The Centers for Disease Control and Prevention investigators Monday were looking into two more outbreaks of gastrointestinal illnesses aboard cruise ships.
CDC inspectors were investigating the report of a Norwalk virus outbreak among 190 passengers and 13 crew members Sunday aboard the Carnival Cruise Lines ship Fascination, said Bob Dickinson, company president.
The number was slightly more than 6 percent of the 2,430 passengers and 920 crew members who made the three-day voyage to the Bahamas, which got under way Friday. None, including about 30 children, required hospitalization, a company official said.
An apparently minor outbreak of suspected salmonella, a food-borne bacteria, was reported by the Seven Seas Mariner when it docked Monday at Port Everglades on a 10-day voyage that originated in the Canary Islands, said David Forney, chief of the CDC’s vessel sanitation program.
Forney said five of the 586 passengers and 16 of the 449 crew members fell ill about a week ago. That is about 2 percent of those aboard, about normal for most cruises. All have recovered, said Mark Conroy, chief executive officer of Radisson Seven Seas Cruises.
Forney said inspectors were checking the salmonella diagnosis and reviewing food-handling procedures. Conroy said the infection could have been picked up when the ship stopped in Morocco. Most salmonella cases are mild, causing vomiting, diarrhea and abdominal cramps for a day or two.
The Fascination and Seven Seas Mariner were the third and fourth ships in recent weeks whose passengers contracted gastrointestinal illnesses. Holland America’s vessel Amsterdam and Disney Cruise Line ship Magic also have been hit.
The Fascination is the third ship to experience a gastrointestinal illness outbreak in recent weeks.
“The reality is that these cases are happening all the time,” said Steve Williams, Carnival medical director. “It’s when they get out of control that you have a problem.”
He said the stringent monitoring procedure on board cruise ships is “probably one of the reasons we know about it.”
A Carnival official said the cruise line presumed the symptoms aboard the Fascination were caused by the Norwalk virus, as was the case with the other recent outbreaks on cruise ships. “We’re treating it like it was a Norwalk-like virus,” she said.
A common problem
The Norwalk virus is one of the most common causes of gastrointestinal illness and tends to strike people in confined spaces, Forney said.
The virus can be transmitted person to person or by consuming contaminated food or water. Outbreaks occur regularly on land and cruise ship outbreaks occur several times a year, Forney said.
A worker cleans the Amsterdam after a virus outbreak.
“Any outbreaks are of concern to us,” he said. “The cruise lines are doing everything they can to address the problem.”
Norwalk virus infection is typically marked by vomiting and diarrhea, but the symptoms tend to go away without treatment within a day or two, Dickinson said.
In addition to the outbreak on the Fascination, nearly 500 passengers and crew aboard the past two voyages of the Disney cruise ship Magic fell ill with Norwalk virus.
Holland America Line’s Amsterdam returned to sea Sunday after more than 500 people fell victim to the virus on its past four cruises. Carnival also owns Holland America.
Similar outbreaks occurred earlier this year. In July, the Holland America ship Ryndam had Norwalk outbreaks on two successive Alaskan cruises; 395 passengers and crew got sick. The ship was taken out of service for a week for decontamination.
As in the current outbreaks, person-to-person transmission was the suspected cause.
Ship cleaned before departing
The 8-year-old, 855-foot Fascination was disinfected and departed Monday evening for a four-day cruise to Key West, Florida, and Cozumel, Mexico, a few hours later than scheduled, a Carnival spokesman said.
Nearly 100 people, or 4.5 percent, of 2,220 passengers booked on the trip elected not to go, he said. All have the choice of a refund or a cruise at another time, he said.
None of the passengers sickened during the weekend voyage would be offered refunds, Dickinson said.
Dickinson said there was no way to guarantee people wouldn’t get sick on the next voyage.
Carnival President Bob Dickinson
“We can have this ship perfectly sanitized … [but if] somebody comes on board with the virus, any efforts you have up to that time are for naught,” he said. There is no known method of preventing the disease, he said.
People can take precautions against gastrointestinal infections by washing their hands regularly and by minimizing hand-to-mouth contact.
The CDC said it did not see any reason for people to delay booking a cruise because of the outbreak of cases.