Yikes! Noro on the Maasdam - two fold deep cleaning question please.

[POA1]

We are in Fort Lauderdale at long last! A lot of flight changes and rushing to avoid our storm that was coming. With a hurricane warning in effect, you just KNOW that no plane is leaving the ground.

 

Many thanks to all who have posted while I was travelling.

 

I got the NICEST email from a cc member telling me that the Noro was licked and that the Maasdam was a great ship. They had a lot of positive comments - so did a fellow roll call member from our Prinsendam cruise who is currently on onboard. So nice to hear and so appreciated.

 

Thank you all. I can't wait to see her outside my window on Friday morning:D

 

Welcome to Fort Lauderdale! Sorry it's so brutally cold today. ;)

 

It will warm up for your sail away on Friday though . On Thursday morning, you can marvel at all the people bundled up against the frigid 68F/19C weather.

Edited March 27, 2014 by POA1

[slabeaume]

I am also on the Maasdam and it is fabulous.The ship is in excellent condition,the staff are friendly and can not do enough for you.The food is delicious.Everything on this cruise has been done with perfection.

 

Thanks---really good to hear!!!!

[slabeaume]

Welcome to Fort Lauderdale! Sorry it's so brutally cold today. ;)

 

It will warm up for your sail away on Friday though . On Thursday morning, you can marvel at all the people bundled up against the frigid 68F/19C weather.

 

So true!!! My daughter lives not far from Ft. Lauderdale and talks about how cold it is when it's in the 60's. I'm looking forward to those 60s!

[Salacia]

Quoted from the CDC:

 

 

Investigation Update on the ms Maasdam

 

 

 

Cruise Line: Holland America Line

 

Cruise Ship: ms Maasdam

 

Voyage Dates: March 2-28, 2014

 

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 65 of 1096 (5.93%)

 

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 8 of 569 (1.41%)

 

...Three CDC Vessel Sanitation Program environmental health officers will board the ship on arrival in Ft. Lauderdale on March 28, 2014 to conduct an environmental health assessment and evaluate the outbreak and response activities. Stool specimens are being collected and will be shipped to the CDC lab for testing. copied from http://www.cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

[Salacia]

Apparently there is currently Noro on the Maasdam. At least according to this article - http://www.travelerstoday.com/articles/9167/20140319/holland-american-maasdam-passengers-claim-to-be-sick-with-norovirus-on-cruise-ship.htm I am unfamiliar with this publication so not sure how seriously to take it but.......assuming NORO is on the ship........

 

I don't know if they will beat it before we board on March 28th (sure hope so).

 

I know if it is still there they will be doing a deep cleaning. What would be a time that you would expect to be able to embark?

 

If they beat the NORO and the ship is now ok, do they still deep clean after a Noro outbreak? Just trying to figure when to go to the ship. If embarkation (boarding) is delayed, we will obviously go later.

 

Thanks so much for the advice :D

 

kazu, yes, there is an outbreak of a gastrointestinal-type illness on the Maasdam. Most recent report from the CDC posted 26 March, is that 7.34% of passengers and crew have reported ill.

 

Will your boarding be delayed? Just my guess, but based on the following, I'd think your boarding will be delayed.

 

•[ HAL]Is consulting with CDC on plans for their comprehensive sanitation procedures in Ft. Lauderdale, FL on March 28, 2014, including ◦providing additional cleaning crew to complete a thorough public and accommodation super-sanitization cleaning and disinfection,

◦planning staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and

◦planning for sanitation of terminal and transport infection control procedures.

 

"Three CDC Vessel Sanitation Program environmental health officers will board the ship on arrival in Ft. Lauderdale on March 28, 2014 to conduct an environmental health assessment and evaluate the outbreak and response activities..." copied from http://www.cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

 

Best wishes,

Salacia

Edited March 27, 2014 by Salacia

[POA1]

kazu, yes, there is an outbreak of a gastrointestinal-type illness on the Maasdam. Most recent report from the CDC posted 26 March, is that 7.34% of passengers and crew have reported ill.

 

Will your boarding be delayed?

 

•[ HAL]Is consulting with CDC on plans for their comprehensive sanitation procedures in Ft. Lauderdale, FL on March 28, 2014, including providing additional cleaning crew to complete a thorough public and accommodation super-sanitization cleaning and disinfection,

planning staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and

planning for sanitation of terminal and transport infection control procedures.

 

"Three CDC Vessel Sanitation Program environmental health officers will board the ship on arrival in Ft. Lauderdale on March 28, 2014 to conduct an environmental health assessment and evaluate the outbreak and response activities..." copied from http://www.cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

 

Best wishes,

Salacia

 

If that's the CDC's percentage, then we have a problem. If it's your percentage calculation, here's where you went wrong:

 

You added the percentage figures. You should have added the total # of ill people (65+8=73) and divided it into the total number of people (1,096+567=1,665) which would yield a result of 4.38% taken to two decimal places.

 

You overstated the percentage of infected individuals by 168% (rounded to the nearest percent.)

[Salacia]

If that's the CDC's percentage, then we have a problem. If it's your percentage calculation, here's where you went wrong:

 

You added the percentage figures. You should have added the total # of ill people (65+8=73) and divided it into the total number of people (1,096+567=1,665) which would yield a result of 4.38% taken to two decimal places.

 

You overstated the percentage of infected individuals by 168% (rounded to the nearest percent.)

 

Thank you, my mistake. In the future, I will only quote the CDC figures:

 

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 65 of 1096 (5.93%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 8 of 569 (1.41%)

 

Of course, we all know that all passengers and crew report their symptoms to the Medical Center, so these percentages couldn't possibly be an underestimate.;)

[POA1]

Thank you, my mistake.

 

....

 

Of course, we all know that all passengers and crew report their symptoms to the Medical Center, so these percentages couldn't possibly be an underestimate.;)

 

No problem. It's just that when you add the percentages in error and then throw in the sentence about reporting symptoms, it's hard not to think that your goal is to make the numbers seem worse.

 

It would be logical to assume that any underreporting - from people who don't tell the medical center - should be fairly consistent across all outbreaks. (Speaking in percentage terms, not absolute numbers.) If there is overreporting - people who mistake some other illness for Norovirus - that should be washed out when comparing outbreaks as well.

[Salacia]

No problem. It's just that when you add the percentages in error and then throw in the sentence about reporting symptoms, it's hard not to think that your goal is to make the numbers seem worse.

 

It would be logical to assume that any underreporting - from people who don't tell the medical center - should be fairly consistent across all outbreaks. (Speaking in percentage terms, not absolute numbers.) If there is overreporting - people who mistake some other illness for Norovirus - that should be washed out when comparing outbreaks as well.

 

I have no idea if this outbreak is norovirus or not. I'll wait for the CDC findings. My "goal" as you call it, was simply to respond to the OP's original questions, i.e. was there an outbreak on board and would her boarding be delayed. I believe my response, with references supplied, was more helpful than a bunch of cheerleading saying everything is fine. Or maybe not: some only want the rah-rah-rah. I don't care to argue, so have it your way! :)Cheers, -S

[POA1]

I have no idea if this outbreak is norovirus or not. I'll wait for the CDC findings. My "goal" as you call it, was simply to respond to the OP's original questions, i.e. was there an outbreak on board and would her boarding be delayed. I believe my response, with references supplied, was more helpful than a bunch of cheerleading saying everything is fine. Or maybe not: some only want the rah-rah-rah. I don't care to argue, so have it your way! :)Cheers, -S

 

I'm a little unsure as to how you get to "cheerleading" just because I corrected your math.

 

As for not being here to argue: When you state your side of the argument, and then close with "I don't care to argue," you might be better served by saying, "I just made my argument. I would like to have the last word, please."

 

I think it's good that you both gave figures and cited the CDC. I think it's great that you had a sourcing link for your information. I really do. I just think the whole thing went south when the math was wrong. If I were in your shoes, I would have simply said, "My mistake. Thanks for the correction."

 

Of course, that's probably because I am a cheerleader - for mathematics and science. :cool:

[cbr663]

If I were in your shoes, I would have simply said, "My mistake. Thanks for the correction."

 

 

If you go to post #82, that is exactly what OP wrote, "Thank you, my mistake. In the future, I will only quote the CDC figures"

 

Let It Go....

[POA1]

If you go to post #82, that is exactly what OP wrote, "Thank you, my mistake. In the future, I will only quote the CDC figures"

 

Let It Go....

 

Consider it done!

 

Thank you, my mistake. In the future, I will only quote the CDC figures:

 

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 65 of 1096 (5.93%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 8 of 569 (1.41%)

 

Of course, we all know that all passengers and crew report their symptoms to the Medical Center, so these percentages couldn't possibly be an underestimate.;)

[Flying is for Planes]

http://www.cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

 

 

Ten days ago we wrote about a gastrointestinal outbreak on the Holland America Line (HAL) Maasdam which was sailing routes in South America.

Passengers were stating that numerous people are sick with nausea, vomiting, diarrhea and other noro virus like symptoms.

Some passengers complained that they became tired of the HAL captain blaming them for the outbreak.

The public relations people at HAL and parent company Carnival Corporation ignored our requests for information.

The Maasdam finally returned to Fort Lauderdale and the CDC boarded. The CDC is now reporting that 65 of 1096 passengers (5.93%) and 8 of 569 crew (1.41%) were ill with an unspecified gastrointestinal illness.

[sail7seas]

It is mandatory for crew to report and quarantine should they become ill with Noro like virus.

 

IF the virus continues to spread, you can be sure there are guests who are either not reporting their illness and are going out and about spreading their illness or there are those who do not yet know they are contagious and are out and about. Noro sufferers remain contagious even after their symptoms subside. If they break ordered quarantine, IMO, they should be left in a locked cabin until next port and then put ashore. Room Service can deliver and properly suited stewards can clean for them and they should not be allowed out of their cabin. Off the ship is where they belong.

 

Of course, if they honor quarantine, they are to be well taken care of and commended.

 

The passengers you mention may have gotten tired of Captain blaming guests, where did they think he was wrong in doing so?

 

More often than not, it is guests who bring the illness aboard and it is mostly them that spread it. We have all seen the poor hygiene some fellow guests practice and certainly most of us have seen their filthy fingers touch food in Lido and then put it back on the tray. Captain is cerrtainly right to blame those inconsiderate, selfish or ill informed guests who behave in such ways.

 

Edited March 29, 2014 by sail7seas

[c-legs]

http://www.cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

 

 

Ten days ago we wrote about a gastrointestinal outbreak on the Holland America Line (HAL) Maasdam which was sailing routes in South America.

Passengers were stating that numerous people are sick with nausea, vomiting, diarrhea and other noro virus like symptoms.

Some passengers complained that they became tired of the HAL captain blaming them for the outbreak.

The public relations people at HAL and parent company Carnival Corporation ignored our requests for information.

The Maasdam finally returned to Fort Lauderdale and the CDC boarded. The CDC is now reporting that 65 of 1096 passengers (5.93%) and 8 of 569 crew (1.41%) were ill with an unspecified gastrointestinal illness.

 

And your point is ? Exactly ?:confused:

This a ''live from '' blog'' by an active Cruise Critic member, not a podium to air reports from the CDC and ''offer'' ''personnal views'' on them.

:mad:

[Kooolmomma]

Kooolmamma---on another note about the Maasdam, is she in as bad of condition as the cruisers right before you said? Seems it got rave reviews until it went through dry dock in Jan., then really bad reviews. Hoping it's back up to par for our upcoming cruise.

 

The Maasdam is a wonderful cruise ship albeit she is showing her age in some areas. The GI disorder could have been contained much earlier if some passengers admitted they were sick and stayed away from other passengers. The crew was amazing helping out all over. They put in many additional hours over and above what they usually do.

 

I would sail on her again for a cruise. the ship did not cause the illness.

Edited March 30, 2014 by Kooolmomma

[cbr663]

[quote=Flying is for Planes;42246240<snip>

Some passengers complained that they became tired of the HAL captain blaming them for the outbreak.

/quote]

 

It is most unfortunate to read that a HAL Captain was blaming passengers for an outbreak. If you visit the CDC's Outbreak Updates for International Cruise Ships (http://www.cdc.gov/nceh/vsp/surv/gilist.htm#2007) and scroll down to 2006 you will find several copies of specific outbreak Investigative Reports released by the CDC. You can read the scientific and research study details that was undertaken by the CDC (data sampling, statistical significance, medical test analysis...) and in some cases discover that the CDC was unable to determine an exact cause.

 

Without the scientific research to back up the claims, IMO, any captain publicly blaming passengers for an outbreak is demonstrating poor judgment and unprofessional behavior.

Edited April 2, 2014 by cbr663

[chengkp75]

[quote name='Flying is for Planes;42246240<snip>

Some passengers complained that they became tired of the HAL captain blaming them for the outbreak.

/quote]

 

It is most unfortunate to read that a HAL Captain was blaming passengers for an outbreak. If you visit the CDC's Outbreak Updates for International Cruise Ships (http://www.cdc.gov/nceh/vsp/surv/gilist.htm#2007) and scroll down to 2006 you will find several copies of specific outbreak Investigative Reports released by the CDC. You can read the scientific and research study details that was undertaken by the CDC (data sampling' date=' statistical significance, medical test analysis...) and in some cases discover that the CDC was unable to determine an exact cause.

 

Without the scientific research to back up the claims, IMO, any captain publicly blaming passengers for an outbreak is demonstrating poor judgment and unprofessional behavior.[/quote']

 

I doubt the Captain was blaming the "outbreak" on the passengers, especially repeatedly. Once its onboard, its going to do its thing. He was justified in blaming the passengers for SPREADING the outbreak, and nullifying the crews efforts to contain it. First, there are more passengers than crew to spread the virus. Second, the crew is trained in the proper sanitation procedures, while the passengers are not. Third, the crew are required to report to medical if they feel ill, while the passengers are not. Which do you think is the greater TRANSMISSION vector, passengers or crew?

 

While it is true that the USPH/CDC cannot always trace back to "patient zero", this is generally due to incomplete or erroneous answers to the GI contact questionnaire, which is their only tool for tracking an outbreak. And where does the information on the contact form come from? The passengers and crew who are ill.

 

I have worked on ships that had significant outbreaks, and I know the protocols (trained by USPH/CDC), and I know how hard it is to fight once it has a hold, and I know how hard it is for passengers to give up their vacation to be quarantined. The Maasdam had a captive passenger group for 28 days, not a new group every 7 days, so if everyone had participated fully in containing the outbreak, through personal hygiene, it should have been contained much sooner than it was.

[cbr663]

 

I doubt the Captain was blaming the "outbreak" on the passengers, especially repeatedly. Once its onboard, its going to do its thing. He was justified in blaming the passengers for SPREADING the outbreak, and nullifying the crews efforts to contain it. First, there are more passengers than crew to spread the virus. Second, the crew is trained in the proper sanitation procedures, while the passengers are not. Third, the crew are required to report to medical if they feel ill, while the passengers are not. Which do you think is the greater TRANSMISSION vector, passengers or crew?

 

 

I expect the Captain to demonstrate strong leadership by making decisions based on evidence and findings and not based on superficial assumptions and speculation. So no, I disagree that the Captain would be justified by blaming the passengers for spreading the outbreak without clear evidence.

 

There is a clear difference between the Captain blaming passengers for the spread versus a Captain who repeatedly requests that the passengers take precautions to prevent the further spread of the illness. This may very well been what happened on the Maasdam.

 

I also wish to note that even though crew are required to report to medical when feeling ill, the CDC investigative reports show that this does not always happen. The CDC reports also show that even though crew are trained on proper sanitation procedures, these procedures are not always followed. One CDC report stated that a cruise line crew member was ordered out of quarantine by cruise line management prior to the completion of the CDC mandatory quarantine limits.

[chengkp75]

 

I expect the Captain to demonstrate strong leadership by making decisions based on evidence and findings and not based on superficial assumptions and speculation. So no, I disagree that the Captain would be justified by blaming the passengers for spreading the outbreak without clear evidence.

 

There is a clear difference between the Captain blaming passengers for the spread versus a Captain who repeatedly requests that the passengers take precautions to prevent the further spread of the illness. This may very well been what happened on the Maasdam.

 

I also wish to note that even though crew are required to report to medical when feeling ill, the CDC investigative reports show that this does not always happen. The CDC reports also show that even though crew are trained on proper sanitation procedures, these procedures are not always followed. One CDC report stated that a cruise line crew member was ordered out of quarantine by cruise line management prior to the completion of the CDC mandatory quarantine limits.

 

I can't vouch for the Captain's exact wording of his announcements, but I doubt he would have "blamed" anyone. That is just not good PR, which is one of the large portions of the Captain's duties.

 

Yes, I've seen many reports where the crew did not report immediately upon becoming symptomatic, but I have not seen where it was documented that a crewmember worked in the period between onset of symptoms and reporting to medical. If you've ever had noro, you know that there are times where you just wish you could crawl in a hole and die. Likely, and I've known cases of this myself, the crew crawled into bed or hovered over the porcelain goddess for a few hours. When they don't show for their next shift, a supervisor will come looking, and at that point, at the latest, they will be taken to medical. Who is going to force a guest to go to medical, at any time? And yes, mistakes happen, protocols are not always followed to the letter. But remember, the crew continue to live on the ship after all of the passengers have departed, so if they don't actively work to contain the outbreak, it will continue the next voyage, and the next, so they really want to stop it in its tracks. The vast majority of outbreaks are caused by an infected passenger, and generally only those that persist for more than one cruise have been linked to infected crew, as they are the only ones who remain cruise to cruise.

 

Could you let me know which ship and which report had the crew taken out of quarantine? I'd like to review.

[cbr663]

The ship concerned was the MS Explorer of the Seas from Royal Caribbean Cruise Lines. The date of the CDC report was March 29, 2006. The report contains the following:

 

"Several crew members stated that they were forced to report to work despite their listed isolated status on the GI illness log. Those who objected were reprimanded or told that this was normal practice. Neither the ship’s physician nor the hotel director was aware of this practice."

 

Not surprisingly, the very first recommendation in the report is:

 

"Ensure that all staff understand the necessity of adhering to isolation procedures for sick crew members."

[chengkp75]

The ship concerned was the MS Explorer of the Seas from Royal Caribbean Cruise Lines. The date of the CDC report was March 29, 2006. The report contains the following:

 

"Several crew members stated that they were forced to report to work despite their listed isolated status on the GI illness log. Those who objected were reprimanded or told that this was normal practice. Neither the ship’s physician nor the hotel director was aware of this practice."

 

Not surprisingly, the very first recommendation in the report is:

 

"Ensure that all staff understand the necessity of adhering to isolation procedures for sick crew members."

 

Thanks for the example. Unfortunately, unlike the inspection reports, there is no corrective action reports from these investigations. Because of that, we don't know if the supervisors involved were disciplined for this practice. In the recent Norwegian Star failed inspection, where the medical staff was noted as being "evaluated for written and or verbal warnings based on their failure to follow these established practices". And I won't say that any ship or line is perfect in all regards of the VSP, but the requirements are far in excess of any regulations imposed for land based venues like hotels, restaurants, nursing homes, etc, where noro outbreaks are common.

 

However, looking at the report, the curve of cases by reporting date shows a pretty usual curve for an outbreak contained in reasonable time. Even with the noted delayed onset of crew incidences, the reportable cases continued to drop. And the CDC itself says that the main source of transmission was from passenger to passenger.

[cbr663]

It is most unfortunate that there aren't any corrective action reports from the CDC Investigative Reports. I find it very unfortunate that the CDC doesn't publish more of its reports and findings. If the CDC were more open and transparent, it would help travelers make more informed decisions.

 

For instance, I looked at the CDC's Outbreak Updates from 2003 - 2014 and discovered that HAL has the the unfavorable distinction of having the highest number of outbreak investigations. The three HAL ships with the most investigations are the Ryndam (10), Veendam (9) and the Amsterdam (7). What's even more interesting is that during this same time period, 3 HAL ships did not have any reported CDC investigations: the Eurodam, Statendam and Prinsendam.

 

I also found it very interesting that during the 10 year period noted above that Disney Cruise Line did not have one CDC investigation.

[chengkp75]

It is most unfortunate that there aren't any corrective action reports from the CDC Investigative Reports. I find it very unfortunate that the CDC doesn't publish more of its reports and findings. If the CDC were more open and transparent, it would help travelers make more informed decisions.

 

For instance, I looked at the CDC's Outbreak Updates from 2003 - 2014 and discovered that HAL has the the unfavorable distinction of having the highest number of outbreak investigations. The three HAL ships with the most investigations are the Ryndam (10), Veendam (9) and the Amsterdam (7). What's even more interesting is that during this same time period, 3 HAL ships did not have any reported CDC investigations: the Eurodam, Statendam and Prinsendam.

 

I also found it very interesting that during the 10 year period noted above that Disney Cruise Line did not have one CDC investigation.

 

Well, its an interesting situation regarding the CDC and cruise ships. Since the cruise ships are foreign flag, the CDC, per se, does not have any mandate to investigate infectious diseases onboard. The only real mandate the CDC has is through the USPH, which is a division of CDC, whose mandate is to prevent introduction of infectious diseases into the US. The USPH inspect all foreign ships (cargo as well as passenger) that call at ports in the US to see if there are sick crew or passengers that will disembark in the US.

 

The Vessel Sanitation Program of the USPH, which as you probably know is the code of requirements that cruise ships must meet in order to embark and debark passengers in the US, was actually designed by the cruise lines themselves. So the CLIA membership has actually set these requirements on themselves. Basically, by setting a code of compliance, and agreeing to conform to it, the USPH agrees that USPH will have uniform inspections and not require an unwarranted amount of inspection.

 

You can also look at the last year that the CDC has posted on their online database for noro outbreaks, and there are 220+ just for the year 2011. So, the cruise industry gets additional scrutiny and reporting (there are 14 cruise ship reports for 2011, and there are already reports for 2014 listed, where are the 2012-2014 land based reports?).

 

All of what I'm saying is that the CDC really has no mandate to keep cruise passengers healthy while cruising (only to ensure that ill passengers don't disembark), so there is no real mandate to inform the general public or the cruising public which ships to choose.

 

And, as you've said yourself, even HAL has had a mixed result over a ten year period, but please also remember that over the first 8 years of your decade of data, Disney only had 2 ships in service, and only have a total of 4 ships.

Edited April 2, 2014 by chengkp75

[BruceMuzz]

Looking at the numbers and percentages can sometimes be confusing.

The CDC's 2% threshold for reporting an "Outbreak" is 2% of pax and crew on a sinigle voyage. The length of the voyage has everything to do with how easy it is to reach that 2% threshold.

Every day on nearly every cruise ship in the world, we have 2 or 3 pax report GI symptoms that COULD BE Norwalk.

On a 5,000 passenger ship on a 7-day cruise, they might have 21 passengers report illness in a given week. A tiny percentage. Not nearly large enough to even consider reporting. When the cruise is over after 7 days, the total is reset to zero again.

 

On a 1,000 passenger ship on a 49-Day cruise, 2 or 3 passengers reporting each day would put the ship at the outbreak level of 2% in just a week - with 6 more weeks to go in official "outbreak status".

 

Which ships are most likely to hit that 2% CDC reporting threshold?

Easy answer: Large ships on very long cruises.

 

But very few large ships ever make very long cruises. They typically make 7 days or shorter trips. Half the pax who might contract Norwalk on the ship are on their way home before they know they have it.

 

Which ships are next most likely to hit the 2% CDC threshold?

Easy answer: Small ships on long cruises.

 

Which cruise line has the highest number of reported outbreaks? HAL

 

Which cruise line has the highest number of small ships on long cruises? HAL