Royal Caribbean’s Explorer of the Seas returned to New Jersey today filled with hundreds of diarrhea-plagued passengers disappointed that a dream vacation turned into a nightmare. The vessel returned two days early after over 600 passengers and crew were stricken with severe gastrointestinal problems. The illness-plagued cruise raises the question of whether additional health precautions are needed to protect travelers, or is the risk of epidemic on a cruise over-publicized?
Gastrointestinal outbreaks on cruise ships have received a lot of attention in recent years. However, the U.S. Centers for Disease Control and Prevention (CDC) statistics do not indicate that the number of outbreaks is increasing. While incidences have not grown in frequency, the numbers of people stricken are greater since cruise ships have become larger and now carry more passengers and crew. The Royal Caribbean vessel housed more than 4,000 people with nearly 20 percent becoming sick.
What caused this outbreak? The CDC will test samples from those impacted this week, but odds are that the culprit is the norovirus, a highly contagious disease that has been responsible for most of the cruise ship outbreaks reported in recent years.
Usually mislabeled as stomach flu or food poisoning, norovirus is the most common gastrointestinal illness in the U.S. and affects millions per year. Symptoms include diarrhea, vomiting, fever and stomach cramps. Most people recover in a few days, but it can lead to dehydration and other problems for infants, those with other conditions and the elderly. Noroviruses are usually spread through contaminated food or liquids, but can also be spread by touching a surface that has been contaminated.
Norovirus infections are highly contagious and spread rapidly in crowded, closed environments like a cruise ship. One infected person touching ship rails, bathroom fixtures and buffet counters can easily impact hundreds. So, those planning vacations must raise the question of what health precautions are needed for a cruise and how vacationers can avoid illness-plagued voyages like the one experienced by Royal Caribbean’s passengers.
The CDC runs a Vessel Sanitation Program that requires cruise operators to try to contain outbreaks. Ship crews are required to isolate those infected, notify passengers and staff that the disease has been reported on the ship, establish additional cleaning and disinfecting procedures and if needed, stop shipboard activities that are high risk like buffet lines. So, even those unaffected passengers on the Explorer of the Seas were impacted as shipboard activities were canceled.
The Vessel Sanitation Program includes training for ship personnel on how to prevention and control infections. The CDC periodically conducts unannounced as well as scheduled inspections of vessels to ensure sanitation procedures are followed.
Experts want to raise awareness of health precautions people need to take against noroviruses on cruise ships, such as the illness-plagued Royal Caribbean Explorer of the Seas, precaution that apply against most viruses in everyday life. Washing and sanitizing hands constantly is paramount. While people cannot realistically avoid touching surfaces typically handled by others including bathroom doors, stair railings or elevator buttons, it is imperative to wash thoroughly before eating or drinking. Some recommend avoiding buffets or going early when the food is fresh and the counters are clean.
By Dyanne Weiss