CDC Investigates Illnesses on Cruise Ships

With another cruise ship reporting similar illness as the previous cases, the Centers for Disease Control and Prevention (CDC) has been following the reoccurring scenarios. P&O’s Oceana is the most recent cruise ship that has reported gastrointestinal illness. On Tuesday, the Caribbean-bound cruise ship reported 117 on board becoming violently ill with vomiting and diarrhea. Since October at least 900 cruise ship passengers and crew members have been affected by a Norwalk-virus, which is said to be a common and highly contagious infection. According to a recent New York Times article, scientists said the recent patterns of shipboard cases indicated that the illness was coming not from food or water on the ship, but from infected passengers or crew bringing the virus onto ships.

The Centers for Disease Control and Prevention’s Vessel Sanitation Program (VSP) has been investigating several instances of gastrointestinal illness aboard cruise ships. Following are updates of investigations of Holland America’s Amsterdam, Disney’s Magic, Carnival’s Fascination, Radisson’s Seven Seas Mariner and P & O UK’s Oceana. At the current time, VSP is working closely with cruise industry officials to identify the causes.

The Oceana, which departed Port Everglades, Florida, on November 29 on a 14-day Caribbean itinerary, notified the CDC by the vessel’s medical staff and the medical director of P&O UK that 114 of 1,859 passengers and 3 of 868 crew had reported to the ship’s infirmary with gastrointestinal illness. All of the passengers originated in the United Kingdom and flew on chartered aircraft to Ft. Lauderdale, the point of embarkation. Most of the ill passengers were reported to be on one chartered flight originating in Manchester, United Kingdom. CDC staff will board the vessel this week to conduct interviews with ill passengers and crew. CDC staff will conduct an environmental assessment and expedite the collection of stool specimens for shipment back to CDC. On November 29, the vessel underwent a routine, unannounced inspection. The Oceana scored 95 out of 100 points.

Holland America Amsterdam The Amsterdam returned to service on December 1 and is providing daily reports to CDC on the health status of passengers. As of the afternoon of December 4, the vessel reported that 2 of 1,208 passengers and 1 of 579 crew had gastrointestinal illness. Previously, laboratory analysis confirmed that the cause of a recent outbreak aboard the vessel was Norwalk virus. Symptoms include nausea, vomiting, diarrhea, and abdominal pain. The illness usually develops within 12 to 48 hours of exposure and lasts from 1 to 3 days. On November 21, Holland America temporarily took the vessel out of service to do aggressive cleaning, to isolate infected crew, and to undertake other control measures.

Disney Magic The Magic remains in port in Port Everglades, Florida, and is undergoing intensive cleaning and disinfection. Last week, laboratory analysis confirmed that the cause of a recent outbreak of gastrointestinal illness aboard the vessel was Norwalk virus. CDC staff visited the vessel on December 3 to monitor the activities; they will return to the vessel on December 6. The vessel is expected to return to service on December 7.

Carnival Fascination CDC staff boarded the Fascination when the vessel returned to port in Miami on December 2 after a 3-day voyage. The vessel reported that 189 of 2,416 passengers and 13 of 895 crew experienced a gastrointestinal illness. The illness was characterized as mostly vomiting with some diarrhea. CDC staff collected food and ice samples; laboratory tests are pending.

Radisson Seven Seas Mariner The Seven Seas Mariner reported that 5 of 586 passengers and 16 of 449 crew experienced a gastrointestinal illness shortly after leaving Tenerife on a 15-day cruise; consequently, the cruise was terminated in Port Everglades, Florida, on December 2. Initial laboratory results have identified Salmonella as the causative organism, with shelled eggs as the suspected source. Samples of the eggs are being tested. Laboratory results are pending.