Norovirus infection on cruise ships

The Health Protection Agency working closely with the cruise industry through the Passenger Shipping Association (PSA) and with the Maritime and Coastguard Agency and the Association of Port Health Authorities today published Guidance for the Management of Norovirus Infection in Cruise Ships.

Norovirus infects between 600,000 and one million people in the community in the United Kingdom every year. This guidance has been produced to help prevent and control outbreaks on the comparatively rare occasions when they occur on board cruise ships.

Norovirus is highly infectious and causes a very unpleasant but generally short-lived infection lasting 1-2 days from which people will usually recover without treatment. The symptoms are vomiting, which is often sudden and “projectile”, diarrhoea and sometimes both. Some people may have a raised temperature, headaches and aching limbs.

There is no specific treatment for norovirus apart from letting the illness run its course. It is important for those affected to drink plenty of fluids to prevent dehydration.

Outbreaks most commonly occur in semi-closed environments such as hospitals, nursing homes and schools and can be difficult to control and long-lasting because norovirus is easily transmitted from one person to another. The virus can survive in the environment on surfaces or objects.

The newly produced Guidance for the Management of Norovirus Infection in Cruise Ships provides guidance for health professionals, port health and other agency staff and ships' crews on how to prevent, identify and manage norovirus outbreaks on the rare occasions that they do occur on board cruise ships.

Professor Pat Troop , the Health Protection Agency's Chief Executive, said: “The aim was to produce straightforward and practical advice to discourage the introduction of infection to cruise ships in the first instance and to help the industry and public health authorities manage outbreaks in a consistent manner when they do occur.”

Dr. John Curnow who chaired the multi-agency group that developed the guidance said: “Passengers on a cruise ship expect to enjoy a relaxing holiday. Our aim as a group was to identify and recommend procedures that will be robust enough to manage any possible outbreak and at the same time ensure that infected passengers are able to get back to normal holiday activities as quickly as possible”.

Mr. William Gibbons, Director of the Passenger Shipping Association, said: “We worked closely with the Health Protection Agency and with a range of other partners in the development of the guidance and we are delighted that the published document is now available on the HPA website. It means that all parties who are required to deal with an outbreak of infection will have immediate access to sound and practical advice that will minimise the impact for passengers and crew alike.”

The guidance covers risk assessment and management, pre cruise actions, the on board incident team, outbreak control group, cleaning procedures, hand hygiene and management of the vessel whilst in port.