Norovirus Outbreaks on Cruise Ships Rise as Passengers Return in Record Numbers

(Updated 7pm PST July 12th)

Millions of Americans eagerly embark on cruise ships from various ports across the country, seeking a well-deserved vacation. However, the smooth sailing experience may not always be guaranteed when it comes to the health of travelers.

This year, the US Centers for Disease Control and Prevention (CDC) reported 13 outbreaks of norovirus on cruises, the highest number recorded since 2012. The recent surge in norovirus cases is raising concerns, especially with nearly half of the calendar year remaining.

The most recent outbreak occurred during a Viking Cruises voyage from Iceland, which docked in New York City on June 20. Approximately 13% of passengers and several crew members fell ill onboard.

According to a Viking representative, the gastrointestinal illness is believed to have originated from a shoreside restaurant in Iceland where a group of guests dined during their free time.

Norovirus is a highly contagious virus that causes acute gastroenteritis, resulting in symptoms such as nausea, vomiting, diarrhea, and stomach pain.

It spreads easily through contact with infected individuals, contaminated food or water, and even by touching contaminated surfaces. The virus can remain infectious for over two weeks.

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Dr. William Schaffner, an infectious diseases expert, emphasizes the exceptional contagiousness of norovirus. Only a small number of viral particles are needed to initiate an infection in exposed individuals, making hand hygiene crucial.

Handwashing with soap and warm water is highly recommended, as hand sanitizers are ineffective against the virus.

Experts are trying to determine the exact cause behind the surge in norovirus cases this year. It is believed that the soaring demand for cruises and the record number of passengers may be contributing factors.

In 2020 and 2021, there were no recorded norovirus outbreaks on cruises due to limited cruising and improved sanitation protocols implemented during the Covid-19 pandemic.

However, with the CDC lifting the risk advisory for cruise travel in March 2022, passengers are returning in record numbers. It is projected that 31.5 million passengers worldwide will set sail this year, exceeding pre-pandemic levels. This increase in passenger density creates an environment conducive to virus transmission.

Royal Caribbean has experienced the highest number of norovirus outbreaks among individual cruise companies this year, with four outbreaks affecting a total of 449 passengers and crew members.

The close quarters and large groups aboard cruise ships make them ideal environments for norovirus outbreaks. Crowded spaces, prolonged proximity, and aerosolized particles from vomiting can easily facilitate the transmission of the virus.

While norovirus outbreaks remain relatively uncommon on cruise ships compared to the general population, the nature of cruise ship settings poses unique challenges. Some might confuse the nausea for motion sickness and disregard the cleanliness.

The virus can cause dehydration, especially among older passengers who may be at higher risk. It is essential for passengers to remain vigilant and promptly seek medical attention if they experience symptoms.

To mitigate the spread of norovirus, the CDC recommends thorough handwashing, avoiding contaminated food, and keeping hands away from the mouth. Passengers who become ill should stay in their cabins and notify the ship’s medical team immediately.

As cruise ship travel resumes at full capacity, it is crucial for both cruise lines and passengers to prioritize health and hygiene to ensure a safe and enjoyable voyage for everyone on board.

Besides monitoring disease outbreaks on board, the CDC’s Vessel Sanitation Program plays a vital role in promoting public health on cruise ships.

It requires regular illness reports from cruise ships, conducts unannounced inspections to ensure sanitation standards are met, and provides training to cruise ship employees about public health protocols.

In addition to the CDC’s recommendations, experts emphasize the importance of passenger awareness and responsibility. It is crucial for individuals to understand norovirus and take necessary precautions to protect themselves and others, especially as the COVID-19 pandemic winds down.

Jeffrey Fisher, an associate professor of nutrition and dietetics, highlights the “knowledge gap” among the public regarding norovirus. People may relax their guard as the pandemic situation improves, potentially neglecting good hygiene practices they learned during COVID-19.

Dr. Schaffner suspects that passengers feeling unwell before boarding may contribute to the rise in norovirus cases. After enduring a lengthy pandemic delay, individuals eager for their long-awaited vacation may unintentionally bring the virus onboard.

To minimize the risk, Dr. Schaffner advises passengers to postpone their trip if they are feeling unwell. By doing so, they can limit the exposure of others and reschedule their cruise for a later date.

As cruise ships welcome record numbers of passengers, it becomes crucial to maintain hygiene practices, adhere to health guidelines, and promptly address any signs of illness.

Open communication with the ship’s medical team and following their guidance can help prevent further spread of the virus.

While norovirus outbreaks pose challenges for the cruise industry, it’s important to remember that they remain relatively rare compared to the general population.

By implementing rigorous safety measures and educating passengers about the importance of hygiene, cruise lines can strive to provide safe and enjoyable voyages for all travelers.

As the industry moves forward, a collective effort is needed to navigate these challenges successfully. With proper precautions, awareness, and cooperation between cruise lines, passengers, and health authorities, the journey towards healthier and safer cruising experiences can be achieved.

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