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Norovirus strikes cruise ships in the Caribbean

When Explorer of the Seas returned early to Port Liberty New Jersey on Wednesday, it brought with it one of the worst outbreaks of Norovirus in over 20 years, according to health officials. The ship which carries over 3,000 passengers had almost 700 cases of illness onboard. It was bad enough for the ship to return early and to have the cruise line offer passengers 50 percent off the current cruise and a 50 percent discount on a future cruise.

According to the CDC “norovirus is a very contagious virus. You can get norovirus from an infected person, 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.”

Federal officials have been investigating the cause of the outbreak but it is unlikely that they will be able to determine the source. The most likely culprit is one or more of the passengers who brought the virus onboard with them. Symptoms usually occur between 24 and 48 hours after exposure but can begin as soon as 12 hours.

Outbreaks of norovirus are in no way related to the flu (influenza), which is a respiratory illness caused by influenza virus and for which you can get a flu shot. A flu shot will not protect you from the norovirus.

The CDC states that “norovirus is the most common cause of acute gastroenteritis in the United States. Each year, it causes 19-21 million illnesses and contributes to 56,000-71,000 hospitalizations and 570-800 deaths. Norovirus is also the most common cause of foodborne-disease outbreaks in the United States.” Most of the deaths from norovirus are among the elderly and small children with more than 50 percent of cases happening in long term care facilities. Most outbreaks of norovirus in the United States occur between November and April.

Norovirus commonly spreads quickly in confined spaces such as nursing homes, day cares, schools and cruise ships. The Explorer of the Seas is not the only ship to be affected this year. Earlier in 2014 there was an outbreak on the Norwegian Star which had 130 cases of norovirus. The Caribbean Princess also reported at least 178 cases of the virus onboard when it returned early to Houston on Friday, Jan. 31. There were nine vessel outbreaks in 2013 and 16 in 2012, according to the CDC.

Health officials have cleared the Explorer of the Sea to take on its next group of passengers on Friday January 31. The ship was cleaned three times according to officials at Royal Caribbean.

This writer has been onboard a cruise that was affected by the norovirus. The passengers are not allowed to serve themselves from the buffet, hand sanitizer is required when entering the dining area and affected passengers were quarantined from the general population. The doors to their cabins were marked so there was no way not to know where the sick passengers were. Did it affect the overall enjoyment of the cruise? It did, but in this case, no compensation was offered to the rest of the passengers.

According to the CLIA (Cruise Line International Organization) “in 2013, there were 7 norovirus outbreaks on cruise ships reported to the CDC, involving a total of 1,238 passengers. To put that into perspective, approximately 21.3 million passengers sailed on CLIA member cruise ships in 2013 so this figure represents approximately six one thousandths of one percent (.006%) of global passengers. Additionally, the CDC reports there are about 20 million norovirus cases in any typical year on land in the United States.”

When you consider the statistics, your chances of getting the norovirus on a cruise are still quite small with at most a couple thousand passengers out of 20 million getting sick. You have a better chance of being infected by your children or family members. If you have a cruise planned for anytime through April this year, unless you are high risk, feel confident that your risk from cruising is small.