Keeping Norovirus at bay

[pchurchley]

I have searched and viewed just about everything on Norovirus on this forum and else where on the web but I am still uncertain how to reduce the chance of us catching Norovirus when on board.

 

I know washing hands with soap and water is the main weapon and I intend to do that regularly (as I hope others on the cruise will too!). But is there a few "must do's" apart from that if you want to minimise your chances of catching it. I know there is no guarantee but we want to try.

 

Firstly we have bought some hand sprays and surface cleaners that are active against Norovirus. I know alcohol gels are not all that effective but better than nothing, but these ones say they kill Norovirus...

 

http://shop.responsebeta.com/

 

When we board the first thing I shall do is clean all surfaces with that product. Shouldn't take longer than 30 mins I would guess.

 

We will wash our hands whenever we get the chance and particularly before and after eating and after using any public spaces. We expect to use the spray inbetween whenever we get the chance and particularly after using the buffet serving utensils, condiments, looking at menus etc.

 

I guess that is all we can do except prey!

 

Just one other question... most ships have sauna and hottubs. I am assuming they are adequately sanitised to prevent any increased risk and that a sauna is hot enough (generally 80-90C) to kill any pathegens. Is this a reasonable assumption? I would like to use those facilities but not if they carry a significant increase risk of infection.

 

Any help/advise would be appreciated. We sail next money!

Edited March 4, 2015 by pchurchley

[chengkp75]

I have searched and viewed just about everything on Norovirus on this forum and else where on the web but I am still uncertain how to reduce the chance of us catching Norovirus when on board.

 

I know washing hands with soap and water is the main weapon and I intend to do that regularly (as I hope others on the cruise will too!). But is there a few "must do's" apart from that if you want to minimise your chances of catching it. I know there is no guarantee but we want to try.

 

Firstly we have bought some hand sprays and surface cleaners that are active against Norovirus. I know alcohol gels are not all that effective but better than nothing, but these ones say they kill Norovirus...

 

http://shop.responsebeta.com/

 

When we board the first thing I shall do is clean all surfaces with that product. Shouldn't take longer than 30 mins I would guess.

 

We will wash our hands whenever we get the chance and particularly before and after eating and after using any public spaces. We expect to use the spray inbetween whenever we get the chance and particularly after using the buffet serving utensils, condiments, looking at menus etc.

 

I guess that is all we can do except prey!

 

Just one other question... most ships have sauna and hottubs. I am assuming they are adequately sanitised to prevent any increased risk and that a sauna is hot enough (generally 80-90C) to kill any pathegens. Is this a reasonable assumption? I would like to use those facilities but not if they carry a significant increase risk of infection.

 

Any help/advise would be appreciated. We sail next money!

 

While I will never dissuade anyone from using a product that makes them feel better or safer, I'm not sure that the products you mention are effective against noro, despite the manufacturer's claims. I have not heard of this product before, and in trying to access the ingredients, their website locked up my browser twice, so that kind of influences my thinking. Anyway, I will continue to look at this product and get back to you. While I know you are from the UK, I look at the US USPH/CDC (where I was trained) for guidance on noro agents, and that list is very short, and includes almost no consumer available products. The problem is that the active ingredient needs to be at the proper concentration and the contact time needs to be met, which is the problem with most consumer products. Their concentration is low to keep from having to use protective equipment, so the contact time becomes so long that it is impossible for people to actually follow.

 

If you are really worried about noro, one thing to consider is not eating anything with your hands. No burgers, no chips, unless using knife and fork. If you've researched noro on CC, you've probably seen my posts as to why this is.

 

Saunas are sanitized daily. Hot tubs are chlorinated to kill bacteria and viruses, but the temperature actually has the opposite effect of what you said. The optimum breeding temperature for Legionella (Legionnaire's disease) is 102-104*F, which is where most hot tubs are maintained. Further, the water is aerosolized by the air jets (though many hot tubs have had these disconnected for this reason), and Legionella is an airborne bacteria. To prevent this, hot tubs are drained, cleaned, and super-chlorinated nightly. Personally, I don't use public hot tubs for these reasons.

 

And you should know from your research that you may have noro virus on your hands right now, or can get it from contacting any surface in any public area anywhere. Noro is not limited to cruise ships, but college dorms, conventions, and nursing homes don't report outbreaks to the CDC for publishing on their website.

[hallasm]

I have been on 23 cruises and never experienced any problems with norovirus myself

The problem is not area's where you can sanitize, like in the cabin - I strongly believe that the cabin will be clean and no further sanitation needed. The problem is the public areas and in particular the buffet's.

I try to avoid public toilette and if I use a public restroom, I never touch door handles - I use a paper towel.

By use of common sense, I think that there is not a problem unless there is an outbreak of norovirus, and then the ship will take preventative actions!

No problems using pools, sauna and hottubs.

I addition wash you hands and use hand sprays/gels.

Enjoy your cruise and just use common sens.

[chengkp75]

I did some more searching, and found a claim by this company that their hand sanitizer kills ebola. This, given that the same site says it has no alcohol or chlorine, makes me very skeptical about the manufacturer's claims. They say that they use multiple active ingredients, but if this is so, either the stuff is very toxic or the concentrations of effective agents is so low as to render them ineffective. Most agents effective against both noro and ebola require protective equipment and clothing for application.

[john watson]

Whilst Norovirus is presented as a major problem on cruise ships; I too have never contracted this in the past fifty years cruising.

 

From your original post I should say you are worrying about this too much but not focusing on the likely ways of contracting it.

 

First line of defence is washing and particularly hand washing. It is important to keep hands from touch the mouth while moving around the ship. As has been mentioned using knives and forks will stop hand to food touching which then gets eaten.

 

You can pick up the virus by touching communal areas such as hand rails on stairs, elevator buttons etc. I knuckle elevator buttons and if the elevator is full just say deck 12 and someone does the button.

 

Public toilets usually have doors wedged open if there is an outbreak or they are trying to prevent one. I wash hands with soap and use paper towel which gets thrown in bin on way out. If the door needs to be opened using your hand use a paper towel to hold the handle.

 

If you pick up the virus you need to ingest it to become ill.

 

I am a Main Dining Room cruiser fixed seating big table. All the people handling the food are highly trained and know procedures. Sanitiser used on entering the MDR go to my table see same people each night. I do breakfasts in MDR similar but share table.

 

Buffet; different animal. The food is handled by highly trained people and any passenger so are the plates and cutlery. I walk in occasionally, get sanitised whereas some others do not, only a minority but that's all you need. Are the plates warm, people place their palm onto top one in pile and reject it by walking away - that plate is now for you. So you need to watch the plates pile! People pick up a bread roll then throw it back. Pick up a cake by hand and touch other cakes which are left - touched. I saw a guy on you tube picking up a cake by hand, got cream on fingers so licked them and carried on hand picking down the line. Cutlery is sterilised but some lines leave it bare for self-selection other lines wrap sterile cutlery in sets in a freshly laundered napkin. Try to get just a knife of these guys they say take a set. "I just want the knife and am being helpful" well no you are not you are messing up the system of cleanliness. Ohh I need another pudding the first one was not enough. I'll just take my old plate back to the counter and use the tongs this time and mess them up.

 

So basically what I am saying is the buffet needs to be looked at by you, is it being run safely and you need to decide when to go and what to have. The vast majority of cruisers like to comply with health regulations some do not see the point and continue regardless. It's the few that ruin the health and safety system.

 

You should have a good cruise but it's not all about sterilising your cabin. It's more about a sensible lifestyle as you cruise.

 

PS if it's Oceana on Monday 9th I'm on it.

 

Regards John

Edited March 4, 2015 by john watson

[pchurchley]

I think you may have misunderstood my post a bit...

 

I am not focussed on cabin cleaning. That was just one of the things I can do at the start to make sure we have a reasonably clean cabin ourselves. Are you saying that the cleaning staff are not likely a source of contamination? Surely they clean all cabins and so could they not cross-contaminate between cabins? Don't get me wrong... I am not arguing... just trying too understand what is important and what is less so.

 

So, when in public areas, it is worth carrying around with me some paper towels and using them if I need to touch anything. Does that mean using a paper towel every time I use the stairs? Again, not arguing, just want to understand to what extent is sensible/viable.

 

Does it help to wear gloves?

[Talisker92]

We embarked on a 32 day cruise, and were concerned about getting Noro. We brought some Lysol #5 spray, which claims to kill Noro. When we got to our cabin, the steward opened the door for us. The first thing we did was to spray the door handle!

Once inside, we sprayed the TV remote, the phone, all the door and drawer handles and the entire bathroom.

At home we are scrupulous hand washers, and rarely get colds. The colds we catch we get from airports and airplanes. I now have cold meds purchased in 6 different countries!

We were very fortunate that we did not catch anything during the cruise.

[chengkp75]

I think you may have misunderstood my post a bit...

 

I am not focussed on cabin cleaning. That was just one of the things I can do at the start to make sure we have a reasonably clean cabin ourselves. Are you saying that the cleaning staff are not likely a source of contamination? Surely they clean all cabins and so could they not cross-contaminate between cabins? Don't get me wrong... I am not arguing... just trying too understand what is important and what is less so.

 

So, when in public areas, it is worth carrying around with me some paper towels and using them if I need to touch anything. Does that mean using a paper towel every time I use the stairs? Again, not arguing, just want to understand to what extent is sensible/viable.

 

Does it help to wear gloves?

 

You can carry paper towels with you, and you can wear gloves. It all depends on your fear of infection, and how much you want that fear and the measures you take to influence your enjoyment of the cruise. If you don't take these precautions when going about your normal life, I don't see why you should worry about them on a cruise.

 

I don't understand why people feel that cruise ships are petri dishes for infectious diseases, more than any other gathering of people.

 

If you are afraid of cross-contamination by the cabin steward, do you plan on sanitizing your room every day after they have serviced it? Do you do this in hotels? Again, I will speak of cruises embarking out of the US, as I am familiar with the USPH regulations, but even more than in hotels, the cabin stewards will wear gloves when cleaning the bathroom, and then remove the gloves for the rest of the service, and re-glove when cleaning the next toilet (though many will use one pair of gloves to clean a group of baths and then de-glove to finish all the rooms, and this does not present cross-contamination).

 

I really think you have a wrong idea of the frequency of illness on cruise ships, and its relationship to illnesses in the general population. Perhaps cruising is not for you. Only you can weigh the pros and cons of cruising to see if it is worth your vacation money.

[pchurchley]

Thank you for your educating posts. I take everything you say on board (excuse the pun!).

 

I don't believe I have the wrong idea about illness on cruise ships. I go through my life, as we all do no doubt, just living and taking normal precautions against infections. But a cruise ship is not normal life. It is a closed community of normally 1000-2000 people all eating and drinking in an enclosed living space. It really is not like normal life. The risks of cross-contamination are considerably higher than normal life and so I believe that we should take extra precautions. All I want to do is find out what extra precautions are sensible to help mitigate that extra risk.

 

Cruising is definitely for us but we want to do whatever we can to keep healthy whilst on board. That is all. :)

 

Your explaination about the cabin steward and cleaning procedures has helped. Thanks.

 

I really don't think we are being paranoid about this. We just want to be sensible and enjoy the holiday. It is a learning process that is all.

Edited March 4, 2015 by pchurchley

[chengkp75]

Thank you for your educating posts. I take everything you say on board (excuse the pun!).

 

I don't believe I have the wrong idea about illness on cruise ships. I go through my life, as we all do no doubt, just living and taking normal precautions against infections. But a cruise ship is not normal life. It is a closed community of normally 1000-2000 people all eating and drinking in an enclosed living space. It really is not like normal life. The risks of cross-contamination are considerably higher than normal life and so I believe that we should take extra precautions. All I want to do is find out what extra precautions are sensible to help mitigate that extra risk.

 

Cruising is definitely for us but we want to do whatever we can to keep healthy whilst on board. That is all. :)

 

Your explaination about the cabin steward and cleaning procedures has helped. Thanks.

 

I really don't think we are being paranoid about this. We just want to be sensible and enjoy the holiday. It is a learning process that is all.

 

Again, I will preface my comments using USPH requirements. While some cruise lines that operate ships that do not call at US ports will continue to follow the USPH Vessel Sanitation Plan (VSP), some don't, and some ships never call at US ports. Many countries have their own Public Health requirements, and at the very least, the ships must follow WHO requirements, as mandated by the IMO.

 

Saying that, I believe that cruise ship crew and staff are better trained and more conscious of infectious disease spread than most shoreside hotels and restaurants. Remember, those crew are living onboard as well, and it is in their interest not to allow a disease to run through the ship. In fact, they will remain onboard when the passengers leave at the end of the cruise, so they will try not to allow anything to linger that could affect the next cruise.

 

As I said at the beginning, if you feel better about wiping down the cabin, then by all means go ahead and do so. Just take all manufacturer's claims with a grain of salt (buyer beware) and don't rely on these things to the exclusion of what you do on a normal day.

 

If you are interested, you can go here to find the USPH's VSP manual, which lists the many, many areas of cruise ship operation that must meet strict sanitation guidelines, everything from food sourcing to lighting and ventilation, which most cruisers have no idea about.

 

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CB8QFjAA&url=http%3A%2F%2Fwww.cdc.gov%2Fnceh%2Fvsp%2Foperationsmanual%2Fopsmanual2011.pdf&ei=zjP3VMrhKsaZNu2UhNgI&usg=AFQjCNE3hpkP37yfQzBY8MTHYWeIq_Xu8A&bvm=bv.87519884,d.eXY

 

I was Chief Engineer on a cruise ship for 4 years (never had noro), but I cannot remember a single cruise where we did not have at least one case of GI illness reported to medical, yet the number of times we had "outbreaks" was very few (I can remember two in 4 years).

[sail7seas]

Wash your hands, wash your hands, wash your hands.......

Wash them often and keep them away from your mouth, eyes, nose and ears. Those are portals to the body. You can have noro on your 'dirty hands' but if you do not touch an open wound or other body opening, your chance of becoming ill is very small.

 

Instead of all the mania about what is the best hand sanitizers, use what a great many professionals say is the best protection of all. Hot water and plenty of soap, rub your hands and fingers vigorously to create the wanted friction to clean them well. Keep those clean hands away from body openings!

 

My late DH and I have been on about 100 cruises all total, and I once had a light case of noro about 12 years ago. DH never contracted it even from me the once I had it.

 

[john watson]

There are many experienced cruisers about who have travelled good safe healthy cruises. If you follow reasonable lifestyle choices onboard as we have described your chances of being affected by norovirus are very very small. I think you are excessively cautious to the point of not enjoying your cruise through your own tough regime.

 

Regards John

[chengkp75]

The reason I'm here at CC is to help educate the cruising public about ship operations, safety, sanitation, and to try to clear away rhetoric when an incident like the Triumph or Concordia happens. I'm not that experienced a cruiser, just a few, but counting work, I've got more than 1000 days on cruise ships. My problem, while I like cruising, is that I spend half the year at sea already, do I really want to go back? When I do cruise, my better half has to keep reining me in from entering crew spaces when I know the quickest way from A to B is through that crew door. :p

[pchurchley]

There are many experienced cruisers about who have travelled good safe healthy cruises. If you follow reasonable lifestyle choices onboard as we have described your chances of being affected by norovirus are very very small. I think you are excessively cautious to the point of not enjoying your cruise through your own tough regime.

 

Regards John

Thanks.

 

Again... I think you have misunderstood me... I am certainly not excessively cautious. I am not anything at the moment as my cruise starts Monday (can't wait!). The reason for my questions are so that I can find out what is cautious enough WITHOUT being excessively cautious :)

 

I have a plan now thanks to you helpful lot...

 

We are generally very clean in our normal living habits so we will just carry on with that but thoroughly wash hands whenever we can and always before and after eating, often when in public areas, when returning to or leaving our cabin etc. We will have Purell gel but we will use that only as a adjuct and not a replacement. Avoid touching face if at all possible. Use elbows for public doors if poss etc. We will be cautious at the buffet but still use it (we will have to because that is the only alternative to the MDR on formal nights and I am not taking a DJ or suit).

 

All those things are not excessive in my opinion and I see as just sensible precautions that are not likely to impact on what we do or our enjoyment.

 

Thanks for discussing it everyone :)

[cb at sea]

You are MORE LIKELY to catch Noro at home, than on a cruise. It's everywhere...grocery stores, Schools, especially!, Church, hospitals, nursing homes,...anywhere there are crowds.

[Kiran]

We were on the Equinox sailing 2/13 that had an outbreak but did not get Noro. Celebrity has auto openers for public bathroom doors and permanent notices saying to use a paper towel to open door and then discard paper towel.

We washed hands thoroughly each time using a restroom and used auto opener or paper towel to open restroom doors after the washing of the hands, We accepted sanitizer everywhere offered. We used knuckles for elevator buttons. We didn't touch railings unless ship motion was rough and were careful to wash hands after touching railings.

I was most worried about my daughter,13, because she has an unconscious habit of touching her face. But we were lucky and she did not get sick either. We ate stuff from Oceanview everday in addition to MDR. We went in the lukewarm tubs and didn't get sick.We ate french fries with our fingers and didn't get sick.

 

Celebrity Equinox staff went to great effort in cleaning everywhere very often.

It was the passengers you had to watch out for.

My Mom used a Handicap restroom stall after another women only for her to tell us she was sick and had not been able to find when the medical office was open and she thought it was better not to go to the Doctor anyway(This conversation was second or third night of 10 day trip). Passengers kept leaving their cabins even when directed to stay in their cabins-kept hearing the pages and overheard two staff talking wondering why the passengers would do that.

Disembarkation day the ship wheelchairs were sanitized between each person. We were sitting and chatting and sharing some water with a couple only to later hear one of the couple telling staff that they had been sick since Wednesday.Aaagh! But still we didn't get sick.

I have had the opportunity to use a Glo-Germ handwashing trainer so am confident in my handwashing skills.

 

If you want to do something to up the odds against getting sick that might be a good way to go. Basically it is microscopic particles of white plastic in a lotion, dust or gel. First the stuff is applied to hand and you inspect your hands under blacklight. Then you wash your hands. Last you inspect your hands under blacklight again. Anywhere missed will have particles glowing in the blacklight. The hardest areas for me to clean are under fingernail edges or in the wrinkles on back of knuckles, but then I figure any germs would have a hard time traveling from those places into my food.

 

http://www.amazon.com/American-Science-Surplus-Germ-Mini/dp/B001BO6R9W/ref=sr_1_1?ie=UTF8&qid=1425493773&sr=8-1&keywords=glo+germ

 

http://*******.com/GloGerm

[pchurchley]

You are MORE LIKELY to catch Noro at home, than on a cruise. It's everywhere...grocery stores, Schools, especially!, Church, hospitals, nursing homes,...anywhere there are crowds.

That is good to know... eeerm... not that it is everywhere :eek: ... I meant, it is good to know that it is unlikly on a cruise. Thx :)

 

I guess I have just picked up on a few high profile outbreaks and got concerned... well, wouldn't anyone if you hadn't cruised much before? :) :)

[Hlitner]

We think that the Noro - cruise ship issue has been somewhat over publicized and causes a lot of unnecessary anxiety. Noro (Norwalk Virus) is one the 3 most common viruses that sicken humans. In fact, it is estimated that over 90% of all gastro illness is caused by this bug. Since the OP is from the UK we would point out that its often called the Winter Vomiting Bug on your side of the pond.

 

The issue with cruise ships is magnified because cruise ships have required reporting guidelines whereas most land-based outbreaks are never reported. If a lot of folks catch Noro at a London restaurant it is unlikely it would ever be known since those folks go their own ways and when they get sick they say, "I have a stomach bug" and in a few days they usually recover.

 

Yes, the chances of catching Noro are increased when in "travel mode" because of the exposure to so many different people and the constant dining in large groups (and at buffets).

 

We would just mention that DW and I have spent nearly 4 years on cruise ships as passengers and neither of us have ever contracted Noro on a ship (I have had it on land). The bigger issue for us on cruises is the catching of common colds and various respiratory bugs. You just cannot escape being near folks who have colds, cough, sneeze, etc. 8 passengers cram into an elevator (to go down one floor) and perhaps one coughs and spreads a bug. And those other 7 pay a price for taking that particular elevator....hence we think that avoiding ship elevators is probably more effective at avoiding viruses and bacteria then cleaning an already clean cabin.

 

Hank

[pchurchley]

Points taken. Thanks. :)