Cruise ship nightmare: After measles, norovirus outbreaks, why does anyone still set sail?

  
Via:  tig  •  one month ago  •  44 comments

Cruise ship nightmare: After measles, norovirus outbreaks, why does anyone still set sail?
As an expert in microbiology and infectious diseases, what I see when contemplating a cruise excursion does not sound like a fun vacation.

S E E D E D   C O N T E N T


By   Tara C. Smith, professor of epidemiology at Kent State University


I took my 5-year-old to see the live-action version of   "The Lion King" last weekend. While we were waiting for the film to begin, we were subjected to a commercial for Disney's cruise line, sold as a family-friendly excursion with your favorite Disney characters. My son, of course, was ready to go tomorrow. I didn't have the heart to tell him that as my child, he's never getting on one of those things.

I know plenty of people love cruises. The convenience of seeing a variety of places without having to plan them individually; the all-inclusive meals; the variety of entertainment options; and for those with kids, the special activities provided for youngsters. I get it. But as an individual trained in microbiology and infectious diseases, what I see when contemplating such an excursion is the potential to be trapped with thousands of others in a confined space, suffering from gastrointestinal aliments like   norovirus   and   E. coli , respiratory infections including influenza and   chickenpox , or, as a   recent Scientology cruise   demonstrated,   measles . And that just doesn't sound like a fun vacation to me.

Granted, I could become ill via any type of travel, or even via a staycation with my kindergartener. But cruise ships take those risks of background infection and amplify them.

This hardly a secret: Just this week it was reported that inspectors from the Centers for Disease Control and Prevention (CDC)   gave the Carnival ship “Fantasy”   one of the company’s worst ever sanitation inspection reports. (The   Carnival Corporation & plc made close to   $19 billion in full revenues in 2018.)

Granted, I could become ill via any type of travel, or even via a staycation with my kindergartener. But cruise ships take those risks of background infection and amplify them due to the constant shared quarters of travelers onboard. The ships are   notoriously difficult to clean   when a case of norovirus is diagnosed. And norovirus is so infectious that it's almost impossible to avoid in close quarters — a   mere 10 viral particles   is enough to make someone sick. I've suffered through a travel-related norovirus illness alone in a hotel before and it was horrible. I can't even imagine how much worse it would have been if I was sharing that tiny room (and that nasty virus) with my family.

While norovirus is the key cruise ship pathogen, other stomach bugs can proliferate as well. Among the violations reported  on Carnival’s “Fantasy,” for example, included “brown water discharged from two shower hoses in the medical center.” The medical center! The main pool gutters on the 855-foot ship were also not functioning correctly: “There was a visible film on the top of the water, and there was excessive visible debris floating on the water.”

And inspectors observed a general lack of attention to food safety throughout, including deficiencies “related to food equipment and facilities, protection of food and clean items, handling of waste and soiled items, food employee knowledge, and food employee managerial control.”  Utensils for the buffets were stored in soiled water, or dirty ones were added in with clean utensils; water was leaking onto containers of vegetables; sneeze guards were missing or improperly used; breads with visible fly contamination were reused; and on and on.

Seriously, I’ll pass.

While this most recent inspection may be an outlier, the CDC investigates an average of 12 to 13 gastrointestinal disease outbreaks on cruise ships   each year , monitored by the Vessel Sanitation Program ( VSP ). And while I can readily avoid local restaurants that have poor ratings from food inspections, once you're on the ship, you're basically stuck when it comes to dining options.

And the purview of the VSP is gastrointestinal infections — not   all infections. Respiratory infections very likely go   under-reported for a variety of reasons , including lack of diagnostic capabilities on the ship, and a lack of knowledge by employees or passengers that such illnesses should be reported to health officials. Such infections could easily be transmitted on the ship, and because their incubation period may be days or weeks, could go undiagnosed until after you return home.

I realize that in the bigger picture, most cruise travelers will be just fine. The   CDC notes : “From 2008 to 2014, 74 million passengers sailed on cruise ships in the Vessel Sanitation Program’s jurisdiction. Only 129,678 passengers met the program’s case definition for acute gastrointestinal illness and only a small proportion of those cases (1 in 10) were part of a norovirus outbreak.”

But personally, I’d rather not take the risk. (There’s also the   small but very real chance   you could get stranded,   fall overboard   or spend the trip without working plumbing.) For those of you who are cruise lovers and want to know how your ship rates, you can check the   vessel’s inspection history   before you book or travel to see if they have a history of brown water or fly-bagels. For those of you who abstain like myself, I'll still see you at the beach — I'll just drive or fly there instead.

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TᵢG
1  seeder  TᵢG    one month ago
I know plenty of people love cruises. The convenience of seeing a variety of places without having to plan them individually; the all-inclusive meals; the variety of entertainment options; and for those with kids, the special activities provided for youngsters. I get it. But as an individual trained in microbiology and infectious diseases, what I see when contemplating such an excursion is the potential to be trapped with thousands of others in a confined space, suffering from gastrointestinal aliments like   norovirus   and   E. coli , respiratory infections including influenza and   chickenpox , or, as a   recent Scientology cruise   demonstrated,   measles . And that just doesn't sound like a fun vacation to me.

Well, hell, this is not what I want to read before heading out on our anniversary cruise.  jrSmiley_85_smiley_image.gif

 
 
 
sandy-2021492
1.1  sandy-2021492  replied to  TᵢG @1    one month ago

Oohh, where are you going?

 
 
 
TᵢG
1.1.1  seeder  TᵢG  replied to  sandy-2021492 @1.1    one month ago

London to Russia with Scandinavian and Baltic stops along the way.

 
 
 
sandy-2021492
1.1.2  sandy-2021492  replied to  TᵢG @1.1.1    one month ago

That sounds like a great time.

 
 
 
pat wilson
1.1.3  pat wilson  replied to  TᵢG @1.1.1    one month ago

Is it one of the huge ships ?

Did that once. My first time was my last time.

 
 
 
TᵢG
1.1.4  seeder  TᵢG  replied to  pat wilson @1.1.3    one month ago

Unfortunately the huge ships are on the Caribbean cruises.   Larger ships take the Mediterranean, etc.   Northern Europe (due to the route) has the smaller ships.

I like the big ships (personally) but the smaller ships are certainly better when playing the germ game.

 
 
 
pat wilson
1.1.5  pat wilson  replied to  TᵢG @1.1.4    one month ago

I'm just not a cruise person. But I do think I'd like the small ones that go through Europe.

 
 
 
sandy-2021492
1.1.6  sandy-2021492  replied to  pat wilson @1.1.5    one month ago

I've enjoyed the cruises I've taken, but always wished we had more time in port.  I'm trying to talk my sister into going on a river cruise in Europe with me sometime.  Or I may just end up going on my own.

 
 
 
TᵢG
1.1.7  seeder  TᵢG  replied to  pat wilson @1.1.5    one month ago

Check out the Rhine River Cruises (and similar).   These are very small ships (200 passengers I believe).   We considered this (and might still do this later) so from what I saw I think it would be a cool vacation.

 
 
 
TᵢG
1.1.8  seeder  TᵢG  replied to  sandy-2021492 @1.1.6    one month ago

Yeah, you have to plan well to make the most of your time.   The whole point of a cruise is the ports of call.

 
 
 
sandy-2021492
1.1.9  sandy-2021492  replied to  TᵢG @1.1.8    one month ago

I like being at sea, too.  Something about being out there in the middle of nowhere, with no land or other ships in sight, just appeals to me.  Maybe I was a sailor in a past life.

 
 
 
TᵢG
1.1.10  seeder  TᵢG  replied to  sandy-2021492 @1.1.9    one month ago

We always have a balcony.   There is just nothing like reading a book on a balcony while at sea.   It puts you right in the center of the awesomeness of nature (realizing the size of it all).

 
 
 
sandy-2021492
1.1.11  sandy-2021492  replied to  TᵢG @1.1.10    one month ago

Same here.

 
 
 
Tessylo
1.1.12  Tessylo  replied to  pat wilson @1.1.3    one month ago

Other than being on a plane, a ship, a big ship, a cruise ship, is one of my biggest fears.  Being out in the middle of the ocean?  NO!  

 
 
 
Trout Giggles
1.1.13  Trout Giggles  replied to  TᵢG @1.1.7    one month ago

That's what I want to do, the Rhine River or the Danube

 
 
 
Trout Giggles
1.1.14  Trout Giggles  replied to  Tessylo @1.1.12    one month ago

Same here...I have to see land at all times! LOL!

 
 
 
MrFrost
1.2  MrFrost  replied to  TᵢG @1    one month ago

TiG... You're a smart person but I will still state the obvious. Wash your hands, often. Best defense against catching someone else's germs. 

Oh yea, I want a t-shirt and a bobble head hula girl. 

 
 
 
TᵢG
1.2.1  seeder  TᵢG  replied to  MrFrost @1.2    one month ago

Good advice.

Good thing about cruise lines is that they have hand sanitizers everywhere and pretty much force passengers to use them upon entering a dining area.

 
 
 
MrFrost
1.2.2  MrFrost  replied to  TᵢG @1.2.1    one month ago

That's a good idea as well, and you can always pack your own as well. Personally, I think we use it too much, (don't get me wrong, I use it all the time), because it's starting to make some 'bugs' resistant to it. MRSA, (Methicillin-resistant Staphylococcus aureus), was born in a big way from people not taking all of their antibiotics until they are gone. They feel better, so they stop taking them, not killing off the bacteria completely, but enough so the body's own defense systems to take over. Using hand sanitizer may be leading us down a similar path. Still it's an excellent way to protect from public germs.

Ok, last thing, then I gotta get to bed... 

Another thing we USED to do was have brass handles on doors in public places. But, brass is soft and expensive, so we stopped using it. The reason we used it in the first place? Brass is a natural antimicrobial. 

But that whole thing is a long article all in itself and my chemistry is rusty. 

 
 
 
sandy-2021492
1.2.3  sandy-2021492  replied to  TᵢG @1.2.1    one month ago

I remember the hand sanitizers - every dining room, every staircase and elevator, every theater entrance, and on the gangway returning from every shore excursion.

You'll be fine.

 
 
 
TᵢG
1.2.4  seeder  TᵢG  replied to  MrFrost @1.2.2    one month ago

Only time I use hand sanitizers is on a cruise or when eating in a public place.   The rest of the time it is good old-fashioned soap.   For the very reason you state.

 
 
 
TᵢG
1.2.5  seeder  TᵢG  replied to  sandy-2021492 @1.2.3    one month ago

We are experienced cruisers so we will be careful.

 
 
 
Tacos!
2  Tacos!    one month ago
we were subjected to a commercial for Disney's cruise line, sold as a family-friendly excursion with your favorite Disney characters. My son, of course, was ready to go tomorrow. I didn't have the heart to tell him that as my child, he's never getting on one of those things.

Well then, you (author) are making a big mistake. Disney cruise ships consistently score extremely high in the CDC's tests of cruise ship cleanliness - almost always at or near 100. Having cruised with Disney myself, I can tell you they are very fastidious and concerned with avoiding disease. Also, the kids absolutely it and it's the kind of vacation you can take with kids and actually relax because they are very well taken care of.

 
 
 
Split Personality
3  Split Personality    one month ago

In my own scientific bubble, I subscribe to the theory of the Aquatic Ape.

Being drawn to the beaches by the millions every summer does little to dissuade me me from my favorite theory of evolution.

Being creatures of the oceans who came to the land, evolved into large land based primates who almost returned to the seas to join our

cousins, the whales, dolphins, seals, porpoises, sea otters and others, 

for some reason(s) we, like the hippos and elephants turned back to the land,

but never forgot our love of the seas.

From the earliest recordings of human histories we have taken to the sea

to fish

to sail

and explore

it's in our DNA

 
 
 
Kathleen
4  Kathleen    one month ago

Happy Anniversary Tig.

I hope you both have a nice time. We have never taken a cruise yet, but thinking about if for next year. 

Just have a great time.

 
 
 
TᵢG
4.1  seeder  TᵢG  replied to  Kathleen @4    one month ago

Thanks Kathleen.

 
 
 
Sparty On
5  Sparty On    one month ago

Having spent my share of time vacationing on Islands visited by cruise ships, i developed a name for people on cruises.

Pod people.   They all look and act the same.

They arrive at the island and squadrons of transportation shows up to help them on their time sensitive missions.   You learn which establishments to stay away from while they are in port.   First they come in squad size, then it swells to Platoon, company and even Battalion size.   Hurry up .... gotta get there to buy Vanilla Extract, gotta get a hammock there, need a t-shirt from there and hit the famous watering hole for shooters before they gotta get back, etc, etc.   Get to point A, B, C .... X,Y,Z as fast as possible and don't get in their way ....

I'm with ya Tig, there is NO WAY they'll every get me on one of those things and we've been severely tempted by the Alaska cruises of late.

Give me strength ....

 
 
 
Kathleen
5.1  Kathleen  replied to  Sparty On @5    one month ago

My sister and her husband went on the Alaskan cruise. They enjoyed it, but the water was rough. Get that sea sick patch ready..

 
 
 
katrix
5.2  katrix  replied to  Sparty On @5    one month ago

The Alaska cruise is well worth it. There's really no other good way to see the Inside Passage. I took my mom on a cruise-tour - a week on the ship going up the Inside Passage (and nice long amounts of time docked at the ports of call, Ketchikan, Juneau, and Skagway) and then three nights in Denali State Park. I booked the excursions through the ship; it cost more but was worth it, because they won't leave without you that way. With an 80 year old in tow, I did not want to risk missing the ship!

One of my friends used to work at Denali State Park and his friend was still the superintendent at the time; they told me to go in June. It's a little cooler out, but you have a much better chance of actually seeing the mountain - and it was out every single time we were in range to see it! Only 30-some percent of people get to see it, so we were lucky. I have a picture of myself kayaking in a lake with Denali in the background.

For the Caribbean, though?  Hell, no. I want to spend my time on the beach and trying out local restaurants, not on a cruise ship. Except for Alaska, I think I'd just do European river cruises.

 
 
 
Sparty On
5.2.1  Sparty On  replied to  katrix @5.2    one month ago
I think I'd just do European river cruises.

Yeah, those sound interesting as well.

 
 
 
TᵢG
5.2.2  seeder  TᵢG  replied to  katrix @5.2    one month ago
The Alaska cruise is well worth it.

Best thing about it (other than the scenery) is the opportunity to get out and explore.   If one likes to hike in nature, take helicopter rides to isolated areas, ride in various boats to isolated islands, etc. then this is a great cruise.   This cruise is all about nature; the little port towns are quaint but not very interesting.

 
 
 
SteevieGee
5.3  SteevieGee  replied to  Sparty On @5    one month ago

I once spent some time on Grand Cayman Island.  There are basically two modes for the island.  Ship in and ship gone.  Normally it's a very laid back and relaxing place.  With a ship in the population of the island doubles and everything is crowded and all the locals are busy making money.  That's when we stayed out at the east end where it's more rural.  If you dislike crowds cruising may not be the best option.  Wherever you go you bring the crowd with you.

 
 
 
Sparty On
5.3.1  Sparty On  replied to  SteevieGee @5.3    one month ago

Yep been there.   Little Cayman is much better in that regard.   I've been diving Caribbean and other islands for decades.   Take Cozumel for example.   40 years ago it was a pretty sleepy little island.   Fantastic diving.

Not so much now, haven't been in years.   Used to be you might see one or two cruise ships per week.   Last time i was there, there was a half a dozen or more nearly everyday.   It really destroyed what Coz was.

 
 
 
Kavika
5.3.2  Kavika   replied to  Sparty On @5.3.1    one month ago

IMO, Fiji and the South Pacific are the best diving in the world. 

The coral coast of Fiji is unmatched. 

Diving the Truk Lagoon in Micronesia is a once in a lifetime experience. There is something for everyone, from the novice diver to the experienced technical deep diver. 

Both my wife and I have been diving in Australia on the ''Great Barrier Reef''.....I believe that Fiji and the surrounding island are better diving. Micronesia is in a world of its own.

 
 
 
Sparty On
5.3.3  Sparty On  replied to  Kavika @5.3.2    one month ago

Yep Truk was great for wreck diving.   Not much else though really.   Did live-aboards when we dove there.   A week stop once in Palau to dive and see where my Uncle fought on Pelelui.   Short stop in Yap one trip.   Great trips!

Believe it or not i still say Cozumel was the best overall diving I've done.   But that was 40 years ago.  The strong currents there kept the sealife and coral thriving.   Not even close today unfortunately.   Too many novice divers bouncing off the reefs, feeding groupers and trying to blow up Pufferfish.

It's still nice but nothing close to what it was.   And the island life is out of control with all the cruise ships stopping now.

 
 
 
Kavika
5.3.4  Kavika   replied to  Sparty On @5.3.3    one month ago

The last time I was diving in Cozumel was in the mid 80's....Haven't been back since. 

In Fiji you can do the live-aboard thing as well...Hundreds of island in the chain and many of them have never seen a diver.

We've done that live-aboard thing in Fiji, twice. 

 
 
 
Sparty On
5.3.5  Sparty On  replied to  Kavika @5.3.4    one month ago

Fiji is on my list ....

 
 
 
Freefaller
5.3.6  Freefaller  replied to  Sparty On @5.3.5    one month ago
Fiji is on my list ....

Just a suggestion but I've done some south pacific (never Fiji) a lot of the Caribbean and Central America and imo the best diving was in the Maldive islands

 
 
 
Sparty On
5.3.7  Sparty On  replied to  Freefaller @5.3.6    one month ago

So many dive sites, so little available bottom time ....jrSmiley_9_smiley_image.gif

 
 
 
Kavika
5.3.8  Kavika   replied to  Freefaller @5.3.6    one month ago

I've heard that the Maldive Islands is really spectacular diving.

 
 
 
Freefaller
5.3.9  Freefaller  replied to  Kavika @5.3.8    one month ago

I could go on for hours about it, but trust me it's amawsome (amazing + awesome)

 
 
 
TᵢG
5.4  seeder  TᵢG  replied to  Sparty On @5    one month ago

If you ever want to take the plunge (so to speak) I recommend a Mediterranean cruise.   Best cruise ever!   You visit many of the most famous ancient cities of the world like Rome, Athens, Pompei, etc. and every port of call is rich in culture, archeology, scenery and outstanding local cuisine.

 
 
 
Freefaller
5.4.1  Freefaller  replied to  TᵢG @5.4    one month ago
Best cruise ever!   You visit many of the most famous ancient cities of the world like Rome, Athens, Pompei, etc. and every port of call is rich in culture, archeology, scenery and outstanding local cuisine.

I think the same way about the Nile River cruise I did

 
 
 
Kavika
6  Kavika     one month ago

We've taken a number of sailing vacations over the years. Only two of them were ''large ship'' cruises. The Mexican coast and an Alaska cruise. 

The majority of the time we take small ship cruises. 199 ft sailing ship through the Caribbean. 150 motor sailer off the coast of Yugoslavia. 175 ft motor sailer through the Greek Islands. A 100 sailboat off the coast of Turkey and of my favorites, a small ship cruise in Alaska. 40 cabins and a ton of fun. 

I could recommend any of these adventures. The large cruise ship, not so much.

 
 
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