Celebrity Cruises Have Third Straight Bout with Norovirus

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About 350 of the 1,829 passengers on the Celebrity Mercury cruise ship have become ill with norovirus. The cruise left Charleston SC on March 8th headed for the British Virgin Islands, and will return to port a day early.

Noroviruses are a group of viruses previously known as the Norwalk-like virus. The virus causes gastroenteritis, an inflammation of the stomach and large intestines. It is transmitted through the fecal-oral route, and may or may not be related to food. The CDC reported an increase in the number of norovirus outbreaks in 2006 and 2007.

Most norovirus outbreaks are seen in settings where people cluster, such as nursing homes, hospitals, day care centers, hotels and cruise ships. Symptoms most often include vomiting, diarrhea, and stomach cramping. Fever, chills, headache, muscle aches and fatigue are less common symptoms. The illness often begins suddenly and lasts about 1 to 2 days.

The most recent cruise is the third for the ship. More than 400 passengers and crew aboard the Mercury became ill and returned to Charleston on February 26th and 182 cases were reported on another sailing.

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Many cruise ships participate in the Centers for Disease Control and Prevention Vessel Sanitation Program (VSP). They are required to report the total number of gastrointestinal illnesses evaluated by the medical staff before the ship arrives at a U.S. port. The CDC says that this year there have been eight outbreaks, compared to six at this time last year.

The VSP operates under the authority of the Public Health Service Act and conduct sanitation inspections as well as monitor and investigate reports of illness outbreaks. Cruises that carry 13 or more passengers or have a foreign itinerary with US ports are under the VSP jurisdiction.

Outbreak investigations are conducted when ships have 2% or more of the passengers or crew with reported symptoms of gastrointestinal illness or if an outbreak has occurred and the ship has difficulty in getting the outbreak under control.

Prior to the occurrence of an outbreak, cruise lines are required to develop an Outbreak Prevention and Response Plan (OPRP) that include a detailed infection control procedure plan in the case of illness aboard ship. This is similar to a HAACP plan in food service establishments.

Should you be embarking on a cruise this year, the CDC offers these tips to protect from norovirus infection and illness:
• Engage in proper hand washing techniques throughout your voyage, but especially after using the bathroom, after smoking, and before eating;
• Avoid any food or water that you think may be contaminated;
• Avoid raw or undercooked shellfish, unnecessary direct hand contact with surfaces such as toilet room door handles, and unnecessary close contact with symptomatic ill persons.
• Take care of yourself by getting plenty of rest, drinking lots of water, and eating a healthy diet.

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