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The Norwalk virus
is actually quite common and is not a deadly or life-threatening
illness. In fact, it is second only to the common cold as a
reported cause of illness in the U.S. The original Norwalk virus
strain was named after an outbreak of gastroenteritis in a
school in Norwalk, Ohio in 1968. The gastroenteritis caused by
the Norwalk virus (or Norwalk-like viruses/noroviruses) is a
mild, self-limiting, but highly contagious disease characterized
by nausea, vomiting, diarrhea, and abdominal pain. Headache and
low-grade fever may also occur. Symptoms of Norwalk virus
typically develop within one to two days of exposure and may
last from one day to one week.
Water is the most
common source of outbreaks of the Norwalk virus. This may
include water from municipal supplies, wells, recreational
lakes, swimming pools, and water stored aboard cruise ships. The
Norwalk virus is transmitted by the oral-fecal route, directly
from person-to-person, through ingestion of contaminated water
and foods, or through contact with a surface that has been
contaminated.
Shellfish and
salad ingredients are the foods most often implicated in Norwalk
virus outbreaks. Ingestion of raw or insufficiently steamed
clams and oysters poses a high risk of infection with Norwalk
virus. Foods other than shellfish can be contaminated when
washed in water that contains the virus or by food handlers
carrying the virus.
The Cruise Ship
Connection: The close living quarters of a cruise ship amplify
the opportunities for transmission of Norwalk-like viruses.
Because cruise ships offer such a conducive environment, the
International Council of Cruise Lines (ICCL) and the Center for
Disease Control (CDC) established the Vessel Sanitation Program
(VSP) in the early 1970's. This program states that every vessel
with a foreign itinerary, which carries 13 passengers or more
and calls in a U.S. port is subject to unannounced, bi-annual
inspections by VSP staff.
Unfortunately,
despite routine cleaning and strict sanitation standards, the
arrival of new, susceptible, or affected passengers every one to
two weeks provides an environment in which the Norwalk virus can
flourish.
How Can You
Reduce Your Risk of Getting Sick? There are some measures you
can take to reduce your risk of getting sick during your cruise.
Before
the trip:
-
Check the
history of the cruise ship you are planning to take; i.e.,
any previous outbreaks, any failed inspections
-
If you have a
chronic illness, ask your healthcare provider if it is safe
for you to go.
Once
onboard:
-
Wash your
hands thoroughly, with soap and warm water, and often,
particularly before eating, before preparing food, and after
using the bathroom
-
Avoid eating
raw or steamed shellfish (the Norwalk virus is strongly
associated with the consumption of raw or under-steamed
oysters and clams)
-
Wash fresh
fruits and vegetables before eating them
-
Avoid other
passengers who are ill Use only bottled water, even for
brushing your teeth
-
Avoid ice
(the Norwalk virus can survive freezing; many outbreaks have
been traced to ice made with contaminated water)
-
Avoid foods
that may have been washed in contaminated water
-
Go to the
infirmary if you have symptoms of the virus
What to Do If You
Get Sick: Seek medical attention immediately. All cases of
suspected Norwalk virus should be reported to the ship's
medical staff.
The most common
complication of Norwalk is dehydration. Drink plenty of bottled
water, clear liquids such as defizzed ginger ale or
decaffeinated colas (caffeine may make the diarrhea worse),
fruit juices, or decaffeinated teas or broth made from safe
drinking water.
If you become
extremely sick and dehydrated, you may need a special
rehydration solution. This is best obtained from the ship's
medical staff, but may be available in a dry mix, which may be
purchased in a drug store before you leave home (ask your doctor
about this before you go). Very severe cases may require a
hospital admission so that you can receive hydration and
electrolytes through an IV.
Get as much rest
as you can and stay calm. Gastroenteritis is an uncomfortable,
but not serious illness, which will usually resolve itself
within a few days. If you become ill onboard, you may be
isolated from the rest of the passengers, or you may be asked to
disembark at the next port. This is done for your own
protection, as well as the protection of the other passengers on
the ship. It may not be the end to your vacation you’d
envisioned, but it will be in everyone's best interest.
Remember, new ships sail every day. Once you're feeling better,
you can be on the next one! |