Health & Life® MedixNet® • Health and Medical Publications, November 6th, 2006
Food Poisoning in cruises...
Cruise-ship outbreaks of infectious diseases demonstrate how easily germs can be transmitted from person to person in a closed environment, resulting in large numbers of passengers affected.
The continuation of these outbreaks on consecutive cruises with new passengers and the resurgence of outbreaks caused by the same virus strains during previous cruises on the same ship, or even on different ships of the same company, suggests that environmental contamination and infected crew members can serve as reservoirs of infection for passengers.
The increase in reported 'Norovirus' outbreaks on cruise ships might reflect an actual increase in Norovirus outbreaks or it might be attributable to improved reporting and more frequent use of new, sensitive lab tests.
Noroviruses are well-known etiologic agents of Acute Gastro Enteritis [AGE]; They cause millions of cases each year in the general population and are the leading cause of outbreaks of this disease, which usually lasts between twelve hours and five or six days, and is characterized by sudden onset of nausea, vomiting, and watery diarrhea. The incubation period is between twelve and forty eight hours.
The virus is transmitted by hands contaminated through the fecal-oral route, directly from person to person, through contaminated food, water, miscellaneous beverages or by contact with surfaces contaminated by saliva droplets [fomites], unwashed hands or utensils, etc.
Because of high infectivity and persistence in the environment, transmission of these viruses is difficult to control through routine sanitary measures. Although Noroviruses causes a self-limited gastroenteritis, elderly passengers, children, and those with severe underlying medical conditions might be at increased risk for complications because of volume depletion and electrolyte disturbances.
Hospitalization of adults who contract this virus, who are otherwise healthy is rare. Neither specific antiviral treatment nor a vaccine has been developed for Noroviruses.
In addition to emphasizing basic food and water sanitation measures, control efforts should include thorough and prompt disinfection of ships during cruises, identification and isolation of ill crew members and, if possible, passengers for three or four days after clinical recovery.
Suitable disinfectants include freshly prepared chemical compounds. Cruise ships also should promote frequent, rigorous hand washing with soap and water by passengers and crew members.
Rapid implementation of control measures at the first sign of a suspected virus-induced gastroenteritis outbreak is critical in preventing additional cases. When routine disinfection measures are unsuccessful at interrupting the spread of virus during an outbreak, more extensive disinfection and a period of time without passengers aboard a ship might facilitate elimination of the virus.
If we are planning to go on a cruise, we should find out about recent gastroenteritis -or other infectious diseases outbreaks on a specific cruise or cruise line by contacting our travel agent and the health department at the city of the port of departure, or the Center for Disease control [CDC], Vessel Sanitation Program [VSP], 1-800-323-2132.
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