Ruby Princess - Norovirus Outbreak

[SalishSea]

Per the CDC for the sailing ending yesterday 3/6 although the numbers have not been updated since 3/3:

 

Number of passengers who reported being ill during the voyage out of total number of passengers onboard: 199 of 2,881 (6.61%)

Number of crew who reported being ill during the voyage out of total number of crew onboard: 20 of 1,159 (1.73%)

 

For anyone currently on board, I would like to know how the ship and crew are handling this. What is different, and what are you surprised is not different? I'll be on the sailing after, and am interested in knowing what you are observing. Thank you!

[trickylibrarian]

We'll be on March 19 so interested as well.

[Beav1279]

I'm sailing on March 12 so I'm hopeful it will be a very clean and healthy cruise by then!

[jenp123]

Got on the carribean princess the cruise after they had noro issues on board the previous voyage.  A few days before the cruise, we got an email saying boarding is delayed and will not start until 1pm and to not come to the terminal before that.  This was to accommodate a deep clean of the ship.

 

Upon boarding, there were buffet attendants at the entry points to the buffet getting everyone to wash their hands.  Servers were serving everyone from the buffet as opposed to self serve items.  No bread, butter or salt and pepper at tables and no sharing tables.  They kept these protocols for 3 or 5 days (can't remember exactly) and because cases stayed low, they started loosening up on all of the extra precautions.

[snoozecrooze]

Suggestion to merge with this thread here: 

 

[riffatsea]

Noro virus is around now on land too!!

A nasty strain!!

Edited March 6, 2023 by riffatsea

[Married15]

Yes, Norovirus is going around everywhere. I have been caring for my husband and daughter who have been sick since last week and still not well. My older daughter and grandson had it also. Somehow, I managed to escape it (knock on wood).  If I were on a cruise ship now, I would wear a mask, avoid close quarters (crowded elevators) and wash my hands a lot as well as use sanitizing wipes. I think the above is what kept me from getting it.   

[justafem]

You can always tell when there's noro, the salt and pepper shakers disappear and the rolls are served with tongs instead of a basket.  And the buffet may be served instead of selfserve.  All the good old days. 

[CruisingWalter]

17 hours ago, jenp123 said:

Upon boarding, there were buffet attendants at the entry points to the buffet getting everyone to wash their hands.  Servers were serving everyone from the buffet as opposed to self serve items.  No bread, butter or salt and pepper at tables and no sharing tables.  They kept these protocols for 3 or 5 days (can't remember exactly) and because cases stayed low, they started loosening up on all of the extra precautions.

 

Nice, standard procedure for an incident like this. We've been on at least one cruise that sailed immediately after an outbreak and this is exactly what they did on that ship as well. The first 3-4 days all service in the buffet is done by the staff. And then it starts to loosen up. That 'outbreak' was quite minor and honestly if folks would just wash their hands and sanitize properly, it would all be good. Personally I would not mind if the buffet switch to full service instead of self serve. The unsanitary practices from people have returned even post pandemic based on what I saw on the Sky Princess last week. Reaching in with their hands to grab food, tasting things with the tongs, etc... You just shake your head and ask the servers to remove items before someone gets sick.

[SargassoPirate]

Norovirus is spread by the fecal-oral route, so it's easy to tell who didn't wash their hands before touching their food or sticking their fingers in their mouth.

 

I take the approach that every surface in the world is contaminated with germs, viruses, and bacteria and if I've touched anything before I touch my food, I wash and/or sanitize. 

 

All of the procedures such as the crew serving in the buffet and no common use containers on the tables is theater since there are many other surfaces to touch and pick up noro.  How about when you grab the bottom of your chair to pull it in - for example?

 

 

[PescadoAmarillo]

The key thing to avoid noro is just don’t eat any food with your fingers. We were on a Code Red noro ship for three weeks (two cruises) over Christmas and New Years one year (800 kids on each!) and managed to avoid it. Personal precautions are much more effective against noro than anything spread by air. 

[mibright]

We were on this sailing and my spouse got sick. We generally consider ourselves to be very communicable-disease aware since COVID (hand sanitizer, masking in crowded spaces, using elbows to push buttons, etc.) however I thought I would share some things we have learned during our experience over the last few days.

Things we would prepare for next time:

- Norovirus is not killed by usual alcohol-based hand sanitizers. Surfaces (including fabrics) can still harbor the virus for up to 2 weeks. Microban sanitizing spray specifically mention killing norovirus on their label.

- Next time we will store toiletries outside of the bathroom. Once my spouse got sick I considered anything in the bathroom contaminated with airborne particles. My tiny Lysol travel spray was not enough for what was out. I threw away our toothbrushes and bought new ones at the "gift shop." Everything else was put in a Ziplock back for sanitation once we got home.

- In retrospect, we should have reconsidered or cancelled our shore excursions when they notified us of an outbreak. The tour operators seemed to operate as usual including snorkeling and self-serve buffets. When we asked, the operators said items were sanitized but now we are questioning that.

- I'm not sure what medical was issuing for vomiting, but we were given generic imodium for diarrhea and were charged quite a bit for it. We usually bring it, but they dropped it off before we realized what it was. I was also grateful Pedialyte packets are also on our usual packing list. They came in handy.

- We were required to fill out a food/drink/activity survey for the 5 days prior to symptoms. We will try to take pictures next time in case we need to document it again.

 

Other items to note:

- Early on we observed there was not much in the way of ongoing sanitization (wiping down surfaces) compared to other cruises we have been on. Even towards the end of the sailing there  seemed to be medium effort.

- One staff member we interacted with regularly that got sick and had only a few hours off (current OSHA guidelines say return to work after 48 hours of no symptoms). This person was handing us menus, serving food and drinks, etc. We might not have even known they was sick if we hadn't interacted with them several times up until that point and noticed their absence and asked.

- Once we notified medical of the illness, a cleaning team arrived hours that sanitized the bathroom, replaced towels, and wiped down a few walls. I did not have any symptoms and was not offered any alternative arrangements to use another bathroom or otherwise protect me from getting it. 

- Communication with the staff about our instructions for disembarkation was delayed and inconsistent. I would think 3 years since COVID this type of thing would be somewhat more organized.

- We were some of the very last people to get off the ship and were escorted by medical personnel and in very small groups. By then all shuttles, taxi's, ubers, etc. were long gone. We had to wait a while for something to finally come, but there were others who had earlier flights that were panicking.

 

We have another cruise scheduled for later this summer, but this experience has put a big damper on our enthusiasm to book again. 

Edited March 7, 2023 by mibright

[Cruise Raider]

2 hours ago, SargassoPirate said:

Norovirus is spread by the fecal-oral route, so it's easy to tell who didn't wash their hands before touching their food or sticking their fingers in their mouth.

 

I take the approach that every surface in the world is contaminated with germs, viruses, and bacteria and if I've touched anything before I touch my food, I wash and/or sanitize. 

 

All of the procedures such as the crew serving in the buffet and no common use containers on the tables is theater since there are many other surfaces to touch and pick up noro.  How about when you grab the bottom of your chair to pull it in - for example?

 

 

💯% spot on!  
 

[trickylibrarian]

mibright thank you for your comments.  We will be on the Ruby March 18 and prefer not having

our meals in the MDR.  Hoping that self serve will NOT be available.  We bought microban for covid

so will pack it.  Very disconcerting to hear about the sick staff member who returned so quickly.  

We are platinum and have always dodged noro and want to keep it that way.

 

[grobbins]

We just got off the Ruby on Sunday.   The crew was cleaning continually.   Buffets were not self serve and the beverage stations were also staffed.  Tables were wiped down as soon as they were vacant.   I did not get noro.     

[PaperSniper4]

1 hour ago, grobbins said:

We just got off the Ruby on Sunday.   The crew was cleaning continually.   Buffets were not self serve and the beverage stations were also staffed.  Tables were wiped down as soon as they were vacant.   I did not get noro.     

Thanks much for posting. I'm on the 19 March cruise and I am tracking this sort of feedback. Please update here is your condition changes....and I hope it doesn't!

 

 Doug

[Sigyn]

Yahoo News posted an article on this: https://www.yahoo.com/news/over-280-sickened-princess-cruise-154112026.html

[jc foster]

4 hours ago, PaperSniper4 said:

Thanks much for posting. I'm on the 19 March cruise and I am tracking this sort of feedback. Please update here is your condition changes....and I hope it doesn't!

 

 Doug

  We got off this ship two weeks ago. Its older but well maintained.  We were in a balcony on deck 10 and you will see come rust on the outside but not too bad.  My only recommendation would be to carry a couple of bars of bar soap and quality hair care products.  Yall have a nice cruise.

[VibeGuy]

Note that the provided sanitizer is the Food Code strength that *is* effective against Noro.  Clean to remove organic soils, sanitize to make virons inactive.  Sanitize again after touching shared utensils but before touching food/cutlery. 
 

or, be one of us ridiculously genetic wonders who are immune to the predominant strains of Norovirus. 

[jeromep]

1 hour ago, VibeGuy said:

Note that the provided sanitizer is the Food Code strength that *is* effective against Noro.  Clean to remove organic soils, sanitize to make virons inactive.  Sanitize again after touching shared utensils but before touching food/cutlery.

I think some more specificity is needed here.

 

I have always known that alcohol based hand sanitizers, Purell and anything private label or third party, that is gelatinized alcohol based, is ineffective against Noro.  But just to make sure I wasn't crazy I did some research and the CDC, for whatever they are now worth, confirms this, along with a number of university research papers.  The nature of the structure of Noro is such that alcohol can't penetrate the virus casing, and as such it survives even after using alcohol based hand sanitizers.

 

Wet Ones, the most visible market competitor to Purell, has an active ingredient of Benzethonium Chloride.  Over the years I've watched the advice regarding the effectiveness of Benzethonium Chloride against Noro go from "the jury is out, probably better than alcohol based hand sanitizers," to "nope, not effective against Noro".  And again, a number of research papers indicate that Benzethonium Chloride doesn't have any effect against Noro.

 

So, what is effective against Noro?  Bleach and hydrogen peroxide.  A number of widely used spray disinfectants, like Lysol, claim to be effective, but read those product labels.  The label on a can of Lysol indicates the contact and hold time necessary for their product to eradicate different bacteria and viruses.  It varies greatly from bacteria to bacteria and virus to virus.  Some contact times are instant, some a few minutes.  Some contacts times are upwards of 30 minutes or longer.  Of course, when it comes to sanitizing your hands, handwashing immediately prior to eating, with no touching of other surfaces from the sink to the table, is the best practice to limit spread.  And what is it that really gets our hands clean?  Soap helps and is honestly necessary, but hot water and agitation, rubbing your hands together, is what washes away the viruses and bacteria on your hands.  Soap acts as a detergent and surfactant which helps to improve the capabilities of water to remove whatever is on the surface of your skin and carry it away down the drain.

 

The introduction of wash basins in buffets and requiring passengers to use them and use them properly goes a long way toward cutting down on viruses which are passed through touching surfaces.  Is it Carnival that has automated hand washing systems installed in some of their buffets, you basically put your hands in these tubes and the machine turns on and hot, soapy water, is blasted on your hand for a pre-determined period of time and then your hands are clean.  This type of technology is widely in use in the commercial food processing arena so as to standardize and ensure that food workers have clean hands before being in contact with food that will feed thousands or even millions of people.

 

As for "Food Code" strength hand sanitizer.  I'm not aware of any such product and the research I've done doesn't indicate that such a thing exists.  If it does, please correct me.  Please provide a link to the product so that I can read up about it.

 

 

[dreaminofcruisin]

1 hour ago, jeromep said:

I think some more specificity is needed here.

 

I have always known that alcohol based hand sanitizers, Purell and anything private label or third party, that is gelatinized alcohol based, is ineffective against Noro.  But just to make sure I wasn't crazy I did some research and the CDC, for whatever they are now worth, confirms this, along with a number of university research papers.  The nature of the structure of Noro is such that alcohol can't penetrate the virus casing, and as such it survives even after using alcohol based hand sanitizers.

 

Wet Ones, the most visible market competitor to Purell, has an active ingredient of Benzethonium Chloride.  Over the years I've watched the advice regarding the effectiveness of Benzethonium Chloride against Noro go from "the jury is out, probably better than alcohol based hand sanitizers," to "nope, not effective against Noro".  And again, a number of research papers indicate that Benzethonium Chloride doesn't have any effect against Noro.

 

So, what is effective against Noro?  Bleach and hydrogen peroxide.  A number of widely used spray disinfectants, like Lysol, claim to be effective, but read those product labels.  The label on a can of Lysol indicates the contact and hold time necessary for their product to eradicate different bacteria and viruses.  It varies greatly from bacteria to bacteria and virus to virus.  Some contact times are instant, some a few minutes.  Some contacts times are upwards of 30 minutes or longer.  Of course, when it comes to sanitizing your hands, handwashing immediately prior to eating, with no touching of other surfaces from the sink to the table, is the best practice to limit spread.  And what is it that really gets our hands clean?  Soap helps and is honestly necessary, but hot water and agitation, rubbing your hands together, is what washes away the viruses and bacteria on your hands.  Soap acts as a detergent and surfactant which helps to improve the capabilities of water to remove whatever is on the surface of your skin and carry it away down the drain.

 

The introduction of wash basins in buffets and requiring passengers to use them and use them properly goes a long way toward cutting down on viruses which are passed through touching surfaces.  Is it Carnival that has automated hand washing systems installed in some of their buffets, you basically put your hands in these tubes and the machine turns on and hot, soapy water, is blasted on your hand for a pre-determined period of time and then your hands are clean.  This type of technology is widely in use in the commercial food processing arena so as to standardize and ensure that food workers have clean hands before being in contact with food that will feed thousands or even millions of people.

 

As for "Food Code" strength hand sanitizer.  I'm not aware of any such product and the research I've done doesn't indicate that such a thing exists.  If it does, please correct me.  Please provide a link to the product so that I can read up about it.

 

 

 

Thanks for the informative post. This is also what I thought.

Yes, Carnival ships (at least the Horizon) has the 'car wash' type of hand sink. Unfortunately, they are hidden in a corner and no one suggests to people to use them. The week we were on, the only ones that used them were our group, especially my 5 year old grandson who thought they were 'cool'.

Too bad the Ruby doesn't have the sinks installed outside the buffet....it really should...

[PescadoAmarillo]

2 hours ago, Bobbiegentry said:

And of course the lamestream media is right there fomenting fear and discontent. 

What part of the article was incorrect?  Unfactual?  There was no fear, discontent or other histrionics in what I read. 

[VibeGuy]

Purell VF Plus is the proprietary 85% ethanol formula.  This paper specifically discusses how it inactivates norovirus, leaving it unable to infect gastric cells. 
 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756425/

 

Here’s another paper comparing it to BAK:

 

https://www.frontiersin.org/articles/10.3389/fmicb.2022.869087/full

 

The previous cruise ship strength formula was VF481, a 70% ethanol/6% isopropanol formula with a modified pH and a copper salt - it was the first to be substantially better than 70% ethanol gels which are literally 10-20x better than isopropanol scrubs. 
 

Food Code compliant refers to model food code Section 2 301.16 - which is both an efficacy claim on particular foodborne pathogens and that the ingredients are food safe without rinsing the hands afterwards.  
 

I was not on team gel prior to the development of VF481 specifically because of their lousy performance on non-enveloped viruses.  Two things changed my mind - one was a move away from whether gels reduced viral loads as measured by PCR to tests based on reductions of infectious capability - you can PCR the DNA in a Dorito really easily but you can’t plant one and harvest corn on the cob later. Better cell culture techniques make infectivity testing a better choice for evaluating sanitizer claims.  
 

The other thing that changed my mind was the very rapid improvement in the gel performance, due in part to research sponsored by the cruise lines - they’re tired of the association of Noro with ocean vacations, when it is endemic in childcare and healthcare environments shoreside.  While a 3.3log decrease isn’t particularly impressive on, say, fecal coliform species, it’s darned impressive on such a tenacious virus as Noro.  99.97% reduction in infectivity, when used properly, is enough to prevent a lot of cases.  The old formula was good enough to convince me to use it as an adjunct, the new formula is demonstrably better. 

I would like to see the automated systems on more ships - they’re effective and the sanitizers can be updated/swapped as new threats emerge.  Until then, I’m just going to assume that literally every other guest has infectious fecal matter on their hands and add an additional kill step after touching shared utensils, even though my hands are usually still damp with sanitizer when I’m touching said utensils.  I’m not a germaphobe.  I’ve literally consumed chicken sashimi.  I just don’t trust the hand hygiene of people who can’t be fired for improper handwashing when it comes to food. 

 

 

[Bobbiegentry]

My “never leave home with out it” sure fire way to prevent noro. 
These have been on my cruise packing list beginning the first cruise after my first (and only, to date 🤞🏻) infection. 
 

The key, of course, is to use them. And no, I don’t wear them all the time. Only in the buffet. 
The rest of the time it’s a matter of Washy-Washy. 
 

@Vibeguy, what specific hand sanitizer do you feel does the best job?

 

Edited March 9, 2023 by Bobbiegentry

[Sigyn]

9 hours ago, PescadoAmarillo said:

What part of the article was incorrect?  Unfactual?  There was no fear, discontent or other histrionics in what I read. 

Yes, the article was accurate.