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Sea Sick: The Norwalk Virus Strikes

Gastroenteritis Outbreaks Leave Passengers on Cruise Ships Feeling Queasy

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January 2014 Norwalk Virus Incident: 170 Sickened on Princess Cruises' Caribbean Princess

January 2014 Norovirus Incident: 600 Sickened on Royal Caribbean's Explorer of the Seas

January 2008 Norwalk Virus Incident: 143 Struck on Carnival Cruise Lines' Holiday, sailing a Mobile, Alabama to Cozumel, Mexico itinerary record of outbreaks on Carnival Cruises

December 2007 - January 2008 Norwalk Virus Incident: 133 Suffer on maiden voyage of Cunard's Queen Victoria

May 2007 Norwalk Virus Incident: 130 Affected on Norwegian Star

January 2007 Norwalk Virus Incident: 300 Succumb on Queen Elizabeth 2

December 2006 Norwalk Virus Incident: 400 Struck on Freedom of the Seas, the largest ship at sea.

November 2006 Norwalk Virus Incident: 700 Fall Ill on Carnival Liberty, among largest outbreaks ever, according to the Center for Disease Control.

July 2006 Norwalk Virus Incident: 200 Passengers Plus Crew Members Succumb on Mariner of the Seas

January 2005 Norwalk Virus Incident: 230 Sick, Vomiting on Veendam

List of Cruise Ship Outbreaks from the Center for Disease Control

Original Story: On December 1, 2002, travelers will once again board Holland-America's ms Amsterdam, a luxury cruise ship introduced in 2000 with a capacity of 1,380 passengers. The December sailing marks her first cruise since November 21, when the ship was taken out of service for decontamination. Embarking from Fort Lauderdale on a ten-day cruise, the Amsterdam is scheduled to call at the Bahamas, St. Thomas, Martinique, Trinidad, Venezuela, and Curaçao before returning to Florida.

According to the Associated Press, "The Seattle-based Holland-America cruise line hopes to kill a virus that has been sickening cruise ship passengers by the hundreds in recent weeks." Despite the cruise line's repeated attempts to disinfect the ship's 10 passenger decks and 690 staterooms over the past month while the Amsterdam remained in service, more than 500 people aboard the ship contracted the Norwalk virus on four successive sailings from Florida to the Caribbean.

"Norwalk-like viruses, named for an outbreak in Norwalk, Ohio, 30 years ago," the Washington Post reports, "are spread through food and water or contact with infected people. A cruise, where hundreds of passengers and crew mingle in close quarters, can provide ideal conditions for a virus to spread." Though not life-threatening, the bug can cause nausea, vomiting, and diarrhea for one to three days.

By law, "cruise ships are required to report all gastrointestinal illnesses to the CDC [Centers for Disease Control and Prevention] 24 hours before entering a U.S. port," notes Laura Bly in USA Today. "Cruise lines must file a special report if at least 2 percent of passengers or crew are ill."

The Holland-America cleaning this time involved some 600 crew and subcontractors supervised by Harvard School of Public Health epidemiologist Megan Murray. Everything touched by hands that might have carried the virus -- from Bibles to poker chips, railings to remote controls -- has been cleaned and sanitized. The ship's 2,500 pillows have been replaced, and upholstery fabrics have been steam-cleaned to a temperature of 170 degrees.

Passengers originally scheduled to depart on the Amsterdam November 21 for a 10-day cruise out of Port Everglades found their plans canceled. They were offered refunds or rescheduled cruises.

However, a number of those affected by the virus on the four prior Caribbean cruises joined in a class-action lawsuit against Holland-America Cruise Lines. The complaint, filed on November 25 in Seattle, alleges the company "knew or should have known" that passengers could contract the contagious virus and should have immediately removed the ocean liner from service to sanitize her and eliminate the prospect of causing more passengers to fall ill.

Disney Magic Casts Unwanted Spell

Holland-America isn't the only cruise line to recently experience Norwalk virus outbreaks on board. During two consecutive weeks aboard the Disney Cruise Line ship Magic, passengers have suffered from the same uncomfortable malady. Since Saturday, November 23, some 69 guests and 16 crew members on the Magic have fallen ill. The 2,400-passenger ship had been disinfected that day because a similar gastrointestinal outbreak had caused 312 people to become sick on a previous seven-day cruise.

As a result, the November 30, 2002 sailing of Disney's Magic was canceled. Scheduled passengers were offered a full refund and 50 percent discount on a future Disney cruise. Disney set up a toll-free Guest Information Line (866-724-5325) to field questions and reassure passengers. Magic is next expected to set sail on December 7 from Port Canaveral, 90 minutes east of Walt Disney World. She will depart on a seven-day, western Caribbean itinerary calling at Key West, Grand Cayman, Cozumel, and Disney's private island, Castaway Key.

Like the Amsterdam, Disney's Magic was inspected by the CDC -- and rated 99 out of 100 on June 15, 2002.

Should You Set Sail?

Pro-active responses from the cruise lines involved could keep these unfortunate events from turning into public-relations disasters and engendering lawsuits. I think this would be a reasonable way to handle outbreaks:

  • Pull a ship out of service as soon as ten or more people are diagnosed with Norwalk-like symptoms
  • Guarantee affected passengers full refunds; process immediately upon receiving a doctor's note attesting to the illness
  • Offer booked passengers the opportunity to choose another sailing date or receive a full refund
  • Provide a booklet in every stateroom informing passengers of the symptoms of Norwalk virus and recommending preventative actions they can take to avoid contracting it.
That said, it's important to keep these incidents in perspective. At this writing, the outbreaks have affected fewer than 1 percent of all cruise passengers.

CDC officials say they see no reason for people to delay booking a cruise because of the outbreaks. And AAA Travel Vice President Sandra Hughes stated, "It is understandable that some people are concerned about the reports of flu-like illnesses on cruise ships, but it should be noted that of the nearly 7.5 million Americans who will cruise this year, only about 1,400 cases have been reported." She adds, "The good news for those who may contract the illness is that it typically runs its course in 24 to 48 hours."

Of course, if those are 24 or 48 hours out of your honeymoon or long-awaited vacation, that's not much consolation.

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