THE WORST CRUISES OF 2012

Gastric illnesses, often caused by food poisoning, are quite common on cruises. They spread quickly in these crowded, close quarters, and can totally ruin your vacation.

The U.S. Centers for Disease Control and Prevention (CDC) tries to keep you as safe as possible. When cruise ships participating in the CDC operated Vessel Sanitation Program arrive in a U.S. port from a foreign port, they are required to report the total number of gastrointestinal (GI) illness cases that have been brought to the attention of the medical officer on board during that particular cruise. These will only be a small percentage of actual cases that have occurred on the cruise: lines are often long, passengers are afraid of additional costs, and, as a result, they frequently tough it out rather than report being ill.

If 3% or more passengers or crew have had symptoms of GI illness, the ship has to file a special report. Only sizeable cruise ships (with over 100 passengers) participate in this CDC program, but some are very large indeed, carrying 5,000 or more passengers. Therefore, even this low percentage will often mean hundreds of people on board have been ill.

So which cruise ships had such large outbreaks in 2012, and what was the cause? As you can see from the below chart, norovirus or "the cruise ship virus" is the most common cause of a miserable cruise. Princess Cruises has been heavily hit, with the same ship having outbreaks more than once in the case of Ruby Princess and Crown Princess. This is not unusual, particularly in the case of the very contagious norovirus outbreaks, since it is extremely difficult to 100% decontaminate the ship after an outbreak. Princess Cruises was also heavily hit with outbreaks the previous year (2011) with Sea Princess and Coral Princess each having two serious outbreaks. Of course, since it is a huge cruise ship line, it is also more likely to have such problems. But still, it is a good idea to check out your ship if you are planning to go on a cruise (see next post).


LARGE OUTBREAKS ON CRUISES IN 2012

Cunard Line Queen Mary 2 12/22 - 01/03 - cause unknown
Princess Cruises Emerald Princess 12/17 - 12/27 - cause unknown
Prestige Cruise Oceania Riviera 11/15 - 11/29 - cause unknown
Holland America LineAmsterdam 11/11-12/5- caused by Norovirus
Princess Cruises Ruby Princess 10/09-10/28- caused by Norovirus & E. coli
Princess Cruises Dawn Princess 08/21-09/13 -caused by Norovirus
Royal Caribbean Rhapsody of the Seas 08/24-08/31- caused by Norovirus
Carnival Cruise Line Carnival Glory 08/06-08/11-caused by Norovirus
Princess Cruises Sun Princess 07/08-07/21-caused by Norovirus
Princess Cruises Ruby Princess 02/26-03/04-caused by Norovirus
Princess Cruises Crown Princess 02/04-02/09 -caused by Norovirus
Celebrity Cruises Celebrity Silhouette 01/29-02/10- caused by Norovirus
Celebrity Cruises Celebrity Constellation 01/28-02/11-caused by Norovirus
Princess Cruises Crown Princess 01/28-02/04 -caused by Norovirus
P & O Cruises Aurora 01/04-01/26 - caused by Norovirus
Royal Caribbean Voyager of the Seas 01/28-02/04 - caused by Norovirus

To your good health,

TSF

PRINCESS CRUISE SHIPS SCORED 100 FOR SANITATION!

Out of curiosity, I thought I would check out how a couple of the cruise ships with recent Norovirus outbreaks have done under the U.S. Vessel Sanitation Program (VSP) inspections (see previous post for what this is). Well...surprise..both the Ruby Princess and the Crown Princess - scored 100 during their last inspections

The Ruby Princess has an average VSP inspection score of 99 over the years, with a range of 94 to 100. During the latest inspection - in November, 2011 - when the ship scored 100, the inspectors actually found 27 infractions of vessel sanitation according to the report. Here are four random examples (they are not necessarily the worst).

• A badly scored white cutting board was observed at the soiled side of the dishwash station in one of the galleys..

• A live fruit fly was seen flying inside the cold counter display container at the crew officer mess.

• There were serious delays in reporting gastrointestinal illness among crew which could result in spread of illness. For instance, a crew dishwasher experienced gastrointestinal illness symptom onset at 5 am and only reported to the medical center at 4:30 pm. A crew member in video experienced gastrointestinal illness symptom onset 7 am and only reported to the medical center at 8 am on the following day.

• There was no procedure in the written for notifying embarking passengers following an outbreak voyage.

The Crown Princess has an average inspection score of 97, with a range from 89 to 100 over the years. During the latest inspection, also in November, 2011, when it also scored 100, some 33 infractions of good sanitation practices were listed. Here are a few examples.

• There was no 'WASH HANDS AFTER USING TOILET' sign in the restroom used byfood workers.

• None of the staff in the food preparation areas were equipped with tip-sensitive food thermometers.

• The door tracks of both food transportation lifts were soiled with an accumulation of debris.

• The safety signs for the swimming pools did not include: 'do not use these facilities if experiencing diarrhea, vomiting or fever', 'shower before entering the facility', or the bather load number. The safety sign at the children's pool did not have the above information or 'take children on frequent bathroom breaks or take children on frequent toilet breaks'. The safety signs for the whirlpools did not include the information required for the swimming pools above or a caution against pregnant women, elderly persons, or exceeding 15 minutes of exposure.

Alright, I have to acknowledge that these were not huge issues - not at the level of the water on board not being potable or the food refrigeration not working (as was the case with a couple of other ships that failed inspection), but, the sanitation on board either ship wasn't great either. As events showed, they probably should not have scored 100.

To your good health,

TSF

WHY IS NOROVIRUS SUCH A RISK ON CRUISE SHIPS?

The Safe Food Handbook has a box entitled "The Cruise Ship Virus" which highlights how frequent Norovirus illnesses are on cruise ships. Most outbreaks - like the recent ones we have had - affect both passengers and crew. So why is this nasty virus such a risk on cruises?

One of the most regular readers ran off a list of reasons to me yesterday. He even added a few that I hadn't thought of when I wrote the book. (Remember - you can get this virus from your food, water, surfaces, or, from contact with sick people). Here they are:

• The food is mass catered and therefore more subject to contamination.
• Buffets are a common feature, and these are known to be particularly risky.
• Passengers are in close physical contact with each other over a period of days or even weeks
• The ventilation systems could be adding to the problems.
• On some cruises, a large proportion of these passengers are senior citizens who tend to be less healthy and more vulnerable to such illness.
• On other "party" cruises, passengers tend to play hard and sleep little, resulting in them getting "worn down" which can also decrease their resistance.
• Passengers tend to keep going, even if feeling a bit ill, since they want to enjoy the cruise they have paid for. This may result in them passing the virus on to others.
• While any ships with outbreaks are very thoroughly cleaned when they dock, while at sea the cleaning of common facilities and cabins may be less than perfect, especially if a large number of crew are also ill and out of action.

To your good health,

TSF

HUNDREDS FALL ILL ON CRUISE SHIPS

Are you really serious about taking that cruise? I wouldn't worry too much about the ship sinking, but you may want to keep food poisoning in mind.

The cruise ship industry has been hit with a lot of bad publicity lately. First, there was the Costa Concordia disaster off the coast of Italy. And now, two Princess Cruises ships, limping into port in Florida with hundreds of very miserable passengers and crew on board due to Norovirus outbreaks.

We don't know how the virus got on board both ships, but the chances are that it boarded with the food, most likely from a common source, and spread from there. This virus is very contagious, very common on cruise ships and probably the most common cause of food poisoning. It can spread not just through food itself, but also passenger to passenger, through surfaces where droplets of vomit have landed and many other ways.

The Crown Princess, has so far reported 140 people, or about 4 percent of passengers to be ill, plus 18 members of the crew. On the Ruby Princess, 81 passengers - 2 percent of the total- and nine crew members have been reported ill so far.

Two things you can be sure of: one, these numbers will increase, and secondly, the ships will be extremely difficult to clean up. In fact, history of such outbreaks shows that there will be increased risk of another Norovirus outbreak on subsequent cruises in spite of all the efforts made.

If you are thinking of going ahead with a planned cruise, or, have a family member or friend who will do so, check out the several earlier posts on this blog which will help you to be one of the people who stays healthy.

Is Cruise Ship Food Safe to Eat? - 2/25/11
Why are Cruise Ships Risky Places to Eat - 2/26/11
How to Avoid Getting Sick on a Cruise Ship - 2/25/11
Cruising May be No Carnival if You Get Food Poisoning - 1/10/12

To your good health,
TSF
UPDATE: 02/7/12 - Two more cruise ships have reported Norovirus outbreaks in the past few days and the number of illnesses on the Princess cruises has risen (see later posts).
UPDATE" 01/7/13 - Almost a year later, outbreaks continue, including on Princess cruises. See most more recent posts.

UPDATE: 1/28/14 - The latest reported outbreak with perhaps as many as 600 ill passengers and crew (see post of 1/26/14 -
"Another Outbreak on a Cruise Ship") is on the Royal Caribbean line ship "Explorer of the Seas."