Norovirus leaflet on Fred. Olsen voyages

[Pushpit]

In this thread, one valiant passenger has explained the bad things that can happen if you get Norovirus whilst on board MV Balmoral. It's grim reading but it was good to share it, since hopefully it can serve to educate. I work in this area, Noro is a killer, thankfully not a big scale, it's a much more sophisticated viral pathogen than say Coronavirus. Only a small exposure to the virus can cause an infection, and it's largely formite spread (by touch) rather than respiratory. So all the gallons of sanitizer used during the pandemic didn't greatly affect Covid-19's spread but at least for a while we saw very little Noro transmission. But Noro gets everywhere, it's not special to Fred. Olsen and it would be wrong  to attribute particular risk to that company since it can be transmitted in all sorts of settings.

 

There is one very particular way it gets transmitted and I am trying to not make people uncomfortable, so I'll just say what really, really matters: after you have been to the toilet, you must really wash your hands very, very thoroughly if you are in a Noro risk scenario. The virus is very small and get into all sort of nooks and crannies. Hand washing with soap is the single best barrier, and we know >90% of people do not wash their hands properly.

 

 

The good news is that if you are sensible, follow the advice below and wash your hands with soap (much better than sanitiser) then you don't need to worry and can get on with enjoying your trip. It's more effective than forcing people to isolate, in my view.

 

Here is Fred. Olsen's leaflet on Norovirus and as with all photos in Cruise Critic you should be able to see a larger version by clicking the image.

 

Finally there is some really good handwashing techniques in the last poster, particularly points 4 to 9 inclusive, which is what I mean about nooks and crannies. 20 seconds = 2 versus of Happy Birthday. Or the chorus to Dolly Parton's Jolene, (but you don't need to sing it out loud).

 

Safe but enjoyable travels everyone.

 

 

[Lleyncruiser]

The one time I caught Norovirus on the Balmoral was undoubtedly from a book that I borrowed from the onboard library. After my comments to the staff they started taking returned books to be disinfected which they had not done previously.

 

[Eglesbrech]

On 8/26/2023 at 6:50 PM, Pushpit said:

The good news is that if you are sensible, follow the advice below and wash your hands with soap (much better than sanitiser) then you don't need to worry and can get on with enjoying your trip. It's more effective than forcing people to isolate, in my view.

I was sensible, I did wash my hands, I never visited a public toilet onboard but I still got noro (or some such). I know perfectly well how to wash my hands properly and have indeed done the blue light UV training for this.

 

As you are in the field you will know that one can be absolutely scrupulous and as careful as possible and simply touch something eg a lift button, a handrail,  a salt cellar, a book as mentioned above or chair back then eat a roll or crisp and get noro. Add to this the CDC assertion that much is actually transmitted through food sources (via the F/O route you delicately reference above).

 

It’s certainly not just a Fred Olsen issue or a cruise line issue as it is prevalent in many closed environments (and probably elsewhere but not as easily tracked). 
 

I got really cross reading comments on social media about it being the passengers fault that they “got noro through lack of hygiene”. I can categorically state that is not the case.
 

 

[Pushpit]

I am happy to go along with most of those comments. The one point I would make is that the concept of fault in public health isn't always useful, if ever. What you are trying to do is to remove bad conditions, get down to the source of infectious conditions, and focus on best practice, rather than get into the blame game or finger pointing. No one seeks to get ill or make others ill, it's no fun for those involved. Our aim is to minimise future incidents as far as possible.

[Eglesbrech]

10 hours ago, Pushpit said:

I am happy to go along with most of those comments. The one point I would make is that the concept of fault in public health isn't always useful, if ever. What you are trying to do is to remove bad conditions, get down to the source of infectious conditions, and focus on best practice, rather than get into the blame game or finger pointing. No one seeks to get ill or make others ill, it's no fun for those involved. Our aim is to minimise future incidents as far as possible.

I would agree that fixing the problem and not the blame should always be the priority but that works both ways.
 

Cruise lines generally blame passengers, “passengers brought it onboard” when that cannot possibly always be the case, particularly when it transmits cruise to cruise to cruise when all passengers disembarked.

 

 

[twotravellersLondon]

1 hour ago, Eglesbrech said:

I would agree that fixing the problem and not the blame should always be the priority but that works both ways.
 

Cruise lines generally blame passengers, “passengers brought it onboard” when that cannot possibly always be the case, particularly when it transmits cruise to cruise to cruise when all passengers disembarked.

 

 

 

There Court of Appeal have already decided against FOCLs that even if Norovirus was introduced by a passenger that FOCLs has a duty to manage the problem. In the past, passenger on "Fred"  have been awarded significant compensation by the course because they contracted the illness on board FOCL ships.

[terry2]

The other thing you can do is have your own hand sanitiser that specifically deals with norovirus (most don't), and use that in addition to handwashing and the ships sanitisers. 

[twotravellersLondon]

8 hours ago, terry2 said:

The other thing you can do is have your own hand sanitiser that specifically deals with norovirus (most don't), and use that in addition to handwashing and the ships sanitisers. 

 

We've not been able to find one... even with the help of the NHS website... so any suggestions of a hand sanatizer effective against norovirus would be welcome.

[Pushpit]

All sanitisers have some effectiveness against Noro, it's just much weaker than soap and water. From clinical studies there are several reasons for this, but the main one is that people tend smear a small amount of sanitiser over some of their hands, quickly, and that's not adequate for dealing with Noro. It's a small virus, which doesn't clamp that well to surfaces. Other virus have these little suckers on the outside to help grip, Noro just rolls around until if finds a crevice. Hand washing, with water taking stuff off your hands, is great since the pathogens just go down the sink hole, the soap lubricates them off the hands. Sanitisers are at risk of just shuffling the pathogen around your hands. Noro is also unusually self protective, it can survive in a water tank for quite a while - it's not one of those bugs that get killed quickly with a shot of alcohol, they can even survive 4% bleach solution for a small while, though eventually that will kill them.

 

Moreover the infection rate of Noro is that just a few pathogens are needed to get infected. We had a hell of a trouble getting healthy students to get infected with Covid-19 for clinical trials, which people tend to think as highly infectious - we had to put it repeatedly down their trachea. Noro - 2 specs would be quite enough.

 

If you have washed your hands thoroughly there is an argument not to use sanitisers (they also get on to sanitiser squirters!). But if you have no alternative then any alcohol sanitiser will make some difference, and will kill off other pathogens,which may damage immunity levels to let Noro in.

[terry2]

6 hours ago, twotravellersLondon said:

 

We've not been able to find one... even with the help of the NHS website... so any suggestions of a hand sanatizer effective against norovirus would be welcome.

 You might need to search for something that meets EN 14476 - which is a test for anti viral products that includes norovirus. Though that info is often hard to find on web pages. 

 

 One such is purell advanced hand sanitiser gel, although there are others. I  normally use the sterizar hand sanitiser. 

 

 

[Pushpit]

1 hour ago, terry2 said:

 You might need to search for something that meets EN 14476 - which is a test for anti viral products that includes norovirus. Though that info is often hard to find on web pages. 

 

 One such is purell advanced hand sanitiser gel, although there are others. I  normally use the sterizar hand sanitiser. 

It's actually targeted at murine noro, which is easy to research, rather than human versions of noro. In the NHS we use Purell Advanced in hospitals and labs. along with the Clinell equivalent - more usually the latter due to a big contract with them and the slightly higher alcohol content. But it's still nothing like as effective as soap and water for the reasons given.

[terry2]

fair enough, but I would rather use both a sanitiser and hand washing,

[terry2]

Sorry, to be more accurate, a good handwashing which is then followed by using a sanitiser.

[tring]

It is the foam sanitisers which are anti viral ones, whilst the alcohol gels are not really anti virals.  Can get on the net, or search the net for places selling them.  We have got them in the past.  There have been lots of outbreaks on all cruise lines recently, as there always was pre-covid.  The ships always refer to norovirus like bugs, no assurance that is what the cause is of course, but if it was possible to prove it heralds from the kitchens of a ship, then they would clearly be implicated, hence the term norovirus like infection.

 

May be a good idea to skip filter feeders anywhere, even when ashore.  I worked in a hospital lab for one of my research contracts and many of the staff would never touch filter feeders, though must say I love that sort of thing and never seem to have suffered after eating them.

 

Edited September 4, 2023 by tring

[Leither]

23 hours ago, tring said:

It is the foam sanitisers which are anti viral ones, whilst the alcohol gels are not really anti virals.  Can get on the net, or search the net for places selling them.  We have got them in the past.  There have been lots of outbreaks on all cruise lines recently, as there always was pre-covid.  The ships always refer to norovirus like bugs, no assurance that is what the cause is of course, but if it was possible to prove it heralds from the kitchens of a ship, then they would clearly be implicated, hence the term norovirus like infection.

 

May be a good idea to skip filter feeders anywhere, even when ashore.  I worked in a hospital lab for one of my research contracts and many of the staff would never touch filter feeders, though must say I love that sort of thing and never seem to have suffered after eating them.

 

What’s a filter feeder?

[Eglesbrech]

2 hours ago, Leither said:

What’s a filter feeder?

Some shellfish like muscles, clams etc. 

[Leither]

Thanks, didn’t realise you were talking about shell fish.

[Eglesbrech]

4 minutes ago, Leither said:

Thanks, didn’t realise you were talking about shell fish.

Some are associated with the possible transmission of norovirus because of the way they feed. Like @tring I tend to avoid eating them on a ship or on shore.

[Colin_Cameron]

I once asked a ships doctor, many years ago, long before covid, what use an anti-bacterial sanitizer was against a virus? His reply was that its main effect was that people got so fed up with having sticky fingers that THEY WENT AND WASHED THEIR HANDS! 😁