Vessel Sanitation Program: Disney Magic, Fascination, Oceana, Carnival Conquest Outbreak Investigation, December 2002

Investigation Update - December 19, 2002

Investigation Update - December 19, 2002
During the span of October 2002 through December 2002, the Centers for Disease Control and Prevention’s Vessel Sanitation Program (VSP) investigated several instances of gastrointestinal illness aboard cruise ships. VSP worked closely with cruise industry officials to identify the causes for the following are updates of investigations:
Disney’s Disney Magic;
Carnival’s Fascination; and
P & O's Oceana.
Carnival's Carnival Conquest.

Disney Magic
After a week of extensive cleaning and disinfection, the Disney Magic returned to service on December 7. The Magic has been providing CDC with daily reports and will continue to do so through the end of its current cruise, which ends in Port Canaveral on December 21. As of December 19, the vessel reported 13 of 2,153 passengers and none of the 1,026 crew members with gastrointestinal illness.

Carnival Fascination
CDC’s vessel sanitation staff was notified by the Fascination’s medical staff that for the cruise ending December 6, 13 of 2,042 passengers and 12 of 907 crew had reported gastrointestinal illness. For the cruise ending December 9, 6 of 2,038 passengers and 7 of 922 crew reported ill.
One stool sample was collected from the cruise ending December 2 and confirmed to be Norwalk virus. Food and water samples taken from the Fascination for the cruise ending December 2, 2002 were inconclusive. No other follow-up is planned by CDC.

P & O's Oceana
On December 7, CDC staff boarded the Oceana to conduct interviews with ill passengers and crew. CDC staff also conducted an environmental assessment and reviewed ongoing cleaning/disinfection of the vessel. CDC epidemiologists surveyed a sample of the passengers and all of the crew in an effort to determine how the outbreak began and what particular activities lead to person-to-person spread aboard the ship. Stool specimens have been analyzed at CDC and confirm Norwalk virus as the cause of the illness. The vessel returned to Ft. Lauderdale Florida on December 13 where it was taken out of service for 36 hours to provide time for additional cleaning and sanitizing. 1800 passengers, who had all flown in from the United Kingdom on chartered aircraft, boarded the vessel on December 14. The current cruise will end in Ft. Lauderdale on December 27. As of December 19, the vessel reported that 17 of 1,868 passengers and 15 of 884 crew had reported to the ship’s medical staff with a gastrointestinal illness.

Carnival Conquest
On December 13, the Carnival Conquest reported an increased number of passengers and crew reporting gastrointestinal illness symptoms consistent with Norwalk virus. The cruise began and ended in New Orleans, with cruise dates of December 8-15. The vessel reported 39 of 1,184 crew (3.3%) and 224 and 3,154 passengers (7.1%) ill. Stool samples were collected from ill passengers and crew and will be analyzed by CDC. Laboratory results will probably not be available before the end of the year. Following additional cleaning and disinfection, the vessel embarked on a 7-day cruise, which will end in New Orleans on December 22. As of December 19, the vessel reported that 35 of 3,072 passengers and 23 of 1,181 crew reported to the ships medical staff with a gastrointestinal illness.

General Information
Cruise ship travelers are reminded that simple hygienic practices, such as frequent and thorough hand washing and avoiding contact with other passengers when ill, are important measures to prevent the spread of disease.
Additional information about CDC’s Vessel Sanitation Program is available at http://www.cdc.gov/nceh/vsp.
Additional information on gastrointestinal diseases is available at http://www.cdc.gov/ncidod/dvrd/gastro.htm.
Information on Norwalk-like viruses is available at http://www.cdc.gov/mmwr/pdf/rr/rr5009.pdf.

For more information, CDC’s Vessel Sanitation Program can be reached at vsp@cdc.gov.