Is Norwalk a "Class Disease"?

[momofmeg]

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

 

Okay, mine must have been food poisioning and nothing to do with my cruise. My sympthoms were very strong but it lasted only for about 3 hours. As severe as my attack was though, if it had lasted any longer, I would have had to go to the emergency room.

 

I have ALWAYS washed my hands after using the bathroom and before eating. I just liked the idea of the alcohol spray as an extra "helper".

 

One thing that surprised me though was the Pearl's public bathrooms had only cold water for washing your hands. I always heard you need to wash your hands in HOT water to kill bacteria. I think they should correct that.

[Philip217]

momofmeg.

 

Hot water is always better than cold when cleaning hands.

Hot water kills some bacteria.

 

But you should know that Norwalk is not a bacteria. It's a virus.

 

Water hot enough to kill a virus would take the skin off your hands.

 

When we recommend that you wash your hands well and often with soap and water to avoid NLV, the idea is to wash the NLV spores off your hands and down the drain.

[Terpnut]

 

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.

 

My point is: Is an outbreak every month for the past 15 years on the mass market cruise lines actually mean that a passenger is more likely to get norovirus than one outbreak every 4 years on the luxury cruise lines? IOW, if the mass market cruise lines collectively haul 60x the passengers, then they would have 60x the number of sick incidents. And if that is so, doesn't that make your basic conclusion that one is less likely to get the norovirus on a luxury cruise statistically invalid?

 

You seem to have made your conclusions based on the invalid notion that the absolute number of ship-based outbreaks instead of the statistically more valid number of sick passengers per cruise day sailed. Please correct me if I am wrong.

 

The only question that really matter is: Is a cruise passenger statistically significantly more likely to get norovirus sailing on a Carnival ship than a Crystal ship? I haven't see you put forth any data or information that says the answer is yes.

[momofmeg]

momofmeg.

 

Hot water is always better than cold when cleaning hands.

Hot water kills some bacteria.

 

But you should know that Norwalk is not a bacteria. It's a virus.

 

Water hot enough to kill a virus would take the skin off your hands.

 

When we recommend that you wash your hands well and often with soap and water to avoid NLV, the idea is to wash the NLV spores off your hands and down the drain.

 

I still think public bathrooms should have hot water. Perhaps it isn't strong enough for a virus, but I feel better about it, I feel "cleaner" when I wash my hands with hot water.

[Philip217]

Terpnut,

I am trying to look at this issue from:

 

1. The viewpoint of a prospective passenger. Most people who book a cruise really don't care how many people get sick, or what percentage get sick, or how often. They just want to ensure that they don't get sick and ruin the vacation that they have been planning and saving for, for such a long time.

Should they book a mass market cruise where at least one mass market ship has an outbreak every month of the year (on average over the past 15 years)?

or

Should they book a luxury cruise where one ship has an outbreak every 4 years (on average over the past 15 years)?

 

2. The viewpoint of the operation. People vomiting and having diarrhea all over my ship for one or two weeks is not a good thing. For the past 15 or 20 years we have been trying to determine how and why some ships and some cruise lines are CONSISTENTLY able to avoid this and others are not.

 

There are many theories.

Some blame children.

Some blame older cruisers.

Some blame lower scoio-economic groups of passengers.

Some blame nationalities.

Some blame different chemicals used for cleaning.

Some blame size of ship.

Some blame length of cruise.

Some blame airlines and hotels.

Some blame hand sanitizers.

Some blame not using hand sanitizers.

 

At the end of the day, most cruise lines use the same chemicals and cleaning protocols.

Most cruise lines carry the same demographics most of the time.

Most cruise lines have the same average length of cruise.

 

Have the luxury cruise lines just been incredibly lucky for the past 15 consecutive years?

Have Carnival and Disney just been incredibly lucky for the past 15 consecutive years?

 

Have HAL, NCL, Princess, and RCCL just been incredibly unlucky for the past 15 consecutive years?

 

Or is there something behind these numbers that can tell us:

1. How to fix the problem for those cruise lines that have such poor records.

2. How to choose the best cruise line to avoid getting sick as a passenger.

[navybankerteacher]

Choosing the line is not as important a factor as choosing to wash your hands. Disinfectant soiunds good, and hot water feels better, but any soap and any water get the viruses off your hands and down the drain; while disinfectant can't, and water is never hot enough to, kill a virus.

 

The fact is that most people who come down with the virus have infected themselves - transmitting the virus with their own hands from a tainted surface to their face. You should always have a couple of clean paper towels or kleenex with you - touching the bathroom door handle on your way out after a careful washing will probably negate that washing.

[Terpnut]

Terpnut,

I am trying to look at this issue from:

 

1. The viewpoint of a prospective passenger. Most people who book a cruise really don't care how many people get sick, or what percentage get sick, or how often. They just want to ensure that they don't get sick and ruin the vacation that they have been planning and saving for, for such a long time.

Should they book a mass market cruise where at least one mass market ship has an outbreak every month of the year (on average over the past 15 years)?

or

Should they book a luxury cruise where one ship has an outbreak every 4 years (on average over the past 15 years)?

 

2. The viewpoint of the operation. People vomiting and having diarrhea all over my ship for one or two weeks is not a good thing. For the past 15 or 20 years we have been trying to determine how and why some ships and some cruise lines are CONSISTENTLY able to avoid this and others are not.

 

There are many theories.

Some blame children.

Some blame older cruisers.

Some blame lower scoio-economic groups of passengers.

Some blame nationalities.

Some blame different chemicals used for cleaning.

Some blame size of ship.

Some blame length of cruise.

Some blame airlines and hotels.

Some blame hand sanitizers.

Some blame not using hand sanitizers.

 

At the end of the day, most cruise lines use the same chemicals and cleaning protocols.

Most cruise lines carry the same demographics most of the time.

Most cruise lines have the same average length of cruise.

 

Have the luxury cruise lines just been incredibly lucky for the past 15 consecutive years?

Have Carnival and Disney just been incredibly lucky for the past 15 consecutive years?

 

Have HAL, NCL, Princess, and RCCL just been incredibly unlucky for the past 15 consecutive years?

 

Or is there something behind these numbers that can tell us:

1. How to fix the problem for those cruise lines that have such poor records.

2. How to choose the best cruise line to avoid getting sick as a passenger.

I think you're still missing my point. Based on the CDC and cruise industry passenger numbers (and I have looked at them now!), it's evident to me that you are not much more likely, or even more likely, to get sick on cheap Carnival cruise than you are on an expensive luxury cruise! You must consider the number of cruises, the number of cruise days, the total number of passengers, the number of passengers affected in each incident. So what does lucky or unlucky have to do with anything?

 

Carnival alone, for example, handles almost 30 times the number of passengers than Crystal. Thus, all other things being equal, they should have 30 times the number of norovirus incidents or sick passengers. To make conclusions based solely on the absolute number of ship incidents, instead of per passenger illnesses, is like concluding that people are more likely to trip on pink rugs than beige rugs--there are simply far fewer pink rugs!

 

Looked at another way, the number of sick passengers reported to the CDC number in the several thousands of the over 12M people cruising each year. That means that your overall odds of getting sick are something like 1 out of 250,000 of getting sick on any cruise ship. And even if you proved that there was a difference between one line and another, or between luxury versus "mass market" cruise lines, it is very close to being statistically irrelevant.

 

As Benjamin Disraeli once said, there are "lies, damned lies, and statistics".

[momofmeg]

Choosing the line is not as important a factor as choosing to wash your hands. Disinfectant soiunds good, and hot water feels better, but any soap and any water get the viruses off your hands and down the drain; while disinfectant can't, and water is never hot enough to, kill a virus.

 

The fact is that most people who come down with the virus have infected themselves - transmitting the virus with their own hands from a tainted surface to their face. You should always have a couple of clean paper towels or kleenex with you - touching the bathroom door handle on your way out after a careful washing will probably negate that washing.

 

One thing I liked on the Pearl is they had a small trashcan by the door. That way you could open the door with your paper towel covering your hand and then throw it away as you go out.

[Philip217]

momofmeg,

Since 2006, the CDC has required ALL cruise ships that call at US Ports or have offices in the USA to install trash receptacles within reach of all public bathroom doors.

[luvscruising2007]

On RCL, my only experience, the buffet is self-serve. How are buffets handled on other ships. Do they have a crew member serving, or are they also self-serve.

I was also thinking that it may be the life style one has at home that contributes to the statistics. Perhaps, passenger of the luxury lines are exposed to Noro less, and therefore, they are less likely to bring this virus on board.

And let's face it, older people have had a longer time to build their immune systems. They are also likely to have compromised immune systems from other illnesses, and advanced age. I guess these two thoughts contradict each other.

Philip, I think you have raised a good question and that the CDC should look at it to get ideas on how this virus is really spread.

[BruceMuzz]

I think you're still missing my point. Based on the CDC and cruise industry passenger numbers (and I have looked at them now!), it's evident to me that you are not much more likely, or even more likely, to get sick on cheap Carnival cruise than you are on an expensive luxury cruise! You must consider the number of cruises, the number of cruise days, the total number of passengers, the number of passengers affected in each incident. So what does lucky or unlucky have to do with anything?

 

Carnival alone, for example, handles almost 30 times the number of passengers than Crystal. Thus, all other things being equal, they should have 30 times the number of norovirus incidents or sick passengers. To make conclusions based solely on the absolute number of ship incidents, instead of per passenger illnesses, is like concluding that people are more likely to trip on pink rugs than beige rugs--there are simply far fewer pink rugs!

 

Looked at another way, the number of sick passengers reported to the CDC number in the several thousands of the over 12M people cruising each year. That means that your overall odds of getting sick are something like 1 out of 250,000 of getting sick on any cruise ship. And even if you proved that there was a difference between one line and another, or between luxury versus "mass market" cruise lines, it is very close to being statistically irrelevant.

 

As Benjamin Disraeli once said, there are "lies, damned lies, and statistics".

 

And as many others have said, "Those who refuse to learn from past mistakes are destined to repeat them". Wouldn't it be great if we could take all this free information (paid for by our tax dollars) on the history all this illness and come up with a solution to a problem that gets worse with every passing year?

[cruise kitty]

It always amazes me when people make comments regarding children and illness. It's not like they are walking germ-fests. I think they get sick more easily because they have not built up as much immunity as adults, not because their little hands and feet get dirty from playing. No need to fear them.quote]

 

Having raised 2 of little darlings (and worked in a kindergarten class for 8 years) I can tell you that many kids are in fact, 'walking germ fests' Not all parents teach their kids to wash with soap and warm water every time they use the restroom, & before they eat. Not all parents teach their kids to use a tissue instead of their hands or clothes for a sneeze. Before lunch I used to line up the kids to wash their hands, they all had to pass the "smell like soap" test, or it was back for a second washing (private school, I had the leeway to do this) On Friday 'cooking day', I never ate any of the little treats that we whipped up together, I spent 6 hours a day with those kids and knew exactly where all their grubby little hands had been! By the way, of course, MY kids were clean perfect, & germ free lol! ;)

As another poster said, wash your hands people!!!

[galipemi]

Ok, it might not be popular, but I do have an opinion on the lower reported cases.

 

In order to declare an outbreak of Norovirus, the ship must have 3% of pax and/or crew ill. That's assuming that the medical center "decides" that it is Noro. There is very little that can be done for Norovirus, basically you are quarantined for 24-48+ hours and given fluids if you're badly dehydrated. Sounds like the symptoms of a couple of other very mainstream illnesses. I know of several crew members who have had Norwalk and when they told medical were quarantined for a few days but never listed as Norwalk because it was a cold, or the flu or any one of a list of other things. The stool test was never done, for several reasons. 1. the test takes approx 3 days (so I heard from Medical)

2. if the test is positive, it must be reported on our daily NLV list

3. crap, now that case will count for overall illness

 

So, I'm just theorizing here, but is it possible (or more likely probable), that some cruise lines are more conscientious when it comes to investigating and reporting the disease thus making their incidences look much higher statistically?

 

Again, just a theory.

[Terpnut]

So, I'm just theorizing here, but is it possible (or more likely probable), that some cruise lines are more conscientious when it comes to investigating and reporting the disease thus making their incidences look much higher statistically?

Your point is well taken, however as I said in my earlier posts, no one ever actually provided any evidence or facts that passengers sailing on any particular cruise line or on "mass market" cruise lines in general, are more prone to get norovirus. The absolute or total number of "incidents" is meaningless unless one puts it in context by including the total number of passengers or customers. So I submit that this whole thread is alot of speculating over reasons or solutions for a problem that does not exist. :rolleyes:

[brnsofia]

we sailed on royal carribean mariner of the seas in june of this year and oh my was the

norwalk virus rampid! everyone on the ship has someone sick or who was over it. the doctors office was full and only after the many announcements of the virus going through the ship from the captian did they really start cleaning the ship. when we docked the captian said the whole ship from top to bottom had to be scrubbed down. my hubby got it and they wanted me quarantined in the room with him??!!! I think not! I checked on him but I wasnt going to spend any extra time with him! badf enough he had it all night. the next morn we went to the doctor to get anti puke and diaherra med and they told me to stay in the cabin. haha- dont think so I went and layed in the sun and burned all the germs away!! never did get it. but the elevators button areas were always dirty and sticky and rails on stairs etc only after it got bad did they clean those areas often. we learned to use our elbows more for things!

[quincytoo]

One thing I liked on the Pearl is they had a small trashcan by the door. That way you could open the door with your paper towel covering your hand and then throw it away as you go out.

 

I always try to do this, this is a good idea.

[Terpnut]

...we learned to use our elbows more for things!

I have been using my elbows and paper towels (basically your hands and fingers should avoid touching anything other people routinely use!) since I can remember. This is a good practice everywhere you go--even in your own house is someone else is sick.

[lovesublime]

I'm NOT proposing that wealthy cruisers are cleaner than mass market cruisers.

I'm NOT proposing that wealthy cruisers have better immune systems that mass market cruisers.

But I AM asking, "Why is there such a difference"?

I don't have an answer.

That's why I posted this on the "Ask a Cruise Question" page.

 

I have been asked on many occasions why it is that the luxury ships have far fewer outbreaks than mass market ships. The numbers reported by CDC certainly support that fact.

 

On a luxury cruise ship that carries 100 pax and 100 crew, a total of 6 passengers and crew need to get ill to qualify for an outbreak. You would think that this would happen very often. But it has only been recorded 4 times in 15 years.

 

The large mass market ship I work on has a minimum 20 or 30 sick with Norwalk every week of the year. These are normal baseline numbers for large ships.

 

On a mass market ship that carries 5000 crew and pax, it's not an outbreak until at least 150 are sick. But when you look at the summary reports, this happened 195 times from 1994 - 2008.

 

We know that 10% of the American population is suffering from NLV.

We know that the majority of cruise passengers are American.

We know that the majority of luxury line pasengers are American.

We know that the majority of mass market line passengers are American.

 

Having worked for some of the luxury lines, we used the same chemicals and cleaning procedures there that we use on the mass market lines.

Although there is more public space per pax on the luxury lines, passengers there are usually restricted to a single restaurant, only 1 or 2 bars, only a very few public toilets, only one or two elevators. In theory they would face higher chances of contamination when everyone must use the same facilities.

 

Although a luxury ship has a higher ratio of total crew to passengers, a mass market ship has a higher ratio of housekeeping crew to passengers. The housekeeping crew do most of the sanitizing. In theory, they should be able to do a better job on a mass market ship, with all the extra manpower to do the job. Once again, ALL the ships use the same chemicals and cleaning procedures.

 

So back to my original questions.

Why is it that the luxury lines have so few outbreaks compared to the mass market lines?

 

 

Hey, it looks like you've taken the opportunity, once again, to 'bash' Americans ( specifically "middle Americans", a term you're very fond of) But you know what, I'll take my chances with Noro like virus anyday over Avian flu, Ebola, HIV etc.

[Happy ks]

It always amazes me when people make comments regarding children and illness. It's not like they are walking germ-fests. I think they get sick more easily because they have not built up as much immunity as adults, not because their little hands and feet get dirty from playing. No need to fear them.quote]

 

Having raised 2 of little darlings (and worked in a kindergarten class for 8 years) I can tell you that many kids are in fact, 'walking germ fests' Not all parents teach their kids to wash with soap and warm water every time they use the restroom, & before they eat. Not all parents teach their kids to use a tissue instead of their hands or clothes for a sneeze. Before lunch I used to line up the kids to wash their hands, they all had to pass the "smell like soap" test, or it was back for a second washing (private school, I had the leeway to do this) On Friday 'cooking day', I never ate any of the little treats that we whipped up together, I spent 6 hours a day with those kids and knew exactly where all their grubby little hands had been! By the way, of course, MY kids were clean perfect, & germ free lol! ;)

As another poster said, wash your hands people!!!

 

 

I work at an elementary school, I see what kids do every single day and I do see how dirty their hands get. But, I'd not trust an adult to be any more germ-free than a child when they are sick. I see adults many times sneeze into their hands, not wash after using the restroom, rub their noses or eyes, or even scratch themselves....then put their hands onto surfaces we all touch.

 

I'm not a germaphobe in any way, I don't believe we can hide from germs, I simply don't abide by the erroneous thought that children are any more germy than many adults are.

 

I wash a lot more than most people do, just the nature of my employment working with special needs and needing to assist with nature's calls and feeding times. I still catch the occasional cold, rarely norovirus (probably not for over 15 years), it's just as likely I catch it from the middle aged man in front of me in the checkout at the grocery store as a kid at school.

[beachchick]

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...

 

Yes, these are definitely generalities with no real valid data to back them up. Older generations have better hygiene habits? Please give us your sources for this. Everyone I know still reminds their kids to "wash up for dinner," etc. I think it an utter fallacy that a "monied environment" means someone is more likely to have "instilled proper hygiene habits" than someone of lesser means.

 

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?

 

Your premise is based on your personal belief based on what? That people who cruise luxury lines are somehow "better" people and therefore, would be more likely to self-report illness than the rest of us lowly folks? Please give us factual data to verify this and not just your obvious bias against the "lower classes." I dispute your notion that those who cruise on luxury lines, whether they are wealthy or whether they're not but have saved for a long time for the splurge, are more honest than other people. In fact, it's down right insulting.

 

beachchick

[momofmeg]

Well I may have had a bug from the ship after all. It is going around here an dmost are ill less than 24 hours. If the virus takes 48 hours after exposal to show, that means I caught it on ship.

 

I must say though, that the Pearl was one of the cleanier ships that I have cruised-oh well-that just goes to show-no matter what-it still happens.

[cruisemamma99]

I do think OP has a point, and I don't find this a ridiculous query at all.'

When you have paid $2000-3000 for a cruise, who wants it ruined with a case of Norwalk?

 

Mass market cruises have become more affordable for families. If you check statistics, Noro virus hits daycare, schools just as much if not more than cruise ships. But there is no law mandating that they have to report it or keep statistics on it. Children are not as cleanly as adults. More children on a cruise ship holding 2000-3000 people is going to spread in an instant. Then add in the adults that wipe their behinds, don't wash their hands, then come out to the buffet line, and you a have a disaster waiting to happen.

 

I don't think you will see as many families on the luxury lines, therefore it is easier to advise the passengers & crew of proper procedures, even if an outbreak does occur, it would be easier to contain. JMO!

 

 

I agree with you, its like saying ones class doesn't affect education, health or finances. There are big differences and the OT is nicely pointing out what some might not be aware of.

[spongerob]

I saw this today on Drudge. It puts this discussion into a different perspective. Noro appears to be running rampant in the UK.

 

http://www.express.co.uk/posts/view/75741/Killer-virus-grips-Britain

[nilsbyy]

I'm extremely interested in epidemiology. After a long look at the CDC's outbreak reports, I noticed that there are a handful of ships that show up over and over --- the Seven Seas Mariner is one of them, also the Ryndam. Does anyone know if either of these ships serves an itinerary that might make it vulnerable to outbreaks?

 

Also, I would consider the possibility that many lower-income passengers may have jobs that bring them in contact with many people in the course of a day (I'm thinking jobs in service or retail, teaching jobs, office jobs with lots of coworkers, and such), increasing their odds of picking up the virus.

[happy cruzer]

I posted to this thread fairly early stating that Carnival may not report many cases of noro because of the short duration of the cruises.

 

I doomed DH and myself. On our cruise last week. He got noro on the last full day of the cruise and had recovered for the disembarc and drive home. I got it the night we got home. No reports made. When DH was sick for the first 10 hours we were certain it was just a case of overindulgence ( two servings of lamb at dinner), then once we thought of noro it was so close to the time he should feel better, we just stayed in the cabin and sure enought he got better right on the 24 hours.

 

So there's one data point that was missed for the statistics. No flames, please.