Battle against norovirus

15th of September 2010

Tom Crockford reports on how cruise ship companies are tackling the risk of norovirus outbreaks.

The recent summer has been untypically long and hot in this part of Europe. For example, after a record breaking cold winter, Finland recorded its hottest summer in some 85 years. Passengers on the many cruise ships visiting Helsinki have been met with temperatures more likely to be found on the Mediterranean than the Baltic Sea.

Every summer more than 100 large cruise ships sail these northern waters doing the Copenhagen, Stockholm, Helsinki, St Petersburg, Tallinn tour. They bring both life and colour, as well of course as the ever-important revenues. Oh, and one more thing, in recent years especially, they have brought the risk of disease. And with hot weather, the risk of disease is always much greater.

Cruise ships are, in effect, luxury floating prisons. It is a self-confined environment wherein people mingle at relatively close quarters and, between port calls at least, there is no escape. Under such conditions infection can spread rapidly, and indeed often does. And when the ship arrives in port and passengers disembark, the infection can go along for the ride and be transferred to people on shore.

Most notable amongst cruise line sicknesses in recent years has been the notorious Norwalk Virus, now more familiarly known as the Norovirus. Named after an outbreak of acute gastroenteritis at a school in Norwalk, Ohio in the USA, the virus affects people of all ages. It is transmitted by faecally contaminated food or water, by person-to-person contact and aerosolisation that subsequently contaminates surfaces.

The result is a relatively short but extremely unpleasant, period of vomiting, nausea and diarrhoea. Closed or semi-closed communities, such as cruise ships, are ideal breeding grounds for the illness, which is often traced to food having been handled by an infected person.

Needless to say the negative publicity that surrounded these outbreaks has had the potential for being disastrous to the US$  14 billion cruise line industry. Not surprisingly the industry’s response has been quick, and as far as we can tell, appears to have been somewhat successful. Personal hygiene is of course the key to prevention, and crew members – especially those involved in catering or food handling – are nowadays made particularly aware of this fact. Cleaning too has taken on a seemingly new importance, with more staff employed and increased sanitary measures.

For example it was reported that the Holland America Line’s ‘Amsterdam’ had nearly 600 crew members spend 10 days carrying out a thorough cleaning of the ship after a voyage had to be cancelled because of illness. The entire vessel was scrubbed and disinfected, the bed pillows were replaced and all the linen was steam cleaned. On many ships self-service buffets have been eliminated and replaced by waiter service, with the waiters wearing gloves.

This kind of response has largely been effective, and recently there have been few reported incidents of norovirus outbreaks on cruise ships. At least there don’t appear to have been any major occurrences. All of which is good news for the inhabitants of the port cities where the ships call, and Helsinki’s University Hospital has not had to deal with any significant outbreaks this summer. Let’s mark this up as a victory for good cleaning practices!


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