There is concern that the United States will be attacked by another "viral cruise ship" following the spread of SARS-CoV-2. While on a sightseeing cruise from February 26th to March 5th, 2019, 284 guests and 34 crew members aboard the Ruby Princess reported feeling unwell. Patients mostly complained of stomach upset and gastrointestinal issues.
The ship was boarded by epidemiologists and environmental health officials from the Centers for Disease Control and Prevention (CDC) when it docked in Galveston, Texas, on March 5. The CDC said Princess Cruises increased cleaning and disinfection, notified all passengers about the outbreak and collected fecal samples from infected people for testing. At this time, the CDC has not determined the cause of the illness.
According to the cruise line, the illness might be caused by norovirus which is highly infectious and causes vomiting and diarrhea. The Ruby Princess was totally cleansed shortly after the affected passengers left. Soon later, another set of passengers and staff members boarded the Ruby Princess in a hurry to begin a new sailing period.
Formerly known as Norwalk-like virus, norovirus is a member of the family Caliciviridae and is a non-enveloped, single-stranded, positive-sense RNA virus. They may spread rapidly from person to person and have the potential to cause severe cases of gastroenteritis in people. In humans, NoVs cause 684 million annual illnesses and 212,000 annual fatalities due to epidemics and sporadic cases of acute viral gastroenteritis. As just 10 virions are needed to infect an adult, preventing the spread of norovirus is challenging.
The Ruby Princess has made headlines in the past with multiple COVID-19 outbreaks that have received wide world attention. Early in the outbreak, a cruise trip conducted in 2020 resulted in hundreds of COVID-19-positive cases on board while docked in Australia. To control the path of virus transmission, the U.S. Centers for Disease Control and Prevention has been tracking the COVID-19 outbreak on cruise ships in recent years. This program of tracking cases ends in July 2022.
The incubation time for norovirus infection is short, ranging from 12 to 72 hours (often 24 to 48 hours) as stated on the CDC website. Diarrhea, vomiting, nausea, stomach pain, abdominal pain, headache, fever, and muscular pains are the most prominent early signs of the condition.
Norovirus transmission is mainly by hand-fecal-oral. It can be spread secondarily through interpersonal contact, consumption of contaminated food or water, contact with surfaces contaminated with norovirus, and then hand-to-mouth contact, direct contact with an infected person, e.g., caring for a patient, eating with the patient or using the same utensils.
The CDC notes that norovirus outbreaks usually occur in the spring and winter months between November and April. People can protect themselves and their families by:
l Washing hands frequently
l Rinsing fruits and vegetables
l Cooking shellfish thoroughly
There is currently no vaccine or medicine that can be used to prevent norovirus, therefore patients must instead rely on their bodies' natural immunity to the disease. In most cases, individuals don't need to consult a doctor unless they're experiencing serious symptoms. Patients with vomiting and diarrhea should increase their water intake to make up for the fluids lost. Carbonated beverages and fruit juices should be avoided as well, as they might exacerbate diarrhea in youngsters. Breast milk or other milk-based beverages should still be given to infants as normal.
