Cruise Ship Hygiene Safety Study

Friday, October 29, 2010 // Uncategorized

11/5/2009 10:59:00 PM

Contemplating a cruise?  The following article from Journal Watch may have some helpful information.

Cruise Ship Restrooms: An Exposé

Some are very clean, but most are not . . . until an outbreak of gastroenteritis occurs.

Cruise ships are plagued by outbreaks of acute gastroenteritis, almost always caused by norovirus. This hardy virus can survive on stainless steel surfaces for weeks and is relatively resistant to alcohol-based hand rubs. Thus, good manual scrubbing of restrooms is extremely important in limiting norovirus transmission.

In a 3-year covert operation, a team of 46 medical professionals evaluated the cleanliness of public restrooms on 56 ships. At the start of each cruise, a team member applied a colorless fluorescent gel to standardized objects in several restrooms; the gel — visible under ultraviolet light — is removed easily by light scrubbing with water. Daily evaluations (and reapplications of gel, if it had been cleaned off) were conducted.

Cleanliness scores varied widely by ship, from 100% to <5%. Overall, toilet seats were the best-cleaned objects, but they were cleaned only 50% of the time. Baby changing tables were the least-cleaned objects (cleaned only 30% of the time). Handholds next to toilets often were overlooked as well. Serendipitous outbreaks of gastroenteritis occurred on 16 evaluated ships. Before the outbreaks, affected vessels had significantly worse cleaning scores than unaffected ships had, but significantly better cleaning scores were recorded after outbreaks.

Comment: Not too surprisingly, given outbreak frequency, bathroom surfaces with a high likelihood of contamination by gastrointestinal pathogens are not cleaned well on most cruise ships. But here’s a new travel safety tip: Book a cruise on a ship that’s just recovered from an outbreak — the staff will be newly sensitized to the importance of sanitation.

Abigail Zuger, MD

Published in Journal Watch General Medicine November 5, 2009


Carling PC et al. Cruise ship environmental hygiene and the risk of norovirus infection outbreaks: An objective assessment of 56 vessels over 3 years. Clin Infect Dis 2009 Nov 1; 49:1312.

hygiene, cruise ships, cruise ship, ship cruise, cruise, cruises, health, safety,


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