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cruise shipRecent times have not been good for cruise ships. By the time the Explorer of the Seas docked at Bayonne, N.J., last month, more than 600 passengers and crew members were sick to their stomachs. The Caribbean Princess arrived in Houston the same day after an outbreak sickened at least 192 people onboard. Over the past five years, an average of 14 cruise ships a year have had outbreaks of diarrheal illness, and the culprit is almost always norovirus, as it was on these two ships. So if you’re thinking of going on a cruise, are you going to get sick? The answer is complicated, reports a recent article in The New York Times.

Norovirus: easily contracted, no treatment, over in a few days

Norovirus infects 20 million Americans a year, according to the Centers for Disease Control and Prevention (CDC), thriving in closed areas like dormitories, summer camp cabins, health care facilities and other places, in addition to cruise ships. It spreads through contaminated food or water or by contact with contaminated surfaces. In addition to loose stool and vomiting, it can cause weakness, muscle aches, headache and fever. There is no treatment, and most people recover in a few days.

The best way to avoid it is prevention, and the best prevention is hand washing

The CDC recommends that cruise ship passengers thoroughly wash their hands before eating, or any other action that involves bringing hands near the mouth. It also recommends washing your hands after using the toilet, changing a baby’s diaper and coming into contact with communal features like railings, doorknobs and deck chairs.

Passengers are usually the culprits, not the cruise lines

Though cruise outbreaks make news, Jan Vinjé, head of the National Calicivirus Laboratory at the CDC told The Times that widespread illness occurs on only about 1 in 200 voyages. The cause? Not necessarily sloppy cruise line maintenance. “The food served on ships is usually of excellent quality, and food preparers are well trained,” Dr. Vinjé said. And when illness appears, he added, crews clean quickly and effectively. The problem, he said, is passengers. “If Grandma is sick when she gets on, she’s going on the cruise anyway,” Dr. Vinjé said. “And that’s how the virus gets onboard. Then it lands on handrails and doorknobs, and the transmission continues.”

Germs spread because restrooms are often not cleaned properly

Dr. Philip C. Carling, a clinical professor of medicine at Boston University, said that regardless of the origin, once onboard, the illness spreads widely. The main reason is failure to clean restrooms properly. “Of course they’ve been doing a good job with food,” Dr. Carling told The Times. “And if a person vomits, they soak everything in bleach. But they’re not doing any routine examination of cleaning processes.”

The CDC does inspect ships but not every changing table or bathroom. “We inspect some bathrooms, and we don’t inspect for norovirus,” said Bernadette Burden, an agency spokeswoman. Its inspection reports typically cite ships for inadequate chlorine in swimming pools, food stored at the wrong temperature, dirty cookware and other problems that could provide a breeding ground for the norovirus virus.

Rest assured: cruise lines try their best to avoid outbreaks

If it helps put your mind at ease on your next excursion, bear in mind that cruise lines do their very best to avoid outbreaks and the unflattering attention they can bring. Michael McGarry, senior vice president at Cruise Lines International Association, an industry trade group, said in the article that cruise companies take careful steps to control illness, including asking passengers as they board if they are or have recently been sick, sanitizing frequently touched surfaces, and implementing response plans in case of illness.

The take-away? Even though norovirus has been known to be a pesky passenger on cruise ships, that shouldn’t deter you from taking that excursion you’ve always dreamed of. Just pack plenty of Purell.

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