I Was Diagnosed With Noro Virus on Nieuw Amsterdam

[OlsSalt]

CDC - Show me the Science - effectiveness of hand sanitizers: https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

 

Series of linked studies dealing with this very question - how effective and now are they used. Keeping in mind there are two common problems in these times of settings with two very different transmission routes: (1) upper respiratory infection and (2) noro virus gastro-intestinal infection.

[Floridiana]

The existence of hand sanitizer dispensers reminds me to be extra diligent when washing my hands. I use the sanitizers as an additional measure. On shore, I use hand sanitizing wipes in addition to washing hands. The wipes have the advantage of also rubbing off dirt when no sinks or no soap are available.

[CI66774]

OP - I'm so sorry you fell ill but glad you recovered quickly. Sometimes we do all we can to prevent viruses, etc., but still succumb. Thanks for sharing your experience!

[cruizn2escape]

OP, I am very sorry you were ill but happy you recovered quickly.

 

I wonder, OP, did you fly to join the ship or stay pre-cruise in a hotel? So many people carry the virus (unknowingly) onto the ship afffer being exposed on planes and during pre cruise stays. NO one's faultt, of course, but a c ommon scenarrio and no way t o know for sure if that was the case.

 

Thank you for your post. Stay well.

We flew and also stayed 2 Days pre Cruise in a hotel. I did not become ill until day 7 of the 10 day cruise.

[Arwen]

So, N. Amsterdam doesn't have Noro. There was one confirmed case. You could have caught it anywhere before you got on the ship. Bad thread title.

 

Norovirus incubation period is very very short...12 to 48 hrs, median time ....33 hrs. The OP caught the virus on the ship from someone else who likely came aboard with it. And not everyone who gets Noro will report it if their symptoms are mild.

 

The fact is, sadly, Noro is wildly contagious and it is so...because of the short incubation period and the sudden onset of vomiting. :loudcry:

[Homosassa]

If there were only isolated cases midway through the cruise, I suspect the illness was picked up ashore at a common source 24-48 hours before the symptoms started.

 

The ship was probably not involved with the original infection or there would be many more cases.

[OlsSalt]

I remember when we used to call this "tourista" and considered it one of the expected perils of traveling. And always carried a good supply of Pepto-Bismol, Imodium and drank black tea while it (ahem) worked its way through.

 

It certainly paid our Mediterranean cruise ship Fantasia a visit after we had an overnight stop in Egypt back in the late 1960s. More a subject of laughs and traveler bonding stories, rather than a red alert shutdown. But we were also young and sensed we were invulnerable back then too.

[kentuckycruiser]

I was on the NA last spring break and was diagnosed with the flu. I was required to stay in room for 48 hours. It was the worst ever. At least it was a Neptune Suite and not an inside room.

[Underwatr]

In your opinion, what should the OP have done differently? Self-quarantine for the remainder of the cruise?

[Paulinda]

Are the use of face masks effective for those that experience NV? Or are they effective at all?

[Homosassa]

The OP is probably unaware that people suffering from Norovirus remain contagious for a period after the symptoms stop. The CDC has no exact data, but they do know that your body continues to shed the virus spores for several days - up to several weeks - after your symptoms stop.

By giving an injection to stop the symptoms early, and requiring only 24 hours confinement, they made it possible for you to walk around the ship, spreading the virus to others.

 

First, viruses do not form spores.

 

Second, while someone is still contagious for several days after recovering, transmission is by contact with the fecal matter or vomit of the ill person. This means hand to mouth transmission by touching a contaminated surface and then touching your mouth.

 

Hand washing with soap and water after using the toilet will stop the recovering person for spreading the virus. Don't depend on the ineffective hand sanitizers that are so beloved by many; wash your hands.

[chengkp75]

Since viruses require a host cell to live, the virus forms an envelope which protects the virus outside of the host cell. Theses are referred to commonly as viral spores.

 

I do agree with you that releasing someone who is non-symptomatic for noro, but may still be shedding spores, requires that person's personal hygiene to be such that they get fecal matter on their hands, which they then spread to surfaces.

 

Face masks would be effective against noro only if you are in the presence of someone actively vomiting, as the aerosol from the vomitus could be ingested.

 

The shot given for noro is an anti-nausea shot, to take away the vomiting, but the diarrhea would still be present, and this is the largest vector for the body to expel the virus. The shot did not take this symptom away.

[knittinggirl]

I had "norovirus" on two of Royal Caribbean's ships. But I think it was food poisoning both times.

 

The first time, I got something on the airplane, but the symptoms didn't appear until day 2. Royal Caribbean has free norovirus treatment, and I went down to medical. They quarantined me for 36 hours, and gave me one day cruise credit for quarantine (rounded down). They did tell me I had to stay quarantined until 36 hours after the last symptom. Didn't notice much with the cleaning.

 

The next time, I got some bad food in a food cart in Amsterdam. A couple days later, I came down with norovirus. It happened to be day one of the second leg of our B2B. I missed muster drill, because medical told me I absolutely couldn't attend muster drill w/ norovirus. I went down to medical and got a shot and two types of pills, and was sent back to the room. The crew stood assembled for muster drill in the stairwell, and I explained my problem. The steward ordered me into my room. Then later he cleaned up the walls, the bedding, the bathroom, etc. Huge stinky job! He told me not to drink the tap water, but to drink the bottled water (free to norovirus patients). Medical sent down some powerade for me to drink. That time, I got quarantined for 2 days, and got two days future cruise credit. We'd had mid-afternoon boarding on the first leg because they had some bad norovirus. Lots of procedures, wall cleaning, fumigating, etc.

 

They'd changed the procedure on that cruise (Legend of the Seas). Only the steward was allowed in the room, the room service were forbidden from entering.

 

After they lifted the quarantine, I noticed a three inch yellow dot stuck to the door frame above our door. And our steward said it would remain there for the rest of the cruise. I've been on the look out for other dots. I did see some red circles and yellow circles on door frames on Celebrity ships. Don't know what system they use on Holland America ships.

 

I've discovered puke and poop in public bathrooms, and reported them to crew and they moved fast.

 

On Noordam, a lady reported vomit in the stairwell to the man that chimes the xylophone and serves the after dinner mints, and he hurried off. But we had some pretty high beaufort that evening.

 

We were on two ships w/ norovirus that made the news: Princess and Celebrity. They did the cleaning and serving like Princess, but the other difference happened to be the empty library. We read a note saying the books had been removed due to norovirus. We pretty much hid in our rooms during the second half of the cruise on Princess, and we had a pretty empty table at dinner. By the time we returned to port, captain's daily reports on norovirus had stopped.

Edited January 31, 2018 by knittinggirl

[knittinggirl]

. . .

I do agree with you that releasing someone who is non-symptomatic for noro, but may still be shedding spores, . . .

They only lifted quarantine 24 hours after last symptom. On the first norovirus experience, I waited the 24 hours, and tried to leave the ship for a shore excursion. An alarm sounded, and they told me to report back to medical. Medical cleared me, and I was off to my shore excursion.

 

Fortunately, medical wrote a note to shore excursion, and refunded our first shore excursion on quarantine day.

 

I missed our first two ports in Norway, and haven't been able to find an itinerary with them since.

 

One of the nights r in the MDR, dh was the only person at the table. I was quarantined and the rest were either visiting the Windjammer (RCI's version of Lido) or Specialty.

[OlsSalt]

Are the use of face masks effective for those that experience NV? Or are they effective at all?

 

Noro-virus is a gastro-intestinal condition; not an upper respiratory condition. Wash your hands and do not put potentially contaminated fingers tips into your nose, eyes, or mouth. Pays to understand what is at stake, what precautions work best, what are the common transmission routes for both types of infections; and how inadvertent contact can never protect everyone, every time.

 

CDC has health information specific for cruise travel: https://wwwnc.cdc.gov/travel/page/cruise-ship

[OlsSalt]

From the CDC, all the technical details you might want to know ahead of time about cruising health issues, sanitation, inspections, and inspection ratings for various cruise ships: https://www.cdc.gov/nceh/vsp/public/public.htm

[Homosassa]

Since viruses require a host cell to live, the virus forms an envelope which protects the virus outside of the host cell. Theses are referred to commonly as viral spores.

 

Now you are talking about my area of expertise. Viruses do not form spores. They can be enveloped which is basically a protein layer to allow budding into a new cell. No virologist would ever call them "spores."

 

Should an enveloped virus be found outside of the body they are easily killed by heat, disinfectants or desiccation. Nonenveloped viruses are more difficult to kill.

 

The only viral "spores" are found in Star Wars fantasies.

[OlsSalt]

Report about cruise ships from 2008 -2014 - outbreaks of acute gastroenteritis "Noro":

https://www.cdc.gov/mmwr/volumes/65/wr/mm6501a1.htm?s_cid=mm6501a1_w

 

 

Approximately 73.5 million passengers sailed on voyages that required a VSP report during 2008–2014. During that period, 172,810 passengers and crew members met VSP’s case definition for acute gastroenteritis, accounting for 0.18% of passengers and 0.15% of crew members (outbreak and nonoutbreak illnesses combined).

Among cruise ship outbreaks with clinical specimens tested, 92% were caused by norovirus, with enterotoxigenic E. coli the second most common etiologic agent. Noroviruses are highly transmissible, can spread easily, especially in environments where persons live in close quarters such as long-term care facilities or dormitories, and can remain infectious on environmental surfaces for long periods of time (7,8).

Good hand hygiene is vital to preventing outbreaks of acute gastroenteritis, including on cruise ships. This is best accomplished by washing hands with soap and water because it allows for the mechanical removal of the virus from the hands (7,9). Alcohol-based hand sanitizer use alone has shown limited efficacy, but can be used in conjunction with handwashing with soap and water (7).

[OHCruiser]

After seeing this thread, I went to research what disinfectants kill norovirus--I had noticed that the towelettes used at the computer stations are hydrogen peroxide based and say that they cover a real host of bacteria and viruses. Sure enough, small concentrations of hydrogen peroxide or chlorine bleach--1 tsp/5ml to make up a cup--will do the job.

Now, obviously, the reasons for not having this available in place of alcohol based hand sanitizer is because it would be very drying to skin with repeated use and I suppose it might be enough to damage fabrics.

I'm going to purchase some of these wipes to take on my next cruise. I'll put them in our bathroom and carry a few in my purse. I'll deal with dry hands for added layer of protection.

[sail7seas]

BARS of soap, hot, warm water, wash your hands all the time and keep them away from your eyes, nose, ears and mouth...... they are the 'entry po rtals, that let virus into your body. WASHING YOUr hands is the best.

[OlsSalt]

I am sorry to see people still rely on any form of wipes or sanitizers as some sort of magic potion.

 

They are not - at best they mechanically remove some debris that may or may not be contaminated, so the solution that actually wets and removes is of little consequence, particularly for the short duration of contact with the magic solution.

 

Agree, the best thing to do with clean or dirty fingers is to not stick them in your mouth, eyes or nose. Also time to think about the amount of disposables these pre-packaged wipe also represent. I hear you, no one wants to get sick. But wasting time on ritual acts of little to no values diverts attention from those inadvertent acts that can cause the trouble.

[chengkp75]

After seeing this thread, I went to research what disinfectants kill norovirus--I had noticed that the towelettes used at the computer stations are hydrogen peroxide based and say that they cover a real host of bacteria and viruses. Sure enough, small concentrations of hydrogen peroxide or chlorine bleach--1 tsp/5ml to make up a cup--will do the job.

Now, obviously, the reasons for not having this available in place of alcohol based hand sanitizer is because it would be very drying to skin with repeated use and I suppose it might be enough to damage fabrics.

I'm going to purchase some of these wipes to take on my next cruise. I'll put them in our bathroom and carry a few in my purse. I'll deal with dry hands for added layer of protection.

 

There are two factors to disinfect a bacteria or virus: concentration and contact time. The concentration you mention is about 1200ppm (200ppm is considered a sanitizing solution) of bleach (haven't checked the stock concentration of peroxide), so is in fact extremely high and would be bad for skin. As well as concentration, you need to know the contact time required to kill the virus at that concentration. What is the recommended contact time for the wipes you are talking about?

[knittinggirl]

I don't understand why they quarantine for norovirus but not upper respiratory infections.

 

On our second leg in Australia, during cocktail hour, there was a couple that said they visited medical and they were lined up 20 feet outside the doorway to medical.

 

I caught the upper respiratory the last day of the cruise, and was sick for a solid month. Wonder if I had caught this year's influenza. DH and I were both sick, and it took a shot, two rounds of antibiotics to fix it for both of us. DH can usually walk it off. But we were also had a 13.5 hour plane ride to get home.

 

A nasty case of norovirus can put people in the hospital if they get dehydrated enough.

[OlsSalt]

I don't understand why they quarantine for norovirus but not upper respiratory infections.

 

On our second leg in Australia, during cocktail hour, there was a couple that said they visited medical and they were lined up 20 feet outside the doorway to medical.

 

I caught the upper respiratory the last day of the cruise, and was sick for a solid month. Wonder if I had caught this year's influenza. DH and I were both sick, and it took a shot, two rounds of antibiotics to fix it for both of us. DH can usually walk it off. But we were also had a 13.5 hour plane ride to get home.

 

A nasty case of norovirus can put people in the hospital if they get dehydrated enough.

 

CDC is really strict about ship's reporting Noro incidents, not sure they are as strict about upper respiratory ailments - both are bummers.

[MogeyMan]

I don't understand why they quarantine for norovirus but not upper respiratory infections.

 

On our second leg in Australia, during cocktail hour, there was a couple that said they visited medical and they were lined up 20 feet outside the doorway to medical.

 

I caught the upper respiratory the last day of the cruise, and was sick for a solid month. Wonder if I had caught this year's influenza. DH and I were both sick, and it took a shot, two rounds of antibiotics to fix it for both of us. DH can usually walk it off. But we were also had a 13.5 hour plane ride to get home.

 

A nasty case of norovirus can put people in the hospital if they get dehydrated enough.

 

And don't forget how incredibly filthy planes are. We wipe down our seats, headrests, trays, windows, overhead buttons, vents, everything. I've gotten sick on planes way more often than on the boat.