VIRUSES: Recent illnesses aboard ships spark call to boost cleaning measures.
By Paula Dobbyn
Anchorage Daily News

State and federal epidemiologists are urging cruise-ship companies to aggressively sanitize and disinfect their vessels to prevent Norwalk-like viruses from spreading among passengers.

After a series of viral outbreaks sickened hundreds of cruise passengers this summer, the Alaska Department of Environmental Conservation, the Alaska Division of Public Health and the federal Centers for Disease Control and Prevention have issued new guidelines. The voluntary measures announced Thursday call for unusually strong chlorine cleansers, easy access to motion sickness bags, super-hot laundry temperatures, and meticulous hand washing, among other steps.

Norwalk-like viruses are typically spread through fecal matter or vomit, the epidemiologists said.

In June, more than 250 people aboard the Ocean Princess came down with flu-like symptoms, including nausea, vomiting and diarrhea. The bug was identified as a Norwalk-like virus, a hardy strain that can withstand freezing temperatures and temperatures up to 145 degrees Fahrenheit, said Sue Anne Jenkerson, nurse epidemiologist with the state public health division. “It’s very hard to eliminate,” said Jenkerson.

More than 170 passengers and crew members aboard the Ryndam, a Holland America ship, fell ill with a Norwalk-like virus in late July, the company said. Less than a week later, a recurrence of the virus sickened more than 230 passengers and crew members. Holland America canceled the next voyage so the company could intensively disinfect the ship.

On the Wilderness Discoverer, a small cruise ship owned by Glacier Bay Cruiseline, some 18 passengers and crew members suffered flu-like symptoms that mirrored those produced by Norwalk viruses.

This summer’s illnesses aren’t unusual, said Dr. Beth Funk, a state epidemiologist. Cruise ships plying Alaska waters report clusters of illness among passengers virtually every year, she said. If more than 3 percent of people on board get sick, the ships must report the outbreak to the Centers for Disease Control and Prevention.

After this summer’s first outbreak aboard the Ocean Princess, health officials sent cruise lines recommendations for how to keep Norwalk viruses at bay. But Thursday, they released strengthened guidelines that apply to cruise ships and tour bus and railway operators.

The old guidelines for cleansing solutions called for using one teaspoon of bleach per quart of water, a standard hospital formula, said Funk. Under the new recommendations, companies are urged to mix two tablespoons of chlorine into a quart, or 21/2 cups per gallon. Chlorine is the only cleanser effective in killing Norwalk viruses, according to the guidelines.

They also say laundry should be washed in 160-degree water and that bleach should be added to the rinse. “Do not agitate linens soiled with vomit or fecal matter, in order to minimize the risk of aerosolization of the virus,” the guidelines say.

Cruise employees who get ill shouldn’t return to work until three days after their symptoms disappear. Crew members are advised to wash their hands vigorously with soap and warm water for at least 20 seconds, including wrists, under nails and between fingers.

Erik Elvejord, a spokesman for Holland America, said he hadn’t yet seen the new recommendations. But after the recent Norwalk incidents, the cruise line stepped up its protocol for keeping passengers and crew healthy. It’s a stringent, fleet-wide directive, Elvejord said.

National health experts advise caution for the elderly and people with chronic medical conditions considering a cruise, because they may be more susceptible to infection. The CDC recommended in 1998 that anyone over age 65 or those with existing illnesses check with their doctor before embarking on a cruise.
Wire services contributed to this story.

For more information about how to prevent the spread of Norwalk-like viruses, go to: