Several Florida-based ships have reported outbreaks. The Carnival Freedom was denied entry to Aruba and Bonaire after an undisclosed number of passengers and crew aboard caught the virus.
The Mexican government said Tuesday it would allow cruise ships with reported coronavirus cases to dock. The country's Health Department said passengers or crew who show no symptoms will be allowed to come ashore normally, while those with symptoms or a positive virus test will be quarantined or given medical care. More News. Limited Open Choice spots now available to Norwalk students.
Solar power on the rise in Norwalk school buildings. In-Depth Coverage. Even when they do happen, most outbreaks of gastrointestinal illness on ships affect a relatively small percentage of passengers. Even the Oasis of the Seas outbreak, as big as it was, only affected about 8.
So why do we keep reading about outbreaks on ships? The cruise industry is the only major industry that tracks every single gastrointestinal illness reported by its customers and passes on the data to the CDC in real time.
The illness runs through schools, nursing homes, offices and other places people congregate in large numbers every year. In , the CDC recorded 11 outbreaks of gastrointestinal illness on cruise vessels operating out of US ports. But most of those events involved just a small number of passengers. An outbreak was recorded for a Pearl Seas Cruises sailing in September where just six of passengers reported being ill.
Ditto for a Viking Cruises voyage in December where just 28 of passengers showed signs of illness. Even the June outbreak on the Holland America ship affected fewer than passengers.
At the same time, the number of cruise ships, ship departures and people cruising has been rising rapidly, meaning the decline in outbreaks is even more pronounced than it initially seems. Cruise lines over the past 15 years have implemented ever more elaborate measures to cut down on the spread of illness between passengers, from intensive shipboard cleaning regimens to increased passenger screening.
The efforts might even seem drastic by some. The poker chips in the casinos on Royal Caribbean ships, for example, are regularly washed and sanitized to stop the spread of germs. So are the menus in restaurants.
Elevator buttons are cleaned at least twice a day. In a lengthy discussion with TPG , Rivas ticked off the many steps the company now takes to shut down illness transmission on ships, which are mapped in an outbreak prevention and response plan that has grown from around 20 pages to pages since But if just six report symptoms of gastrointestinal illness in six hours, Rivas says the vessel will go to Level Two on the plan, which brings enhanced washing and sanitization procedures across the vessel.
With more cases comes a Level Three alert, which triggers even more drastic measures that include a stop to self-service at buffet stations. They also waive the charge for passengers to come to a shipboard medical facility for cases of gastrointestinal illness and offer a credit to sick passengers who require isolation.
In another illness prevention effort, many cruise companies have begun building hand-washing stations into the entryways of restaurants and pushing passengers hard to use them. Hand-washing stations at the entrance to restaurants are now standard on all of the new ships the company is building. Symptoms include nausea, vomiting, diarrhea and severe stomach cramps. Those infected generally recover on their own within two to three days after symptoms appear.
The outbreak was detected soon after it began when two staff members who worked closely together became ill with diarrhea. A norovirus outbreak was immediately suspected because there had been numerous reports of illness throughout the Baltimore region.
As part of their investigation, nurse managers began screening all staff and patients for any signs of gastrointestinal illness. Patient stool samples confirmed that the culprit was a norovirus, and genetic testing later verified that it was the same viral strain, genogroup II.
As the investigation proceeded, staff implemented strict precautions to control the outbreak and prevent it from spreading. Patients with symptoms were placed in isolation, by being moved to either private rooms or into the same room with other sick patients.
Group therapy sessions in psychiatry were temporarily halted, and no new patients were admitted to the units primarily affected. Sick staff were sent home for as long as they had symptoms plus an additional 72 hours, sufficient time for the illness to pass and no longer be contagious. The investigation showed that many of the initial health care workers in the CCU who became ill had attended a social event outside of the hospital, where one of the non-staff guests was already experiencing symptoms.
Others likely became ill after touching a patient chart that had been handled by another ill colleague. Standard precautions to guard against infection were also followed, including a mandatory, hospital-wide staff review of basic infection control procedures with an emphasis on more frequent hand washing, accompanied by a thorough washing down of all affected hospital facilities. Even the CCU was closed for 24 hours to allow for a thorough cleaning, with all exposed surfaces getting washed down with bleach solution.
The easiest known way to kill noroviruses is through repeat washing of surfaces using bleach solutions containing at least 10 percent sodium hypochlorite. However, researchers say that even after intense cleaning efforts, norovirus particles have been found to cling to carpet surfaces, elevator buttons, bed rails and dining room tabletops. Because the norovirus outbreak was citywide, staff from outside of JHH were not allowed to work on site, while Hopkins staff, in turn, were banned from working at other facilities.
Even visitors to the Hospital were asked screening questions to identify stomach problems and, if present, were told not to see patients for 72 hours.
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