CRUISING Be sure to wash up, or risk being sick at sea

By ARLINE BLEECKER
KNIGHT RIDDER NEWSPAPERS
If the Centers for Disease Control and Prevention had its druthers, you would be humming "Happy Birthday" on your cruise ship a dozen times a day.
That's because the ditty -- which lasts about 15 to 20 seconds, depending on who's doing the humming -- is the CDC's rule of thumb for how long to wash your hands to sufficiently combat communicable germs.
I bet most cruisers hardly come close.
The wisdom of such diligent attention to hygiene was underscored by a recent and persistent outbreak of the Norwalk virus, a bug that cumulatively plagued more than 500 cruisers and crew members aboard four consecutive sailings of Holland America Line's 1,380-passenger Amsterdam. While not considered serious, the highly contagious virus delivers up to two days of diarrhea, vomiting and stomach pain.
Similar situation
A suspiciously similar illness surfaced aboard a Disney Magic sailing Nov. 22, making almost 300 people ill. Tests are being conducted, and Forney wouldn't speculate as to whether it was the Norwalk virus.
Even if you don't plan to sail aboard one of the affected ships, conscientious hand-washing on any ship is the best protection, says Dave Forney, chief of the vessel sanitation program for the CDC.
"Anybody who travels -- even by train, plane or bus -- should never pass up an opportunity to wash their hands."
Forney is quick to note that illness is reported on just about every cruise, but the recurrence of the Norwalk strain serves to remind us that a ship is a virtual cocoon -- an ideal incubator for passing along such viral varmints that thrive in closed spaces. Norwalk-type viruses easily can be contracted by touching anything -- from banisters to poker chips -- that has been touched by a person who has the virus.
Virus is widespread
Forney says the Norwalk virus is much more widespread than most of us realize. "The virus has been around for a while with breakouts in the U.S. and throughout the world."
About 181,000 people are affected every year, though only a small percentage of them occur on cruise ships. Nevertheless, a vessel presents a particularly virus-friendly environment.
"The issue on ships is that you have 2,000 people from all over the world converging on a confined space -- in the case of the Amsterdam, 10 days at a time," Forney says. "The Norwalk is extremely infectious ... and it's going to spread rapidly."
Because the agency found nothing wrong with the Amsterdam's water system or food-handling practices after the outbreak, it is convinced that person-to-person contact spread the virus. That's why Forney urges the all-important hand-washing. He emphasizes: "People need to be very proactive in their hand-washing habits ... because hands are the route of exposure; it's not through the skin. Be diligent about hand-washing, and keep your hands out of your mouth."
The Norwalk also is "not bacterial, so there's no treatment to kill the organism," he says. A normal healthy individual stricken with it might be uncomfortable for only a couple of days, but the elderly and those with chronic illnesses can quickly dehydrate, he says.
No travel advisories
Intractable as the Amsterdam's outbreak has been, the CDC is not issuing any travel advisories, Forney says.
The Amsterdam wasn't the virus' first sea-going victim. A similar outbreak last year felled passengers in Alaska on the Ryndam, and two years before that, on Princess' Regal Princess. The Norwalk virus also recently blazed through Royal Caribbean, Norwegian and Celebrity vessels in Europe.
As a result, hands aren't the only things that get scrubbed. During any shipboard flare-up, a stricken vessel itself becomes subject to an extremely stringent cleaning campaign, as was the case with the Amsterdam.
Six hundred workers cleaned and sanitized the ship before it left Fort Lauderdale on 10-day Caribbean cruise Nov. 11. "We had crew cleaning Scrabble tiles and the poker chips," Holland America spokesman Erik Elvejord told the Associated Press.
In a handout, the line alerted the 1,316 embarking passengers to the ongoing problem and gave passengers the choice to board or not.
On the four beleaguered sailings, the Amsterdam was sanitized twice daily, and both the Centers for Disease Control and Holland America closely monitored the situation.
However, the only sure way to break the infectious cycle is to take a vessel out of service to clean and sanitize it, suggests the CDC. Indeed, all attempts to vanquish the virus aboard the ship have failed to this writing. After consulting with the agency, Holland America voluntarily canceled the ship's Nov. 21 sailing in order to break the person-to-person cycle and "to provide peace of mind to future guests on the Amsterdam," according to a press release issued by the line. Passengers booked on the canceled voyage were given the option of a refund or upgraded travel packages.
The sanitizing cure, Forney suggests, requires a combination of time and cleaning. Exactly why those things remedy the problem is uncertain, he says. "You can't test for the Norwalk virus. The only test is if there's no further occurrence of illness."
To be on the safe side while on any vessel, it's a good idea to heed Forney's advice: Wash your hands early and often. If hot soapy water isn't handy or if you're disinclined to scrub, he recommends using an instant hand sanitizer and following manufacturer's directions. It can save you a lot of aggravation.
XFor information about the CDC's Vessel Sanitation Program, call (770) 488-7070. On the Web, check www.cdc.gov/nceh/vsp.