Published Date: 2006-03-09 23:50:00
Subject: PRO> Viral gastroenteritis, cruise ships - USA: background (02)
Archive Number: 20060309.0753
VIRAL GASTROENTERITIS, CRUISE SHIPS - USA: BACKGROUND (02)
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Date: Thu 9 Mar 2006
From: George Robertson <geo456@adelphia.net>
Source: Reuters Health, Thu 9 Mar 2006 [edited]
<http://www.reutershealth.com/en/index.html>
Diarrheal Disease on the Rise in Cruise Ships
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Cruise ship passengers are currently more likely to experience
diarrheal disease than they were in the 1990's, new study findings
suggest [published in the March 2006 issue of the American Journal of
Preventive Medicine. - Mod.CP]. The expected incidence of
gastroenteritis per 7-day cruise has increased from 2 cases between
1990 and 2000 to 3 cases in between 2001 and 2004, the report
indicates.
"Despite good environmental health practices on cruise ships, and
high performance scores on environmental health inspections,
gastroenteritis likely associated with person-to-person spread of
illness caused by norovirus infection is difficult to predict and
prevent," study author Dr. Elaine H. Cramer of the US Centers for
Disease Control and Prevention told Reuters Health. What's more,
added the Vancouver, British Columbia-based researcher, the findings
can be generalized "to a variety of hospitality venues and
conveyances, airplanes and trains in which there is a high density of
travelers."
In 2000, the incidence of diarrheal disease among cruise ship
passengers was 16 cases per 100 000 passengers, down from 29 cases
per 100 000 passengers in 1990. Just a short while later, however,
diarrheal disease outbreaks on cruise ships increased. According to
the CDC, 29 outbreaks occurred in 2002, compared with just 3 in the
previous year.
Cramer and her colleagues, members of the CDC's Vessel Sanitation
Program Environmental Health Inspection Team, evaluated the incidence
of gastroenteritis on cruise ships that docked in US ports and
carried at least 13 passengers from 2001 through 2004. They also
explored whether the ships' performance on health inspections was
associated with the frequency of outbreaks. The number of
gastroenteritis outbreaks per 1000 cruises increased from 0.65 to
5.46. What's more, the total number of gastroenteritis outbreaks
increased to a median of 15 per year from 2002 to 2004, up from 2 in
2001.
Yet, the ships continued to perform well on regular, unannounced
health inspections throughout the study period, with half of the
vessels scoring above 95 on a scale of one to 100, study findings
indicate. Inspection scores were not associated with either increased
or decreased rates of gastroenteritis, and they also did not appear
to predict more or less frequent outbreaks of the illness, the
researchers note. "The increase we have seen at sea is paralleled by
an increase in the prevalence of norovirus-associated gastroenteritis
on land," Cramer said. The illness is common in Scandinavia, the UK,
Europe and North America.
Norovirus [infection] is a frequent cause of gastroenteritis, and its
symptoms -- including diarrhea and vomiting -- are unpleasant but
rarely dangerous. The virus is transmitted through person-to-person
contact, contaminated food or water, or by touching a contaminated
surface, such as elevator buttons and stair handrails.
However, prospective cruisers [cruise passengers] need not abandon
their plans. Cruisers have less than a one percent chance of
contracting gastroenteritis while spending an average of 7 days at
sea, the researchers note. "The most important preventive strategy
against gastroenteritis associated with person-to-person transmission
of disease is hand washing," Cramer told Reuters Health. "Travelers
should wash their hands for 20 seconds frequently, using soapy water
and using hand sanitizers only as an adjunct to handwashing, not as a
substitute for handwashing," she added.
[Byline: Charles Huggins]
--
George A. Robertson
Frederick, MD 21701
<geo456@adelphia.net>
See Also
Viral gastroenteritis, cruise ships - USA: background 20060306.0727Norovirus, cruise ship - Caribbean 20060305.0718
2005
----
Norovirus, post-hurricane - USA 20050911.2693
Viral gastroenteritis update 2005 (08) 20050307.0675
Viral gastroenteritis update 2005 20050109.0070
2004
----
Viral gastroenteritis update 2004 (36) 20041222.3379
Viral gastroenteritis update 2004 (02) 20040127.0317
2003
----
Viral gastroenteritis update 2003 (28) 20031227.314131
Viral gastroenteritis update 2003 (01) 20030108.0058
2002
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Viral gastroenteritis update 2002 - (04) 20020101.0005
Viral gastroenteritis update 2002 - (03) 20021225.6122
Viral gastroenteritis update 2002 (02) 20021219.6097
Viral gastroenteritis update 2002 - (01) 20021218.6088
Norwalk-like virus, cruise ship - USA (FL) (15) 20021212.6049
Norwalk-like virus, cruise ship - USA (FL) (12) 20021207.6000
............................cp/msp/lm
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