9/4/03 -- Onboard the
August 18, 2003
sailing of Princess Cruises' ship Regal Princess, which concluded
in New York on Tuesday, September 2, there was an increased
incidence of gastrointestinal illness among the passengers. This
illness was confirmed through laboratory testing to be caused by
Norovirus (also known as Norwalk Virus), which is a common but
highly contagious illness that is easily transmitted from
person-to-person. Over the full course of the voyage, a cumulative
total of 302 passengers (20%) and 45 crew members (7%) reported
ill with the virus. Princess began extensive measures to interrupt
the spread of the virus when it was noticed on the third day of
the cruise.
Regal Princess has now completed an extensive
sanitation process over the last three days, and the ship has been
thoroughly cleaned and is now ready for its next cruise departing
this afternoon. CDC's Vessel Sanitation Chief Dave Forney has
expressed satisfaction with Princess' response procedures and
disinfection measures, and feels that the ship is safe for
embarking passengers. He was quoted in the press yesterday as
saying Princess' protocols are "top notch," and that "they
notified the CDC well before they were required to do so."
Throughout this sanitizing process, we have been working closely
with the CDC, who are supportive of the measures we
implemented.
Regal Princess had arrived one day earlier
than scheduled into New York in order to conduct this thorough
sanitization. While we regretted shortening the previous cruise by
one day, we did so as the health and well-being of our passengers
and crew is our highest priority. Conducting this intensive
cleaning without passengers onboard was the most effective way to
stop transmission of this common but contagious virus, which we
believe was brought aboard by an ill passenger in Copenhagen.
There was no increase in gastrointestinal incidences during the
previous cruise.
The additional time in New York gave us extra days to
conduct a full sanitation of the vessel, and this was concluded
successfully last night. The ship's crew, in an addition to an
18-member specially-trained sanitation team, and 25 members of an
outside sanitation company worked to disinfect all areas of the
ship, including all passenger and crew areas. Some of these
measures included:
- Public areas including passenger
and crew cabins were either "fogged," or sprayed with an
effective sanitizing solution designed to kill Norovirus
- Contact surfaces were wiped clean
with the sanitizing solution
- Linens and food utensils were
disinfected
- Carpets through the ship were
shampooed with the disinfectant solution
- The passenger terminal was
sanitized by a fully-trained local sanitation team after the
passengers departed on Tuesday
- The motorcoaches used to transport
the passengers back to the airport on Tuesday were fully
sanitized
Our intensive measures are
credited with reducing the number of passengers who reported
unwell each day on the previous sailing. When the ship arrived in
New York, only two passengers were still unwell, and those
passengers stayed aboard the ship overnight and departed for home
yesterday. We sincerely regretted any disruption to our
passengers' vacation plans and are pleased that, under the
circumstances, the large majority of our guests were understanding
of the situation and pleased with our crew's efforts to continue
to provide an enjoyable cruise experience. The previously ill crew
members aboard Regal Princess have completely recovered.
Passengers embarking the ship today were
notified through their travel agents last week that there was an
increased incidence of gastrointestinal virus, identified as
Norovirus, onboard the ship, and invited them to contact us with
their concerns. In the event some of the passengers did not
receive this information, they are being provided with details
upon check-in, and we have Princess medical and hotel staff
standing by during embarkation to answer any questions.
The ship is sailing today close to its
capacity of 1,590 passengers with 679 crew members. The Regal
Princess departs New York at 5 pm on a 10-day cruise through New
England and Eastern Canada, calling at Newport, Boston, Bar
Harbor, St. John's, Halifax, Quebec and
Montreal.
What Happened on the Previous
Sailing:
At the onset of the increased incidence of
gastrointestinal illness, which occurred on the third day of the
cruise, we immediately intensified sanitation efforts onboard
Regal Princess to minimize transmission to other passengers.
Princess collaborated with local and international public health
agencies and initiated an extensive sanitation program onboard in
association with the U.S. Centers for Disease Control and
Prevention (CDC), U.K. Port Health Authorities and Health Canada,
to interrupt the spread of this virus.
As a result of our
efforts, we saw a decline in the number of passengers who reported
unwell each day, and the majority of people affected by the
illness recovered quickly and completely within 12-24 hours. As
the cruise concludes, we're pleased that our efforts to contain
the illness were successful, and there are only two remaining ill
passengers who are recovering onboard and are expected to depart
for home on Wednesday, September 3.
The pattern of the
spread of illness suggests that the virus was most likely
introduced onto the ship in Copenhagen by a passenger with the
illness. Land based Norovirus outbreaks are common and have been
occurring recently throughout Europe and North America. Under the
circumstances, we decided to conduct a special, comprehensive
sanitation of the ship without any passengers onboard, and to
proceed directly to New York to accomplish this sanitization
process and minimize the risk of any further transmission. This
necessitated a cancellation of two ports -- Qaqortoq in Greenland,
and St. John's in Newfoundland, and the ship arrived one day early
in New York.
The ship departed Copenhagen August 18 and
sailed on a 16-day Northern Europe/Atlantic crossing itinerary,
arriving in New York on September 2. The ship carried 1,528
passengers and 679 crew members. Over the course of the voyage,
301 passengers and 45 crew were affected.
What Princess did to contain the
illness:
The safety and comfort of our passengers
and crew is always Princess' number one priority. As is currently
standard procedure across our fleet, all the ship's passengers
were provided with a health notice advising of the increased
activity of the Norovirus worldwide and the precautionary measures
to avoid contraction and spread. We enhanced the already intensive
measures onboard Regal Princess to contain this illness, which
included sanitation of every aspect of the ship.
* Two of
Princess' Senior Public Health Officers joined Regal Princess, and
two special sanitation teams created by Princess to support its
vessels in a situation such as this were mobilized on the ship. A
third sanitation team joined the ship to further assist. The team
members have been specially trained in sanitizing routines using
disinfectant agents and supplemented the efforts already being
implemented by the ship.
* Passengers and crew were
provided with regular health advisories alerting them to an
increased incidence of gastrointestinal illness, along with
measures to minimize the risk of infection such as washing hands
frequently and thoroughly, avoid touching the mouth, avoiding use
of the buffet area if symptomatic, and reporting to the medical
center if any symptoms are experienced.
Examples of
sanitation measures undertaken onboard Regal Princess
included:
-
Using a powerful sanitation solution to regularly
clean all food and beverage areas of the galley, affected
passenger cabins, public restrooms and all surfaces in the ship's
public areas (e.g. handrails, door knobs, elevator buttons)
including soft furnishings, multiple times each day
-
Suspension of all galley tours
-
Slot machines and casino
furnishings were sanitized several times daily
-
Gym equipment
was sanitized regularly
-
Public restroom doors were propped
open to reduce risks of unwitting door handle contamination
-
Bar snacks were offered in single servings only
-
All
dishwashers were being checked hourly to ensure they were
operating at a temperature of 165F or above
* Passengers
who reported to the medical center with symptoms were treated,
without charge. Passengers who were unwell were asked to isolate
themselves in their stateroom until non-contagious and comply with
the doctor's instructions. Unwell passengers were also asked not
to proceed ashore, and any shore excursion costs were
refunded.
* Room service was provided to affected
passengers and every effort was made to make them as comfortable
as possible.
* As drinking large amounts of clear fluids is
helpful for diarrhea, we provided complimentary bottled water to
affected passengers.
What is
Norovirus?
Norovirus is an extremely common and
highly
contagious virus which causes gastroenteritis (an
inflammation of the stomach and the intestines). Symptoms of
Norovirus include nausea, vomiting and watery diarrhea; some
people may also experience headache, mild fever and abdominal
cramps. It is sometimes known as the "24-hour stomach bug."
Symptoms usually last between one and three days and generally
resolve without treatment or long-term consequences. The
incubation period of the virus averages about 24 hours, and people
infected with the illness typically remain contagious for 72 hours
after they have recovered.
Norovirus is spread by direct
person-to-person contact. As the viral particles are able to
survive for long periods in the environment, the illness can be
spread through contact with surfaces such as hand rails, door
knobs and elevator buttons, or by sharing food, water or eating
utensils.
Norovirus is not an upper respiratory virus such
as the flu, and only the common cold is reported more frequently.
The CDC estimates that Norovirus is the causative agent of some 23
million cases of gastroenteritis in the USA annually, however the
vast majority of all outbreaks occur on land. Statistics have
shown that the chance of contracting Norovirus on land is 1 in 12;
and 1 in 4000 on a cruise ship.
Source:
Princess
Cruises
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The Centers for Disease
Control and Prevention (CDC) established the Vessel Sanitation
Program (VSP) in 1975 as a cooperative endeavor with the
cruise vessel industry. The VSP utilizes a two-prong
approach to disease control aboard cruise ships:
- Prevent the introduction, transmission or spread of
communicable diseases into the United States through
established public health policies and procedures.
-
Assist the cruise ship industry in the
development and implementation of comprehensive sanitation
programs to protect the health of passengers and crew
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