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Cruise industry re-examines how it can prevent outbreaks of sickness at sea

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A recent spike in stomach-churning illness blamed on a nasty virus has forced the multi-billion-dollar cruise industry to re-examine how it can prevent wide-scale outbreaks of sickness at sea.

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A recent spike in stomach-churning illness blamed on a nasty virus has forced the multi-billion-dollar cruise industry to re-examine how it can prevent wide-scale outbreaks of sickness at sea.

Cases of norovirus, which includes symptoms such as vomiting, diarrhea and sometimes fever, are up dramatically on cruise ships since the first of the year, according to the Centers for Disease Control and Prevention in Atlanta. The CDC has documented outbreaks of norovirus-related sickness on nine different voyages already in 2010, compared to 15 voyages for all of 2009.

Just recently, the Celebrity Mercury, which sails out of Charleston, S.C., underwent an extensive three-day cleaning from bow to stern following its third consecutive wide-scale outbreak of norovirus. The ship’s most recent turn at sea ended with more than 20 percent of the passengers contracting the illness.

David Forney is the former chief of the CDC’s Vessel Sanitation Program, which monitors cruise ships for cleanliness and incidents of illness. He said cruise lines are taking several precautions to prevent new outbreaks, including:

Requiring passengers to fill out a questionnaire before boarding asking whether they have been sick in the past 30 days.
Reminding passengers on board to wash their hands frequently, particularly before dining or after using the bathroom.
Instituting comprehensive hygiene programs, which include fliers reminding passenger to be hygiene conscious, TV commercials in every cabin on cleanliness and hand-sanitizing gel dispensers scattered throughout the ship.
However, despite any ship’s best efforts to keep illness at bay, Forney said added measures aren’t foolproof in preventing ship-board sickness.

Cruise lines “are doing the best, but they still have to rely on passengers to be honest in those questionnaires,” Forney, now a consultant for the Cruise Line International Association, told AOL News. “But let’s say you live in Buffalo, N.Y., and the weather is bad, and you get sick before your cruise, what do you? You go, right?”

Some ships will deny entry to passengers with visible signs of illness, he said. Those who become ill once a ship sets sail are required to remain in their cabin for the duration of their symptoms plus 24 hours, he noted.

The CDC’s Vessel Sanitation Program started keeping a close eye on luxury liners long before the recent headlines. The program began monitoring ships from U.S. and foreign ports in 1970, attempting to minimize the spread of gastrointestinal illnesses on board. The program requires companies operating the vessels to log and report the number of passengers and crew members with symptoms of GI sickness.

The program also mandates that ships keep a record of everyone on board who requests anti-diarrheal medicine.

When more than 2 percent of those on board report having a GI-related illness, the CDC unit inspects the ship to determine the cause of the outbreak.

After the large outbreak on the Mercury, the CDC and the ship’s parent company, Royal Caribbean Cruises, agreed that it was necessary to take additional steps to sanitize the vessel after it returned to port March 8.

To clean up the Mercury, extra crew members were brought on board to disinfect the ship, said Cynthia Martinez, the corporate communications manager for Royal Caribbean. Every carpet was steam cleaned and every nook and cranny disinfected, she said.

But Martinez conceded that the threat of another norovirus outbreak isn’t over. “Even though the ship will be spotless, there is still a possibility that someone could bring norovirus onto the ship,” she told AOL News.

The Mercury will be sailing under “code red” conditions on future voyages, Martinez said. That means “passengers won’t be able to serve themselves from the buffet, hand sanitizing gel will be provided throughout the ship, and we are encouraging everyone to wash their hands often,” she said.

And in the event that someone does contract norovirus while at sea, the crew can ask passengers to remain in their rooms until they are well. “We ask people to respect their fellow guests” in the event of illness, Martinez added.

Concerns about passengers bringing the sickness on board come amid a recent rise in norovirus outbreaks on land as well, according to the CDC.

“Cases of norovirus have increased in many areas of the general population, usually in areas where large groups of people gather including college campuses, elder-care facilities and camp sites in the U.S. and abroad, and this will naturally result in a similar increase on cruise ships,” Jay Dempsey, a health communication specialist with the CDC, told AOL News.

South Carolina has in recent months seen the number of norovirus cases increase dramatically across the state, a statistic Martinez cited when discussing the recent norovirus outbreaks aboard the Mercury.

“It’s a unique situation that we are not seeing in any other ports,” she said.

As for the Mercury, it returned to sea on March 21, and so far, the reported illnesses are almost negligible.

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