Norovirus

[brillohead]

40 minutes ago, PelicanBill said:

Here's why the child vomiting isn't a likely scenario:

It takes 24-48 hours to become symptomatic after coming in contact with the virus.  How many people could that be? and then for the second order exposure, to affect hundreds? The CDC incident records show that almost all outbreaks affecting large numbers are caused as a result of contaminated food preparation or a careworker in a nursing home or medical facility where someone touches the food of many people.  Noro is not a virulent spreader - it does not cover huge surfaces like a sneeze does. So it does not spread rapidly by incidental contact with door handles or even buffet utensils.  that said, I wash my hands like crazy and use and sanitizer a LOT on a cruise. 

Oh, it most certainly does get spread that way, if an infected person didn't properly wash their hands before touching public surfaces!



 

[Starry Eyes]

54 minutes ago, PelicanBill said:

Here's why the child vomiting isn't a likely scenario:

It takes 24-48 hours to become symptomatic after coming in contact with the virus.  How many people could that be? and then for the second order exposure, to affect hundreds? The CDC incident records show that almost all outbreaks affecting large numbers are caused as a result of contaminated food preparation or a careworker in a nursing home or medical facility where someone touches the food of many people.  Noro is not a virulent spreader - it does not cover huge surfaces like a sneeze does. So it does not spread rapidly by incidental contact with door handles or even buffet utensils.  that said, I wash my hands like crazy and use and sanitizer a LOT on a cruise. 

A few points:

there may well have been more than one person infected at the start.  The rest of that child’s family, for example, were likely our spreading the illness.  the child could even have been part of a could have been part of larger group.  But let’s say the number at the start was three contagious and careless family members.

 

secondly, your incubation period data is incorrect.  Per the cdc, “The average incubation period for norovirus-associated gastroenteritis is 12 to 48 hours, with a median period of approximately 33 hours.”  So, some people exposed to patient zero’s germs became symptomatic as soon as 12 hours later.

 

Thirdly, vomiting in a public area can spread the virus quite effectively, much like a sneeze. That event could have infected children and adults in the vicinity right then and also expelled viral particles on many surfaces in the area, which could tracked and picked up by others.  Three careless contagious family members touching all sorts of surfaces on day one includind a child vomiting in a sensitive area...they could leave virus inenough places for 100, 200 or more people to start incubating the very first day.

 

Finally, the distribution of cases argues against your infected food worker theory in this case in my opinion.  Really, 90+% of us remained well. Those that did become ill did not all fall ill at once as though one infected meal was served; rather the cases ramped up, then declined After increased sanitation measures were enacted.  A dirty worker likely would have made even more of us sick even faster.  And no reason for a dirty worker to show up at the start of our cruise not seen at the end or the last one.

 

As a retired health care professional, I find the vomiting child story totally plausible.  Perhaps her family would Like to deny the problems they caused bringing an illness aboard ( knowingly or unknowingly?) but it is believable imho.

Edited January 15, 2019 by Starry Eyes

[John&LaLa]

I didn't realize it declined

[Starry Eyes]

7 minutes ago, John&LaLa said:

I didn't realize it declined

Well, I infered that the rate of presentation was declining toward the end  based on limited data at hand.   

 

Later in the cruise, they said only 100 were still in quarantine, and presumably some of those were well into their 24 hour symptom free period, looking froward to release from quarantine.  From my previous experience with epidemic illness, if presentations were steady or increasing, I’d have expected far more than 100 in quarantine.  

 

So educated guess that the control was working.  And really, with the effort expended, they deserved results.

[Trinam2]

I wonder how the current sailing is fairing?

[chengkp75]

2 hours ago, Starry Eyes said:

A few points:

 

Finally, the distribution of cases argues against your infected food worker theory in this case in my opinion.  Really, 90+% of us remained well. Those that did become ill did not all fall ill at once as though one infected meal was served; rather the cases ramped up, then declined After increased sanitation measures were enacted.  A dirty worker likely would have made even more of us sick even faster.  And no reason for a dirty worker to show up at the start of our cruise not seen at the end or the last one.

 

As a retired health care professional, I find the vomiting child story totally plausible.  Perhaps her family would Like to deny the problems they caused bringing an illness aboard ( knowingly or unknowingly?) but it is believable imho.

This is the type of data the CDC studies in these cases, not just the raw number of cases.  If the number of new cases increases during the cruise, and then declines, it is most likely a passenger who brought it onboard (this is what they tell me during training for cruise ship VSP), while a crew member would keep the rate of new cases pretty constant, and carry over to the next cruise, and the next cruise, and so on.

 

The CDC and USPH will tell you that food borne illness is almost non-existent on cruise ships these days, and this is one reason noro is so virulent, it has no competition on the ship.

 

I won't say whether it was caused by the child vomiting, but that child, or his/her family were likely patient zero and were not real diligent when cleaning up themselves particularly after the child's incident.

[platina416]

27 minutes ago, Trinam2 said:

I wonder how the current sailing is fairing?

I have been wondering too, and scouring boards and Twitter but nothing. I think no news is good news! We board this coming Sunday! 

[CruiszBug]

When I spoke of "Patient Zero" it was not as the definitive person who started all this. (Who can actually know that?)  It was the first person treated by medical, so maybe the first person reported? As previous posters have pointed out, sick people self-medicated, did not report, or tried to report but couldn't get through so were not counted. The last number I saw per the CDC investigation on their website (updated on 1/12/19) was 561 which was almost 9% of the passengers (not 1 - 2% which is what we were told onboard.) The crew listed 31 as sick and that number was approximately 1.5%.

 

As for the quarantine, my dad was violently ill and put in quarantine. The nurse came with meds and gave him a shot. He thought he was having a heart attack due to the severity of the nausea. After 24 hours he was feeling much better and was released from quarantine, but was struck down again a couple of days later. So if that happened to anyone else, it also skews the numbers for new cases since it probably was not re-recorded. Infection rates probably slowed down with the cleaning protocol, but I don't think numbers went down because you are still considered infectious for a period of time afterwards.

 

Here's hoping no cases occur on the current sailing of Oasis this week!

[Gershep]

2 hours ago, Trinam2 said:

I wonder how the current sailing is fairing?

 

I have a friend on the Oasis right now. She facetimed me today and all is well. No known cases of norovirus.  She said that there are many crew members out cleaning surfaces right after someone touches them, crew is serving food in buffet and room stewards ask you if you washed your hands if they see you leave your cabin. I have another friend on the NCL Escape and apparently there are some reported cases of norovirus onboard.

[shazza_h]

4 hours ago, Trinam2 said:

I wonder how the current sailing is fairing?

Hi - We are on board right now.  The crew have been very diligent in making sure that everyone washes their hands, wiping down surfaces etc.  You don't have to go far anywhere to find someone cleaning something!

Crew is serving food at the Windjammer, the Coastal Kitchen buffet, park café etc.  You can't even get too close to the food as it is all roped off with a crew member standing between the rope and the food.  Slows down the whole process but for the best I guess.

[Trinam2]

13 minutes ago, shazza_h said:

Hi - We are on board right now.  The crew have been very diligent in making sure that everyone washes their hands, wiping down surfaces etc.  You don't have to go far anywhere to find someone cleaning something!

Crew is serving food at the Windjammer, the Coastal Kitchen buffet, park café etc.  You can't even get too close to the food as it is all roped off with a crew member standing between the rope and the food.  Slows down the whole process but for the best I guess.

That’s good to hear. Enjoy the rest of your cruise.

[ONECRUISER]

5 hours ago, CruiszBug said:

When I spoke of "Patient Zero" it was not as the definitive person who started all this. (Who can actually know that?)  It was the first person treated by medical, so maybe the first person reported? As previous posters have pointed out, sick people self-medicated, did not report, or tried to report but couldn't get through so were not counted. The last number I saw per the CDC investigation on their website (updated on 1/12/19) was 561 which was almost 9% of the passengers (not 1 - 2% which is what we were told onboard.) The crew listed 31 as sick and that number was approximately 1.5%.

 

As for the quarantine, my dad was violently ill and put in quarantine. The nurse came with meds and gave him a shot. He thought he was having a heart attack due to the severity of the nausea. After 24 hours he was feeling much better and was released from quarantine, but was struck down again a couple of days later. So if that happened to anyone else, it also skews the numbers for new cases since it probably was not re-recorded. Infection rates probably slowed down with the cleaning protocol, but I don't think numbers went down because you are still considered infectious for a period of time afterwards.

 

Here's hoping no cases occur on the current sailing of Oasis this week!

I think the numbers on CDC are "reported" not confirmed cases. Also will never know if they all had it or how many under reported, those like 1-2 on CC that said they never told anyone and continued on exposing others...

[davelinde]

We were on the infected cruise and I'm curious when the first cases presented?  My wife got sick around 11pm the night we left Labadee and was done with symptoms by 6am the next morning.  We assumed food poisoning due to lax standards on Haiti and were actually considering attempting to take a tour in Jamaica.  We actually tried to report her incident to medical but gave up after they kept answer the phone with "we will call you back" (and didn't).

 

BTW - for the comment above on crew...  the initial CDC report (the day we returned) noted 17 crew but as of today the report was updated to near double that.  On the day the captain notified us the rumor I heard was 2% of passengers, and by the second day I think that number was 4%,   the day we returned the CDC reported above 6% and now the CDC web site show over 9%.  It is interesting that the CDC does not report Oasis having hit epidemic before.

 

I wonder how cautious Jamaica was because we were inbound from Haiti (where cholera is still present).   For my wife we really think the source was Haiti and not the ship - though we have nothing but the timeline and symptoms to support that guess.  Other infection sources are possible I suppose.

[davelinde]

1 minute ago, ONECRUISER said:

will never know if they all had it or how many under reported, those like 1-2 on CC that said they never told anyone and continued on exposing others...

 

We tried to report but after several promises of "we will call you back" (no call back) we gave up.

My wife was symptom free when she left the cabin again and if she had food poisoning she was not contagious in any case.  But yes...  it is hard to know for sure how pervasive this is and how many people are not careful while still symptomatic.

[ONECRUISER]

4 minutes ago, davelinde said:

 

We tried to report but after several promises of "we will call you back" (no call back) we gave up.

My wife was symptom free when she left the cabin again and if she had food poisoning she was not contagious in any case.  But yes...  it is hard to know for sure how pervasive this is and how many people are not careful while still symptomatic.

Wasn't specifically pointing you out, there are at least 3 threads on this sailing...

[davelinde]

4 minutes ago, ONECRUISER said:

Wasn't specifically pointing you out, there are at least 3 threads on this sailing...

 

didn't mean to sound defensive, you made an on point observation and I was just adding our experience here.

As you noted, some won't report and for us we gave up on reporting, but in fact we were likely not norovirus but food bourne infection. 

 

FYI as I mentioned in one of the other threads on this sailing, I overheard crew saying they thought Haiti was the culprit.  No idea if that is accurate but it is plausible.

[brillohead]

Typical onset of symptoms is 24+ hours after infection.... if symptoms started the evening of Labadee, the infection occurred the day before.

 

[ONECRUISER]

51 minutes ago, davelinde said:

 

didn't mean to sound defensive, you made an on point observation and I was just adding our experience here.

As you noted, some won't report and for us we gave up on reporting, but in fact we were likely not norovirus but food bourne infection. 

 

FYI as I mentioned in one of the other threads on this sailing, I overheard crew saying they thought Haiti was the culprit.  No idea if that is accurate but it is plausible.

Understand, no problem..

[ChiliTiger]

15 hours ago, Trinam2 said:

I wonder how the current sailing is fairing?

I am currently on Oasis too. Not a peep about anyone falling ill.they made an announcement at muster about what had happened during the previous cruise and that the ship had been thoroughly sanitized. They strongly implored everyone to practice diligent hand washing...and from my observation everyone is taking it very seriously...if the women’s restrooms are any indication...we all look like we are preparing for surgery with all the hand scrubbibg going on in there. We avoided windjammer but decided to check it out yesterday..won’t go back...just too many folks crammed in to one space for my liking. Anyway..so far so good!!! 

 

[Trinam2]

1 hour ago, ChiliTiger said:

I am currently on Oasis too. Not a peep about anyone falling ill.they made an announcement at muster about what had happened during the previous cruise and that the ship had been thoroughly sanitized. They strongly implored everyone to practice diligent hand washing...and from my observation everyone is taking it very seriously...if the women’s restrooms are any indication...we all look like we are preparing for surgery with all the hand scrubbibg going on in there. We avoided windjammer but decided to check it out yesterday..won’t go back...just too many folks crammed in to one space for my liking. Anyway..so far so good!!! 

 

That’s great news! We are leaving on Oasis this Sunday.

[island lady]

16 hours ago, platina416 said:

I have been wondering too, and scouring boards and Twitter but nothing. I think no news is good news! We board this coming Sunday! 

 

"Sea" you on board.  Looking forward to a good (and healthy!) cruise this time.  😉 

[StrikeEagle]

For those who don't know this already,  probiotics helps with stomach virus including Norovirus.  Our family on every cruises we takes probiotics supplement daily.  The stuff we got is called Culturelles. 

If you do a search on the internet,  you will find several articles on how probiotics helps with stomach viruses

 

https://www.wral.com/lifestyles/healthteam/story/10742574/

Edited January 16, 2019 by StrikeEagle

[gatour]

Sometime today Cruise Critic posted in their "News" section about how noro outbreaks are on a downward trend.  They based this on the difference between the 2017 and 2018 numbers.  One year does not make a trend.

 

They then brought up that the Oasis outbreak only had over 200.  Thanks to a prior poster who said that CDC has reported 500+ infected, I responded that they needed to do better fact checking before submitting such an article.  I provided a link to the actual lastest CDC report in regards to this Oasis nora occurance.

[vanelli56]

On the current sailing....

The crew is working as hard as I have ever seen regarding cleaning and sanitizing.  

Like others have said,  we have not heard of anyone being sick in this sailing.  

I ventured to the wind jammer once for breakfast... while I was glad to see the crew serving the food instead of passengers serving themselves... I haven't been back... still too many people for my comfort level.  

 

Fingers crossed for a continued sick free sailing.  

Looking forward to St. Marteen tomorrow.  

[John&LaLa]

On 1/15/2019 at 10:54 PM, davelinde said:

 

didn't mean to sound defensive, you made an on point observation and I was just adding our experience here.

As you noted, some won't report and for us we gave up on reporting, but in fact we were likely not norovirus but food bourne infection. 

 

FYI as I mentioned in one of the other threads on this sailing, I overheard crew saying they thought Haiti was the culprit.  No idea if that is accurate but it is plausible.

 

We did not get off in Labadee.  I had symptoms, but never vomited,  so I did not get counted.