Norovirus outbreaks surging on cruise ships this year

Table Of Content

• CDC ship illness outbreak investigations
• Cases Rise, Criticism Mounts, but Ships Keep Cruising
• Norovirus outbreaks on cruise ships surge to decade-high levels: How to avoid the stomach bug
• What is cruise ship norovirus?
• CDC cruise ship Norovirus reports
• Outbreaks 2017 reports

Centers for Disease Control and Prevention, which keeps a record of annual case counts dating back to 1994. Norovirus cases aboard cruise ships were on a steady decline between 2006 and 2019, according to CDC data. When the Covid pandemic hit, the CDC made a travel health notice advising against cruise ship travel.

CDC ship illness outbreak investigations

In humans, Zika virus causes the Zika fever which is known to occur only within some equatorial regions. In 2014, Zika spread across the Pacific Ocean to French Polynesia, and soon to Easter Island. In 2015, Zika virus reached Central America, the Caribbean, and South America. In February 2020, the shipowner cruise company Lindblad Expeditions announced the "Premium Purity" program with a shipwide cleaning system based on ACT CleanCoat technology.

Cases Rise, Criticism Mounts, but Ships Keep Cruising

So far, cruise lines have reported 13 separate norovirus outbreaks to the CDC through the six months ending in June. It’s the most number of reported norovirus outbreaks on cruise ships since 2012, when there were 16. It's a very common, highly contagious, ruthlessly efficient and uncomfortably bad virus affecting the stomach and large intestines. Often called "stomach flu" (the med term is "Gastroenteritis") the infection results in massive vomiting and diarrhea.

Norovirus outbreaks on cruise ships surge to decade-high levels: How to avoid the stomach bug

Cruise ship cabin study reveals optimal airflow to curb virus spread - News-Medical.Net

Cruise ship cabin study reveals optimal airflow to curb virus spread.

Posted: Sun, 05 Nov 2023 07:00:00 GMT [source]

Cruise illness issues often result in lower booking rates and cheaper prices - which is bad for the business. Summer travel has returned and people are flocking to cruises again, with more than 31.5 million passengers expected to sail in 2023. Based on the math, you have less chance of catching a gastrointestinal illness on a ship than at many places you're likely to visit on land. Additionally, the CDC's Vessel Sanitation Program, implemented in the 1970s, subjects all passenger ships carrying 13 or more people to random, unannounced inspections if they wish to call on ports in the United States. Typically, norovirus lasts for one to three days, though you can spread the illness for a few days after. Moreover, the cruise industry often finds itself under scrutiny following an outbreak, which can affect the public’s perception and willingness to book cruises, ultimately impacting the industry’s bottom line.

What is cruise ship norovirus?

What causes Norovirus on cruise vessels is mainly contaminated food/water. When it comes to ships, it spreads mostly through physical contact with sick people or handling contaminated objects. This includes sharing food/utensils and poor hygiene (not washing hands after bathroom use). The virus also spreads fecally, so you can catch it into the onboard laundry, or while changing diapers, etc. However, many passengers likely can blame a sick crewmember for the virus. According to a survey based on 170 inspection records on ships that docked in Florida ports in 2012, on 59 cruises violations of the required illness reporting laws were reported.

Princess Cruises reported its first outbreak of the year in February, and Royal Caribbean International reported two the previous month. P&O Cruises also reported an outbreak on its Arcadia cruise ship this year. The most recent outbreak hit passengers and crew members on board a Viking Cruises trip from Iceland that docked in New York on June 20. More than 13% of passengers on the Viking Neptune — 110 of 838 in total — reported being ill while onboard, according to the CDC.

That was the first Mr. Suphan heard about the virus spreading on the ship. If you haven't cruised since before the pandemic, you might be surprised by how many new health- and safety-related policies cruise lines have implemented to keep COVID-19 off ships. Centers for Disease Control and Prevention reported that 5,013 COVID-19 cases had been reported on cruise vessels operating in U.S. waters during the last two weeks of the month, up from just 162 cases during the first two weeks of the month.

Why is Norovirus a problem on Cruise Ships?

All foreign-flagged cruise ships that carry at least 250 passengers must abide by the order and provide the CDC access to their vessels and passenger health records upon request to ensure compliance. Cruise lines that fail to secure a Covid-19 Conditional Sailing Certificate from the CDC will be barred from operating in U.S. waters. Many passengers and media reports, including those from CNN and Euronews, said authorities of a few ports in the Caribbean, Puerto Rico and Mexico disallowed passengers to disembark from cruise ships that were carrying active Covid-19 cases. When COVID-19 is detected on a ship, cruise lines sometimes then test passengers multiple times to ensure it isn't spreading.

As part of the program, ships are required to adhere to stringent health and safety protocols that dictate everything from the cleaning of high-touch areas to how food is stored in freezers, refrigerators and galleys. They ask passengers who feel ill during their cruises to report symptoms to the medical center and keep themselves isolated in their cabins. “We believe the gastrointestinal illness originated from a shoreside restaurant in Iceland where a group of guests dined during their free time,” the cruise line said in a statement.

Sickness outbreaks are considered as such if the percentage of infected people is over 3%. It hits 1 in 5 people annually and is the cause of ~50% of all foodborne illness outbreaks in the USA and for ~90% of all non-bacterial gastroenteritis worldwide. Norovirus spreads easily in close quarters, such as those found on cruise ships. Thirteen ships so far this year have reported outbreaks of the highly contagious stomach bug, the most since 2012, according to the U.S. Nearly 1,700 passengers have come down with the virus, which causes vomiting, nausea, diarrhea and stomach pain. Not only does it take the joy out of vacation, keeping passengers confined to their stateroom, but for older travelers, there’s a concern of dehydration, doctors say.

▪ Norovirus is the “leading cause of vomiting and diarrhea and food-borne illness in the United States,” with more than 2,500 norovirus outbreaks reported every year, according to the CDC. That means data for norovirus on cruise ships is more readily available than for other entities. It's easy to make norovirus case numbers sound alarming, but context matters. For example, 100 cases on a single ship might seem like a lot, but on a vessel like Oasis of the Seas, which carries more than 5,400 passengers, 100 cases are only about 2% of the onboard population.

The total number of infected was 2570 (of those 2458 passengers and 112 crew). In 2016, the number of reported illness outbreaks on cruise ships was 23. The total number of infected was 2504 (of those 2378 passengers and 126 crew). In 2017, the number of reported illness outbreaks on cruise ships was 21.

The U.S. Centers for Disease Control and Prevention has also identified more than 85 cruise ships with Covid-19 cases on board, the agency said on Tuesday. On Dec. 30, the CDC added cruise ships to its list of "Level 4" destinations you should avoid visiting for now due to high levels of COVID-19. A growing number of cruise lines are canceling sailings on short notice, citing the disruptions caused by COVID-19. The world's largest cruise operator Royal Caribbean on Friday canceled soon-to-depart sailings on four of its 25 ships, including the next three departures of the world's largest ship, Symphony of the Seas. Notably, all 92 cruise vessels currently operating in U.S. waters have recorded at least a handful of COVID-19 cases in recent weeks, according to CDC data.

▪ While the virus has garnered the nickname “cruise ship virus,” in reality, norovirus outbreaks on cruise ships account for only 1% of all reported norovirus outbreaks, the CDC says. In fact, acute gastrointestinal illness is fairly uncommon on cruise ships, the agency says. The threat of norovirus on cruise ships is a serious issue that has both health and economic impacts. The confined environment of a cruise ship, combined with the virus’s highly contagious nature, creates a significant challenge. It’s crucial for cruise lines, passengers, and health officials to remain vigilant, proactive, and informed to prevent and contain potential norovirus outbreaks. Workers also directed sick passengers to isolate themselves in their rooms, a Princess Cruises spokesperson said.

Norovirus Outbreaks Surge on Cruises: Here's How to Avoid the Bug

Table Of Content

• Using a Smartphone to Detect Norovirus (Winter Vomiting Bug)
• How does norovirus spread on cruise ships?
• Why are acute gastrointestinal illnesses including noroviruses associated with cruise ships?
• Norovirus outbreaks on cruise ships
• Credit Card Reward Programs
• Environments Where Norovirus Spreads Quickly

According to the Centers for Disease Control and Prevention, there are 19 to 21 million cases of vomiting and diarrhea illnesses caused by norovirus each year. The Ruby Princess has made headlines in the past as the site of several COVID-19 outbreaks, including a 2020 cruise early in the coronavirus pandemic that docked in Australia with hundreds of positive cases on board. As 95 of the world's top 100 largest megapolises are port cities, "hospital ships" could provide healthcare very quickly and more efficiently to large numbers of people. The crew serves with short-term (2 weeks to 2 years) and long-term (min 2 years) contracts. Volunteer crew members occupy both medical (surgeons, dentists, nurses) and general jobs (deckhands, seamen, engineers, machinists, electricians, teachers, cooks, welders, plumbers, agriculturalists.

Using a Smartphone to Detect Norovirus (Winter Vomiting Bug)

Several ships recently had to skip port calls in Mexico, for instance, after passengers and crew on board the vessels tested positive for COVID-19. The ports have since reopened after Mexico's Health Department overruled the decisions of local port officials. In total, 284 of 2,881 passengers on the Ruby Princess reported being sick during the voyage between Feb. 26 and March 5, CDC investigators said, and 34 of the 1,159 crew members also reported illness. Norovirus is a highly contagious virus often described as a “stomach bug,” the generic description of the leading cause of nausea, diarrhea, stomach pain and vomiting in the U.S., according to the Centers for Disease Control and Prevention. The most common symptoms of norovirus are vomiting, nausea, diarrhea and abdominal pain, Dr. Albert Ko, infectious disease physician and professor of public health, epidemiology and medicine at Yale School of Public Health, tells TODAY.com. However, unlike on land, most basic travel insurance policies don't cover medical treatments on cruise ships as they are not from the patient's primary caregiver.

How does norovirus spread on cruise ships?

Lines also are dealing with a small but growing number of destinations -- India and Hong Kong, for example -- that are at least temporarily closing to cruising completely, even for ships where no one has tested positive for COVID-19. If anything, the positivity rate is far lower on ships than on land, thanks to much stricter health protocols (more on that in a moment). Royal Caribbean Group's eradication program is certainly a positive step, but if you're still worried about catching norovirus, the risks are low. The team reviewed public health trends and past areas of concern to come up with recommendations to do better. The CDC's Vessel Sanitation Program epidemiologists and environmental health officers responded to the ship when it docked in Galveston, Texas on March 5, the agency said.

Why are acute gastrointestinal illnesses including noroviruses associated with cruise ships?

About 13% of its passengers and several crew members became ill with the virus while on board. Such viral/bacterial outbreak incidents affect the vacation experience of thousands of people, being packed up in a floating resort for many days on end. In confined spaces with frequent passenger turnover (like big capacity cruise ships), it is easy for diseases to spread - whether food- or air-borne, or otherwise. Including this outbreak, so far this year there have been 12 notable instances of gastrointestinal illness on international cruise ships reported by the CDC. That's already significantly higher than in previous years, with 2022 seeing four instances and 2021 only one.

The recent surge in Norovirus outbreaks underscores the necessity of vigilance and proper understanding of this issue, both for those planning a dream vacation at sea and for those in the cruise industry itself. Together, we can work towards ensuring that cruise ships remain a place of relaxation and enjoyment, rather than a breeding ground for this troublesome virus. A norovirus outbreak on a cruise ship in late May left 152 passengers and 25 staff members sick, according to a CDC (Centers for Disease Control and Prevention) investigation. In addition, most cruise lines now are requiring passengers to wear masks at all times while in interior spaces of vessels, and they have stepped up cleaning regimens, improved air filtration systems on ships and made other onboard changes. While health authorities no longer are quarantining whole ships when a few passengers or crew test positive for COVID-19, the presence of the illness on board a vessel still could result in notable disruptions to your itinerary.

Credit Card Reward Programs

You can get norovirus from an infected person, from contaminated food or water, or by touching contaminated surfaces. The virus causes your stomach or intestines or both to get inflamed (acute gastroenteritis). This leads you to have stomach pain, nausea, and diarrhea and to throw up. The following statistics show the number of cruise ship illness outbreaks in recent years.

Environments Where Norovirus Spreads Quickly

This is partly because health officials track illness on cruise ships, so outbreaks are found and reported more quickly on a cruise ship than on land. The CDC's "Vessel Sanitation Program" is for monitoring illness outbreaks on passenger ships carrying 100 or more guests on sailings from 3 to 21 days in length. The ship's medical staff is required by the CDC to maintain illness counts for each itinerary involving a stop at a US cruise port and to give CDC the number of all passengers/crew, plus the number of reported diarrhea cases during that voyage. This is done 24 hrs prior to arrival at any US port of call from a foreign port. In 2012, the number of reported illness outbreaks on cruise ships was 34.

How to prevent seasickness on cruise ships (tips)

Quarantining the ill passengers and crew to their cabins is mandatory (at least for 48 hours) to slow the outbreak's spread. Failing to comply with the crew's orders results in fines or even discharge from the ship. Should you be worried about catching norovirus or another gastrointestinal illness when you cruise? The CDC says cruises account for some of the lowest case numbers in the U.S. annually.

The company said the sickness was likely caused by norovirus, a very contagious virus that causes vomiting and diarrhea. Norovirus, which is sometimes called the "cruise ship virus," causes more than 90% of diarrheal disease outbreaks on cruise ships, according to the CDC. In the following table, you can see all 2019-reported Norovirus outbreaks on cruise ships. It shows the number of sick passengers and crew (with the respective percentage to all), along with the corresponding CDC report pages (if available) as outgoing links. While only about 1% of all annual norovirus cases reported in the U.S. happen on cruise ships, the perception is it occurs more frequently due to media reports of gastrointestinal viral outbreaks on cruise ships.

Norovirus Is Rising on Cruise Ships: How to Stay Safe - AARP

Norovirus Is Rising on Cruise Ships: How to Stay Safe.

Posted: Thu, 20 Jul 2023 07:00:00 GMT [source]

VSP doesn't charge fees for consultations related to shipping facilities renovations or new ships. ▪ You can get norovirus in a variety of ways, such as by eating or drinking contaminated food and drinks, touching an infected surface and then touching your mouth or having direct contact with someone ill from the virus, according to the CDC. In a study of acute gastroenteritis cases from 2006 to 2019 (before the cruise industry's COVID-19 shutdown), the CDC found that the number of cases on ships decreased over those 14 years. It also noted that the number of cases tends to be higher on larger ships and on voyages of a week or longer. Cruise lines employ crews dedicated to keeping public areas and high-touch surfaces clean.

Norovirus infects between 19 million and 21 million Americans annually, the CDC reports. Land-based operations ("Field Service") include mobile clinics providing screening for potential surgery patients, healthcare, dental care, also mental health programs, infrastructure projects. They are located on upper decks and include cabins for families, couples and single cabins. The navies of USA, UK, Australia, China, France, Italy, Spain, Argentina, and Japan have some classes of military ships fitted with onboard hospitals. In January 2016, the CDC issued travel guidance on affected countries and suggested using enhanced precautions and even postponing travel. Similar travel warnings were issued by other health agencies and governments.

Still, it's important to note that most of these "cases" of COVID-19 are asymptomatic or mild, only discovered during routine testing. While some ships only are testing passengers who report feeling ill for COVID-19 (and close contacts of those who subsequently test positive), other ships are testing every single passenger at least once per voyage, sometimes more. One line, Viking, is testing every single passenger for COVID-19 every day.

However, as travel surges this summer, travel-related illnesses are expected to surge, as well. “I think our travel frenzy after COVID is partially fueling this continued spread (of norovirus),” says Ostrosky. Major (in some cases epidemic) illness outbreaks are among the "biggies" that can bring down the brand's reputation on the market.

Studies have shown that norovirus can continue to spread for two weeks or more after an infected person stops having symptoms of the illness, according to the CDC. The virus spreads easily and is typically contracted when someone accidentally ingests tiny particles of vomit or feces from someone who is infected with it. The CDC writes that people who are infected "can shed billions of norovirus particles that you can't see without a microscope," and exposure to just a few norovirus particles can make someone sick. The CDC advises frequent hand washing with soap and warm water for at least 20 seconds to prevent the spread of norovirus.

There are passenger testimonials about quarantined ships and how badly guests have been treated by the line. Virus outbreak news speaks of a lack of proper hygiene control, badly trained staff, bad ship management. The whole responsibility goes to the shipowner (cruise line company) and its management.