Norovirus — Don’t Call It ‘the Cruise Ship Disease’

Dr. Joyce Johnson, MD

Recently two Royal Caribbean International-owned cruise ships were struck with what’s believed to be norovirus outbreaks. Norovirus is caused by contaminated food and water, and its symptoms include vomiting and diarrhea.

Both ships left Fort Lauderdale at the end of March for 15-night cruises. Of the 2,100 people aboard the Celebrity Infinity, 106 reported norovirus symptoms. One hundred and fourteen people became sick on the Legend of the Seas. Today both ships have docked in San Diego for passengers to be treated and the vessels cleaned. 

According to CBS News, there have now been five flare-ups of norovirus on cruise ships this year. Even with this news, Dr. Joyce Johnson, former surgeon general to the U.S. Coast Guard, shares why norovirus isn’t something that should prevent you from sailing. 

Though disease outbreaks on cruise ships seem to get a lot of publicity, travelers have more reason to fear contracting a “stomach bug,” such as norovirus, on shore than during a vacation at sea.  Millions more people get norovirus on land — in hospitals, dormitories, schools, restaurants, and hotels — than on cruise ships. Norovirus is not “the cruise ship disease." 

Norovirus is often referred to as the common stomach bug, and the unpleasant but rarely serious symptoms typically last between 24 and 72 hours. Twenty million people on land in the U.S. — about 1 in 15 — fall ill with norovirus every year, according to estimates by the Centers for Disease Control and Prevention, making it one of the most widespread illnesses in the country. In contrast, cruise passengers embarking from the United States have about a 1 in 12,000 chance of becoming sick during an onboard norovirus outbreak.  

Even though incidents on cruise ships are uncommon, years ago, the cruise industry voluntarily worked with the CDC to implement a system to proactively monitor and report cases of gastrointestinal illness. While outbreaks of norovirus on cruise ships pale in comparison to those on land, the cruise industry’s trade group says the industry voluntarily works with the CDC out of an abundance of care for passengers and to strive for a goal of zero outbreaks. Thus, the few outbreaks that do occur on cruise ships are recognized and publicized, unlike the many outbreaks in our communities, such as those at restaurants, nursing homes, and schools.  

The cruise industry is the only travel component to actively monitor and report these outbreaks. Cruise lines implement aggressive procedures to prevent the transmission of illness. For example, cruise line cleaning crews typically exceed the rigorous CDC guidelines and repeatedly sanitize bathrooms, door handles, tabletops, stair rails, and even elevator buttons, to name just a few of the surfaces they treat. 

As in our everyday lives, while on a cruise we each play a role in keeping ourselves, our families, and our fellow passengers healthy. Whether on land or at sea, hand washing is the most important way to prevent the spread of disease. Wash your hands with soap and water, especially before eating.  

Wash thoroughly, frequently, and every time you use the bathroom. It’s also crucial that you make children and other family members do so as well. The CDC defines a norovirus outbreak on cruise ships as affecting as few as 3 percent of people onboard (meaning that 97 percent are healthy and not affected).  

Thus, good hygiene, the efforts of the ship’s crew, and simple math make it a pretty safe bet you’ll stay healthy even if there is an “outbreak.” No matter where you are, good hygiene is essential to good health. Cruise lines are doing their part to ensure that passengers have a safe and healthy cruise, but when it comes to preventing the spread of viruses, we’re all in this together. 

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