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Old February 9th, 2012, 03:07 PM
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Default Norovirus question

Since there seems to be a norovirus outbreak on so many cruises what is the likelihood that people will cancel upcoming cruises ?
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Old February 9th, 2012, 05:05 PM
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I haven't personally heard anything, but my friend said it was on the news here about cancellations and drop in bookings.
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Old February 9th, 2012, 05:25 PM
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Little or none.

If you think this is bad go back to around 2005. There was a wave of outbreaks. It was nationwide but the cruise ships got most of the publicity.

I would also stay away from hospitals, nursing homes, schools and other places where people are in close quarters.

Notorious outbreak at 35 hospitals closes dozens of wards - Telegraph

A bit of Trivia from the CDC

http://www.cdc.gov/ncidod/dvrd/revb/...ase-burden.htm



Of 660 outbreaks confirmed by CDC between 1994 and 2006,
  • 36% were from long-term care facilities (e.g., nursing homes),
  • 31% were from restaurants, parties, and events,
  • 20% were from vacation settings (including cruise ships), and
  • 13% were from schools and community settings.
Outbreaks refers to "groups" and not single cases. If you notice "vacation settings" is number 3 on the list and includes hotels, motels, resorts and other settings. The other 80% of Norovirus outbreaks occurred in places other than a "vacation" setting.

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Old February 9th, 2012, 05:55 PM
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I work in an operating room with docs all day (oh how fun) and they said that it is such a rare thing that nobody should really worry. I leave in about 2 weeks and don't have the slightest thought about it.
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Old February 9th, 2012, 05:57 PM
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I would not worry about it either.

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Old February 9th, 2012, 11:10 PM
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I'm not worried ,just curious .
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Old February 10th, 2012, 06:02 AM
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Originally Posted by Manuel View Post
I would not worry about it either.

TM
One can't worry about being on a cruise. This virus is rampant everywhere. Chances are if you get sick on board, it's because the bug was picked up prior to boarding, contrary to narrow minded people who insist it was the ship's fault.
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Old February 10th, 2012, 11:28 AM
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On this last Princess cruise that they cut short only 7% of the passengers got sick.

Plus the problem is that you cannot cancel a cruise without a penalty if you have already made final payment *after its due date).

Noro is not a qualified or valid reason to cancel a cruise.

Even if you have travel insurance you can't cancel the cruise, unless you actually get sick, saythe day you were going to leave. And then the virus runs its course in 48 hours and you would have been fine.

(Travel insurance will only cover you if you are sick, it does not give you the option to cancel)
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Old February 10th, 2012, 11:30 AM
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Is there anything one can do to avoid getting the virus ,a preventative pill,spray ,etc ?
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Old February 10th, 2012, 01:21 PM
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The reason the CDC is being so vigilent about Noro on cruise ships this year is because it is so prevalent on land.

It has been getting worse that last two years. In 2010 London had half a million cases. They had to shut down the emergency rooms.

But Noro is not a "reportable" disease to the CDC, so you rarely hear stories about it hitting other institutions.

It is only reportable by cruise ships because the cruise lines chose to make it reportable under the Vessel Sanitation Program the cruise lines created in conjunction with the CDC back in the 1970s.

(How do I know all this? I just talked to Michael Crye at CLIA)
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Old February 10th, 2012, 02:05 PM
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Is there anything one can do to avoid getting the virus ,a preventative pill,spray ,etc ?
There are many things you can do to avoid getting a virus - and you do not have to get involved with all the pills, sprays, potions, and other goofy ideas that usually don't work.

It's all about common sense - which is not very common these days.

I am on my 1,412th cruise this week. Around 200 of those cruises were in Code Red conditions, with as many as 500 sick and vomiting passengers all around me. I had to go into many of their cabins to meet with them, I shook hands with many who knew they were sick (but they forgot to tell us), I wheeled many of them down the gangway to go to a hospital.

But I have NEVER contracted Norovirus in all those years, despite constant exposure to it.
There is no immunity to Norovirus - except for those who are just recovering from it. And that immunity is very short-lived.

For the 1,000th time, to prevent getting Norovirus on a ship:

1. ALWAYS wash your hands frequently and properly with hot soapy water.
2. NEVER put your hands or fingers into your mouth, nose, or eyes.
3. NEVER eat in the buffet, especially during the first 72 hours onboard.
4. NEVER touch food with your bare hands.
5. DO NOT shake hands with anyone.
6. After touching public handrails, elevator buttons, and door knobs, clean your hands.
7. The sanitizing gel may help - but not if you are too dumb to realize that the outside of the bottle is always contaminated.
8. NEVER, NEVER, EVER use a public toilet on a ship.
9. DO NOT eat anything in a public toilet. This seems to be a new trend with Americans. We are carrying more and more dirty plates and glasses out of toilets every day.
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Old February 10th, 2012, 02:26 PM
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Bruce...

I agree with all of your suggestions - especially never touching your eyes, nose, mouth until you wash your hands anyway.

You can also hit elevator buttons with elbows.

By the way - if you see people serving you in the buffet, it is a sign that Norovirus is aboard, probably affecting 3% of the population (that is when that protocol is triggered).

If you DON'T see it, you are probably on a pretty safe ship.

I have never heard the one about not eating in the buffet for the first 72 hours - can you explain that logic, please?

And by the way - I do use public toilets on ships, but I also wash my hands very carefully afterwards and do not grab the door handle with a bare hand (I use a towel, or my elbow if I can). Many ships now have automatic restroom doors. I fugure it is better to have clean hands than to walk around with possibly dirty hands.

Also - they have known for awhile now that alcohol sanitizers do not kill Noro - so why do ships continue to provide them everywhere. They are somewhat useful if you also provide a towel to wipe it off, but the main goal is to get the virus off of your hands.

And finally, uummm.... just because you find dishes in the restrooms it doesn't mean people are eating in there. I am guessing they just left the dishes in there rather than out in a public area. I know I have done that.
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Old February 10th, 2012, 07:01 PM
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Paul,

Last year my colleagues at the CDC made 2 awards to cruise lines who were doing the best job of preventing and controlling the spread of viruses on ships.

Holland America Line received the top prize for their "Code Orange" procedure. This calls for no self-service in the buffet for the first 48 hours of every new cruise.

NCL received the second prize for their monitoring and sanitizing of ship's public toilets after EVERY use, for the first 24 hours of every new cruise.

Why did they award these prizes?
1. We know that the #1 place on a ship to get food contaminated by newly ill passengers is the buffet. There is a stampede on Day 1 to get there and start eating your money's worth. After 48-72 hours, most of the ill passengers are either recovered, or too ill to go to the buffet to contaminate the food any further.

2. We know that the second most likely place to contract a virus is in a public toilet. People raised by wolves would rather make a mess in a public toilet than in their own. These same people rarely wash after using the toilet. When they behave like this in their own bathrooms, they do not put the rest of us at much risk. Doing it in a public restroom enangers us all.

So your comment about a no self-service buffet indicating an outbbreak of some sort is quite true on most cruise lines - except HAL.

Having an attendant standing outside a public toilet to sanitize after every use would also indicate some sort of problem on just about any cruise line - except NCL.
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Old February 10th, 2012, 09:12 PM
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I, too, find the buffet thing curious.

If I use the stairs, holding the handrail, on my way to the buffet, or I take the elevator, pushing the button to the deck the buffet is on, who is to say I did not contract the bug from the button or handrail along the way to the buffet and not in the buffet itself?
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Old February 10th, 2012, 09:53 PM
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Not using a toilet onboard is absurd! Should passengers start packing Depends?
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Old February 10th, 2012, 10:00 PM
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Not using a toilet onboard is absurd! Should passengers start packing Depends?

I hope he is not advocating the pollution of the seas .
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Old February 10th, 2012, 11:03 PM
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I avoid the public restrooms as much as I can. I usually go back to my cabin if I have to relieve myself. There are times it isn't feasible but if it isn't an "emergency" I will opt to go back to the cabin.

Take care,
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Old February 10th, 2012, 11:07 PM
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I try to avoid public restrooms anywhere ,planes ,trains ,ships ,stores ,movie theatres .However ,there are times when one in a civilized world has no alternative .
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Old February 11th, 2012, 09:25 AM
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Mike, I agree, that's the option I seek as well, but, the lines, say, after the show gets out, tell another tale.
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Old February 11th, 2012, 11:07 AM
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My wife is like a camel, she can store water for days - because she really dislikes public restaurants. Now, if we could only stop that nail-biting.
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Old February 11th, 2012, 01:51 PM
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I, too, find the buffet thing curious.

If I use the stairs, holding the handrail, on my way to the buffet, or I take the elevator, pushing the button to the deck the buffet is on, who is to say I did not contract the bug from the button or handrail along the way to the buffet and not in the buffet itself?
There is a massive difference between 1) having your hands contaminated on a dirty handrail and 2) having your food contaminated by a dirty passenger.

In the first case, your hands may not be sterile, but you still have the choice to put them into your mouth or not. Keeping them out of your mouth and away from direct contact with your food keeps you well.

In the second case, you have no choice and no way of knowing if some slob has handled the buffet food and contaminated it for you. If your hands are absolutely clean and sterile, you will still get ill if you unknowingly eat buffet food that was contaminated by the person who was there 2 minutes before you.
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Old February 11th, 2012, 01:58 PM
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Quote:
Originally Posted by Trip View Post
Not using a toilet onboard is absurd! Should passengers start packing Depends?
I have been "not using public toilets" on ships for several decades. It may be only coincidence that I have never contracted NLV in all that time. It may be only coincidence that the CDC gave the award to NCL for their efforts in controlling NLV by sanitizing public toilets so often.

I find it absurd that the cruise lines continue to market to a group of people who are so unclean with basic hygiene that we have to go to these lengths to stay well.
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Old February 11th, 2012, 03:57 PM
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Well, Bruce, I applaud your ability! So, many don't have your fortitude.
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Old February 11th, 2012, 04:59 PM
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Many years ago I worked with a woman who traveled (not cruises) with jars for her husband to relieve himself because she feared public restrooms .This was in 1972 .
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Old February 11th, 2012, 05:05 PM
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Henry you just raised the yuck factor....<blech>
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Old February 11th, 2012, 06:40 PM
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Quote:
Originally Posted by Bruce Chafkin1 View Post
There is a massive difference between 1) having your hands contaminated on a dirty handrail and 2) having your food contaminated by a dirty passenger.

In the first case, your hands may not be sterile, but you still have the choice to put them into your mouth or not. Keeping them out of your mouth and away from direct contact with your food keeps you well.

In the second case, you have no choice and no way of knowing if some slob has handled the buffet food and contaminated it for you. If your hands are absolutely clean and sterile, you will still get ill if you unknowingly eat buffet food that was contaminated by the person who was there 2 minutes before you.
The point here is that there is an assumption that the bug was contracted by food in the buffet. Look at the timing. "I got sick after eating so it must be the food". There is no way to say with certainty that the person did not pick up the bug along the way to eat on their hands, then grab a hot dog or burger from their plate with their contaminated hands and consume the contaminate passed from their hands onto the bun. It didnt originate in the food.
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Old February 11th, 2012, 09:14 PM
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Here is an in depth medical article on the subject.

Medscape: Medscape Access
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Old February 11th, 2012, 11:13 PM
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Quote:
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The point here is that there is an assumption that the bug was contracted by food in the buffet. Look at the timing. "I got sick after eating so it must be the food". There is no way to say with certainty that the person did not pick up the bug along the way to eat on their hands, then grab a hot dog or burger from their plate with their contaminated hands and consume the contaminate passed from their hands onto the bun. It didnt originate in the food.
Whenever we have more than 2 passengers sick with GI symptoms - which is just about every day of the year - we are required to complete a "cluster form". This form details every activity, and every bit of food consumed (and where and with whom) for the previous 72 hours, for each afflicted person.
We are trying to identify commonalities between the ill passengers, attempting to identify a source of their illness.

We know for sure that people do not get sick from having dirty hands.
They get sick after putting those dirty hands into their mouths, noses, or eyes, or after they or somebody else with dirty hands contaminated their food.

When you order food in the dining room, there are very few opportunities for someone else to contaminate your food. It is cooked or prepared in the galley, plated, and delivered straight to you. Most dining room food is eaten with utensils, reducing the chance that you may be dumb enough to contaminate your own food with dirty hands.

When you eat in the self-service buffet, thousands of people have a chance - intentionally or otherwise - to contaminate your food before you get it. They handle the same serving utensils you do. They put the handle of the serving utensils into the food you are about to take. They touch food in the buffet.They pick up food items and then put them back. Some people take a bite of food and put it back. They fill personal water bottles, pushing the parts they have touched with mouth and hands against the tap that you are about to get water or juice from.
They use the ice scoop and put the dirty handle back in the ice.
Even worse, many buffet food items are eaten with the hands; pizza, sandwiches, hot dogs, cookies, ice cream cones.

So we fill out these Cluster Forms every day for our ill passengers.

What is the #1 commonality among these sick people?
Eating in the buffet.
That in itself doesn't tell the entire story. Many people eat in the buffet.
But it is very rare when we interview a sick passenger who did NOT eat in the buffet.
The CDC has done extensive studies that confirm the elevated risk of eating in the buffet.
HAL ships used to have the highest rate of outbreaks in the mass market category. They asked the CDC for advice and help to reduce the numbers. CDC recommended that they suspend self-service in buffets for the first 48 hours of every new cruise. As soon as they started this, the number of outbreaks on HAL ships went down more than 50%, and has stayed there.

And the #2 commonality amongst ill passengers?
Using public toilets on ships.
This also doesn't tell the entire story. Many people use the public toilets.
But the ones who do not almost never appear on those cluster forms.
The CDC once again did extensive tests to confirm that public toilets on ships are high risk areas.
Logic tells us that if only 2 people are using a toilet and both are well, the odds of catching something in that toilet are very slim. If 1,000 people are using a toilet, the odds that at least one of them is ill and not very clean are very high.
As soon as NCL started their public toilet sanitizing after every use for the first 24 hours of every new cruise, their numbers dropped and stayed low.
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