gastrointestinal illnesses?

[boomerSexyK]

I had too much time on my hands last night at 2AM and as I was surfing around cruise stuff particularly cruisejunkie.com, the CDC site, National Centre for Environmental Health, etc. I started to notice what appeared to me to be a "trend" in this virus problem. It is of interest to my DW and myself because she is susceptible to colds and such.

It started out by looking at the occurences of the illness this year (17). Then I checked last year's totals ... 17....?? Then I noticed that 16 of 2005's incidents were in the 1st 6 mos. 2004's total= 24 , 12 in the 1st 6 mos.! It would appear that the dreaded gastointestinal problems seem to occur in the 1st part of any particular year. This seemed very strange to me. Then I started thinking, I wonder if it could be because of a large portion of the USA and virtually all of Canada locks itself indoors during the colder months and then we all run onto a cruiseship bringing the virus with us???? I know a big leap!! Maybe the day is coming when they'll have tubs of "Purell" at the embarkation terminal!!

 

As a sidebar..... a CDC report covering 2001-2004 noted that the incidence of "virus" increased from 0.65/1000 cruises to 5.46/1000. At the same time, health inspections noted that the average CDC Green Sheet score was 95/100, 86 is considered a passing grade. Sounds like some new testing procedures may be in order.

 

Also, I did note that even on ships that had been "red code"d ( considered an outbreak requiring special arrangements for dining and cleaning) only approx. 4-5% of the pax were affected with the illness, so the cruiselines do jump on these things.

 

I believe that we will definitely add hand sanitizer and wipes to our cruise neccessities though.

 

Like I said in the beginning WAY TOO MUCH time on my hands...:D

[grannynurse]

Hi,

If you haven't already noticed, HAL ships have hand sanitizer dispensers at many locations. examples, at boarding stations, by elevators, in Lido, dining room, and most public rooms. the problem being that many pax walk right by them without using them. Hal does a great job with prevention procedures. If there is a hint of an outbreak, all self service anf buffet stops and wait staff serves, even removing salt and pepper from tables and serving bread and rolls instead of having them sitting on the tables in an open basket. They remove the cloth towels from the public restrooms and hang signs advising pax to use kleenex on door handles. Pax who become ill are asked to report to the ship's clinic and are asked to stay in their cabins from 24-48 hrs.

Hal ships are kept spotlessly clean but pax who board when they are ill or in the incubation stage bring the bugs with them.

GN

[Randyk47]

An interesting observation and some excellent points! Certainly there appears to be a correlation between the "winter" months and the occurence of viruses on cruise ships. Luckily, so far, neither my wife or I have been sick on a cruise. Interestingly, after we got off the Volendam this past March the very next sailing got hit with the dreaded norovirus. Norovirus is not limited to the winter months or, more important to know, to cruising. It does seem to happen more often amongst "captive" groups so outbreaks are not unusual in schools, rest homes and hospitals.

[Jim Gallup]

boomer,

 

You made some interesting observations and generally got it right. The higher incidence of NLV (a group of viruses) in the first part of the year mirrors the higher incidence of colds and flu (a group of viruses) in the first part of the year. Both are related to large numbers of people confined together in closed spaces for long periods during cold weather. Both are also related to large groups of people who are not very clean.

 

However, if you try to connect high or low USPH Inspection scores with NLV Incidence, you will get nowhere. The CDC is most concerned with how ships handle, prepare, store, and serve food and drink. Improper handling and storage can result in GI symptoms that are in no way related to NLV viruses.

 

Having said that, the cleanest ship in the world has little defense against the trailer park denizens and those raised by wolves who cannot or will not wash their hands after using a toilet.

 

Instead of trying to relate USPH Scores with NLV Numbers, you might want to go back the the CDC Web Page and look at the types of ships that suffer from NLV. If you look closely, you will discover that only ships carrying large numbers of Americans seem to have repeated NLV outbreaks. There is also some evidence to support the claim that a lower number of ships carrying Brits also suffer.

But if you look for a German, Spanish, Italian, Russian, Chinese, or just about any other nationality clientele suffering from NLV problems on a cruise ship, you won't find it.

 

You want to avoid NLV on a ship?

Avoid the Americans.

[lougee1043]

the virus is not the fault of the ship its the fault of some of the pax that board ill and pass it on with a handshake -sneeze or some other form of transmission ------dont know if these pax ALL live in trailer parks --some of my cleanest friends llive in trailer parks-----------its simply the fault of unthinking pax who in some cases should have cancelled but didnt

 

the ships do all they can to prevent the spread --but they end up playing fireman and trying to kill the problem after it surfaces

[Old As Dirt Mom]

....This is an honest question, Jim; I'm really am curious. Do you think the Spanish, Germans, Chinese, etc. actually have better cleaning habits, or do you think the ships they're on perhaps don't bother to report any cases to the CDC? After seven years as a flight attendant for an international carrier, I have become a FREAK about cleanliness and good sanitation. I could regale you with some interesting stories about the conditions of our airplanes after long flights to various parts of the globe. From first hand observation, I can tell you that slobs come in all nationalities.:rolleyes: (Hey, good questions and observations, Boomer.)

[sail7seas]

Maybe the day is coming when they'll have tubs of "Purell" at the embarkation terminal!!

 

That day is here!! There are hand cleaning dispensers at the gangway. (as well as all over the ships). As we board the ships at initial embarkation and each time when coming back from port, those dispensers should be used by EVERYONE boarding.

[Jim Gallup]

Middle-Aged Mom,

 

You make a very good point. Anytime we deal with the great unwashed middle class - from ANY country - we are asking for trouble.

When you look at the CDC Reports for Norwalk numbers worldwide (not on cruise ships) you will find the same high numbers for USA, with lower numbers for most other countries. This could also be a reporting issue - and not a true reflection of the actual numbers.

 

But consider this. Cruising has only recently (the past 10 years or so) become really popular and affordable with the American middle class. This is about the same time frame as the rise and notoriety of outbreaks of NLV on cruise ships. When the upper classes were cruising, we didn't see these problems.

 

In those other countries (which might be under-reporting their shipboard NLV cases) cruising is generally more expensive and still primarily popular and affordable with the upper classes.

 

And just one more thought. In 2004 the CDC conducted a rather unusual study. They went to international airports in several countries and checked the hands of passengers leaving public toilets in the airports. After determining whether or not the passengers had washed their hands after using the toilet, the CDC then asked the passengers which passport they carried.

 

The results were quite enlightening. In last place were the Mainland Chinese; 18% of them washed their hands after using the toilet. Second to last were the Americans; only 21% of them had washed their hands after using the toilet.

 

What is the most efficient way to spread NLV?

Not washing your hands after using the toilet.

[mrskmirolla]

I really feel anyone can twist the numbers and hey maybe it is from all of our ILLEGAL aliens where this is all coming from:rolleyes: Jim I am not trying to get testy but oh never mind it would only get a negative reaction and I love this board and don't want to start anything negative.

 

Kathy

[Cruising Illini]

We have been on three cruises with major ourbreaks of noro "virus". The key here is that it is a "virus" and not a "bacterial" infection so the best weapon to fight this is simply soap and water and wash hands, wash hands, wash hands. The purell type liquids and anything that talks about "bacterial" are not effective. We had a CDC staff member on a trip a year ago (Veendam-14 days-Tampa) to do a study of the problem and he emphasized over and over that this is generally a virus. There were 10 of us on that trip and just by washing our hands and being very careful of railings, etc. and I personally only used our own bathroom -- none of us were sick. We had an "S" suite and our next door neighbors were quarantined for about 3 days but it didn't spread -- thanks to the effective methods used by Holland America.

As has been said previously, most of the blame is on passengers coming on board with the virus and also not reporting the illness to the medical staff on board -- it is not a problem of a dirty ship!!! "Wash your hands" !!!!

[boomerSexyK]

Well I guess that started some discussion anyways. Please be aware that I was not trying to push any panic buttons or such. Like I had said, it was really just a bunch of data gleaned from various health sites and as the mind sometimes does at 2AM...leaps of conjecture just seem to flow better in the wee hours.

 

If nothing else, at least it will hopefully remind travellers to wash wash wash! The information did indicate that in reality, it affects a realtively small %age of the pax. Of course, if you're one of them that's all it takes to spoil a holiday.

[Jim Gallup]

According to the CDC:

 

The bad news: Last year 23,000,000 people in America suffered with NLV.

The good news: 22,999,000 of them were NOT on a cruise ship.

[arabrab]

I trust the reported % of passengers/crew affected about as much as I trust our local high school's graduation rates -- not much. Not very surprising, but each group on board has a reason to underreport: passengers who don't want to be quarantined, especially if that also ends up in others in their cabin quarantined even if they aren't sick, crewmembers who are sick but still able to work may not want to miss work and risk the cruise line deciding not to offer another contract because they've been ill too much, and the cruise managment wanting to make the situation less dire that it might seem if 15-20% of those on-board were affected.

 

And I'm still of the belief that some people (passengers or crew) may well be asymptomatic carriers of some of these diseases -- the typhoid Mary's of the cruiselines, infecting who knows how many people.

 

The CDC ought to be doing more genetic analysis of I these kinds of infections. If the genetic analysis shows the same dominant subtypes on successive week cruises, then you'd have to believe that it is more likely that the crew is passing it on to new passengers; if the subtypes are quite different than you'd think that it is new passengers bringing it in from the outside.

 

Either way, I hope they eventually get a vaccine for this.

[Krazy Kruizers]

We have been on quite a few HAL cruises where the virus either broke out while we were on the ship or before we got on the ship. So this is not new to us. Fortunately neither of us have gotten the virus. We do wash our hands quite often and we do use the hand sanitizers as often as possible.

 

Note that I mentioned the only place we did not have them available was as we entered the King's Room for breakfast on the Amsterdam.

 

DH is now taking more medications than before that cruise (Mar/Apr 2006) and is now in "weaker" condition and more subsitable condition to get a virus of any sort.

[boomerSexyK]

Jim.....so I guess we should just cruise more..???:D :D

[sail7seas]

We have been on quite a few HAL cruises where the virus either broke out while we were on the ship or before we got on the ship. So this is not new to us. Fortunately neither of us have gotten the virus. We do wash our hands quite often and we do use the hand sanitizers as often as possible.

 

Note that I mentioned the only place we did not have them available was as we entered the King's Room for breakfast on the Amsterdam.

 

DH is now taking more medications than before that cruise (Mar/Apr 2006) and is now in "weaker" condition and more subsitable condition to get a virus of any sort.

 

 

There are very few if any people who are more aware, cautious and careful about washing, not touching, using hand sanitizers etc than me. I probably am a little more susceptible to contracting viruses than I was prior to suffering health issues. We had been on at least several cruises when there was a Code Red aboard and we were both fine. On a cruise last year, I caught it.

 

I knew it was aboard; I was (as always) extremely careful but nevertheless, contracted Noro Virus. My DH did not catch it aboard nor from me.

 

I KNOW for certain I caught it on the ship and not while ashore in some port as we had not been off the ship for days. My DH and I chose to stay aboard in several ports so it had been days since we had left the ship.

 

No matter how careful you are.......anyone can catch it. So what!!! Living is a risk. It stinks (no pun intended) to get sick while on vacation but, well....it happens. It can happen in any hotel you stay in, at any restaurant at which you dine, any airplane, train, bus, any school, any nursing home, dormitory, grocery store, church, anywhere.

 

Don't worry about it. Be careful; take reasonable precautions and if you do get sick be decent about it and think of someone besides yourself and QUARANTINE YOURSELF!!! It simply is not fair to anyone else (not the crew, not fellow passengers, not anyone) for you to go out and about and spread it to others.

[Tricia724]

According to a show I saw on TV last year (I think it was Oprah), apparently many of us do not even wash our hands right! The discussion was washing hands to avoid viruses, and the "expert" (don't remember whether it was a medical person or someone from CDC) said that the average person does not wash his/her hands long enough to kill viruses....that a quick swish and dry doesn't do the trick.

 

How do you know how long to wash? To kill viruses, you need to wash your hands vigorously with soap and hot water for about 15-20 seconds....or as long as it takes you to sing "Happy Birthday!" Everyone in the audience laughed, but it is a good point of reference, and there are times when I stand at a basin and mentally sing "Happy Birthday" in my brain. I hope I don't ever lose it and start singing out loud....but then I guess I'd rather be eccentric than sick!

[travlin4fun]

Getting sick is no fun. But speaking as someone who has flown a lot (though only cruised a few times) I have noticed that the majority of women in airport bathrooms fail to wash their hands when they leave.

 

I don't know their nationality or anything like that, but I do know that more often than not, they leave without washing. All kinds of women. I assume that it is the same with the men.

 

Once in awhile I've seen women who not only wash, but refuse to touch ANYTHING afterward, except for a paper towel that they use to buffer everything they touch. It may seem extreme, but considering all the germs that are left on every handle, rail, doorknob, whatever, it really isn't. In fact, it's a wonder that we aren't all sick all the time when traveling!

 

Then there are those like me...allergies allergies allergies. Every time I sneeze, people worry they will be infected. Don't worry, it's just allergies. And I will not touch anything but my tissues until I get my hands washed!

 

I used to think it was extreme to see people so fastidious, but since have learned about immune system problems that can have dire consequenses.

 

Bottom line? Be careful when traveling! Wash often! Try to be aware where our hands are and don't touch. Wash often.

 

And sing Happy Birthday!

[sail7seas]

Once in awhile I've seen women who not only wash, but refuse to touch ANYTHING afterward, except for a paper towel that they use to buffer everything they touch. It may seem extreme, but considering all the germs that are left on every handle, rail, doorknob, whatever, it really isn't ....

 

That's me. Once I have washed my hands, I will not touch the faucet, door handle, anything.....I use either a paper towel, tissue or hand cloth. What is the sense of washing and then touching what is assuredly a dirty faucet?

 

 

[sail7seas]

For those who say they see women leave the restroom without washing (or men in the gentlemen's rest room) .....

 

If this were aboard a ship and you watched them leaving, would you say something to them?

 

Would you think it worth embarrassing them in order to perhaps avoid you or someone you know and love getting sick?

 

That's a tough one, isn't it??? ;)

[travlin4fun]

Yes, that is a tough one. I, for one, avoid using public restrooms wherever possible, and have yet to use one outside my own stateroom on a cruise. But being confined on a cruise ship is different than witnessing this behavior in an airport, where people are headed in many directions, and you most likely won't be seeing them again. Not that it is okay to use the washroom without using the sink.

 

This is a dilema. Seems that education is the only answer, something we should already have.

 

How to get the message out? Don't know. Do know it will take more than signs. As time goes on, this is becoming more and more of an issue.

[whogo]

You do not get the norovirus from shaking hands with an infected person. You get it from sticking your contaminated fingers in your own nose, mouth or eyes. Wash your hands to protect yourself.

 

It's not the people leaving the washroom without washing their hands that spread the disease. It is the people vomiting and not washing their hands.

 

Look around a crowd and you'll see someone rubbing his eyes. Pay attention to how often you rub your own.

[boomerSexyK]

I think I would be tempted to say something. Maybe just a casual remark about the number of viruses onboard a ship of this size. "I'd wash my hands extra well to-day, I hear there's a virus onboard!"

I've also noticed that if someone is leaving the washroom and they notice me washing my hands, a number of them will do a quick turn-around and grab the soap and water!! Hopefully it was just a memory lapse for them as opposed to being embarassed into washing. The end result would be all good nonetheless.:rolleyes:

[Jim Gallup]

Whogo.

 

You and the Center for Disease Control seem to disagree a bit on how NLV is contracted and spread.

Since I know and trust them - and I don't really know you - I plan to follow their recommendations over yours on my ship.

 

In any case, If you want to see what they have to say, please go to:

 

http://www.cdc.gov/ncidod/revb/gastro/norovirus-qu.htm

[Robin7]

If this were aboard a ship and you watched them leaving, would you say something to them?

 

Would you think it worth embarrassing them in order to perhaps avoid you or someone you know and love getting sick?

 

That's a tough one, isn't it??? ;)

 

It is tough, and I most likely wouldn't say anything. I'm not very brave.

 

Here's an interesting tidbit I ran across this morning:

 

Water was the most effective at removing stomach bug viruses from the hands, Emory University researchers find. They planted stomach bug viruses on volunteers' fingers and allowed them to dry. The results, presented this week at the American Society for Microbiology Meeting in Orlando, Fla., showed the percentage of the viruses removed by water, hand soap, and alcohol-based hand sanitizer. Water removed 96 percent of the virus; liquid antibacterial soap removed 88 percent; and the hand sanitizer removed only 46 percent.

I guess I'll be washing my hands and THEN using Purell etc. onboard the Zaandam this summer.

 

Isn't it you, Sail7Seas, who always says, "Wash your hands, wash your hands, wash your hands"? Looks like that's the best advice of all.

 

Robin