Cruise Lines Press for Term To Describe Viral 'Outbreak'

[bellebaby]

This article appeared in today's Wall Street Journal.

http://aolsvc.news.aol.com/business/article.adp?id=20050208100109990007

Happy reading!!

[RuthC]

I couldn't get a connection---says I have to be a member. :eek:

Is it possible for you to give the jist of the story? :confused:

[LAFFNVEGAS]

Ruth, I probably should not copy, but here it is....

Feb. 8) -- Robert Pearson's seven-day Caribbean cruise was no holiday. On the second night on Royal Caribbean International's Mariner of the Seas ship last month, Mr. Pearson doubled over with a stomach virus that confined the 66-year-old retired insurance executive to his room for three days with bouts of diarrhea and vomiting. About 275 people, or 8% of the 3,465 passengers, reported gastrointestinal problems.
A month into the cruise industry's "wave season," when cruise companies get the bulk of their bookings, more than 1,100 passengers on seven ships have gotten sick, according to the Centers for Disease Control and Prevention. At the current rate, the number of onboard outbreaks in 2005 will top last year's record of 37.

There's no sign that the latest illnesses are hurting bookings, which did happen in 2003 after negative publicity from an outbreak. Cruise lines have tried squashing the virus with everything from stronger industrial cleaners and new sanitation regimens to installing antibacterial hand sanitizers near the buffet line. Passengers who are a bit green before their cruise are being asked to stay home.

But those efforts haven't proven enough to keep the virus at bay. So now the cruise industry is proposing a new remedy of sorts. Frustrated by the media coverage that often accompanies onboard illnesses, the International Council of Cruise Lines, a trade group that lobbies on behalf of cruise companies, has asked the CDC to eliminate the word "outbreak" from the agency's health reports. "If they used the words 'increased incidences,' it wouldn't be misreported by the media," says Michael Crye, the trade group's president.

The CDC acknowledges that it is considering eliminating "outbreak" from its reports. "We're trying to come up with a term that better describes an issue of public health importance," says David Forney, chief of the CDC's vessel-sanitation program. But he says a change isn't certain. "We're not going to change just because the industry doesn't like it," he says. He says the measures used to track illnesses are more important than the term used to describe the findings. The term "outbreak" dates back a number of years, when bacterial infections were the dominant source of illness (the CDC has been inspecting ships since the 1970s). Now it's viral infections, which tend to be less severe, so the CDC is re-examining the terminology, he adds.

The industry also wants the CDC's vessel sanitation program Web site to show how many passengers are reported sick during each day of a cruise, to better show that many passengers recover after a few days of illness. The current cumulative report tallies all passengers suffering from either three bouts of diarrhea or vomiting plus one other symptom ranging from achy muscles to fever, all within 24 hours. (The CDC tally doesn't include routine seasickness.) Cruise-company officials note that more people are bound to become ill at one point during longer cruises, which wouldn't necessarily mean there was an epidemic.

While conceding that the current reporting system can make longer cruises appear riskier than shorter ones, Mr. Forney says no changes are planned to how the CDC counts illnesses. He says the agency has discussed how to reflect illness patterns on longer cruises more fairly, but the cruise industry has yet to offer an acceptable proposal.

Mr. Forney insists the agency isn't backing down from its ship-inspection and surveillance duty. The agency conducts twice-a-year inspections on any foreign-bound vessel carrying more than a dozen passengers, and requires cruise ships to log and report the number of passengers and crew who seek medical attention for vomiting and diarrhea. It posts reports on its Web site when the number reaches 3% or more of the people on the ship.

"We're not going to change how we respond," Mr. Forney says. "We will do what we think is in the best interest of the public and protecting public health."

The chief culprit of cruise-line illnesses is norovirus -- commonly called Norwalk virus -- which triggers about three days of stomach-related agony. Noroviruses are fairly common and are responsible for illness outbreaks every year at nursing homes, hotels and hospitals throughout the world. Nearly 3,000 guests at two Las Vegas hotels were sickened recently by two persistent norovirus outbreaks. But the CDC's health-reporting rules for the cruise industry make shipboard outbreaks easier to track and higher-profile.

Cruise-line officials say their industry gets more attention simply because the CDC's reporting rules are more onerous for them than it is for hotels or hospitals. "We are unfairly singled out," says Tim Gallagher, a spokesman for Carnival Corp.

The CDC estimates that there are about 23 million cases annually of stomach ailments caused by norovirus. In one study of 232 cases, the CDC said only about 10% were in vacation settings or cruise ships, compared with 23% in nursing homes and 36% in restaurants.

The surge in disclosed norovirus outbreaks in recent years is partly the result of the CDC's move in 2000 to broaden its definition of gastrointestinal illness that ships are required to report -- to include vomiting, instead of just diarrhea. "We made the change to better capture what we were actually seeing on the ships," Mr. Forney says. The increase also reflects a growing number of norovirus outbreaks on land, which can infect people who carry the virus on board.

Cruise lines say most norovirus illnesses are brought on board by passengers who are sick even before they board. The illness typically spreads when passengers don't wash their hands properly before leaving the bathroom, and then touch handrails, doorknobs or even elevator buttons. The virus can live on surfaces for up to three weeks. About 10.6 million people took cruises last year, up more than 11% from the year earlier.

Cruise lines have taken steps to increase their vigilance. Royal Caribbean Cruises Ltd., parent company of Royal Caribbean International, dispatches sanitation crews to clean public restrooms every half-hour to hour during "code red" alerts that are triggered if 1% of passengers have reported being sick. "This system has helped us control this illness; we're able to kill it," says Vince Warger, Royal Caribbean's director of medical services.

The cruise industry first raised the notion of removing "outbreak" in 2003, and the two sides have discussed it since then, the CDC's Mr. Forney says. Ultimately, it will be up to the agency to determine what changes are made, he says.

Far from sanitizing information, Mr. Forney says his goal is to post more data on the agency's Web site. Currently, many outbreak reports lack final counts of the number of passengers who fell ill. The agency has asked cruise lines to send final counts, and has added staff at its Atlanta headquarters to keep its Web site updated.

The effort by cruise companies to ease their public-relations dilemma may backfire with some passengers. Mr. Pearson, the sick passenger on the Mariner of the Seas, says changing the language may make it look like the industry is trying to cover up onboard illnesses. "I don't like spin of any kind," Mr. Pearson says. "Just tell us the truth, we can handle it."

[RuthC]

Thank you, Lisa. I do hope there was no violation of any kind of rule doing the copy/paste.

[jhannah]

I personally don't see where jockeying with semantics will accomplish anything productive.

[Oceanwench]

Even if the CDC were to call it "increased incidences," you can believe that a reporter ... or an editor ...will change it to "outbreak."

[heyabbott]

Even if the CDC were to call it "increased incidences," you can believe that a reporter ... or an editor ...will change it to "outbreak."

If a high school had 200 out of 1800 students come down with the same illness over a 2-3 day period it would be called an epidemic or plague. I don't see how intentionally minimizing it is at all helpful.

[wander]

Having taught in five high schools, if 200 of 1800 students have the same illness like colds, flu or GI upsets or the like it would NOT be called a "plague" or "epidemic". Such a number out with such illnesses at certain times of year is not that unusual. Now, if it were encephalitis, meningitis or such, it would be.