Holland West Coast (including Noordam) plagued with Norovirus

Let me try something here. HAL does seem to have a lot of Alaska norovirus this year which seems quite strange. CDC data shows 4 outbreaks, 3 of them on the ships (2 Volendam, 1 Nieuw Amsterdam) that do 7-day cruises from Vancouver. These cruises exchange a number of PAX at Skagway embarking/disembarking for land tours. Is it conceivable that a hotel/bus/train car serving Skagway could be a source? Just wondering.

 

Roy

Cruisetour passengers who board in Skagway are screened by a nurse before boarding the ship. They have been traveling as a group with a journey host and if someone had gastrointestinal issues they would have been identified. They still fill out the health questinairre and talk to the nurse if there are any issues.

We did have an elderly gentleman who became ill during a Yukon bus trip. We left him in Tok, Alaska and in a couple of days he met us in Dawson to continue the journey. Our group leader wiped down the seats of the bus and kept the hand gel handy. Nobody else got sick. We joked that he had the "meal plan" and maybe he just ate too many crab legs at the restaurant at the hotel!

Does anyone know if these issues are on Volendam also? We are sailing on this ship soon with babies that are 11 months old- our previous cruise was DCL's Fantasy and they were always wiping and polishing, but reading stuff like this does make me nervous, with babies crawling around and into everything. It is sounding like Holland's cleaning standards aren't that great? Like we will need to be extra diligent about wiping things and such - I'm a bit embarrassed to say I didn't realize this was such a problem

Holland America ships are clean, IMO their standards are good.

We were on Fantasy last year with a one year old and a three year old and noticed exceptional cleanliness, including full time restroom attendants. My daughter still wiped down surfaces as best she could, just like she wipes Target shopping carts and restaurant tables when in her home town.

Hopefully your twins are walking when you cruise but whether they are crawlers or walkers use Clorox wipes to clean surfaces. Wipe down hotel rooms, ship cabins, restaurant tables, planes. Wash their hands and your hands often with soap and water.

Enjoy your vacation, if the babies are healthy you don't need to live in a bubble.

Holland America ships are clean, IMO their standards are good.

We were on Fantasy last year with a one year old and a three year old and noticed exceptional cleanliness, including full time restroom attendants. My daughter still wiped down surfaces as best she could, just like she wipes Target shopping carts and restaurant tables when in her home town.

Hopefully your twins are walking when you cruise but whether they are crawlers or walkers use Clorox wipes to clean surfaces. Wipe down hotel rooms, ship cabins, restaurant tables, planes. Wash their hands and your hands often with soap and water.

Enjoy your vacation, if the babies are healthy you don't need to live in a bubble.

Thank you, and to the others who have chimed in- having been on the Fantasy and seeing babies around I wasn't concerned about cruising with the babies (mine and my sisters) and honestly in all my prep for that cruise, I didn't see Noro mentioned. will def get some wipes to wipe things off. My hubby is a paramedic so we are fairly exposed to germs indirectly

Could you provide a source for this statement? If an average of 60 people board every cruise already infected (1 to 5% of all cruisers) how is it that so few ships (relatively) have outbreaks?

what is the percentage of crew who are carrying the virus at any time? Are some people carriers who transmit the virus while remaining unaffected?

Even on 4 Carnival Cruises :eek: I've never met a single person who had experienced Norovirus on board; guess I need to expand my acquaintances.

The CDC site on Noro states that is results in 19-21 million cases a year. That equates to 6% of the US population, sound familiar to your number above? So, if the general population is so affected, why don't we hear about widespread outbreaks all over the US? Because it relies on a fixed population in a closed environment, like a cruise ship, hospital, college dorm, school, or senior home. These are where outbreaks happen, but again, not that many that it makes national headlines, just one here and one there. Same with the ships. Also, the ships have their protocols that happen every day that are designed to keep the spread of noro and similar infections down, and the crew are trained in these mediation procedures far more than say school teachers, college dorm supervisors, and even some health care professionals, due to the requirement for periodic USPH inspections.

So, in 4 cruises, with lets say 9000 total passengers, have you discussed noro virus, or any illness on a ship with 5% of them (450 people)?

There may be some "non-symptomatic" people with noro, but the big key is even if you have noro, if your personal hygiene is good (wash your hands after using the bathroom), you won't transmit it. It requires someone who is infected, and has poor hand hygiene to start an infection of a ship.

As I noted before, the tracking of cases per day reveals whether it is a passenger or crew member who may be causing the outbreak, and the ones caused by crew are fairly rare, since the crew live onboard even after the passengers change out, and they don't want the virus persisting, so they tend to take hygiene seriously. The percentage of the crew with the virus is about the same as the percentage of the general population.

As to "how is it that so few ships have outbreaks", I cannot remember a single cruise in the years I worked for NCL when there wasn't at least one case of GI illness, and remember, there can be 2.9% of the passengers and crew reporting, and no one even sees a report, even though the reports are submitted.

From the CDC: (bolding added by poster)

"Passengers and crew aboard cruise ships are affected frequently by norovirus outbreaks (80). Virus generally is introduced on board by passengers or crew infected before embarkation but might also result from food items contaminated before loading or persistently contaminated environmental surfaces from previous cruises. Virus also might be acquired when ships dock in countries where sanitation might be inadequate, either through contaminated food or water or passengers becoming infected while docked. Repeated outbreaks can occur in subsequent sailings as a result of environmental persistence or infected crew, particularly if control measures have not been implemented consistently and thoroughly. Genotyping of outbreak strains from repeated outbreaks has demonstrated that this can occur through the introduction of new virus or recrudescence of virus from one sailing to the next (81,82). CDC's Vessel Sanitation Program assists the cruise ship industry in preventing and controling the introduction and transmission of gastrointestinal illness by inspecting cruise ships, monitoring gastrointestinal illnesses, and responding to outbreaks (http://www.cdc.gov/nceh/vsp). Outbreaks also have been reported in association with bus tours and air travel, in which environmental contamination and proximity to ill passengers facilitated norovirus transmission (83,84)."

It's important to remember that on average, one quarter of all noro cases are caused by food borne transmission. Food borne transmission typically occurs by contamination by infected food workers. Food eaten raw (leafy vegetables, fruit and shellfish) and ready to eat foods handled by infected workers are common factors associated with outbreaks.

Those wishing to learn more can visit this CDC source: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6003a1.htm.

Does anyone know if these issues are on Volendam also? We are sailing on this ship soon with babies that are 11 months old- our previous cruise was DCL's Fantasy and they were always wiping and polishing, but reading stuff like this does make me nervous, with babies crawling around and into everything. It is sounding like Holland's cleaning standards aren't that great? Like we will need to be extra diligent about wiping things and such - I'm a bit embarrassed to say I didn't realize this was such a problem

Just a heads up. Our daughter brought her 17 month old son on a 14 day Alaska cruise on the Amsterdam which ended earlier this week. If there was norovirus on our cruise, it wasn't brought to our attention. However our grandson had serious cold symptoms about 10 days into the cruise and was feeling terrible by the end of the cruise. So, if your kids like to crawl around and put everything in their mouth dont be too alarmed if they get sick.

But more importantly what I wanted to pass along is that HAL requires a child to be potty trained before they will offer ANY babysitting services or access to Club HAL. You probably already know this, but we didn't. We assumed they did because the last cruise we were on with a child was Disney and they offered baby nursery service. I noticed you had just cruised on DCL and didn't want you to think HAL offers the same service.

The CDC site on Noro states that is results in 19-21 million cases a year. That equates to 6% of the US population, sound familiar to your number above? So, if the general population is so affected, why don't we hear about widespread outbreaks all over the US? Because it relies on a fixed population in a closed environment, like a cruise ship ...

 

So, in 4 cruises, with lets say 9000 total passengers, have you discussed noro virus, or any illness on a ship with 5% of them (450 people)?

 

You evidence some good points in general but a total misunderstanding of statistical analysis:

 

1) if CDC reports 19-21 million cases a year, that DOES NOT equate to 6% of the population AT ANY GIVEN TIME, unless the Norovirus typically lasts a year per case (which of course it doesn't) ; assuming for the moment that each case lasts an average of 10 days which is very unlikely, the total number of people suffering from Norovirus AT ANY GIVEN TIME would be 10/365 X 19-21 million, or 500,000 to 600,000, not 19-21 million, get it?

 

2) If 6% of the population is infected with Noro at any given time I would only need to talk to 15-17 people to have a statistical likelihood of talking to people who has it currently if I spoke to 450 people 27 people on average should have had it personally within the past year; now I have not made a scientific study but on my 20+ total cruises I have met people with upset stomachs that they ascribed to sea sickness but nary a one ship Noro victim; I know they are out there and I suspect the culprit is that more and more people's immune systems are compromised rather than anything particularly wrong about the ship.

3) for the reasons stated above I distrust the 6% Noro estimate at any given moment which would in fact suggest an average of more than 500 million cases of Noro per year. That clearly is not even remotely happening. Even 500,000 - 600,00 a year seems high but not impossible.

We are currently on the Noordam northbound from Vancouver, ending at Sitka (Anchorage) tomorrow, August 5.

This will be the third cruise in a row that the Noordam has had a huge Norovirus outbreak. The medical officer on this cruise refuses to confirm how many cases are on this current cruise.

I was on the July 16th sailing of Noordam and there was no mention of a Norovirus outbreak. Hmmm??? The captain said to wash our hands but there was no indication of a problem.

We arrived in Anchorage today and waiting to board Noordam tomorrow in Seward. Not very happy to hear of the viral outbreak on the ship 😢

Average period of illness from Norovirus is 12 to 60 hours; this means average of US sufferers at a time based on CDC 19-21 million yearly figure would be at most about 150,000; since Noro is seasonal the average number is higher in winter months. At no time does the figure remotely approach the suggested 6%; that's just bad analysis.

The good news if you get it it probably won't last long.

 

I would also add that if HAL no longer takes the precaution of serving food in the buffet for the first 48 hours then one can hardly expect passengers to quarantine themselves. Prevention is always better than trying to deal with it after the norovirus has spread.

igraf

I keep getting back to this, in the "old" days we didn't seem to have this many outbreaks. Lock up the LIDO for 48 hours and save us.

We were on an Oceania cruise in Mar 2016 when the Riviera experienced the 3rd outbreak of the norovirus in 4 months. On that particular cruise 102 passengers out of 1150 plus crew came down with it. Luckily not us though. However, before the Captain informed the entire ship what was happening, we started noticing red labels being attached to various cabin doors and the door frame. After hearing from the Captain over the audio system, we figured out the passengers in those rooms had been quarantined for what we later found out was a 4 day period.

My question is for those people on the HAL noro cruises, did you by chance see any of these red labels on cabin doors? If you were quarantined on our cruise, you surrendered your room card and you weren't allowed to leave your room. If you did the seal would be broken. Also they started checking room cards at all the dining venues to make sure those that were quarantined didn't sneak out and go eat. Instead, their meals were brought to their room.

We were on an Oceania cruise in Mar 2016 when the Riviera experienced the 3rd outbreak of the norovirus in 4 months. On that particular cruise 102 passengers out of 1150 plus crew came down with it. Luckily not us though. However, before the Captain informed the entire ship what was happening, we started noticing red labels being attached to various cabin doors and the door frame. After hearing from the Captain over the audio system, we figured out the passengers in those rooms had been quarantined for what we later found out was a 4 day period.

 

My question is for those people on the HAL noro cruises, did you by chance see any of these red labels on cabin doors? If you were quarantined on our cruise, you surrendered your room card and you weren't allowed to leave your room. If you did the seal would be broken. Also they started checking room cards at all the dining venues to make sure those that were quarantined didn't sneak out and go eat. Instead, their meals were brought to their room.

I was quarantined on a cruise and did not have a red sticker on door or my room card taken - but my partner was not sick so free to come and go. They kept calling to see how I was doing or needed room service, so I think that is how they monitor if you are staying in the room. They also sent an officer and a masked, gowned haz-mat crew to clean all surfaces in room, change out all linens and bagged up and sealed all the used linens. The calls were from the nurse and front desk. They sent soup, jello, tea, etc. I do not think I had noro as I had no vomiting, just bad "runs", aches, and slight fever - food poisoning? I called the nurse to verify dosage of immodium and that is what triggered it all. They suspended it all when I was 12 hours symptom-free. I was so sick I would not have wanted to sneak out anyway or be too far from the toilet. They could not have been nicer or more caring - but the room steward only brought clean towels and robe and ice to the door and never came in - smart. Dining stewards welcomed me back afterwards and put together a light, mild meal - again, very caring. HAL was great all around and they took it very seriously in case I was contagious, but I missed 2 ports, so need a do-over on that Mexican Riviera cruise some day. The couple with us did not get sick either.

There is no treatment or cure for Noro, a viral illness. I would not demean the OP because he declined to pay to see the physician. Treatment is symptomatic and savvy travelers carry OTC med for GI symptoms. Travel 101. Sick passengers need to isolate themselves, most recover in a day or two. They are infectious before symptoms appear which is why the illness spreads.

 

For a few years I've read posts on other cruise boards from Holland America super fans insisting that a medical evaluation for Noro was free. Now we know for sure it is not free.

 

We were in port next to Volendam in late May. We purchased a nature tour dockside in Ketchikan and some of their passengers were in our van. They told us there was significant GI illness on board.

Noro is tough to eradicate on cruise ships. People bring it on board. Presence or absence of the virus does not reflect on ship cleanliness or quality. Noro virus is common in schools, day care centers, nursing homes, prisons.

Nothing to do with being a super fan. I have posted our past experience with Noro. There was no charge for medical services for Noro on the P'dam. A letter was sent to all cabins as well as announcements.

Have others been charged for norovirus treatment? I got sick a few years ago on day two of the cruise and the Captain announced that there was an issue and anyone who was ill should notify the medical staff. My husband called and told them that they DID NOT want me going to them so the doctor came to me and offered me a shot but I told her I was feeling better. I spent the next day sleeping, got some jello, etc from room service and waited until my quarantine was up to leave the ship. My husband did not get sick and was not quarantined. Since then I always pack the immodium in my cruise med bag.

 

I was not charged for my medical visit. I don't think anyone should be charged if they need treatment for norovirus. It is important to the health of all passengers that people be honest about norovirus and treatment, if required, should be free.

Good to hear. I agree on Noro treatments. They have been free for our cruises on HAL. On Oceania, when we sailed her in November (the first major outbreak on Riviera, I believe), the visit was free but the treatment cost was levied. I heard it was not cheap.

The CDC site on Noro states that is results in 19-21 million cases a year. That equates to 6% of the US population, sound familiar to your number above?

For a comparison like that I think you need to adjust for time. The rate of illness for cruise passengers should be much lower than the general population which has 365 days to contract the virus.

So, you came down with Noro on this cruise. Because of cost you refused to be diagnosed by a trained Medical Officer, who could give you meds and whatever else it takes to cure it..

You also propagated the Noro by continuing to hang out in public places around the ship, instead of quarantining yourself and other cabin mates (if any) and therefore spreading it even more.....

I do not think the Medical Officer is in the wrong, ethically or otherwise to answer to a passenger the medical information you asked for. Now if you are CDC, Captain or other responsible person that is in the Need to Know bracket......................

Hubby was on the Noordam a few weeks ago and heard nothing of Noro on her.

Keep in mind that depending on how long you were on the ship BEFORE you started showing/experiencing symptoms, you yourself could have brought it on board with you.

A lot of "alternative facts" there, Joanie.

I began to have symptoms just after midnight on Day 5 (Glacier Bay) - so clearly I didn't have it when I boarded nor did I "bring it onboard".

The "trained medical officer" proffered to me was a nurse who's command of English was not reassuring. And *I* know as I suspect you do, that there is no "treatment" for Norwalk virus. There is no "curing" it.

I did NOT "hang out" in public spaces, I was incapacitated in my cabin and missed completely all of Glacier Bay. Medical put me on the cabin detention list and treated me as quarantined until the morning of Day 6.

After yammering at the staff about the secrecy, the Captain claimed at dinner on Day 6 that "about 60 passengers" had been reported. He also intimated that children who did NOT get reported were not in this count. He also suggested that these children were visited by family and others while contaminated. All very plausible, and as another poster has observed, a situation compounded by the chaotic Lido Deck food trough.

"Need to Know"? It's a public conveyance and they have a duty to report. And as I noted, Holland apparently decided to deceive passengers checking-in for this Norocruise in Vancouver. Not nice.

A lot of "alternative facts" there, Joanie.

 

I began to have symptoms just after midnight on Day 5 (Glacier Bay) - so clearly I didn't have it when I boarded nor did I "bring it onboard".

 

The "trained medical officer" proffered to me was a nurse who's command of English was not reassuring. And *I* know as I suspect you do, that there is no "treatment" for Norwalk virus. There is no "curing" it.

 

I did NOT "hang out" in public spaces, I was incapacitated in my cabin and missed completely all of Glacier Bay. Medical put me on the cabin detention list and treated me as quarantined until the morning of Day 6.

 

After yammering at the staff about the secrecy, the Captain claimed at dinner on Day 6 that "about 60 passengers" had been reported. He also intimated that children who did NOT get reported were not in this count. He also suggested that these children were visited by family and others while contaminated. All very plausible, and as another poster has observed, a situation compounded by the chaotic Lido Deck food trough.

 

"Need to Know"? It's a public conveyance and they have a duty to report. And as I noted, Holland apparently decided to deceive passengers checking-in for this Norocruise in Vancouver. Not nice.

Interesting. You started feeling symptoms early on day 5 and were quarantined in your room until the next morning, day 6. Everything I've read says if you actualy have the Norwalk virus you are contagious for at least 3 days AFTER you recover. I'm surprised and somewhat concerned the ship doctor let you as well as probably others out the day after you started having symptoms. Sure hope that doctor isn't on a HAL cruise we're on.

You are usually quarantined for 24 hours after the last reported symptom

Interesting. You started feeling symptoms early on day 5 and were quarantined in your room until the next morning, day 6. Everything I've read says if you actualy have the Norwalk virus you are contagious for at least 3 days AFTER you recover. I'm surprised and somewhat concerned the ship doctor let you as well as probably others out the day after you started having symptoms. Sure hope that doctor isn't on a HAL cruise we're on.

The initial quarantine period is for 24 hours starting with the day/time of the onset of his/her symptoms

The initial quarantine period is for 24 hours starting with the day/time of the onset of his/her symptoms

Is that a HAL policy or a CDC policy as it was a 4 day period when Code Red was declared on the Oceania cruise we were on?

Interesting. You started feeling symptoms early on day 5 and were quarantined in your room until the next morning, day 6. Everything I've read says if you actualy have the Norwalk virus you are contagious for at least 3 days AFTER you recover. I'm surprised and somewhat concerned the ship doctor let you as well as probably others out the day after you started having symptoms. Sure hope that doctor isn't on a HAL cruise we're on.

The CDC references that it is usually 24 - 72 hours after recovery that a person is shedding the virus at high levels. The problem with determining whether a person is contagious is that the virus can often be detected up to 4 weeks following infection.

For cruise ships, the CDC recommends, "...passengers with gastroenteritis on cruise ships may be asked to remain isolated voluntarily in their cabins during their illness and for a period of 24--48 hours after their symptoms have resolved."

The CDC references that it is usually 24 - 72 hours after recovery that a person is shedding the virus at high levels. The problem with determining whether a person is contagious is that the virus can often be detected up to 4 weeks following infection.

 

For cruise ships, the CDC recommends, "...passengers with gastroenteritis on cruise ships may be asked to remain isolated voluntarily in their cabins during their illness and for a period of 24--48 hours after their symptoms have resolved."

The key phrase is "after their symptoms have resolved" rather than when they are diagnosed. But, hey, I'm not a doctor and I'm sure the ship doctors know what they are doing. It just seemed a little odd given my experience on the Riviera when the code red was issued. Maybe rules are different prior to a code red being officially called.

But I have to say, I'm starting to give more credit to Oceania for how they handled the outbreak in that while you were confined to your cabin for that 4 day period, they took your key card away. That way if you snuck out and wanted to go up to the Lido deck or the MDR to get something to eat, other than what they would deliver to your cabin, you couldn't because they were checking to make sure you had a key card AND you sanitized your hands before entering.

I know it was the pits if someone caught it, but it gave the passengers not infected some piece of mind during a very stressful time when all the public areas on the ship had pretty much been shut down other than maybe the main theater until all cases had been cleared, which turned out to be the last day of the 14 day cruise.

I was not charged for my medical visit. I don't think anyone should be charged if they need treatment for norovirus. It is important to the health of all passengers that people be honest about norovirus and treatment, if required, should be free.

I agree. The way it was presented to me by the medical staff, they would not even TAKE a report about my illness unless I paid them $95 to see the doctor. It was only after I started yammering at ship management that they relented and took the report.

And in this case I believe HAL had even a higher duty of responsibility, as it was known the previous cruise had serious issues that logical thinking points to their failure to stop the virus on the passenger turnover.

The key phrase is "after their symptoms have resolved" rather than when they are diagnosed. But, hey, I'm not a doctor and I'm sure the ship doctors know what they are doing. It just seemed a little odd given my experience on the Riviera when the code red was issued. Maybe rules are different prior to a code red being officially called.

 

But I have to say, I'm starting to give more credit to Oceania for how they handled the outbreak in that while you were confined to your cabin for that 4 day period, they took your key card away. That way if you snuck out and wanted to go up to the Lido deck or the MDR to get something to eat, other than what they would deliver to your cabin, you couldn't because they were checking to make sure you had a key card AND you sanitized your hands before entering.

 

I know it was the pits if someone caught it, but it gave the passengers not infected some piece of mind during a very stressful time when all the public areas on the ship had pretty much been shut down other than maybe the main theater until all cases had been cleared, which turned out to be the last day of the 14 day cruise.

Ken don't give Oceania too much credit.

I suspect they were ordered by CDC to take very strong measures.

We were on the first cruise when Noro raised it's ugly head. No numbers were ever given and we found out more on the CDC website than we did from the captain.

Quarantine was only 24 hours on that cruise and preventative measures were not good. Only thing closed was the laundry. Everything else remained open, all condiments out to be touched, etc. Cooking classes still happened and people eat what they prepare there.

The outbreak did not get controlled but increased to the level that Bermuda refused us entrance.

I think by the time you cruised it was the 4th outbreak? I know from reading the reports that O was reprimanded for the reporting and management of our Noro cruise. I suspect that they were told to do certain things but that's just my suspicion.

By the way, our next door neighbours were quarantined for 24 hours and there was nothing on their door nor were their keys takn away ;). She told me after the quarantine period was over and could go back to her cooking classes.

Oceania turned me off when, for muster drill, we were seated in the dining room, with all the cutlery, glassware and plates set for dinner. While waiting for everyone to file in and take a seat - many at our table (possibly at other tables) were toying with the utensils, rubbing their fingers around the rim of goblets, fiddling with and using the napkins.

It was a real turn off - actually i went and booked late seating for specialty restaurant for sailaway night.