December 5, 2002

Little mystery about "cruise ship" bug

If you're planning a cruise vacation, don't be too worried by recent headlines about a "mystery bug" plaguing cruise ship passengers. If you're super cautious, you might just want to pack some hand sanitizer gel along with the SPF 15 sun screen, but the real message is that there's little to be worried about. The worst thing that's likely to happen is that you may have to point out to a steward which buffet items you would like to have, rather than being able to shovel them on to your plate for yourself. That's one precaution some lines are taking to limit possible spread of a bug about which there's actually very little mystery.

It's called Norwalk-like Virus (NLV) and a statement from the International Council of the Cruise Lines (ICCL) notes that NLV is "a common ailment circulating in North America and Europe, prevalent at land-based facilities and which occasionally occurs on ships."

"The illness [NLV] is seasonal, peaking in the colder months," the ICCL quotes Florida state epidemiologist Dr. Steven Wiersma as saying. "We've already seen some cases in Florida - this is not just a cruise ship issue."

There are some 170 ships offering around 175,000 lower berths currently serving the NorthAmerican cruise market. Thus far, this NLV season, only a minority of passengers on just four of these ships appear to have been affected, The fourth cruise ship to report an outbreak of Norwalk-like virus (NLV) symptoms among passengers and crew is P&O Cruises Oceana, according to the latest update from the Centers for Disease Control and Prevention's Vessel Sanitation Program.

The latest CDC update says that since October its Vessel Sanitation Program (VSP) has been following or investigating several instances of gastrointestinal illness aboard cruise ships. At the current time, VSP is working closely with cruise industry officials to identify the causes. Following are updates of investigations of Holland America's Amsterdam, Disney's Magic, Carnival's Fascination, Radisson's Seven Seas Mariner and P & O UK's Oceana.

Holland America Amsterdam

The Amsterdam returned to service on December 1 and is providing daily reports to CDC on the health status of passengers. As of the afternoon of December 4, the vessel reported that 2 of 1,208 passengers and 1 of 579 crew had gastrointestinal illness.

Previously, laboratory analysis confirmed that the cause of a recent outbreak aboard the vessel was Norwalk virus. Symptoms include nausea, vomiting, diarrhea, and abdominal pain. The illness usually develops within 12 to 48 hours of exposure and lasts from 1 to 3 days.

On November 21, Holland America temporarily took the vessel out of service to do aggressive cleaning, to isolate infected crew, and to undertake other control measures.

Disney Magic

The Magic remains in port in Port Everglades, Florida, and is undergoing intensive cleaning and disinfection. Last week, laboratory analysis confirmed that the cause of a recent outbreak of gastrointestinal illness aboard the vessel was Norwalk virus. CDC staff visited the vessel on December 3 to monitor the activities; they will return to the vessel on December 6. The vessel is expected to return to service on December 7.

Carnival Fascination

CDC staff boarded the Fascination when the vessel returned to port in Miami on December 2 after a 3-day voyage. The vessel reported that 189 of 2,416 passengers and 13 of 895 crew experienced a gastrointestinal illness. The illness was characterized as mostly vomiting with some diarrhea. CDC staff collected food and ice samples; laboratory tests are pending.

Radisson Seven Seas Mariner

The Seven Seas Mariner reported that 5 of 586 passengers and 16 of 449 crew experienced a gastrointestinal illness shortly after leaving Tenerife on a 15-day cruise; consequently, the cruise was terminated in Port Everglades, Florida, on December 2.. Initial laboratory results have identified Salmonella as the causative organism, with shelled eggs as the suspected source. Samples of the eggs are being tested. Laboratory results are pending.

P &O UK Oceana

The Oceana departed Port Everglades, Florida, on November 29 on a 14-day Caribbean itinerary. As of December 4, CDC staff were notified by the vessel's medical staff and the medical director of P&O UK that 114 of 1,859 passengers and 3 of 868 crew had reported to the ship's infirmary with gastrointestinal illness. All of the passengers originated in the United Kingdom and flew on chartered aircraft to Ft. Lauderdale, the point of embarkation. Most of the ill passengers were reported to be on one chartered flight originating in Manchester, United Kingdom. CDC staff will board the vessel this week to conduct interviews with ill passengers and crew. CDC staff will conduct an environmental assessment and expedite the collection of stool specimens for shipment back to CDC. On November 29, the vessel underwent a routine, unannounced inspection. The Oceana scored 95 out of 100 points.

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