How To Avoid Norovirus And Other Outbreaks On A Cruise Ship

Pictured here is the Zaandam in Juneau, Alaska. (Photo by: Sergi Reboredo/VW PICS/UIG via Getty Images)

Zaandam that’s bad vomiting and diarrhea. The Centers for Disease Control and Prevention (CDC) is now investigating what happened on the Zaandam cruise ship that’s part of the Holland America Group was scheduled to travel among different ports in Alaska and then down to Seattle from June 18 to July 2, 2018.

Instead of making its way towards the Mendenhall Glacier, the 781-foot boat remained docked in Juneau yesterday. Apparently the cruise ship became the poos ship for some of the 58 (3.94%) of the 1,472 passengers and 15 (2.54%) of 591 crew members who became ill. Vomiting and diarrhea were the predominant symptoms. Although as of yesterday, the CDC web site indicated that the causative agent is unknown, vomiting and diarrhea on a cruise ship sounds suspicious for a norovirus outbreak.

Here is the CDC list of infectious disease outbreaks on cruise ships so far this year:

Note that this does not necessarily represent all of the outbreaks that occurred on boats this year. It only includes cruise ships that fall within the purview of their Vessel Sanitation Program (VSP), have voyages from 3 to 21 days long, and carry 100 or more passengers and outbreaks where 3% or more of passengers or crew report symptoms of gastrointestinal (GI) illness to the ship’s medical staff. For example, if you had the runs while on a rowboat on a date, it would not be included on this list. Also, Gilligan and Mary Ann having GI symptoms while on the SS Minnow wouldn’t count.

As you can see, identifying the specific virus or bacteria that caused the outbreak can be challenging. Bacteria and viruses don’t tend to fill out paperwork before they board the ship, and investigators may not be able to find the exact food or objects that were contaminated.

So how do you avoid a ship of poo besides never ever going on a cruise? Keep in mind that going on a cruise doesn’t necessarily put you at higher risk for getting a gastrointestinal illness, compared to other situations where there is heavy contact with others such as restaurants, schools, parties, day care centers, and workplaces. However, there are steps that you can when considering cruising:

• Search for the cruise line on the CDC’s Vessel Sanitation Program (VSP) inspection database. Watch out for any cruise line that got a score of below 85 on its inspections. Of course, the database does not include every single craft that goes on to the water, only ships that “carry 13 or more passengers” and “have a foreign itinerary with U.S. ports.” 
• Pay attention to where and when outbreaks are occurring. Naturally, you don’t want to seek a ship where an outbreak is actively occurring. That would be desperately seeking diarrhea. But just because a ship has a great inspection record and no history of outbreaks doesn’t mean that it can’t happen when you are a cruising.
• Wash your hands frequently and thoroughly. You should do this in general and not just on cruise ships.
• Check for general hygiene and sanitation on the cruise ship. Are crew members and employees washing their hands? Is trash being properly disposed? How clean are the kitchens? How often are the rooms and bathrooms cleaned?
• If you see someone vomiting or diarrhea-ing, keep your distance and report it to the cruise staff. You’re probably well aware that throwing up is not the universal sign for come give me a hug. But keep in mind that norovirus is highly infectious and can remain even after a place or person is superficially cleaned.
• Tell the medical staff if you get sick. If you caught a bug on a ship, you may be entitled to a refund or be able to postpone your cruise to a later time. Before you even book a cruise, check the cruise line’s policies, and stick to reputable cruise lines that have established plans on how to prevent and deal with outbreaks.
• Make sure that the food is properly protected. Notify staff if anyone is coughing into the buffet or using their hands, mouth, or other body parts to scoop food into their plates.
• Keep your immune system working well. Get appropriate amounts of rest and sleep, stay well hydrated, and don’t drink too much alcohol.

Certainly, nothing can completely eliminate risk so don’t be too paranoid. However, taking the above-mentioned steps can help reduce your risk of getting a GI bug. After all, your cruise may be full of ship but you don’t want it to be full of certain other things.