There are multiple cruise lines facing Norovirus Outbreaks in 2023
In 2023, there have been 13 reported norovirus outbreaks across various cruise lines, causing concern among travelers. The latest incident affected a Viking Cruises ship that journeyed from Iceland to New York City. Approximately 13% of passengers and several crew members fell ill with the virus during the voyage. The rising number of cases is attributed to highly-congested environments on cruise ships and the decreased exposure to illnesses due to the pandemic.
With an estimated 31 million passengers expected to set sail this year, health experts are analyzing the potential factors contributing to the upsurge in norovirus cases. Sanjiv Shah, MD, MPH, an infectious disease specialist and chief medical officer for MetroPlusHealth, points out that the loosening of COVID-19 restrictions may leave individuals more susceptible to picking up viruses after years of relative seclusion. Additionally, children who have avoided illnesses during the pandemic are now encountering viruses more common during the school year, leading to a higher incidence of norovirus cases. While this year’s numbers are elevated, they are not drastically different from pre-pandemic levels. Vigilance and precautionary measures remain crucial to safeguarding passengers’ health during cruises.
What is Norovirus?
Often mistaken for the “stomach flu,” norovirus is, in fact, unrelated to influenza, as clarified by Brian Labus, PhD, MPH, REHS, an infectious disease expert. To contract the virus, one must ingest it, either through contaminated food or touching infected surfaces and then inadvertently transferring it to the mouth. Causing inflammation of the stomach and intestines, norovirus commonly presents symptoms like diarrhea, vomiting, nausea, and stomach pain. Additional signs may include fever, headache, and body aches. The illness typically lasts one to three days, and infected individuals may continue spreading the virus even after symptoms subside, making containment challenging for public health authorities.
Why Have the Outbreaks Increased?
Potential Factors Contributing to Norovirus Cases Rise
While the exact cause of the increasing number of norovirus cases remains uncertain, Brian Labus suggests that the rising demand for cruises could be a contributing factor. During the pandemic, cruise options were limited, but now that restrictions have eased, more people are opting for the cruises they had postponed.
Another reason for the surge in illnesses is the reduced exposure to common viruses and illnesses during the pandemic. With restrictions lifted, people are more susceptible to getting sick now that they encounter a higher number of infectious agents.
Moreover, reporting practices may also play a role in the perception of norovirus numbers on cruise ships. Health officials on cruises are legally obligated to track any illnesses, which may lead to more frequent reporting of outbreaks at sea compared to land. The Centers for Disease Control and Prevention highlight this reporting discrepancy. As such, while the numbers may seem alarming, a comprehensive evaluation is necessary to understand the true extent of the issue.
Norovirus Spreads Faster in Some Environments
According to Shah, norovirus spreads rapidly anywhere there are large groups of people, like school classrooms, family gatherings, and weddings.
Cruise ships in particular have many of the conditions that make people susceptible to norovirus—close quarters, enclosed spaces, communal dining, and high turnover of passengers.
“The virus is often associated with cruise travel simply because health officials are required to track illnesses on ships,” Shah said. “The CDC estimates only about 1% of annual U.S. norovirus cases happen on cruise ships. Rates are much higher in schools, nursing homes, hospitals, and restaurants, which collectively account for about 91% of cases.”
Minji Kang, MD, an assistant professor and infectious disease specialist in the Department of Internal Medicine at UT Southwestern Medical Center added that norovirus can also be brought onboard by contaminated food or water, or passengers who were infected while ashore.
Essential Measures for a Safe Voyage
With 13 norovirus outbreaks reported on cruise ships this year, it’s crucial to take precautionary steps to minimize the risk of getting sick while onboard. Washing hands with soap and water for at least 20 seconds before meals, after using the restroom, and after contact with high-touch surfaces is the most effective way to prevent norovirus spread. Hand sanitizers are not a substitute for proper handwashing.
Prior to booking, conduct research on your chosen cruise line. Visit the CDC website to review their Vessel Sanitation Program (VSP) inspection results and any corrective actions taken. Selecting a cruise line with a high score can offer extra peace of mind.
If illness strikes during your trip, adhere to CDC guidelines and promptly report your condition to the ship’s medical facility. Rest and hydration are essential to rebuilding your immunity and preventing dehydration. While it may be tempting to conceal your illness, it’s vital to be transparent for the safety of fellow passengers and the crew.
Remember, taking precautions and following guidelines can safeguard everyone’s health, ensuring a smoother and enjoyable cruise experience for all.
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