Are Preventive Noro Practices Effective?

[rdsqrl]

Can someone provide a credible link that specifically states that Purrell kills norovirus?

No, because it doesn't. Just wash your hands. The ship isn't going to run out of hot water and soap.

[caribill]

Also, the CDC says hand gel works.

http://www.cdc.gov/features/norovirus/?mobile=nocontent

 

Not the message I get from that link.

 

"If soap and water aren't available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water."

[brianlojeck]

Not the message I get from that link.

 

"If soap and water aren't available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water."

 

Which is a fair sight better than "Norovirus is immune to alcohol..."

 

You'll have to forgive me, but when "everybody knows" something, I always remember that many of "everybody" also think the world is 6000 years old and vaccines don't help prevent disease...

[caribill]

Which is a fair sight better than "Norovirus is immune to alcohol..."

 

 

Norovirus is immune to alcohol.

 

The way the sanitizers reduce the number of virus particles is not by killing them, but by rinsing them off of your hands.

 

(Washing you hands does the same, washing the virus particles off of your hands and then down the drain.)

[chengkp75]

When we're on a ship under Code Red, DH and I stop eating anything with our hands, which generally means no toast, rolls, popcorn, etc. for the duration.

Certainly what the cruise line does is effective. I'm just not certain of the return on time invested.

 

This is one of the best preventative measures you can take.

 

As far as the return on investment, remember that the vessel's response plan must be approved by the CDC, so it's really not a question of whether the line thinks they are providing overkill, its a government mandate.

 

The way the sanitizers reduce the number of virus particles is not by killing them, but by rinsing them off of your hands.

 

Yes, and please note the following in the CDC's comments on hand sanitizers:

 

These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water."

 

My addition of bolding is significant. CDC does not say what those situations are, but it means that you need to wipe your hands on a clean disposable paper towel or napkin before the sanitizer dries to remove the virus from your skin. Simply rubbing hands together will only loosen the virus, but will not remove it. Hand sanitizer use, with a paper towel is said by CDC to be 60% as effective as hand washing with soap.

[cflutist]

No, because it doesn't. Just wash your hands. The ship isn't going to run out of hot water and soap.

 

My point exactly. I made sure that I washed my hands with soap and warm water for at least 20 seconds before leaving my cabin for the HC.

Did not touch anything along the way (when I have to touch elevator buttons, I use my knuckles). Yet the lady standing at the Purell dispenser said that I HAD to use it. I don't think she even knew the difference between bacteria (e.g. E. coli, Staph Aureus, salmonella, etc) and norovirus.

[Colo Cruiser]

My point exactly. I made sure that I washed my hands with soap and warm water for at least 20 seconds before leaving my cabin for the HC.

Did not touch anything along the way (when I have to touch elevator buttons, I use my knuckles). Yet the lady standing at the Purell dispenser said that I HAD to use it. I don't think she even knew the difference between bacteria (e.g. E. coli, Staph Aureus, salmonella, etc) and norovirus.

 

 

Aw give her a break, she is just doing what she is told to do. :(

[PescadoAmarillo]

My point exactly. I made sure that I washed my hands with soap and warm water for at least 20 seconds before leaving my cabin for the HC.

Did not touch anything along the way (when I have to touch elevator buttons, I use my knuckles). Yet the lady standing at the Purell dispenser said that I HAD to use it. I don't think she even knew the difference between bacteria (e.g. E. coli, Staph Aureus, salmonella, etc) and norovirus.

 

I keep a Wet Ones in my pocket for just such an occasion. First of all, when eating at the buffet, I always use a Wet Ones just after sitting down and before eating (and usually do in the dining room too, after handling the menu. The crew started to look for the opened package to clear from the table, we were so predicatable :)). But if the ship is under Codes Yellow or Red, and they start pushing the Purell at the entrance to the HC, I'll open it right there and use it in front of the "pusher", then stuff it in my pocket and use it again at the table. If I'm caught without one, I'll tell them that I just washed my hands and am allergic to the Purell. That's never not worked, but if it didn't, I would leave and get pizza before I'd use that stuff. Why should I mess up my vacation because others don't wash their hands properly?

 

We go through a lot of Wet Ones and also a lot of foaming Dial Complete soap in our cabin. We always wash when entering our cabin, after handling our shoes, and again just before we leave. Then, if we've touched an elevator button or railing, we wash again just outside the dining room or buffet. What we do might be overkill, but we've never gotten noro on a ship, even when that ship was making the national news.

 

Now, if we could just figure out a way to avoid URIs, it would be truly smooth sailing.

Edited April 24, 2014 by PescadoAmarillo

[MauiLvrs]

Seems to be yes.

 

Which hand sanitizers kill stomach flu viruses (especially norovirus)?http://www.stopthestomachflu.com/Home/which-hand-sanitizers-kill-stomach-flu-viruses

 

"It was previously thought that norovirus was resistant to alcohol and that alcohol hand sanitizers didn't work against norovirus. Unlike most viruses, human norovirus won't grow in a petri dish. It does not want to attack cells in a petri dish, it only likes to attack people. This makes human norovirus very difficult to study. So, most researches study viruses that are closely related to human norovirus and HOPE that their results are applicable to human norovirus. One of the viruses they study is Feline calicivirus. This virus is VERY resistant to alcohol which started the "alcohol doesn't kill norovirus" thing. Now researchers are also using murine norovirus. This virus is genetically more closely related to human norovirus. Murine norovirus is killed by alcohol. So, now researchers are leaning more towards "alcohol hand sanitizers do fine killing norovirus.1"

1- In Vivo Comparison of Two Human Norovirus Surrogates for Testing Ethanol-Based Handrubs: The Mouse Chasing the Cat!

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044752/

Abstract

"Human noroviruses (HuNoV), a major cause of acute gastroenteritis worldwide, cannot be readily cultured in the lab. Therefore, a feline calicivirus (FCV) is often used as its surrogate to, among other things, test alcohol-based handrubs (ABHR). The more recent laboratory culture of a mouse norovirus (MNV) provides an alternative. While MNV is closer to HuNoV in several respects, to date, no comparative testing of FCV and MNV survival and inactivation on human hands has been performed. This study was designed to address the knowledge gap. The rates of loss in viability during drying on hands were −1.91 and −1.65% per minute for FCV and MNV, respectively. When the contaminated skin was exposed for 20 s to either a commercial ABHR with 62% (v/v) ethanol or to 75% (v/v) ethanol in water, FCV infectivity was reduced by <1 log10 while that of MNV by nearly 2.8 log10. Extending the contact time to 30 s reduced the FCV titer by almost 2 log10 by both test substances and that of MNV by >3.5 log10 by the commercial ABHR while 75% ethanol did not show any noticeable improvement in activity as compared to the 20 s contact. An 80% (v/v) aqueous solution of ethanol gave only a 1.75 log10 reduction in MNV activity after 20 s. The results show significant differences in the ethanol susceptibility of FCV and MNV in contact times relevant to field use of ABHR and also that 62% ethanol was a more effective virucide than either 75% or 80% ethanol. These findings indicate the need for a review of the continuing use of FCV as a surrogate for HuNoV."

 

Comparative efficacy of seven hand sanitizers against murine norovirus, feline calicivirus, and GII.4 norovirus.

http://www.ncbi.nlm.nih.gov/pubmed/21219741

Abstract

 

"Contaminated hands or inanimate surfaces can act as a source of infection during outbreaks of human norovirus infection. We evaluated the virucidal efficacy of seven hand sanitizers containing various active ingredients, such as ethanol, triclosan, and chlorhexidine, and compared their effectiveness against feline calicivirus (FCV), murine norovirus (MNV), and a GII.4 norovirus fecal extract. We also tested the efficacy of 50, 70, and 90% of ethanol and isopropanol. Reduction of viral infectivity was measured by plaque assay, and the number of genomic copies was determined with a TaqMan real-time reverse transcription PCR assay. Based on the results of a quantitative suspension test, only one ethanol-based product (72% ethanol, pH 2.9) and one triclosan-based product (0.1% triclosan, pH 3.0) reduced the infectivity of both MNV and FCV (by >2.6 and ≥3.4 log units, respectively). Four of the seven products were effective against either MNV or FCV, whereas chlorhexidine was ineffective against both viruses. For these hand sanitizers, no correlation was found between reduced infectivity and decline of viral RNA. Ethanol and isopropanol concentrations ≥70% reduced the infectivity of MNV by ≥2.6 log units, whereas 50 and 70% ethanol reduced the infectivity of FCV by ≥2.2 log units after exposure for 5 min. The susceptibility of FCV to low pH and the relative high susceptibility of MNV to alcohols suggest that both surrogate viruses should be considered for in vitro testing of hand sanitizers."

 

http://www.microbiologymaven.com/cool-science-stuff/purell-who-knew/

Purell – Who Knew?"Enter Purell: 70% alcohol – the effective concentration to kill microbes – combined with moisturizers to keep your hands from drying out. It can be easily packaged into small bottles or wall-mounted dispensers, perfect for “gelling in” and “gelling out” of patients’ rooms in the hospital. Both the CDC (2002 http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf) and WHO (2009 http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf) have issued guidelines stating that alcohol-based hand sanitizers are as effective or more effective than soap and water. The WHO guidelines go so far as to state that alcohol based hand sanitizers are effective pre-surgery hand cleansing. To quote David Owen:

“…less than fifteen years after its introduction, [Purell] led American’s main public health agency to dramatically change its recommendation for how doctors should clean their hands. A pill with the same potential to reduce hospital-infection deaths would be viewed as a wonder drug.”"

 

Edited April 24, 2014 by MauiLvrs

[Loonbeam]

Note that the one of the tests in question were done with 5 min exposures. Anyone keep their hands wet with Purell for 5 minutes? Also, the test show a reduction in viral activity, NOT elimination. If I did the math correctly, a 62% ethanol solution reduced MNV by about 45% after 20 seconds and 55% after 30 seconds (the typical time on hands). That's not bad, but room for improvement.

 

Noro is not immune to alcohol. Not the issue. The issue is the amount of alcohol in a typical hand sanitizer, plus the way it is used and time of exposure, are not as effective against it as other ways.

 

Hand sanitizer is better than nothing (except with virulent strains where it can spread the virus around the hands instead of killing it). But its nowhere near as good as washing thoroughly with soap and water for noro.

 

 

 

Seems to be yes.

 

Which hand sanitizers kill stomach flu viruses (especially norovirus)?http://www.stopthestomachflu.com/Home/which-hand-sanitizers-kill-stomach-flu-viruses

 

"It was previously thought that norovirus was resistant to alcohol and that alcohol hand sanitizers didn't work against norovirus. Unlike most viruses, human norovirus won't grow in a petri dish. It does not want to attack cells in a petri dish, it only likes to attack people. This makes human norovirus very difficult to study. So, most researches study viruses that are closely related to human norovirus and HOPE that their results are applicable to human norovirus. One of the viruses they study is Feline calicivirus. This virus is VERY resistant to alcohol which started the "alcohol doesn't kill norovirus" thing. Now researchers are also using murine norovirus. This virus is genetically more closely related to human norovirus. Murine norovirus is killed by alcohol. So, now researchers are leaning more towards "alcohol hand sanitizers do fine killing norovirus.1"

 

1- In Vivo Comparison of Two Human Norovirus Surrogates for Testing Ethanol-Based Handrubs: The Mouse Chasing the Cat!

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044752/

Abstract

"Human noroviruses (HuNoV), a major cause of acute gastroenteritis worldwide, cannot be readily cultured in the lab. Therefore, a feline calicivirus (FCV) is often used as its surrogate to, among other things, test alcohol-based handrubs (ABHR). The more recent laboratory culture of a mouse norovirus (MNV) provides an alternative. While MNV is closer to HuNoV in several respects, to date, no comparative testing of FCV and MNV survival and inactivation on human hands has been performed. This study was designed to address the knowledge gap. The rates of loss in viability during drying on hands were −1.91 and −1.65% per minute for FCV and MNV, respectively. When the contaminated skin was exposed for 20 s to either a commercial ABHR with 62% (v/v) ethanol or to 75% (v/v) ethanol in water, FCV infectivity was reduced by <1 log10 while that of MNV by nearly 2.8 log10. Extending the contact time to 30 s reduced the FCV titer by almost 2 log10 by both test substances and that of MNV by >3.5 log10 by the commercial ABHR while 75% ethanol did not show any noticeable improvement in activity as compared to the 20 s contact. An 80% (v/v) aqueous solution of ethanol gave only a 1.75 log10 reduction in MNV activity after 20 s. The results show significant differences in the ethanol susceptibility of FCV and MNV in contact times relevant to field use of ABHR and also that 62% ethanol was a more effective virucide than either 75% or 80% ethanol. These findings indicate the need for a review of the continuing use of FCV as a surrogate for HuNoV."

 

 

Comparative efficacy of seven hand sanitizers against murine norovirus, feline calicivirus, and GII.4 norovirus.

http://www.ncbi.nlm.nih.gov/pubmed/21219741

Abstract

 

"Contaminated hands or inanimate surfaces can act as a source of infection during outbreaks of human norovirus infection. We evaluated the virucidal efficacy of seven hand sanitizers containing various active ingredients, such as ethanol, triclosan, and chlorhexidine, and compared their effectiveness against feline calicivirus (FCV), murine norovirus (MNV), and a GII.4 norovirus fecal extract. We also tested the efficacy of 50, 70, and 90% of ethanol and isopropanol. Reduction of viral infectivity was measured by plaque assay, and the number of genomic copies was determined with a TaqMan real-time reverse transcription PCR assay. Based on the results of a quantitative suspension test, only one ethanol-based product (72% ethanol, pH 2.9) and one triclosan-based product (0.1% triclosan, pH 3.0) reduced the infectivity of both MNV and FCV (by >2.6 and ≥3.4 log units, respectively). Four of the seven products were effective against either MNV or FCV, whereas chlorhexidine was ineffective against both viruses. For these hand sanitizers, no correlation was found between reduced infectivity and decline of viral RNA. Ethanol and isopropanol concentrations ≥70% reduced the infectivity of MNV by ≥2.6 log units, whereas 50 and 70% ethanol reduced the infectivity of FCV by ≥2.2 log units after exposure for 5 min. The susceptibility of FCV to low pH and the relative high susceptibility of MNV to alcohols suggest that both surrogate viruses should be considered for in vitro testing of hand sanitizers."

 

http://www.microbiologymaven.com/cool-science-stuff/purell-who-knew/

Purell – Who Knew?"Enter Purell: 70% alcohol – the effective concentration to kill microbes – combined with moisturizers to keep your hands from drying out. It can be easily packaged into small bottles or wall-mounted dispensers, perfect for “gelling in” and “gelling out” of patients’ rooms in the hospital. Both the CDC (2002 http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf) and WHO (2009 http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf) have issued guidelines stating that alcohol-based hand sanitizers are as effective or more effective than soap and water. The WHO guidelines go so far as to state that alcohol based hand sanitizers are effective pre-surgery hand cleansing. To quote David Owen:

“…less than fifteen years after its introduction, [Purell] led American’s main public health agency to dramatically change its recommendation for how doctors should clean their hands. A pill with the same potential to reduce hospital-infection deaths would be viewed as a wonder drug.”"

 

[chengkp75]

I've got some problems with the first link. She admits that viruses won't grow on her petri dishes, then states that "However, if a particular hand sanitizer or hand washing technique does not work to get rid of bacteria, then it probably doesn't work for viruses either (especially the difficult to kill norovirus)." While probably valid, this is an assumption. And then she uses the opposite of this assumption to "show" that sanitizers work on viruses: If the sanitizer kills bacteria then it must kill viruses. Hokum. All her cute experiments show nothing.

 

The middle two links (while I haven't read them entirely) do show that FCV is not a very good study for noro, and that is what most consumer products test against when claiming noro effectiveness.

 

The last link quotes the CDC report on hand sanitation for health care workers. I've read most of that in the past, just skimmed it again, but 80% of it deals with bacteria reduction, showing that anti-microbial soap is better because the microbes don't cultivate on the bar of soap. They also mention that some viruses like rotavirus and rhinovirus (cold) are susceptible to alcohol, but that many viruses are not.

[mek]

In the dining rooms, you had to ask for salt and the steward would bring over the shaker and salt the food for you. Salt packets were given if requested at the Trident Grill.

 

But everyone still handles the menus?

[Salacia]

And which modes of transmission are these? The food safety requirements that the USPH/CDC have are far stricter than any local or state health code, just ask the USPH inspectors, who tend to be ex-local health inspectors, so if the food is treated in a safer manner, wouldn't noro in restaurants, resorts, and conventions on land be more prevalent than on ships? Oh, that's right, it is.

 

And crew can be disciplined for not following good hygiene, while passengers cannot. And except for multi-cruise outbreaks, where infected crew can be one possible causative agent, it has been shown that a new "patient zero" can come onboard within hours of a deep-cleaning and recontaminate the entire ship. It's also simple statistics, there are about 3-4 times as many passengers as crew.

 

The cause of noro outbreaks, that you claim on the other thread not able to be determined, are in fact studied, and the CDC can determine if it was food that caused the illness (many of the first cases ate the same food, or in the same venue), or whether it started in passenger or crew areas (localized areas of cabins, or common public space usage by patients).

 

Anyone who has read VSP Inspection Reports knows that the health code is not always followed. And ships have a fair idea about when the CDC will inspect the ship, so they have a degree of preparedness. How food and sanitation is handled while at sea when there is no expectation of inspection is another matter.

 

Regarding the disparity between the number of passengers reporting gastrointestinal symptoms as opposed to crew members reporting ill - that is a topic worthy of discussion.

 

As far as the CDC being able to determine patient zero -please share your source. Not all crew members or passengers report illness. To complicate matters further, anyone (passenger or crew member) can be infected with norovirus while being asymptomatic and yet infect others. In addition, there are other sources by which the norovirus is spread such as food and water. So how is patient zero determined?

[Salacia]

Partial quote

....As far as the CDC being able to determine patient zero -please share your source. Not all crew members or passengers report illness. To complicate matters further, anyone (passenger or crew member) can be infected with norovirus while being asymptomatic and yet infect others. In addition, there are other sources by which the norovirus is spread such as food and water. So how is patient zero determined?

 

Ah, I have found the answer: patient zero is the initial person reporting symptoms.

[OzKiwiJJ]

There have been a few threads on the Australia/NZ board about this.

 

Apparently products containing Benzalkonium Chloride are effective against norovirus. Wet Ones wipes contain this substance (at least the ones sold in Australia do), as does a hand santising foam sold online in Australia called Hands First.

 

For more information see http://boards.cruisecritic.com/showthread.php?t=1745768&highlight=hands+first

 

I've tried Hands First and it seems very good. It doesn't dry your hands out and claims to stay effective on your hands for some time. I'll be taking a supply with me when we cruise. :)

[chengkp75]

Anyone who has read VSP Inspection Reports knows that the health code is not always followed. And ships have a fair idea about when the CDC will inspect the ship, so they have a degree of preparedness. How food and sanitation is handled while at sea when there is no expectation of inspection is another matter. It is true that there are violations all the time, no system is perfect. How do you know how much advance notice the ship has about VSP inspections? I've been involved in them, and generally, the only notice there is happens when someone on the ship sees the inspectors in their khakis on the dock.

 

Regarding the disparity between the number of passengers reporting gastrointestinal symptoms as opposed to crew members reporting ill - that is a topic worthy of discussion.

 

As far as the CDC being able to determine patient zero -please share your source. Not all crew members or passengers report illness. To complicate matters further, anyone (passenger or crew member) can be infected with norovirus while being asymptomatic and yet infect others. In addition, there are other sources by which the norovirus is spread such as food and water. So how is patient zero determined?

 

My source is discussion with USPH inspectors in their training seminars and during pre- and post-inspection meetings. I have also seen their investigation reports. The contact interview asks many questions of anyone who reports symptoms during an outbreak. They will question you as to where you ate onboard, on which nights, what you ate, etc. From the patterns, using statistical analysis, which allows for some missed reporting, and some dishonesty in answering interviews, they can find whether the outbreak sourced from a food source or brought onboard by someone. If you want to learn about epidemiology, which is the science of tracing outbreaks back to the source, you can find a lot on the web. I'm not an epidemiologist, but I'm working from my experience with interacting with them.

 

As far as water being a source for noro, that would apply for those who drink water ashore. The water onboard is chlorinated, must retain a residual chlorine at all times (your municipal supply sanitizes water at the plant, but between there and your home there is no requirement that there is any sanitizing agent in the piping), monitored at the farthest point from the chlorination. This chlorine content is recorded on a chart that must be retained for two years, so that USPH inspectors can check every chart since the last USPH inspection.

[chengkp75]

duplicate, deleted

Edited April 25, 2014 by chengkp75

[elliair]

This is Noro "season," it seems to me. You used to hear about cruise ship Noro problems all the time on the news. Now, it's not as often and becomes a bigger deal.

 

I've been on several cruises that implemented Noro prevention and while slightly inconvenient at times, it works.

 

What the media doesn't report is that in most cases, Princess has been able to contain the outbreak within a couple of days. Even with the Crown outbreak, most of the cases were within the first few days and by the end of the cruise, the number was in the teens still infected. That means to me that preventive measures work. The biggest issue is people self-medicating and not reporting their illness. All the preventive measures are ineffective against irresponsibility. :(

 

We have never been sick on any cruise with the noro. People self medicate because they don't want to be quarantined to their cabin. It is irresponsible but they do it because they don't want to miss out. You can touch a chair that someone who has the virus touched, or the table, or spoons at the buffet. While they try to contain it by removing the salt and pepper shakers, one can walk over to the ice cream machine and get the noro right there. I've seen people lick their fingers at the machine because they got some on their fingers. :eek:

[generichandle]

I worked in nursing homes for many years. Noro and other virus' and bacteria were persistent and ever present. We used the 'two rule' system to fight it.

 

1. Wash your hands thoroughly, before and after!

 

2. If you violate rule 1, YOU'RE FIRED!

 

And it worked. We had 5*rating every year from CDC and State inspectors.

 

As for hand sanitizer, you definitely should use it on the ship, but that is not a substitute for hand washing. What the sanitizer WILL do is kill bacteria. Or did you think Noro was the only thing to be concerned about. Those bacteria can cause your immune system to be distracted 'fighting' them, so it is even less able to concentrate on the more difficult virus. Use sanitizer. AND wash your hand before and after ....... well just about any activity where you touch anything anyone else does.

 

Doug

[CoronaCRZR]

We were on the Star 2 weeks ago when the Noro virus reared its ugly head.

I do feel that some of the measures are somewhat ridiculous, as they do not allow you to touch anything from the buffet, but then when I sat down with my plate, the server comes over to bring coffee, utensils etc. not wearing any gloves and touching all kinds of surfaces in the process?? And yes what about handling menus??

 

Also did not like the food having to be salted by the server as that is a very tricky thing to do for anyone else.

 

When a ship's Noro infestation reaches over 2% of the population of the ship the captain HAS to report this to the CDC.

 

The CDC then tells the captain what measures to take to combat this, and is at the mercy of the CDC until it has below the 2% (this according to the captain)

 

On the Star this happened about the 3rd day into our 15 day cruise and we had the Code Red going for the remainder of the cruise.:mad:

[Salacia]

Chenkpt, in reply to your question "How do you know how much advance notice the ship has about VSP inspections? I've been involved in them, and generally, the only notice there is happens when someone on the ship sees the inspectors in their khakis on the dock" - I did not say ships had advance notice, I said "they have a fair idea about when the CDC will inspect the ship". For example, obviously, there's no expectation of a CDC inspection while at sea or at ports that are not in the US. For ships that have recently been inspected and received a good score, there is little likelihood of another inspection from the VSP for some amount of time and conversely, ships that have had serious violations after an inspection can expect to be re-inspected at some point in the not too distant future. Of course, there are inspections conducted by other countries' health authorities, but our conversation was about the VSP.

[chengkp75]

We were on the Star 2 weeks ago when the Noro virus reared its ugly head.

I do feel that some of the measures are somewhat ridiculous, as they do not allow you to touch anything from the buffet, but then when I sat down with my plate, the server comes over to bring coffee, utensils etc. not wearing any gloves and touching all kinds of surfaces in the process?? And yes what about handling menus??Interesting, as all food service personnel are required to be gloved at all times during a noro outbreak. And gloves must be changed whenever switching from dirty dishes to clean dishes.

 

Also did not like the food having to be salted by the server as that is a very tricky thing to do for anyone else.Most ships take care of this with salt packets

 

When a ship's Noro infestation reaches over 2% of the population of the ship the captain HAS to report this to the CDC.

 

The CDC then tells the captain what measures to take to combat this, and is at the mercy of the CDC until it has below the 2% (this according to the captain)Most likely a simplification used by the Captain. In fact, each cruise line, and each ship, must have an Outbreak Prevention and Response Plan onboard, and on file with the USPH, so the actions required are already spelled out by the company and approved by the USPH.

 

On the Star this happened about the 3rd day into our 15 day cruise and we had the Code Red going for the remainder of the cruise.:mad:

 

This is indicative of continual recontamination, where those who are infected and may or may not be symptomatic continue to follow poor personal hygiene and remain in contact with others.

[caribill]

one can walk over to the ice cream machine and get the noro right there. I've seen people lick their fingers at the machine because they got some on their fingers. :eek:

 

Since Princess does not have self-service ice cream machines, are you saying that you have seen the Princess servers lick their fingers at the machine?

[Colo Cruiser]

I have never had the opportunity to use an ice cream machine on Princess?

Where is it?

[elliair]

Since Princess does not have self-service ice cream machines, are you saying that you have seen the Princess servers lick their fingers at the machine?

 

No not on Princess, on Carnival. I should have been more specific, sorry. But still everyone is touching something. I stay out of the public restrooms.