Novovirus - Inevitable?

[Fern Crest]

RC's Explorer of the Seas cut its itinerary and came back with over 600 passengers and crew sick with vomiting and diarrhea. According to the article;

 

"... The virus is easily passed from person to person, spreads through food and ice, and also can survive on inanimate objects for days. Even with scrupulous cleaning, the virus can still remain intact, ..."

 

Yikes. Those poor people. Is it just an accepted risk of cruising now?

[mrsdoc3]

There is risk involved in everything you do every day. Some people avoid risk at all costs and never leave their homes, thinking something bad will happen if they, but bad things happen at home, too (drop a book on your foot, burn your hand on the stove, etc).

 

Some people are risk takers (race car drivers, sky divers, etc).

 

Are you certain to get noro if you cruise? No. Can you be guaranteed that you won't get noro? No. But you can take precautions.

 

How do you avoid getting hit my a car when crossing the street? You take the precaution of looking both ways. How do you avoid getting noro on a cruise (or anywhere)? You take the precaution of washing your hands -- a lot!

Edited January 27, 2014 by mrsdoc3

[Midwestgal]

One thing that surprised me was that the number of outbreaks per year seems to have decreased beginning around 2008. Form a high of 34 in 2006, it seems to have leveled off at around 14 or 15 per year, although 2013 only had 9. Just chance? Or did the cruise lines start taking it more seriously at some point with more preventive measures? These stats are for all cruise lines above a certain size.

 

2003 24 incidents 2007 21 incidents 2011 14 incidents

2004 32 incidents 2208 15 incidents 2012 16 incidents

2005 17 incidents 2009 15 incidents 2013 9 incidents

2006 34 incidents 2010 14 incidents 2014

 

Although the annual listings include every cruise line above a certain size, for comparison sake I just looked at the stats for RCCL, NCL, HAL, Celebrity, Princess and Carnival. Here are the total number of incidents for each of the 6 cruise lines for past 8 years, 2006 through 2013. You tell me if anything surprises you.

 

NCL. 15

RCCL. 15

Celebrity. 22

Princess. 25

HAL. 33

Carnival. 6

 

This was taken from another blog and I copied it.

[pe4all]

My family of 4 has cruised well over 20x - all 7 days or longer. Not one of us has ever gotten "sick" on a ship. However, 2 years ago I caught a nice stomach virus 2 days before one of my February cruises, and cancelled the cruise. (I could have managed to fly in the day before, as always, but didn't think it was right exposing over 200 people to a possible virus) As I work in an elementary school, and have contact with well over 200 students a day, my luck finally ran out! I use anti-bacterial wipes between all my classes, and wash my hands before eating, on top of that. On a ship, I use paper towels to open doors, use my elbow to push elevator buttons (infrequently use elevators - prefer the stairs) and use the "washy washy" on the way in and out of dining rooms, etc. I would never cancel a cruise due to fear of catching something on board. Stuff, unfortunately happens - all an accepted risk of going where masses of people go. I am sure noro appears in Disney also - you just don't hear about it!!

[EZ4]

The geriatric set on HAL needs to learn to wash their hands. Yuk. :p

[BruceMuzz]

Unfortunately, statistics have a way of clouding the issue.

 

An outbreak officially occurs (and must be reported) when more than 2% of the people onboard (during that particular voyage) have experienced GI symptoms that are consistent with NLV.

 

On every cruise, on every cruise ship in the world, we have anywhere from 3 to 5 people - on a normal day - reporting GI symptoms There are no quick reliable tests to positively determine NLV infections on ships, so the medical people make an educated guess and then choose to err on the side of caution when deciding to isolate passengers and make the cases reportable.

 

Most of the time, most of these cases are not NLV, but other viruses, over-eating, over imbibing, sensitive stomachs, inexperienced travelers, seasickness, or other medical issues.

 

The challenges on hitting that 2% threshold are based on the size of the ship and the length of the cruise.

If you have a ship carrying 6,500 passengers and 3,500 crew on a 3-day cruise, you would need to have more than 70 people reporting NLV symptoms each day before the 2% threshold was reached on day 3.

If you have a ship carrying 700 passengers and 300 crew on a 42 day cruise, even one passenger per day reporting ill would put the ship over 2% - but only after 20 days or so.

 

A cruise line with big ships and short itineraries will have far more NLV cases - but far fewer official outbreaks.

A cruise line with smaller ships and longer itineraries will generally have far fewer NLV cases - but far more official outbreaks.

 

Then when you factor in the other significant contributors:

 

More people on longer cruises tend to fly to them and stay in hotels, increasing the chances of contracting NLV on the airplane or in the hotel before the cruise and bringing it onboard with them.

Short cruises from US ports have mostly passengers who did not fly or stay in hotels before the cruise.

 

Incubation period for NLV is between 24 and 72 hours. Many people who contract NLV on a short cruise don't have any symptoms until they are on the way home. Those cases are rarely reported and do not count for the 2% threshold for reporting outbreaks on ships.

 

People with weakened immune symptoms are more susceptible to NLV. Older people - who typically have weaker immune systems - typically take longer cruises on smaller ships.

 

Norwalk virus developed, and was discovered, in Norwalk Ohio, USA. Every year over 10% of the American public reportedly has Norwalk Virus (35 million people). There is probably an equal number of Americans who also have it but do not report it. This is the highest percentage and the highest number of any country in the world. If there is a high percentage of American passengers on your cruise, there is a greater chance that a higher number of passengers will have carried the virus aboard with them.

 

Recent CDC research suggests that people with type O blood are most susceptible to contracting Norwalk Virus. People with Blood Types A and B are significantly less susceptible.

 

Recent CDC research has concluded that many Asians are not affected by Norwalk Virus - even if they are infected. This could be good news if you are Asian - but bad news if it turns out that Asians can be unknowing carriers of the virus without any symptoms.

 

The CDC figured out long ago that the 2 most likely places to contract NLV on a cruise ship are: 1) The Buffet - especially during the first 48 hours of a cruise, and 2) Public toilets at any time during the cruise.

If you are smart enough to avoid those high risk places, (and IF you practice good personal hygiene) the chances of contracting NLV on any cruise are significantly reduced.

Edited January 28, 2014 by BruceMuzz

[dkjretired]

Keep things in perspective. 21 million Americans get noro every year, 4000 on cruise ships.

[paul929207]

I have spent nearly 600 days on cruise ships and have avoided Norovirus so far

[CruiseGirlKS]

Keep things in perspective. 21 million Americans get noro every year, 4000 on cruise ships.

 

Yikes!

[Ethel5]

One thing that surprised me was that the number of outbreaks per year seems to have decreased beginning around 2008. Form a high of 34 in 2006, it seems to have leveled off at around 14 or 15 per year, although 2013 only had 9. Just chance? Or did the cruise lines start taking it more seriously at some point with more preventive measures? These stats are for all cruise lines above a certain size.......SNIP...............................

 

I feel is a combination of the ships being more vigilan,t but also passengers are more aware and are being more cautious regarding hand washing etc.

[BruceMuzz]

I have spent nearly 600 days on cruise ships and have avoided Norovirus so far

 

I have spent 1437 CRUISES - not DAYS - on cruise ships.

I have supervised clean-up of so many NLV outbreaks that I have lost count.

I always wash my hands - very frequently and very thoroughly.

I keep my hands out of my mouth, nose, and eyes.

I do not use hand sanitizing gels. They do not prevent viral contamination.

I never shake hands with anyone.

I never eat in buffets.

I never use public toilets.

I have visited many cabins where the occupants were very ill with NLV.

I have wheeled sick passengers down the gangway on countless occasions.

I have personally confronted many sick passengers who refused to be isolated.

I have visited many public areas to supervise clean-up where sick passengers have vomited.

 

I have never had Norwalk Virus.

[printingchick]

RC's Explorer of the Seas cut its itinerary and came back with over 600 passengers and crew sick with vomiting and diarrhea. According to the article;

 

"... The virus is easily passed from person to person, spreads through food and ice, and also can survive on inanimate objects for days. Even with scrupulous cleaning, the virus can still remain intact, ..."

 

Yikes. Those poor people. Is it just an accepted risk of cruising now?

 

11 cruises, no Norovirus. Lots of my friends cruise and none of them has had it. Inevitable? Nope.

[ehfl]

Norovirus is one of the most common viruses in our environment. Most people are exposed several times per year, and have developed an immunity. As long as you ensure you have a healthy immune system by exposing yourself to a variety of pathogens, you probably won't have a problem with norovirus.

 

If you have weakened your immune system by avoiding exposure to pathogens, then you greatly increase your risk.

 

So for the most part, it's up the the individual how much risk they will accept....based on what steps they take to strengthen their immune system.

[wassup4565]

It's an isolated population, where people use the same spaces. Thus, it's not surprising a virus can establish itself and then quickly spread. However, it's not just Noro - it could be flu or any other virus.

 

Wash hands often and well - doctors are taught to sing one whole verse of "Twinkle, twinkle..." while churning the hands with soap - so a swipe or a rinse is not enough.

 

For what good it does, we also wipe down the entire cabin with disinfectant wipes the moment we enter it. Telephone, door and drawer handles, light switches...anywhere a person's hands could have used often. Don't know if it makes any difference, but I figure if the last guests had a sneezing cold, the wiping might help.

[donaldsc]

Let me slightly restate your question. There will be about 70,000 people attending the Superbowl. Compare this with a maximum of 10,000 people on a cruise ship including crew. All of them will be in close physical contact with each other which is one way that any pathogen is spread.

 

Are you suggesting that if we we could get instantaneous test results which we can not, we check all Superbowl attendees for Noro. What about the other pathogens that they might also be carrying.

 

The possibility of the spread of disease is always there when you have a large number of people concentrated in a small space.

 

DON

[Gunner22aa]

Take 5000 people and put them in a box 1000 feet long by 100 wide and 100 high. Throw one person in there with a virus. More will get it. Yes illness and cruising will go hand in hand for a long time to come. The best you can do is to take all the precautions that you can and the rest as they say is fate.

[Hlitner]

RC's Explorer of the Seas cut its itinerary and came back with over 600 passengers and crew sick with vomiting and diarrhea. According to the article;

 

"... The virus is easily passed from person to person, spreads through food and ice, and also can survive on inanimate objects for days. Even with scrupulous cleaning, the virus can still remain intact, ..."

 

Yikes. Those poor people. Is it just an accepted risk of cruising now?

 

According the CDC, less then 3% of reported Noro cases are on cruise ships. Noro is a very common virus (most folks do not even realize that what they call a stomach virus or flu is likely Noro) and the risk of getting Noro is compounded by traveling. A few years ago we met a CDC Physician on a RCI ship (he was onboard to conduct training for some of the staff) who told us that the theory (at that time) was that most Noro was contracted during the travel process from home to ship...and then carried aboard by one or more passengers. All it takes is a single passenger with Noro, to quickly start the spreading throughout a ship. That sick passenger might not even have developed any symptoms...before they spread the virus to everything they touch.

 

Hank

[sail7seas]

According the CDC, less then 3% of reported Noro cases are on cruise ships. Noro is a very common virus (most folks do not even realize that what they call a stomach virus or flu is likely Noro) and the risk of getting Noro is compounded by traveling. A few years ago we met a CDC Physician on a RCI ship (he was onboard to conduct training for some of the staff) who told us that the theory (at that time) was that most Noro was contracted during the travel process from home to ship...and then carried aboard by one or more passengers. All it takes is a single passenger with Noro, to quickly start the spreading throughout a ship. That sick passenger might not even have developed any symptoms...before they spread the virus to everything they touch.

 

Hank

 

This is exactly what I have been told.

 

Noro is the second most common illness....... second only to the common cold.

 

I use chlorox wipes on our airplane seats/area. I wipe down the seat arms, tray tables, JetBlue's tv buttons on the seat arm, seat belt and the buckle...... I don't know if it helps or not but I feel like at least we tried.

 

We have been on about 100 cruises (various cruise lines). I had a light case of Noro one time about 12 years ago. DH has never had it on a ship.

 

Edited January 28, 2014 by sail7seas

[Happy ks]

It seems to me that noro virus tends to strike at a certain time of year. Being on CC over the years, I read these reports and threads for a while…then they disappear until the next year. The only reason cruise ships get reported to the CDC is the virus is easy to trace to the ship. It would be interesting to see not only the reported outbreaks, but the months when they occurred.

 

Not so easy from a hotel, grocery store, airport or other large areas where people come in contact and then disperse. I work in an elementary school, so if we had an outbreak, it would be fairly easy to trace, but would probably (erroneously) be called "stomach flu". I think most people just wait it out and many only have the symptoms for a couple days, so they don't bother going to the doctor.

 

The only time I've ever had noro virus (confirmed by a tested sample) was totally unrelated to a cruise. We've been on around 25 cruises. No one would have had to confine me, I was so sick I would have done it myself. Job #1 would not allow me to return to work without a doctor note, otherwise I probably wouldn't have seen her about it. That stuff was nasty. The weird part was, no one else at school had it, but job #2, 2 other people were sick with it and we hadn't seen each other for a week prior.

[ladytravlr2]

Many years ago, the night before departing a ship (Carnival), I felt rather sick but didn't associate it with being anything like the Noro Virus. At that time, these types of things weren't broadcasted or even well known to exist where large amounts of people gather.

 

That next morning I could barely muster enough energy to drag myself to the area where cruisers were gathering to depart (it was a lounge type room). As I looked around, I noticed others looking green like me...and laying down around the floor, etc. I still didn't think it was something widespread across the ship.

 

To make a long story shorter, the drive back to northern Florida from Miami was the most awful car trip ever. All the typical symptoms of the now known Nor Virus. My car mate, was not sick YET. After we got to his house in northern Florida, he came down sick too. We were sick for over a week after getting back.

 

I heard later from people we had met on the ship that many ? cruisers on that ship had been ill, most not getting it until almost departure time, or after they left the ship.

 

So, it was not something talked about, or likely to know you would get at that time. In later years people started hearing about such widespread communicable viruses. It was a seven day cruise, and although some may have felt sick early in the cruise, those people were not known about to the general population on the ship. OR, they may have thought they were seasick.

 

I have been seasick, I have had food poisoning too before. The sickness I had on that trip felt more like food poisoning than seasickness. And, it did not feel like any regular flu that I have ever had. So, who knows? I didn't even think of going to the ship doctor since it was just a few hours within departing the ship.

 

I still cruise, and don't worry about getting the norovirus. If I do, I do. I use the normal precautions and wash my hands even more often than that.

[pris993]

I have spent 1437 CRUISES - not DAYS - on cruise ships.

I have supervised clean-up of so many NLV outbreaks that I have lost count.

I always wash my hands - very frequently and very thoroughly.

I keep my hands out of my mouth, nose, and eyes.

I do not use hand sanitizing gels. They do not prevent viral contamination.

I never shake hands with anyone.

I never eat in buffets.

I never use public toilets.

I have visited many cabins where the occupants were very ill with NLV.

I have wheeled sick passengers down the gangway on countless occasions.

I have personally confronted many sick passengers who refused to be isolated.

I have visited many public areas to supervise clean-up where sick passengers have vomited.

 

I have never had Norwalk Virus.

 

Good list . We too void shaking hands, public toilets, sanitizing gel, touching our eyes, noses or mouth area and wash our hands constantly. We also wipe down all areas around our seats on airplanes when we fly.

We often eat food items selected from the buffet and wash our hands before eating. We control the temperature in our cabin, making sure we are not sleeping under cool air at night, by turning on the lowest setting of heat in the cabin at night. Prior to changing the temperature in the cabin at night, we often would get a head cold. We have not gotten norwalk virus - so far. Here is to staying healthy while traveling and happy crusing.

[Hlitner]

This is exactly what I have been told.

 

Noro is the second most common illness....... second only to the common cold.

 

I use chlorox wipes on our airplane seats/area. I wipe down the seat arms, tray tables, JetBlue's tv buttons on the seat arm, seat belt and the buckle...... I don't know if it helps or not but I feel like at least we tried.

 

We have been on about 100 cruises (various cruise lines). I had a light case of Noro one time about 12 years ago. DH has never had it on a ship.

 

 

We actually saw an airline passenger (at ATL) who was wearing a surgical mask (little help against an airborne virus) and surgical gloves. I guess if we were smart we would always put on surgical gloves before entering a plane's bathroom..and properly dispose of those gloves before returning to our seat (it is said that those toilets are among the dirtiest places encountered by most folks). I guess one could go insane trying to figure the best ways to avoid bad germs and viruses (some do need mental health treatment for "Germophobia").

 

Hank

[donaldsc]

 

Yikes. Those poor people. Is it just an accepted risk of cruising now?

 

It is an accepted whether you like it or not risk of living.

 

DON

[spunkyhungry]

I've gone on 7 cruises and have never gotten norovirus. My husband got it once, but he isn't vigilant about washing his hands.

[BruceMuzz]

Isn't it sad that we are in the 21st century and cruise lines are held responsible for teaching their adult North American passengers how to properly wash their hands after using a toilet in order to avoid getting sick?

 

When we have so many people still living like the Flintstones, all those great things on the Jetsons are still a very long way off.