise ships have experienced the most gastrointestinal illnesses and the Veendam has the third most outbreaks of the hundreds of cruise ships operating out of the U.S.  The only other cruise ships with a worse records are the Ryndam and the Amsterdam, both HAL ships. Read about the problem here.    

 

Photo Credit:  Wikipedia / Djheini

Celebrity Century Cruise Ship - Failed CDC ScoreAccording to the Centers for Disease Control and Prevention (CDC), another Celebrity Cruises ship flunked a surprise inspection.

The Celebrity Century failed the CDC inspection, receiving a score of only 78.

Last week we reported that another Celebrity cruise ship, the Summit scored, flunked an inspection with a score of only 81. Three other cruise ships received failing scores as well.  So far this year there have been five cruise ships with failing grades. Read our article: Disease Breeding Grounds: Three Cruise Ships Fail Health & Sanitary Inspections.

The most disturbing finding was not just that the Century was dirty with contaminated food debris, but that crew members worked while ill with gastrointestinal sicknesses. Several of the ill ship employees worked in the galleys or interacted with passengers while ill.  The other cruise ships who flunked the inspections earlier this year also had ill crew members who worked with food and around passengers as well.  

These findings are significant because the cruise lines always blame the passengers when there are norovirus outbreaks and accuse the quests of not washing their hands.  The outbreaks may be due to ill employees who may be contaminating the food and infecting passengers.  

Celebrity Cruise Ship - Failed CDC ScoreYou can read the report of the Century here

The report indicates that two cruise ship cook worked while ill before reporting to the ship’s medical infirmary.  A sick hair stylist worked all day around passengers before going to the medical center. And an ill gift shop attendant worked before going to the medical center and continued working after he was suppose to be in isolation.

A particularly disgusting finding was that the toilet intended for galley workers was found locked when the galley was in service, and when the inspectors opened the door, the bathroom had no toilet paper.

And you wonder why there are norovirus outbreaks on cruise ships?

Leave a comment below or join the discussion on our Facebook page.

 

Photo Credit: Celebrity Century Cruise Ship – Wikipedia / Emesbe

Cruise Ship Virus - NorovirusThursday night a news station in West Palm Beach, Florida is airing an expose into passengers who are sickened on cruise ships.

WPTV – 5 aired a teaser video tonight entitled Cruise Ship Workers are Breaking the Rules, and Making Passengers Sick.

It sounds like the TV station will take a look at the outbreak of gastrointestinal viruses which have plagued the cruise industry over the years. It promises to reveal the cruise lines with the most problems (i.e., Princess Cruises and Holland America Line).

Cruise lines always blame the passengers for not washing their hands, and the passengers usually blame the cruise lines for having unsanitary ships.  Meanwhile no one is conducting a scientific analysis to determine exactly where the virus originated.  

I will be watching tomorrow night at 11:00 PM.