Cruising and noro

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I’ve never been on a cruise. Sometimes we talk about taking one, hopping from island to island and relaxing on the open seas.

And then comes another round of norovirus outbreaks. Lots of news coverage, throwbacks to the poop cruises and pictures of the CDC Vessel Sanitation program officials boarding ships.

Restaurants are linked to 64 per cent of norovirus outbreaks. CDC says that cruise ships get a lot of the attention but only account for only about 1 per cent of norovirus outbreaks.

But not everyone goes on a cruise.

In 2013, according to the Florida-Carribean Cruise Association 11.7 million North Americans (out of a total of ~530 million residents) went on cruises.

In this week’s MMWR, the good folks at the CDC released an analysis of cruise-related noro. MSMajestyOfTheSeasEdit1

From 2008 to 2014, the rate of acute gastroenteritis on cruise ships decreased among passengers from 27.2 cases per 100,000 travel days in 2008 to 22.3 in 2014, while the rate among crew members was essentially unchanged. The rate among both passengers and crew members was higher in 2012 compared with the preceding and following years, likely because of the emergence of a new norovirus strain. Among 73,599,005 passengers on cruise ships during 2008–2014, a total of 129,678 (0.18%) cases of acute gastroenteritis were reported during outbreak and nonoutbreak voyages; among 28,281,361 crew members, 43,132 (0.15%) cases were reported. Only a small proportion of those cases were part of a norovirus outbreak.

Cases of acute gastroenteritis illness on cruise ships are relatively infrequent. Norovirus, the most common causative agent of outbreaks, accounted for 14,911 cases among passengers and crew members during 2008–2014, 0.01% of the estimated number of norovirus cases in the United States during the study period. To further reduce acute gastroenteritis on cruise ships, travelers should practice good hand hygiene, especially after using the toilet and before touching the face or eating; persons experiencing diarrhea or vomiting should promptly report their illness for proper assessment, treatment, and monitoring.

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About Ben Chapman

Dr. Ben Chapman is a professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.