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Gastrointestinal illness outbreak affects cruise ship passengers
A Royal Caribbean Cruise ship ended its Caribbean voyage 2 days early after a norovirus outbreak affected over 600 of its passengers.
The outbreak occurred within the first few days of the 10-day voyage upon the Explorer of the Seas cruise ship, according to a company statement. On Jan. 26, CDC health officials boarded the vessel in St. Thomas, Virgin Islands, to investigate the outbreak. After consulting with medical personnel, Royal Caribbean decided to bring the passengers home early and sanitize the ship with special cleaning products. The ship returned to its home port in New Jersey on Jan. 29.
“New reports of illness have decreased day-over-day, and many guests are again up and about,” according to the statement. “Nevertheless, the disruptions caused by the early wave of illness means that we were unable to deliver the vacation our guests were expecting.”
The CDC said a total of 634 of 3,071 (20.6%) passengers were affected by the outbreak. In addition, 55 of 1,166 (4.7%) crew members became ill. The predominant symptoms were vomiting and diarrhea.
According to the CDC, Royal Caribbean is taking the following actions to address the outbreak:
- Sanitize the vessel according to the company’s outbreak response plan
- Notify onboard passengers of the outbreak and encourage case reporting
- Collect stool specimens from affected passengers and crew for analysis at the CDC
- Make multiple daily reports of cases before reaching the final destination
- Collect additional crew members mid-voyage to assist in case management and sanitation
- Consult with CDC on management of cases after they disembark from the ship
“Guests scheduled for the next cruise on Explorer of the Seas can be confident that all possible measures will have been taken to prevent further problems,” the company said.
– Article updated Jan. 31.
Perspective
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Noroviruses are not common causes of illness on cruise ships. We see about 27 outbreaks each year in the thousands of voyages. It is just so dramatic when it occurs. The inoculum size is very low and the viruses can be found on many sources (food and surfaces like door knobs and even poker chips during outbreaks). Key things to avoid:
- Check the history of the ship to see if it has had a problem in the past — often the virus recurs on the same ship despite cleansing.
- Observe personnel hygiene by avoiding handshaking and by frequently washing hands.
- In a volunteer study with norovirus challenge, bismuth subsalicylate (Pepto-Bismol) improved symptoms and could be taken with the traveler in case illness developed.
- The cruise line has to take the ship out of commission for complete cleansing with Clorox to prevent future outbreaks.