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CDC: Cruises 'absolutely safe'Illness outbreaks abating
ATLANTA, Georgia (CNN) -- An outbreak of gastrointestinal illness continues to affect one ship, but incidents of sickness on several other ships appear to have abated, a federal scientist said Thursday. "I think it is absolutely safe to go on the cruises," said Dave Forney, chief of the Vessel Sanitation Program at the Centers for Disease Control and Prevention. The sole remaining outbreak is aboard P&O's Oceana, which is near Honduras. As of Thursday morning, 269 of 1,862 passengers and 24 of 871 crew members had reported to the infirmary with gastrointestinal illness, Forney said. CDC scientists have boarded the ship and are surveying the passengers and crew members "to determine how the outbreak began and what activities may be leading to its spread aboard the ship," he said. Among other ships, Holland America's Amsterdam returned to service December 1 and completed a 10-day cruise after being taken out of service for several days so that it could be thoroughly cleaned. Illness had affected more than 500 passengers on four consecutive cruises of the ship. This time, just 10 of the ship's 1,190 passengers and two of its 577 crew members reported gastrointestinal illness. "These numbers, we think, reflect all the work that they did in cleaning and sanitizing the ship," Forney said. Aboard the Disney Magic, which was taken out of service for a week so that cleaners could scrub it thoroughly, 25 of 2,153 passengers reported sick on the latest cruise, and none of 1,026 crew members, Forney said. On two prior cruises, more than 300 passengers had been sickened. And Carnival's Fascination, which had 200 sick passengers aboard a cruise that ended December 2, reported 13 passengers and 12 crew sickened on the next cruise, and just six passengers and seven crew on the following one. "They've gone through two cruises basically returning to what we would consider background levels for that vessel," he said. In all, 21 outbreaks of stomach sickness have occurred on 17 cruise ships this year, federal scientists said Thursday. Most of the outbreaks have been blamed on Norwalk-like viruses, and nine have been traced to the difficult-to-isolate viruses, which cause a generally self-limiting disease typically characterized by diarrhea and vomiting. "This is the most common cause of abacterial illness in the United States, estimated at 23 million cases," Forney said. Too early to spot trendsAn outbreak is declared when 3 percent of passengers or crew are sickened with three or more episodes of loose stools in 24 hours or vomiting and at least one other symptom, such as headache, fever, cramps, nausea or muscle soreness. While cleaned ships are critical to stemming the spread of the virus on subsequent voyages, a sterile ship may not ensure an outbreak-free voyage. Some passengers show up at a ship's infirmary on the first or second day at sea, too early to have contracted the illness during the voyage, Forney said. Though he expressed sympathy for the passengers, many of whom have planned their trips months in advance, he said sick passengers should cancel their trips rather than put fellow passengers at risk. "As a public health official, I think these people contribute to the problem," he said. Though the CDC researchers said they did not know whether this year's spate of outbreaks represents an increase from prior years, a study to be published in April in the American Journal of Preventive Medicine reports a steady decline of outbreaks among cruise ship passengers in recent years. Elaine Cramer, medical epidemiologist with the CDC's Vessel Inspection Program, gave these statistics: • From 1975 to 1979, there were 27 outbreaks per 100,000 passenger days. • From 1980 to 1985, there were eight outbreaks of illness per 100,000 passenger days. • From 1986 to 1993, there were six outbreaks of illness per 100,000 passenger days. • From 1990 to 1995, there were four outbreaks of illness per 100,000 passenger days. • From 1996 to 2000, the most recent year for which data have been calculated, there were 3.5 outbreaks of illness per 100,000 passenger days. Last year, just seven outbreaks were detected aboard ships, one-third the number reported so far this year, but officials said that does not necessarily mean the incidence of illness aboard ships has risen this year. "It looks as though there's been a change, but two points do not make a trend," Forney said. "We will have to calculate rates, using 100,000 passenger days, in order to really effect a comparison. We will be doing that." Publicity surrounding the outbreak aboard the Oceania led port officials in St. Maarten to refuse this week to let passengers ashore. Only after the cruise line appealed to government authorities on the island did they relent, Forney said. But by that time, it was too late, and the ship's captain elected instead to weigh anchor and sail on to the next port of call, he said. "In situations where I've talked directly to the port authorities, after they have understood, it has not become an issue," Forney said.
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