Healthy and Happy at Sea

By Kathryn Marchi

It’s always big news when a cruise ship has to return to port because of an outbreak of illness among the passengers. Hard-earned vacations are ruined and the cruise line loses money and time, right along with its employees. The cruise line’s reputation is greatly diminished which means fewer bookings for future cruises. Everybody loses.

The most common virus that may take hold on a ship is called “norovirus,” a very contagious gastrointestinal illness that can infect anyone. It is contracted from an infected person, contaminated food or water, or by touching contaminated surfaces. This virus is not necessarily life-threatening, but is very uncomfortable and debilitating at the time. Of course, folks with compromised immune systems can suffer unwanted complications from it.

So the question is: What are the various cruise lines doing to prevent an outbreak of illness onboard their ships?

On a recent Caribbean cruise with Holland America, I decided to find out. When boarding the ship, Zuiderdam, every passenger was required to fill out a public health questionnaire that was then verified by a security officer. It behooves each passenger to be completely honest when filling out this form. Once onboard, hand sanitizers were quite visible everywhere: along passageways, at entrances and exits of all restaurants and other food courts, public toilets and even on computer terminals in the ship’s library. They were also placed at strategic sites for passengers leaving and returning from various shore excursions. Each stateroom had an informational booklet, which listed common sense guidelines for daily, routine hygiene:

v Wash hands often and thoroughly with hot soapy water for 20 seconds before eating, after using the toilet and smoking.

v Make a habit of using available hand sanitizers.

v Keep hands away from mouth, nose and eyes.

v Sneeze or cough into elbow or tissues.

v Use tissue or toilet paper to open or close public toilet doors or flush toilets.

v If you become ill, isolate yourself in your stateroom after notifying the front office.

Of course, these are the obvious means of preventing the spread of illness on board the ship. But what is being done behind the scenes by the cruise line on your behalf?

I spoke with a member of the ship’s staff, Hotel Director Boban Zivkovic, and met with him for over an hour in his office.

Mr. Zivkovic explained that the CDC (Centers for Disease Control) and the cruise industry work very closely together. The CDC has developed a special sanitation program and manual called “Vessel Sanitation Program” and all cruise lines abide by it. For details so to 

From seminars with the CDC, Holland America determined that the first 48 hours of a cruise is the most critical time for spread of disease since symptoms of illness are usually manifested during that time. The ship’s crew sets about sanitizing all high traffic and public areas: lounges, bars, restaurants, public toilets, accommodation corridors, walls, chairs and “common touch points” such as hand rails, elevator buttons, door knobs. This is done to prevent cross-contamination in case someone was ill when they came onboard.

On day three of the cruise, the entire ship gets “super-sanitized” with a sanitizing agent called Oxyvir. All crewmembers are recruited and all public areas both inside and out are completely washed down. Thereafter, each night of the cruise, public touching areas are again sanitized and continue to be wiped down during the day. If passengers become ill, the ship’s staff is advised and the sanitizing process begins again.

During this 48-hour time frame, where self-service is needed in public dining areas and buffets (salad bars and bread stations), utensils are changed every 20 minutes. They are color-coded and numbered for accuracy of time.

Zivkovic said that all crew aboard the ship are trained in sanitation education training following a protocol called, “Onboard Prevention Procedures.” Each department has a checklist of duties and procedures for basic hygiene and sanitation throughout their domain. These check lists are submitted to the hotel director on a daily basis. Two examples are:

v Housekeeping The crew sanitizes the bathrooms in each stateroom twice daily.  If they become aware that any guest is ill, they will report it to medical personnel. Other crewmembers are also required to report these incidents.

v Food Service All kitchen staff and servers practice basic sanitation procedures mandated by the aforementioned manual, “Vessel Sanitation Program.” These include frequent washing hands, wearing plastic gloves when handling ready-to-eat food and changing gloves between tasks.

One cannot separate food preparation and the food itself. According to the cruise line, all foods are purchased from certified suppliers who practice the HACCP guidelines mentioned earlier. This means that food at the source and onboard is consistently maintained in the correct storage temperature range. Produce and fruit are thoroughly washed in a special sanitizing solution. Preparation of all food is done in a very clean environment where hands, surfaces and utensils are washed routinely and kept in their particular prep area. To prevent spoilage, potentially hazardous food is kept out for consumption for a maximum of four hours, before being discarded.

Cleanup is another important aspect of disease prevention: Dishes and utensils are put through a rigid five-step cleaning program in large dishwashers: prewashing, washing, rinsing, sanitizing and air drying.

Now, what about the ship’s water supply? Even though the water system is “reverse osmosis” a water purification system producing potable water, many folks prefer not to drink the tap water in their stateroom bathrooms. On request for a minimal fee, bottled water is routinely provided in each stateroom , at any place on the ship and also in mini bars.

All of this information about a healthy cruise would not be complete without discussing medical personnel. A medical doctor, nurses and nurse practitioners sail with each ship. They have medicines needed for either intestinal or upper respiratory infections and a sick bay is provided for more serious cases. Many ships also have a pharmacy for a limited amount of medicines. If passengers become ill, they are given medication and quarantined to their stateroom or the sick bay until the medical staff deems them healthy and no longer infectious. It should be noted that costs incurred during a medical situation are the responsibility of individual passengers. It is best to check your health insurance to see just what is covered in this scenario.

During this process of researching a cruise line’s efforts to provide a healthy sailing environment for guests and crew, it became very clear that the process requires a partnership between a ship and its passengers. On the cruise line’s behalf, Zivkovic stated, “We are doing everything practicable in minimizing and reducing the potential cross-contamination and spread of germs in public spaces, but we know we cannot completely eliminate this possibility.” This statement makes it clear that the ship and its crew are supporting their part of the partnership. It then behooves guests to bear their responsibility in the equation and follow the ship’s requirements stated in the brochures given out upon boarding.

Basically, Zivkovic said it all boils down to, “The single most important factor in personal hygiene and prevention of illness onboard (and ashore), is proper hand washing in addition to hand sanitizing with sanitizers throughout the ship.”

Kathryn continues to enjoy travels with her husband and particularly appreciates the convenience of being on board a cruise ship while visiting destinations in a shorter amount of time, She can be reached at [email protected]















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