Is Norwalk a "Class Disease"?

[Chigirlcruzin]

 

Do you think that the lower number of children on luxury lines means lower outbreaks?

I thought the same.

But Carnival has one of the highest average child counts on their ships - and has the lowest outbreak numbers of any mass market line. Nobody else is even close - except the luxury lines.

 

 

This IS an interesting topic now that we've gotten over the class thing. Carnival has the lowest number of outbreaks on any mass market line. Carnival doesn't have hand sanitizers everywhere, so they don't make people use them like some other lines do. I strongly believe these sanitizers do more harm than good and give a false sense of security. Do luxury lines insist on passengers using the sanitizers?

[krystalkruzer]

A large mass market ship typically carries between 40 and 200 passengers in wheelchairs, another 50 with oxygen masks, and an additional 100 with walkers/scooters, etc.

 

I have been on 3 Carnival cruises so far and I remember seeing only about 2 people in wheelchairs over the 3 cruises. Did not see any with O2 masks or walkers / scooters.

[cb at sea]

Noro (or Norwalk) virus has NOTHING to do with cruise ships (although the virus is reported more often on ships) and everything to do with the Virus! I would propose that the "luxury" lines report fewer incidences because the patrons have less contact with children than the mass-market lines. Kids are a prime carrier of ALL kinds of germs and viruses---

This "stomach" virus hits almost every school in the nation at least once a year. It has nothing to do with "class"--except K-12~!!!!!!!!

[spongerob]

The problem might be in the way the statistics are gathered. Under what conditions does a ship have to report an outbreak of illness? Does it have to embark or disembark passengers at a US port? Or, does a call at a US port require a report? Does an outbreak on a ship that does not call and/or disembark at a US port require a report to CDC? (I don't know the answers to those questions - I expect someone familiar with the regs would.)

 

BUT...assuming (and if that is a incorrect assumption, then the rest of this is moot) that the CDC reports come only from ships that are homeported in the US, or call at US ports, the reason luxury vessels would have such a low number might be related to the requirements to report. There are far more mass-markets sailings from the US than on luxury lines. Divide the number of reports by the number of cruises that require a report, and you have your answer for mass-market and luxury lines. I expect that there would be no statistical difference in the results.

[kitty9]

You bring up an interesting point. Although the luxury lines do generally carry an older average demogropahic, they do not generally carry so many older/infirm pax as the mass market lines. By that I mean those who may be physically unable to keep themselves as clean as the rest of the population - and those whose immune systems may not be as strong as others. A large mass market ship typically carries between 40 and 200 passengers in wheelchairs, another 50 with oxygen masks, and an additional 100 with walkers/scooters, etc. Luxury ships rarely see anything like that. They don't have the handicapped accessibility that large ships offer. Are all these people able to easily shower once or twice every day, and make a quick trip to the washroom every few minutes to wash their hands? Could this be a factor? I don't know - but wish I did.

 

 

Have you been on any of the luxury lines? Like I said, I have, and you'd be amazed by some of the infirmities the passengers have. On any given cruise you'd see at least 10 to 20 in wheelchairs or scooters, a number of those with walkers or canes, quite a few on oxygen and others who are on dialysis. What you're missing is the fact that you're dealing with far less passengers on the luxury lines, and therefore numbers are all relative. Believe me, because of the smaller size and accessibility of the luxury ships, they DO tend to attract those with health issues. And, all the luxury lines are TOTALLY and COMPLETELY handicapped accessible. I should know, as I'm disabled. And yes, I shower each and every day.

 

My guess is the reason there are more incidents of illness on the mass markets is for one reason only.....the sheer numbers of passengers and crew. Nothing else matters, period.

[kitty9]

This IS an interesting topic now that we've gotten over the class thing. Carnival has the lowest number of outbreaks on any mass market line. Carnival doesn't have hand sanitizers everywhere, so they don't make people use them like some other lines do. I strongly believe these sanitizers do more harm than good and give a false sense of security. Do luxury lines insist on passengers using the sanitizers?

 

Yes, the luxury lines do require the sanitizers. At least on Crystal, you cannot reboard the ship after a tour unless you use their sanitizer. Crystal has even placed sanitized wipes in the public bathrooms that you take right before you leave so you don't need to physically touch the doornobs on your way out.

[Philip217]

krystalkruzer,

 

Good point about Carnival's low number of wheelchairs and scooters - but that's only on some of their vessels. They have a few itineraries where the wheelchair and scooter count is very high. So the numbers are inconsistent. But Carnival's NLV numbers are consistently very low for the past 15 years.

 

cb at sea,

 

I always thought the same way about children as you. They rarely wash, are always crawling on dirty floors, constantly putting questionable things into their mouths. So we know that the luxury lines generally carry fewer children than the mass market lines - and they have almost zero NLV cases. But Carnival Cruise Line carries loads of children nearly all the time - and they have the best NLV record amongst all the mass market lines. The theory doesn't hold up.

 

Spongerob,

 

Cruise lines that have offices and sell tickets in the USA are required to report onboard illnesses to the CDC on a weekly basis - even is a particular ship never calls at a US Port. So if the Seabourn Pride for example (my old ship) is sailing the South Pacific all season, they still must report weekly to CDC. If they have more than 3% ill onboard they must report twice daily.

So that theory doesn't work either.

 

kitty9,

 

Yes, I worked on many of the luxury ships. The newest ones are a bit more accessible; the others are not so much. Sea Goddess (now Sea Dream) comes to mind as some of the more difficult ones.

Yes, the numbers are all relative - but generally they work AGAINST the smaller ships. On a normal cruise, my ship must have more than 150 people sick before we are required to make any special reports to CDC. That's a lot of people getting ill, regardless of the total number onboard.

A typical Seabourn sailing, frequently only about half full, needs only 3 or 4 people sick before they must make special reports to CDC and be considered an Outbreak. A single family having stomach problems on a Seabourn ship could feasibly constitute an Outbreak that would appear on the CDC website. But it almost never happens. Why not??

 

My ship requires an entire deck of people sick before we have to worry. Once again, considering how the numbers work against the smaller ships, one would expect even higher numbers of outbreaks reported on them.

 

You are talking about sheer numbers making the difference. But the CDC doesn't count sheer numbers - they are only interested in percentages to classify Outbreaks. 3% is the magic number. Above 3% is an outbreak.

 

On a small luxury ship, even one sick person can be 1%. Three sick people (one family) can put them into the Outbreak category. But it has happened only 4 times in the past 15 years; or once every 4 years.

 

On my mass market ship, 1% is 50 people. One sick passenger = .02% That is a lot of sick people, no matter how you look at it. I need to have 150 sick before the CDC even wants to hear about it. This has happened 195 times on mass market ships in the past 15 years, or more than once every month.

 

Back to the original questions:

 

How is it possible for the luxury lines to have so few outbreaks - even with the percentages working against them - and the clientele coming from essentially the same places where the mass market lines are finding their passengers?

 

What is so different that makes sailing on a luxury ship a much safer health bet?

 

What can the mass market lines take away from this to ensure healthier cruises for thier passengers?

[SelectSys]

My thoughts on the subject:

 

1) The greater usage of buffets on mass market ships

2) The lower staff to passenger ratios on mass market ships

 

Additionally, I wouuld expect that high income people which has a postitive correlation with education are generally more conscious of health concerns including keeping their hands clean. This is pretty much like smoking in that the higher the income, the less likely you'll find that the individual smokes: http://eurpub.oxfordjournals.org/cgi/content/full/15/3/262

[Kim4]

Here are some ideas:

 

From cdc.gov

"Passengers and crew members on cruise ships and naval vessels are frequently affected by outbreaks of NLV gastroenteritis (35,92,93). These ships dock in countries where levels of sanitation might be inadequate, thus increasing the risk for contamination of water and food taken aboard or for having a passenger board with an active infection. After a passenger or crew member brings the virus on board, the close living quarters on ships amplify opportunities for person-to-person transmission. Furthermore, the arrival of new and susceptible passengers every 1 or 2 weeks on affected cruise ships provides an opportunity for sustained transmission during successive cruises. NLV outbreaks extending beyond 12 successive cruises have been reported (94)."

 

I'm not a cruise expert by any means, so these are just guesses to throw out there.

 

1. Do the luxury lines have different ports of call than the mass market? Do the mass market lines visit ports that are less sanitary than the luxury ones?

 

2. NLV seems to come through contaminated water. Do the mass market lines handle water differently? Do the luxury lines bring all their water from their home port while the mass market lines bring water on board at the ports?

 

3. Are people usually in closer contact on the mass market lines rather than on the luxury lines? This may have something to do with it...a previous poster mentioned a luxury line with 100 people and it being half full. That makes for plenty of deck space per person. I'm not arguing that since there are fewer people there will be a fewer percentage...I'm saying that there may be much more opportunity for close close contact on the mass market lines. This seems to be a contributing factor. Are the crew quarters on luxury lines significantly different than the crew quarters on a mass market line?

 

4. What about food handling practices? I strongly agree with a previous poster about the buffets. Those are notorious for harboring germs. Are there more buffets on mass market lines than luxury lines (do they measure buffets per person? :) )

 

The CDC site mentions the three most common ways that NLV is transmitted: foodborne, waterborne, and person-to-person. CDC site

 

So, maybe instead of number of children and/or cleanliness of the ship, maybe these three factors would be areas to investigate.

 

To the OP: thanks for sticking to your guns in this topic. You asked a valid question.

[ShedQueen77]

As far as older passengers on luxury lines is concerned, your comment totally incorrect. In fact, the luxury lines such as Seabourn, Silversea and Crystal have a much higher average age than any of the mass market lines. On any given cruise, the average age on these lines can go well above 65. I've cruised on all three of those lines and I was one of the youngest passengers on board in my early 50's.

 

The reasons the small ships don't encounter those problems can be attributed to the following: Less children, fewer passengers, better crew to passenger ratio, smaller ships mean less square footage to keep clean, fewer public rooms, longer itineraries mean less passenger turnover and less a chance of passengers coming on board already sick.

 

This is pretty much what I was going to say. :)

 

As much as I love children they aren't known for their good hygiene habits, making it MUCH easier for a virus to spread when there are a lot of them around. There are not as many children who sail on the luxury lines. These kids touch elevator buttons, hand railings, buffet utensils (a peeve of mine), you name it.

 

Another "kid" factor could be that people who can afford those types of cruises typically do not have young children at home or leave them with a sitter when they go. They aren't exposed to all the 'cooties' us parents of the younger ones can carry along with us despite our religious hand washing rituals. ;)

 

Our household never has a single one of us sick during the summer months. Within a week of the kids being back in school, all of us end up with some sort of bug.

[Sundagger]

Philip, you didn't include Regent on your list - if Crystal is a luxury line, Regent should be also. Regent has had one or more outbreaks in each of the past 3 years!!

 

Disney, with the reputation of being primarily child passengers, has no reports!!

 

I've often wondered at HAL's unfortunate representation on the Norovirus listings (current taxonomy is Norovirus, not NLV or Norwalk-like Virus). As you mention, the age situation isn't nearly as pronounced as legend has it, despite many posts on CC. I have noticed the S & R class ships, which usually have longer, more exotic itineraries, do attract an older population than the Vista class ships, but are not unduly represented, since there are 8 of them and only 4 Vista class.

 

I've also wondered at Carnival's success, since they have so many large ships. On the Carnival CC board, there are occasional threads about Norovirus. Often the sentiments of the posters is "I'll be damned if I report it and get quarantined". There may be more reporting by passengers on HAL than on Carnival, et al.

[steamboats]

steamboats,

 

Actually if you use Google, you can discover how many cases of norwalk were reported last year in Germany or just about any other country. Nearly every country in the world has reported some cases of NLV, but not nearly as many as in North America. If you dig deeper, you can even find out how many ships under any number of national flags had illness outbreaks - not just Norwalk illness, but many others as well. And with today's news reporting, any location on earth that has any significant illness problem is on CNN and BBC within the hour. When 1 baby in rural China was ill from Melamine contamination, the entire world heard about it the same day. Do you think that any cruise ship could have several hundred passengers sick with NLV - anywhere in the world - and keep it a secret?

 

But at the end of the day, I really don't care how many Germans -or any other nationality - had NLV last year.

I am only trying to discover why the luxury lines have so very few NLV outbreaks, when the mass market ships have so many.

 

Philip127,

 

Press only reports what they know about. Norwalk was no big deal over here in Germany. It was simply a stomach flu. Therefore no one thought it worth to report about (press wise). Norwalk is of course also pretty common on European river cruises. I never heard about local health authorities seizing and quarantining a ship until last year. It´s pretty unlikely that there haven´t been problems before - known by the health authorities. But no one reported about them until last year when that big wave hit Germany. I read reports on this website (river cruise board) from passenger hit by that virus and complaining on how the crew handled the outbreak. And I never read of any problems in the German press. I even googled the thing and nothing in the local newspapers or anywhere. Basing statistics on google search results doesn´t give a true picture.

 

Norwalk is still ragarded as no big deal over here. We are not used to hand sanitizers and you will rarely find them on river cruise ships (despite the fact that the sanitizers won´t help pretty much anyway as the stuff is not strong enough to kill Noro). From the river cruise board I know that passengers are complaining about the lack of sanity (based on their point of view). It´s simply still not regarded as a problem - unfortunately.

 

And river cruising in Europe might be regarded as a mass market because of the number of ships. But the ships are small ships for 100 - 200 passengers only (where a virus is spreading pretty fast). And regarding the cost of such a cruise (plus the flight) it´s more luxury cruising.

 

I´ve just checked the website of the Robert-Koch-Institut. In a 2007 report they write that the reported numbers are on the same level than the years before. But because of press reports people are more aware of this kind of disease. Therefore they feel it´s getting worse.

 

steamboats

[Philip217]

Sundagger,

 

Having worked for Regent, I know the company very well. Although they would like to be classified as luxury - and their fares are nearly in that category - they still catch the upper edge of the premium market, somewhat similar to Celebrity and HAL (where I have also worked). Regent is a lovely product - but essentially upper mass market with less nickel and diming.

 

Excellent point about Disney. Their ships are quite large, and nobody can deny that they cater to children - lots and lots of children.

 

As much as we would like to blame the children and large ships as the possible causes of NLV outbreaks, we need to look at Disney and Carnival. Both lines have large ships; both lines carry plenty of children. Both lines have nearly zero outbreaks.

So, those theories don't work.

 

The reporting frequency is something that is often discussed with CDC. If passengers don't admit to it, then ships won't know to report it. That idea works up to a certain point. But in a real outbreak situation, with passengers vomiting and having diarrhea, it is rather difficult to conceal. You need to be aware that Cabin Stewards on all the lines are trained to immediately report any incidences of vomiting or diarrhea in staterooms or public areas. In most cases, in those small cabins, the smell is quite unmistakable.

On EVERY cruise, I receive at least a dozen reports of vomiting and diarrhea in public areas and in cabins. Most of these cases are related to over-indulgence of some kind - but we take every one of them seriously and follow up with every passenger involved.

So, good theory, but in reality, even small numbers of infected passengers can't really hide it from us. So that theory doesn't really work either.

 

Someone mentioned the possibility that luxury lines might call at ports that have fewer health risks, or chances of infection. That is probably true at times, and not true at others. One of our biggest fears is calling at a port that was visited yesterday by an infected ship. Those infected passengers yesterday contaminated the gangways, terminal, tour buses, telephones, bathrooms, bars, restaurants, etc. Then our passengers contact the same surfaces and bring the bug back onto the ship with them. This happens quite frequently.

Better to visit ports that other ships do not visit, with lower risk of cross-contamination. But the small luxury ships visit a wide array of popular, and unknown ports. There is no predictable pattern. Sooner rather than later they would have to come in contact with a contaminated terminal and suffer the consequences. But that doesn't seem to happen. Why?

 

Back to the original questions:

 

What are the factors involved that result in so few NLV outbreaks on luxury ships, and so many outbreaks on mass market ships?

What can the mass market lines learn from the luxury lines to make your cruise healthier?

[cv322]

Nevermind...changed my mind about posting.

[ancldaca]

Probably part upbringing, part age related. If you were raised in a monied environment, you are more likely to have been instilled proper hygiene habits since the day you were born (because of more doctors visits who would admonish). Also, older generations have much better hygiene habits than us younger ones (I still recall the phrase my mother would scream before every meal "Essen ist fertig, Haende waschen" ("Food is ready, wash you hands") when I was a child). How many people still truly follow this BASIC concept nowadays???

 

Caveat: like any post dealing with generalities there are always many exceptions to the rule...

[navybankerteacher]

Probably part upbringing, part age related. If you were raised in a monied environment, you are more likely to have been instilled proper hygiene habits since the day you were born (because of more doctors visits who would admonish). Also, older generations have much better hygiene habits than us younger ones (I still recall the phrase my mother would scream before every meal "Essen ist fertig, Haende waschen" ("Food is ready, wash you hands") when I was a child). How many people still truly follow this BASIC concept nowadays???

 

Caveat: like any post dealing with generalities there are always many exceptions to the rule...

 

Seconded.

 

Cleanliness, on the parts of both passengers and ship's maintenance people, is obviously the key. Clean hands do not transmit viruses to mouth or nose; and frequently cleaned surfaces provide less opportunity for hands to pick up viruses.

[spongerob]

Disney, with the reputation of being primarily child passengers, has no reports!!

Disney has had outbreaks. One occurred during the time that the American press had their jaws firmly clamped on the NLV-cruise ship link and were doing their best to sensationalize the situation. Fox and CNN had reporters waiting dockside for disembarking passengers to comment live. This would likely have been 2004 or 2005. I clearly remember the stories and Mickey Mouse ears on the ship being displayed prominently in the lead up.

 

So that brings the kid factor back into play (and before someone flames me, we have friends and relatives with younger children who will freely admit that they bring home lots of bugs).

 

What are the factors involved that result in so few NLV outbreaks on luxury ships, and so many outbreaks on mass market ships?

Bigger ships. much greater numbers of passengers which increases the probability that someone will bring the disease on board, larger passenger turnover due to shorter sailings which again increases the probability that someone will bring it on board, a higher probability that if things got really bad that someone would be calling a newspaper or local TV anchor thus an incentive to be proactive in any potential outbreak situation, and larger numbers of children.

 

Luxury lines have a lower total number of passengers, and (seriously) passengers who are probably more likely to self-report an illness rather than try to hide it and avoid quarantine. Let's face it, lots of people who cruise mass-market lines have limited vacation time and are probably more likely to keep an illness secret if they can, since they don't want to lose 1 to 3 days in quarantine unless it's a really serious case. There are posts on the pages here where people have admitted to this.

 

What can the mass market lines learn from the luxury lines to make your cruise healthier?

(Philip, this next bit is tongue in cheek - but maybe there is some truth in humor.) Also, luxury lines often include adult beverages or at least wine at no additional charge. Everyone knows that alcohol is a preventative. So, mass market lines should give away adult beverages for medicinal purposes. My logic might be flawed, but I like the conlusion and I'm willing to be part of any on-board test! :)

 

A martini a day keeps the doctor away.

[Philip217]

spongerob,

 

I agree with most of your points.

I have also always suspected that higher numbers of children onboard equates to increased chances of illness onboard.

 

Disney and Carnival both carry extremely high numbers of children and have almost as few outbreaks as the luxury lines.

Princess, RCCL, and NCL also carry high numbers of children - but not as many as Disney and Carnival - and have many outbreaks.

Why would that be the case?

 

I also believe that the self-reporting of illness is probably far more honest on the luxury lines than it is on the mass market lines. But if that is true, it would increase - not decrease - the numbers of reported outbreaks on the luxury lines. Remember that we need only 3% total reporting ill to classify an outbreak. On a typical Sea Dream cruise there are only 50 or 60 pax onboard. One passenger reporting ill is sometimes more than 1%. Just 3 pax feeling ill would cause it to be reported as an outbreak.

But it has never happened there. Why?

[momofmeg]

How quick after being infected do you get this virus? We debarked Sunday morning the NCL Pearl, and last night I had a violent attack from both ends- but it last only a few hours, I am better today. Could I have had Norwalk?

 

One thing I can say, they were CONSTANTLY cleaning on the ship and had the alcohol spray with an employee spraying your hands as you entered the lido. I used it every time, but I did see a few jerks who refused. I could not help but wonder if it helped any when you had the jerks who would NOT use it.

 

Perhaps it should be a policy to refuse admittance to those who refuse to have their hands sprayed.

[happy cruzer]

Good point about the length of the time before the Noro is apparent.

 

Regarding the low reports for Carnival -

 

Carnival has alot of short cruises. Many folks would not know they are sick till reaching home.

 

Carnival also has a high percent of home port cruisers. Many folks report suspecting that they got Noro on a plane on the way to the cruise.

 

This issue would take tons of scientific research to determine the cause for the way the statistics look. It may just be a reporting anomoly. I don't think there is a very scientific approach to tracking this illness it would be very expensive and the net result would be a warning to wash your hands frequently.

[Philip217]

momofmeg,

 

Unfortunately the hand sanitizers used by the cruise lines do not kill norwalk Virus.

 

In fact, the CDC has advised cruise lines to stop offering the hand sanitizer everywhere as it tends to reduce the number of times that people wash their hands.

 

Several cruise lines have stopped the use of hand sanitizers onboard - and the number of NLV outbreaks on their ships dropped sharply.

The cruise lines that chose to continue with the sanitizers have not seen any reduction in outbreaks.

 

This could be an amazing coincidence - or not.

 

But as happy cruzer points out, the best solution always is to wash your hands frequently.

[Philip217]

Good point about the length of the time before the Noro is apparent.

 

Regarding the low reports for Carnival -

 

Carnival has alot of short cruises. Many folks would not know they are sick till reaching home.

 

Carnival also has a high percent of home port cruisers. Many folks report suspecting that they got Noro on a plane on the way to the cruise.

 

This issue would take tons of scientific research to determine the cause for the way the statistics look. It may just be a reporting anomoly. I don't think there is a very scientific approach to tracking this illness it would be very expensive and the net result would be a warning to wash your hands frequently.

 

happy cruzer,

 

Excellent points all around.

Carnival's shorter cruises could help explain their very low number of outbreaks.

But the luxury lines have generally longer cruises, and still have almost zero outbreaks.

 

The home port idea also makes sense for Carnival. The CDC also tells us that most NLV infection happens on the way to the ship, not after you board.

 

But if Carnival has so many home port pax and suffers less as a result, why is it that RCCL and NCL, who also have many home port pax, have rather high numbers of outbreaks?

 

Nobody can argue that the best solution -as you advise - is to wash your hands frequently. I have been doing exactly that for 3 decades on many infected ships. Not once have I contracted NLV.

But unfortunately, when so many of today's cruisers have been raised by wolves, personal hygiene is not at the top of the list.

[Terpnut]

Has anyone even bothered to question whether the basic supposition that the luxury cruise lines have fewer incidents of NLV outbreaks is even statistically valid? I haven't looked at the data, but does the OP's analysis consider that the mass market lines simply sail an exponentially greater number of cruises with an order of magnitude more passengers? I haven't seen anything statistically that shows that I am less likely to experience a norovirus outbreak cruising on Regent or Seven Seas versus Carnival or RCI. Basically, an assertion has been made without any numbers to back them up, and we're all now speculating on the reasons?

[steamboats]

momofmeg,

 

Symptoms show after 48 - 50 hours after the infection and you´re already infectous without even knowing. The symptoms last for about 48 hours. Then you´re still infectous for about 10 more days. That´s why it´s so hard to get rid of this virus.

 

And yes, those hand sanitizers are nice but they can´t kill the virus. You have to use much stronger stuff like chlorine to get rid of it. Buffets are a great way to spread the virus and should be immediately closed when an outbreak occurs.

 

steamboats

[Philip217]

Has anyone even bothered to question whether the basic supposition that the luxury cruise lines have fewer incidents of NLV outbreaks is even statistically valid? I haven't looked at the data, but does the OP's analysis consider that the mass market lines simply sail an exponentially greater number of cruises with an order of magnitude more passengers? I haven't seen anything statistically that shows that I am less likely to experience a norovirus outbreak cruising on Regent or Seven Seas versus Carnival or RCI. Basically, an assertion has been made without any numbers to back them up, and we're all now speculating on the reasons?

 

Terpnut,

Excellent point. You haven't looked at the data - but you SHOULD. So should everyone else who wants to book a cruise. The data is free. Go to http://www.cdc.gov and make a search for Vessel Outbreak Summary. There you can access all outbreak records and reports for the past 15 years. For each one, you can read the entire report, including number of crew and pax ill, suspected or confirmed cause of illness, and length of time the outbreaks lasted. This information is quite educational.

 

The numbers and statistics are hopefully valuable to us if we can spot trends, timelines, particular groups, or any other factor that appears to keep one group of ships healthy, or another group ill. If one of the 390,000 registered Cruisecritic members reads this thread and comes up with an idea or theory that nobody else has yet discovered, we could possibly benefit from it.

 

The actual numbers of reported outbreaks are hopefully valuable to those who want to book a cruise and make every attempt to avoid illness.

 

If I have the choice of booking a mass market cruise, where the lines average one major outbreak every month for the past 15 years - or a luxury cruise, where the lines average one small outbreak once every 4 years over the past 15 years, I will definitely book the luxury cruise.

 

By the way, "Regent" and "Seven Seas" is the same cruise line. Regent (formerly Radisson Seven Seas) isn't really a luxury line. They are owned by a large mass market catering and investment company, called Apollo. Even their own website describes them as "upper premium", the same description you often see given to Celebrity and HAL. And like Celebrity and HAL, Regent (Radisson Seven Seas) has had quite a few outbreaks reported over the past 15 years.