Cruise Ship Norovirus Outbreaks Rise

More than 400 passengers were sickened by the <"">norovirus on a Celebrity Cruise lines trip last month, one of eight such outbreaks this year alone, said MSNBC. Four outbreaks took place in one week, said the U.S. Centers for Disease Control and Prevention (CDC), noted MSNBC.

What’s frightening is that in 2009, there were a total of 15 outbreaks and experts are unclear why 2010 is seeing such an early rise, said MSNBC. “Four in one week—that’s not happy news,” said Dr. Claire Panosian, a clinical professor of infectious diseases at the David Geffen School of Medicine at the University of California at Los Angeles, quoted MSNBC. “It could be a blip or it could be a trend. It’s too early to say,” Dr. Panosian. According to a prior New York Times article, there have been more than 60 outbreaks of norovirus on cruise ships since 2005.

In November, we wrote that a norovirus was ruled as the culprit in another outbreak on a cruise ship. Norovirus, which can survive for weeks on surfaces at room temperature, can be difficult to eliminate, and can only be killed with chorine bleach. Alcohol-based hand sanitizers and other preparations are not too helpful. Norovirus outbreaks occur frequently in closed populations, such as cruise ship passengers.

According to Dr. Neil Fishman, associate professor of medicine and director of health care epidemiology and infection prevention for the University of Pennsylvania Health System said a wait and see attitude is the only way to determine if the outbreaks are a coincidence or an indication that norovirus is changing, said MSNBC. Dr. Fishman said if outbreaks continue to rise, there could be cause for worry, said MSNBC.

Although CDC data has shown a decline in norovirus outbreaks on cruise liners in recent years, that trend has changed with 14 outbreaks in 2008, 17 in 2007, and 32 in 2006 with 2010, in its first three months, exceeding clusters reported in 2006, said MSNBC.

Although cruise liners say that are diligently working to improve sanitation processes, a study we wrote about in November, which was published in the journal Clinical Infectious Diseases found that public bathrooms on cruise ships are not being cleaned properly. What’s more, the CDC, which runs a cruise ship sanitation program, is not doing a very good job of detecting dirty cruise ship bathrooms.
Another problem is buffet tables, said MSNBC noting that buffets are everywhere on cruise liners. Dr. Panosian suggests passengers stick to hot foods and bottled water.

The study used trained health care professionals to covertly evaluate the
“Thoroughness of Disinfection Cleaning” of six standardized objects (toilet seat, flush handle or button, toilet stall inner handhold, stall inner door handle, restroom inner door handle, and baby changing table surfaces) with high potential for fecal contamination in cruise ship public restrooms. The investigators used an easily removable solution visible only under ultraviolet light to mark the objects, monitoring them for five to seven days to see if the solution had been removed by cleaning or disinfecting.

The team evaluated 56 cruise ships, representing less than 30 percent of the vessels operated by nine large cruise lines, from July 2005 through August 2008. There were 19 outbreaks of intestinal illness during the three-year study period. The investigators found that only 37 percent of 8,344 objects in 273 randomly selected cruise ship public restrooms were actually cleaned daily.

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