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On Spirit, Massive Noro Virus Outbreak


scottie99
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15 hours ago, lumpkin8 said:

Does anyone have recommendations for those who cannot use hand sanitizers?  I have severe excema on my hands, and cannot do the washy washy upon entrance to the dining areas.  I do wash my hands with soap and water very, very often, but it sure looks to most people that I am being dirty or intentionally non-compliant when I pass on the hand sanitizing offered at the dining venues.   Any suggestions would be appreciated.

 

I think the one I listed above would be good for anyone with eczema as it's alcohol free and has added aloe vera, but not being a sufferer I am only guessing though.

Easily bought in Boots in the UK or Amazon in the US.

https://www.amazon.com/dp/B078WTN63M/ref=dp_prsubs_1

 

Otherwise, this one is also alcohol free and eczema friendly but unlike the one I listed above, it will kill germs like 99% of hand sanitizers but won't deal with Norovirus. 

https://www.amazon.com/CleanSmart-Cleanser-Alcohol-Free-Antimicrobial-Irritate/dp/B00GX1RFEY

 

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35 minutes ago, cruiser man 60 said:

JAnyone on board who can update present position re the virus as we have elderly parents going on cruise this Sunday from Barcelona and want to update them.

 

I'm not on the ship but there is nothing showing up on the CDC or cruisejunkie websites.

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41 minutes ago, lumpkin8 said:

And WOW for the Ecohydra....I just googled this (info prepared by the company itself)....http://www.antibacproducts.com/img/pdfs/EcoHydra_Technical_Bulletin_HS.pdf

 

Yes an amazing product, for years I assumed wrongly the alcohol based ones were sufficient.

I always wonder what is in the "washy washy" containers and if it would actually help against norovirus. It's quite thin and I guess if they prepare it themselves and added a tiny bit of bleach it would be effective.

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25 minutes ago, ziggyuk said:

 

Yes an amazing product, for years I assumed wrongly the alcohol based ones were sufficient.

I always wonder what is in the "washy washy" containers and if it would actually help against norovirus. It's quite thin and I guess if they prepare it themselves and added a tiny bit of bleach it would be effective.

Hi!  We're on the Spirit in March and I am looking to buy some of the EcoHydra.  It looks like my best bet is directly from the company.  We're in the US, so shipping is a killer and I wanted to make sure I was buying the right sizes.  I was thinking about getting a 50ml for everyone to carry in their pocket and a 100ml for the cabin.  Would those sizes work?  I can't seem to wrap my brain around how big those are.  Should I go up a size and get 100ml for everyone and a 200ml or 500ml for the cabin?  What size do you travel with?  Why do we not have this in the US???  It looks amazing!

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16 minutes ago, jenf22 said:

Hi!  We're on the Spirit in March and I am looking to buy some of the EcoHydra.  It looks like my best bet is directly from the company.  We're in the US, so shipping is a killer and I wanted to make sure I was buying the right sizes.  I was thinking about getting a 50ml for everyone to carry in their pocket and a 100ml for the cabin.  Would those sizes work?  I can't seem to wrap my brain around how big those are.  Should I go up a size and get 100ml for everyone and a 200ml or 500ml for the cabin?  What size do you travel with?  Why do we not have this in the US???  It looks amazing!

 

You can get it from Amazon in the US: https://www.amazon.com/dp/B078WTN63M/ref=dp_prsubs_1

(Amazon only have 100ml though)

 

I buy the 50ml personal bottles, they have "Up to 125 applications" printed on the bottle, the shelf life is 3 year or 18 months once opened. I like the 50ml as it slips in the pocket, the 100ml was a bit big.

 

Hope this helps.

 

Edit:

You also have Clorox in the US which claims it works against Norovirus.

https://www.amazon.com/Clorox-Bleach-Free-Sanitizer-6-Pack-Alcohol-Based/dp/B00DDZNSDK/

Edited by ziggyuk
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1 minute ago, ziggyuk said:

 

You can get it from Amazon in the US: https://www.amazon.com/dp/B078WTN63M/ref=dp_prsubs_1

 

I buy the 50ml personal bottles, they have "Up to 125 applications" printed on the bottle, the shelf life is 3 year or 18 months once opened. I like the 50ml as it slips in the pocket, the 100ml was a bit big.

 

Hope this helps.

Yes, that helps a lot!  Amazon US doesn't have the 50ml size.  It shows "unavailable".  And the 100ml has $10 shipping.  So I figured if I wanted to mix and match sizes, buying direct might be the way to go.  It looks like it comes to around $37USD for 3x50ml and 1x100ml.  That's not too bad.  I've also got some coworkers cruising soon, so maybe I can talk them into buying some as well to minimize the shipping costs.  Thanks for your help!

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22 hours ago, macandlucy said:

Alcohol based hand sanitizers are effective on both viral and bacterial illness (it's antibiotics that don't work on viruses).

 

Only on a very few viruses and not on norovirus.  You can't use antibiotics to clean your hands.

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20 minutes ago, jenf22 said:

Yes, that helps a lot!  Amazon US doesn't have the 50ml size.  It shows "unavailable".  And the 100ml has $10 shipping.  So I figured if I wanted to mix and match sizes, buying direct might be the way to go.  It looks like it comes to around $37USD for 3x50ml and 1x100ml.  That's not too bad.  I've also got some coworkers cruising soon, so maybe I can talk them into buying some as well to minimize the shipping costs.  Thanks for your help!

 

Might be worth seeing how much Amazon UK charge for shipping to the US, I can't see my end, but here is a 6 pack of 50ml:

https://www.amazon.co.uk/gp/product/B078JG9KS9

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3 hours ago, senseib said:

 

Only on a very few viruses and not on norovirus.  You can't use antibiotics to clean your hands.

 

I agree that you must wash hands thoroughly and no hand sanitizers are a good substitute for hand washing. Like mom said, wash your hands! 😉

 

On the efficacy of hand sanitizers we disagree.  This is a quote from the World Health Organization on alcohol based hand sanitizers:

 

Norovirus: the efficacy of alcohol-based handrubs against noroviruses varies with type and concentration of alcohol in the formulation, with a minimum 60% (v/v) concentration of ethanol required for good activity. WHO experts recommend the use of alcohol-based handrubs during outbreaks of noroviral gastroenteritis.

 

 https://www.who.int/gpsc/tools/faqs/system_change/en/

 

I'll leave it up to each individual to determine if the WHO is a reliable source of information of the spread of disease.  (For me it definitely is.)

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On 1/29/2019 at 10:57 AM, blcruising said:

Cant agree more about the hygiene. People not washing their hands, running their hands through their hair while in line, and the absolute worst ----eating with your hands while in the buffet line and then going back in to the buffet to touch the tongs for more food. You even see people walking around with a plate eating, and licking their hands. Please don't start eating until you are finished taking all of your food. And then if you go back to the buffet, please re-sanitize your hands. Rant over. Thank you.

Unfortunately most people are just pigs and lack common sense when is come to their hygiene and others. I've lost count at the amount of people I've seen picking up food (with their hands) smelling it then putting it back......I just want to slap the back of their heads or give them a good kick in the ass. Its usually little kids or older people.....from what I have seen

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1 hour ago, macandlucy said:

On the efficacy of hand sanitizers we disagree.  This is a quote from the World Health Organization on alcohol based hand sanitizers:

 

 

The CDC says:

 

"There are important differences between washing hands with soap and water and cleaning them with hand sanitizer. For example, alcohol-based hand sanitizers don’t kill ALL types of germs, such as a stomach bug called norovirus, some parasites, and Clostridium difficile, which causes severe diarrhea."

 

https://www.cdc.gov/handwashing/pdf/hand-sanitizer-factsheet.pdf

 

And WHO does not claim ethanol-based sanitizers kill norovirus, rather they recommend their use as an important factor for changing behavior and improving overall health.  The next paragraph after your WHO quote reads:

 

"Whether alcohol is effective against microbes such as Clostridium difficile and norovirus can divert attention from a much overlooked issue. Alcohol-based handrubs play a critical role in mass behaviour change and health improvement. Discouraging their widespread use in response to diarrhoeal infections, will only jeopardize overall patient safety in the long term."

 

 

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1 hour ago, Laszlo said:

Unfortunately most people are just pigs and lack common sense when is come to their hygiene and others. 

 

Very true, I can't speak for the ladies but I can say from experience, no more than 40% of men wash their hands in the gents at public venues, I won't even touch the door handle without a tissue!

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18 hours ago, cruiser man 60 said:

JAnyone on board who can update present position re the virus as we have elderly parents going on cruise this Sunday from Barcelona and want to update them.

 

We we are still on ship. Bug is still present but reducing we at told.

 

Full preventative measures still in place. Ie no condiments on table, no self service buffet, sanitisers in lifts, key cards being cleaned when buying a drink. 

 

 

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11 hours ago, ziggyuk said:

 

Very true, I can't speak for the ladies but I can say from experience, no more than 40% of men wash their hands in the gents at public venues, I won't even touch the door handle without a tissue!

 

That brings up a matter of hygienic protocol of after washing ones hands in the loo using the paper towel to open the

exit door and deftly place the towel in the trash can conveniently located there - object after washing hands try and not

touch any loo room hardware.

And those recently installed high flow air dryers do nothing but splash hand wash all over the atmosphere of the loo -

use the paper towels if possible.

Everywhere you go on the ship try and not touch anything unless you are going to eat use it or buy it !

 

No one mentioned the implements used in the casino - dice cards chips and touching the chairs in getting settled

in to play the game and those buttons on the one armless bandits !

 

But for the most part a great deal of overkill - be healthy - stay healthy and clean and monitor closely who and where

you are with. Someone coughing near by move away - avoid the plague so to speak !

Take two of these now and two in the morning and if that doesn't work take two more for good measure.

Two of what - heck I don't know what ever floats your boat - I can't help you from 1500 miles or more away but

wish you all the best.

/s/ Dr. Strangelove - how I loved cruising and the virus

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The only downside (to me at least) of Europe cruises is that noro doesn’t have to be reported to the CDC, so you don’t know which ships have or have had it. Precautions seem to be reduced there because of not having to report. We experienced a huge noro outbreak on a Celebrity ship in Europe and had it not been for people sharing on Cruise Critic, it never would have been known in the U.S. We were almost turned away in Naples and were dubbed the “sick ship”.

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On 2/1/2019 at 10:46 AM, senseib said:

 

The CDC says:

 

"There are important differences between washing hands with soap and water and cleaning them with hand sanitizer. For example, alcohol-based hand sanitizers don’t kill ALL types of germs, such as a stomach bug called norovirus, some parasites, and Clostridium difficile, which causes severe diarrhea."

 

https://www.cdc.gov/handwashing/pdf/hand-sanitizer-factsheet.pdf

 

And WHO does not claim ethanol-based sanitizers kill norovirus, rather they recommend their use as an important factor for changing behavior and improving overall health.  The next paragraph after your WHO quote reads:

 

"Whether alcohol is effective against microbes such as Clostridium difficile and norovirus can divert attention from a much overlooked issue. Alcohol-based handrubs play a critical role in mass behaviour change and health improvement. Discouraging their widespread use in response to diarrhoeal infections, will only jeopardize overall patient safety in the long term."

 

 

I think a standalone comment like "they don't kill noro"  implies that they are useless, like an antibiotic is on a virus.  And in fairness, when  I say simply "they are effective" without qualifying it, I;m guilty of the same kind of thing.

 

So....Alcohol based hand sanitizers are not a substitute for hand washing, but may (depending on strain) for example, reduce the concentration of the virus on your hands. That is important because not everyone washes their hands or washes them very well.  If it's alcohol based hand sanitizer or nothing, I;m going with the sanitizer.  I would not rely solely on sanitizer if I had the option to wash my hands.

 

When I am on board a cruise ship I wash my hands thoroughly and frequently

 

Use alcohol based hand santitizers, with an alcohol concentration of more than 60%

 

Avoid touching my hands to my eyes, nose and mouth.

 

(There's not much I can do about the food I eat, so hope and pray.)

 

While it's true that they don't kill all the the virus immediately on contact,  they nonetheless  have a role to play in reducing the odds that I'll get it.  And that makes them "effective".  It's one more arrow in the quiver. Plus, the people who know a lot more about it than I do, the WHO recommends it, so I will defer to their superior knowledge.

 

There's an argument to be made that excessive use of hand sanitizers will, over time, increase the prevalence of more alcohol resistant strains of norovirus on cruise ships I guess, but that's one for another day 😉 

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     There are a lot of misconceptions and misinformation about Norovirus out there.  One is saying that hand sanitizers are not effective against norovirus.  Norovirus is notoriously difficult to culture "in vitro" (i.e. outside the human body), so directly testing the effectiveness of hand sanitizers or surface cleaners is actually quite difficult.  Researcher use a feline or murine surrogate to test effectiveness, but it is unknown how well these surrogates mimic human norovirus.  What is known is that the feline surrogate (feline calicivirus) is inactivated at a higher rate with higher concentrations of alcohol.  Different types of "alcohol'  were studied, but ethyl alcohol was the most effective in vivo.  What concentration is most effective is a bit controversial.  Depending on which viral surrogate is used (either murine or feline), some studies show 70% being better, others show 95% being better.  Adding other ingredients to ethyl alcohol may help to inactivate the virus also.  Studies also show that washing your hands for 20 sec with warm water and soap is superior to hand sanitizers in removing virus particles (which only makes sense b/c you are mechanically rubbing them off and rinsing them away, whereas hand sanitizers do not rinse the viral particles off your hands; they hopefully inactivate them instead).  What is not fully known is if human norovirus particles remaining on your hands after using hand sanitizers are still infectious.  This isn't known because we can't get human norovirus to replicate outside of the human body.

      So....to summarize:  hand sanitizer MIGHT be effective, but definitely go for brand name stuff with higher ethyl alcohol content (like purell advanced or the clorox one...not the dollar store stuff, because the other additives help to inactivate virus particles).  Washing your hands works by physically removing virus particles from your skin, so wash often, for at least 20 sec (longer=better) with warm water.  To decrease your chance of getting sick, ALWAYS wash your hands with warm soap and water before eating and after using the restroom, use utensils to serve and eat your food (Do not handle your food or touch the rim of your glass.  Nothing should be considered finger food on a cruise ship), and add some hand sanitizer if you want!  It won't hurt and maybe it helps.  If you are in a situation where you don't have access to soap and water, slather on the hand sanitizer.  Its better than nothing.  And don't touch your nose/mouth.  And don't eat with your hands.  Did I already say that?  It bears repeating.

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On 2/1/2019 at 2:07 PM, ziggyuk said:

 

Very true, I can't speak for the ladies but I can say from experience, no more than 40% of men wash their hands in the gents at public venues, I won't even touch the door handle without a tissue!

LOL...I suppose some guys pee on their hands. I was taught otherwise...

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57 minutes ago, Mini&Me_Cruisers said:

     There are a lot of misconceptions and misinformation about Norovirus out there.  One is saying that hand sanitizers are not effective against norovirus.  Norovirus is notoriously difficult to culture "in vitro" (i.e. outside the human body), so directly testing the effectiveness of hand sanitizers or surface cleaners is actually quite difficult.  Researcher use a feline or murine surrogate to test effectiveness, but it is unknown how well these surrogates mimic human norovirus.  What is known is that the feline surrogate (feline calicivirus) is inactivated at a higher rate with higher concentrations of alcohol.  Different types of "alcohol'  were studied, but ethyl alcohol was the most effective in vivo.  What concentration is most effective is a bit controversial.  Depending on which viral surrogate is used (either murine or feline), some studies show 70% being better, others show 95% being better.  Adding other ingredients to ethyl alcohol may help to inactivate the virus also.  Studies also show that washing your hands for 20 sec with warm water and soap is superior to hand sanitizers in removing virus particles (which only makes sense b/c you are mechanically rubbing them off and rinsing them away, whereas hand sanitizers do not rinse the viral particles off your hands; they hopefully inactivate them instead).  What is not fully known is if human norovirus particles remaining on your hands after using hand sanitizers are still infectious.  This isn't known because we can't get human norovirus to replicate outside of the human body.

      So....to summarize:  hand sanitizer MIGHT be effective, but definitely go for brand name stuff with higher ethyl alcohol content (like purell advanced or the clorox one...not the dollar store stuff, because the other additives help to inactivate virus particles).  Washing your hands works by physically removing virus particles from your skin, so wash often, for at least 20 sec (longer=better) with warm water.  To decrease your chance of getting sick, ALWAYS wash your hands with warm soap and water before eating and after using the restroom, use utensils to serve and eat your food (Do not handle your food or touch the rim of your glass.  Nothing should be considered finger food on a cruise ship), and add some hand sanitizer if you want!  It won't hurt and maybe it helps.  If you are in a situation where you don't have access to soap and water, slather on the hand sanitizer.  Its better than nothing.  And don't touch your nose/mouth.  And don't eat with your hands.  Did I already say that?  It bears repeating.

 

Very good, thanks for summarizing some key medical/scientific details.

 

Just wanted to add one other thing:  IF you cannot wash with soap/warm water, or if you want to "do something more" just as you sit down to eat, after you've slathered on the Purell or whatever it is that *might* help, try to use a clean napkin or some tissues to WIPE the residue off.  That's another way to try to physically remove particles (of any nasty type).  Perhaps one slathering that might evaporate mostly, wait a short time in case the potion does indeed help, and then lather a bit more, and wipe off.

 

Some cruise lines always "serve" the buffet items that one chooses, and never use "common serving utensils".

That seems better and better, the more we hear, the more we think about it...

 

GC

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Massive Outbreak?  Outbreaks of any gastrointestinal illness, by law, must be reported to the CDC (Center For Disease Control) before a ship docks in U.S. waters.  Here is the general text regarding that rule:

 

The Vessel Sanitation Program (VSP) requires cruise ships to log and report the number of passengers and crew who say they have symptoms of gastrointestinal illness.

Medical staff on cruise ships with a foreign itinerary that visit the U.S. participating in the program must send gastrointestinal illness case reports to VSP at these designated times:

  1. Before arriving to a U.S. port from a foreign port. This initial report is required even when there are no cases of gastrointestinal illness. Staff make this report at least 24 hours before the ship arrives at a U.S. port.
  2. When 2% or more of the passengers or crew have gastrointestinal illness. Staff must send this report any time the vessel is in the United States or within 15 days of arriving at a U.S. port.

Data on this page are from these surveillance reports and from CDC-led investigations. The gastrointestinal illness cases reported are totals for the entire voyage. These cases do not represent the number of active (symptomatic) GI cases at any given port of call or at disembarkation.

VSP posts cruise ship outbreaks when they meet all of the following criteria:

  • Fall within the purview of VSP (see about VSP).
  • Are on voyages from 3-21 days long.
  • Are on ships carrying 100 or more passengers.
  • Are voyages where 3% or more of passengers or crew report symptoms of gastrointestinal illness to the ship’s medical staff.

VSP may also post outbreak updates for gastrointestinal illness outbreaks of public health significance that do not necessarily meet the above criteria.

 

Interestingly, no NCL ships have reported such outbreaks thus far this year.  As a matter of fact no NCL ship has filed a 3% report since  March of 2016.  Here is the public access to the CDC reports: https://www.cdc.gov/nceh/vsp/surv/gilist.htm

 

 

 

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3 hours ago, Visigoth said:

Massive Outbreak?  Outbreaks of any gastrointestinal illness, by law, must be reported to the CDC (Center For Disease Control) before a ship docks in U.S. waters.  Here is the general text regarding that rule:

 

The Vessel Sanitation Program (VSP) requires cruise ships to log and report the number of passengers and crew who say they have symptoms of gastrointestinal illness.

Medical staff on cruise ships with a foreign itinerary that visit the U.S. participating in the program must send gastrointestinal illness case reports to VSP at these designated times:

  1. Before arriving to a U.S. port from a foreign port. This initial report is required even when there are no cases of gastrointestinal illness. Staff make this report at least 24 hours before the ship arrives at a U.S. port.
  2. When 2% or more of the passengers or crew have gastrointestinal illness. Staff must send this report any time the vessel is in the United States or within 15 days of arriving at a U.S. port.

Data on this page are from these surveillance reports and from CDC-led investigations. The gastrointestinal illness cases reported are totals for the entire voyage. These cases do not represent the number of active (symptomatic) GI cases at any given port of call or at disembarkation.

VSP posts cruise ship outbreaks when they meet all of the following criteria:

  • Fall within the purview of VSP (see about VSP).
  • Are on voyages from 3-21 days long.
  • Are on ships carrying 100 or more passengers.
  • Are voyages where 3% or more of passengers or crew report symptoms of gastrointestinal illness to the ship’s medical staff.

VSP may also post outbreak updates for gastrointestinal illness outbreaks of public health significance that do not necessarily meet the above criteria.

 

Interestingly, no NCL ships have reported such outbreaks thus far this year.  As a matter of fact no NCL ship has filed a 3% report since  March of 2016.  Here is the public access to the CDC reports: https://www.cdc.gov/nceh/vsp/surv/gilist.htm

 

 

 

 

As OP, I am unsure what your point is here?

 

Are you disputing there is/was a “massive outbreak “ (because there was!) or are you saying that NCL don’t report these outbreaks?

 

For information, we sailed in Europe..

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