A Gastroenterologist Speaks Out About the Cruise Illnesses

Cruise lines don’t seem to be the healthiest places to be these days. More than 600 passengers and crew on Royal Caribbean’s Explorer of the Seas became so ill in January that the ship returned to port early. A few days later, 175 passengers and crew on Princess Cruise’s Caribbean Princess were similarly affected. That makes three ships already hit this year with a gastrointestinal virus.

But it’s not an epidemic. In fact, the virus infects fewer cruise ships now than it did 10 years ago. According the Centers for Disease Control (CDC), passengers on 71 cruises got sick since 2009, while 130 cruises were struck with gastrointestinal troubles from 2004 to 2008.

What Causes the Cruise Ship Sickness

A common culprit is a norovirus, highly contagious germs that causes acute gastroenteritis. The symptoms — mainly nausea, vomiting and diarrhea — usually aren’t life threatening if you stay hydrated. Children, the elderly and those with immune deficiencies are most at risk.

The virus acts fast, usually within a day, and lasts one to three days. For a passenger of a seven-day cruise, however, that means missing most of the week’s festivities.

The virus spreads via food touched by an infected person, such as at a buffet, but the infection also can be spread by person-to-person contact, airborne particles, and contact from railings, handles and doorknobs. If someone brings the virus aboard an enclosed environment like a cruise ship, it can spread quickly.

Is the Ship’s Crew At Fault?

When a virus is reported onboard a vessel, the crew notifies the CDC and port authorities. The CDC investigates the incident to discover the exact nature of the virus and the possible cause. Unless the ship or its crew is found negligent, which is rare, the source of the outbreak may never be determined.

Large cruise ships can carry up to 4,000 passengers — all eating, mingling, and swaying together on one hotel-sized vessel. A norovirus can spread rapidly without being detected until it’s too late. Once it hits, the best the crew can do is try to contain it by protecting the food supply, continuously disinfecting the public areas, and limiting exposure to those already infected. The crew can’t prevent an outbreak.

Dealing with a Norovirus

A Manhattan gastroenterologist, Dr. Shawn Khodadadian offers this advice:

If you are infected, your body must fight the virus on its own. Stay in bed, near a bathroom. Keep a bucket nearby for when you feel sick. Drink plenty of water. The danger from the illness is dehydration, so you must drink more than usual.

Water — not fruit juice, soda or energy drinks — is preferred since the extra sugar in those drinks can make your symptoms worse. You have access to a pharmacy, get rehydration powder, which contains the balance of salt and sugar your body needs. If you have trouble keeping the water down, take frequent small sips to keep yourself hydrated.

If you become severely dehydrated, see a doctor. Advanced dehydration symptoms include dry mouth, dry tongue, sunken eyes, and decreased urination.

How You Can Protect Yourself

While there is no vaccine or cure for a norovirus infection, follow these commonsense steps to limit your susceptibility:

  • Wash your hands regularly. Always wash your hands before a meal, of course, but also after using any public facilities, including railings and doors. Don’t touch your face until you’ve washed up.
  • Avoid tepid food from a buffet. Hot food should be hot and cold food should be cold. Lukewarm food that has been sitting out too long could pose a hazard.
  • Disinfect your own area. Wipe down your doorknobs, faucets and handles with an alcohol-based cleanser or alcohol wipe. If you were infected, you may still be contagious up to three days after your symptoms end.
  • Use disposable cups. It’s important to drink plenty of water on a cruise even if you’re healthy. If you’re ill, it’s a lifesaver. Use disposable cups to protect yourself from further infection.