Oasis of the Seas’ norovirus outbreak among worst in a decade. But are cruises getting cleaner?
The cruise ship was about halfway through its voyage when passengers started getting sick.
The illness, whatever it was, spread to 277 people by Jan. 10 before Royal Caribbean International’s Oasis of the Seas had to report it to the Centers for Disease Control and Prevention. The next day, with the news dominating headlines and the vessel on a course back to Port Canaveral, the number rose to 475.
On final count, 592 passengers and crew — 7 percent of the people on the ship — were hit by a gastrointestinal outbreak that seized Oasis and cut the seven-day Caribbean voyage a day short.
All told, it amounted to the second-largest illness outbreak on a cruise ship in a decade.
According to an Orlando Sentinel analysis of CDC data, Oasis of the Seas’ outbreak nearly surpassed the total number of people who reported experiencing a gastrointestinal illness on a cruise ship in all of 2018, when there were 11 outbreaks.
What exactly caused the Oasis outbreak, norovirus or something else, is still being investigated by the Vessel Sanitation Program, the arm of the CDC that ensures cruise ships maintain safety standards. But the issue brought cruise ship illness outbreaks — and whether they are as bad as they seem — back into the public consciousness.
The optics are certainly frightening: More than 6,000 people stuck on a floating hotel while a highly contagious virus gets passed around and crew roam the ship trying to disinfect every surface. Some people quarantined themselves in their rooms, while others still tried to enjoy their trip — but didn’t skip the line for hand sanitizer at the buffet.
For its part, Royal Caribbean said in a statement that it goes to “great lengths” to clean and sanitize ships before, during and after sailings.
“We use a combination of technology and hard work to keep our guests and crew healthy,” spokesman Rob Zeiger told the Orlando Sentinel. “Nothing beats prevention, so we use videos and other announcements to remind guests that it is important to wash their hands frequently and tell our doctors if they are feeling unwell.”
The outbreak on Oasis was actually a smudge in what has otherwise been a trend of fewer outbreaks over the past several years. The outbreaks are made public by the CDC when more than 3 percent of the people on board report symptoms of a virus, which are often stomach pain, nausea, diarrhea and vomiting.
2018 was a particularly good year, with just 689 cases reported, or less than half as many cases of norovius as years past on.
“It could be that the cruise lines are better at sanitation, or it could be that they were lucky with that last year,” said Ross Klein,a professor at the School of Social Work at Memorial University of Newfoundland in Canada who tracks cruise ship outbreaks. Trends are difficult to spot, Klein said, because cruise ships are only inspected about twice a year for sanitation, so often, those reports don’t correlate with outbreaks.
Large ships, like Oasis, and small exploration vessels get outbreaks — thought larger ships are more likely to rise to the top because they simply carry more passengers.
Almost every year since 2009, certain vessels have had back-to-back outbreaks. In 2010, for example, Celebrity Cruises’ Celebrity Mercury had three back-to-back outbreaks after two incidents in 2009. In all, 1,334 passengers and crew got sick with norovirus.
But things have been improving since 2012, when a new strain of norovirus emerged, resulting in 16 outbreaks.
The numbers, on the whole, have started to decrease. And in all, the outbreaks are “relatively infrequent,” the CDC said in a statement. From 2008 to 2014, just 0.17 percent of cruisers got a gastrointestinal illness on a cruise ship — 129,678 people out of 74 million travelers, the CDC said.
“I’m glad the CDC is following this because it has forced the industry to clean up its act,” said Mike Driscoll, an editor with cruise trade publication Cruise Week.
The cruise lines’ responsibility
Over time, cruises lines’ relationship with sanitation has been a fraught one. It’s one of the issues travelers who have never cruised point to when explaining why they don’t opt for a cruise vacation.
And capturing that sliver of the population is important for cruise lines, which have long argued that they compete the most with land vacations for travelers’ time and money.
“[Norovirus outbreaks are] national news,” Driscoll said. “If something happens at a restaurant, it’s local news. That’s what’s kind of unique to me about the cruise ship industry in terms of the perception that is has.”
But restaurants also are faced with frequent inspections, and the possibility of getting closed down if conditions are inadequate. For cruise lines, that’s a rare occurrence.
Cruise ships also have the complicating factor of employees who live where they work, Klein said. Crew members almost always are impacted when there is an outbreak, and under CDC rules, have to stop reporting to work when they exhibit symptoms — but that doesn’t always happen.
“If they are ill, they don’t work, and they don’t get paid,” Klein said. “This has certainly been identified in a number of Vessel Sanitation Program assessments where cruise ships are cited when crew members work when they are ill.”
For instance, an inspection of Royal Caribbean’s Explorer of the Seas in January 2014 found that a crew member with gastrointestinal illness symptoms had still reported to work. A week later, 689 people reported having norovirus on the ship — that largest outbreak of the last decade.
After an outbreak, the CDC typically goes on board and monitors the ship’s response and tests stool specimens. But maritime laywer Jim Walker said he doesn’t think the agency goes far enough. It’s not always clear what caused the problem, he said.
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