Flr-040 Norovirus Poster Final Rgb.qxpSo is norovirus and cruise ships a likely combo? That is a solid maybe!  The answer is complicated.

The CDC tell us that norovirus infects some 20 million Americans a year thriving in closed areas like dormitories, prisons, summer camp cabins, health care facilities and yes…cruise ships. It spreads through contaminated food or water or by contact with contaminated surfaces. In addition to loose stool and vomiting, it can cause weakness, muscle aches, headache and fever. There is no treatment, and most people recover in a few days.

Over the past five years, about 14 cruise ships a year have outbreaks of diarrheal illness and the culprit is usually norovirus.  This year the Explorer of the Seas has the distinction of having the most ill people on board in the past 20 years (more than 600 passengers and crew members).

The best way to avoid it is prevention, and the best prevention is hand washing. The agency recommends that cruise ship passengers wash before eating or any other action that involves bringing hands near the mouth. And it recommends washing your hands after using the toilet, changing a baby’s diaper and coming into contact with communal features like railings.

The CDC lays the blame on the hands of the passengers not the crew.  They describe the food served on ships is usually of excellent quality, and food preparers are well trained. The passengers however…not so much.  If a passenger is sick when they get on board, then it moves to the handrails and doorknobs, and the transmission begins. And once on board the illness spreads widely.

This ships however have been dinged in one area in particular… restroom cleaning. A 2009 study published in Clinical Infectious Diseases noted that toilet seats, flush handles and other objects in restrooms on cruise ships were cleaned only a third of the time. On three ships that had baby-changing tables, none were cleaned at all during the three-year study period.

Cruise ships generally do their best to avoid outbreaks, and the unflattering attention that they can bring. This includes asking passengers as they board if they are or have recently been sick, sanitizing frequently touched surfaces, and implementing response plans in case of illness.

Going on a cruise?  Good hand hygiene and using hand sanitizer (which is widely available all over a ship) is a great idea.