Norwalk Virus May Take Wind Out of Sails on Cruise Ship Vacations by Gina Shaw Take Precautions Could your cruise ship be sick? As we head into the height of winter cruise season, dreaming of Caribbean breaks from the cold, ships from at least three major cruise linesóHolland Americaís Amsterdam and Statendam, Carnivalís Fascination, and Disney Cruise Lineís Magicóhave been hit by large outbreaks of the Norwalk virus. (Another suspicious disease spike on the Radisson Seven Seas Cruisesís Mariner turned out to be salmonella, likely from tainted food.) Holland America took the Amsterdam out of service at the end of November for a stem-to-stern scrubbingódown to the Scrabble tilesóafter four consecutive cruises were hit, and Disney briefly did the same with the Magic. About 181,000 people contract the Norwalk virus annually, according to the Centers for Disease Control and Prevention (CDC). It is spread through contact with infected people, objects touched by them, and contaminated food and water. Named after an early 1970s o utbreak in Norwalk, Ohio, the virus is a particularly contagious gastrointestinal bug that causes nausea, diarrhea, vomiting, cramps, headaches and low-grade feversóall the things you want to bring home from your vacation. So should you cancel your winter sail to the Caribbean? Unless youíre severely immune-compromised or otherwise in fragile health, the answer is probably no. First of all, youíre just as likely to get Norwalk, or another skip-happy virus, on an airplane, in a hotel, or at your college dormitory as you are on the Love Boat. Itís shown up at summer camps, Italian resorts and Army training centers. Norwalk thrives in close quarters, and although cruise ships fit the bill, so do many other placesóitís just easier to track the virus when 2,500 people stay on one ship for seven to 10 days than when 200 people sit on an airplane for a few hours. The only thing thatís new about this rash of Norwalk outbreaks is the high level of attention it has gotten. Cruise lines have dealt with Norwalk attacks frequently in the past, especially on lines cruising to Alaska in the summer. A Norwalk outbreak also doesnít mean your ship is particularly (or at all) unclean or poorly maintained: Recently hit ships scored very high on their latest CDC thorough vessel sanitation reports. And Norwalk at some point or another has hit virtually every cruise line. So unless youíre planning on staying home behind locked doors and never going out in crowds, skipping a cruise or trying to pick a ìbetterî ship does not guarantee youíll keep Norwalk or other gastrointestinal viruses at bay. And because travelers insurance generally wonít compensate you if you cancel because of fear of illness, youíd be out a lot of money if you decided to remain on dry land. Even the cruise lines affected by Norwalk that have offered travelers full refunds for their ticketsósuch as Carnivalóhave not seen a mass exodus of customers fearing the virus. So what should you do if Norwalk arises on your cruise and you do get sick? First, please listen to the shipís likely request that you stay in your cabin and limit contact with other people to avoid spreading the virus further. Some passengers on ìinfectedî ships have complained that people with Norwalk continued to socialize and spread the virus further. Unfortunately, there is no treatment for Norwalk except to ride it out. It takes one to three days after exposure for symptoms to appear and then about 24 to 48 hours before they start to abate. Be sure to drink lots of (bottled) water, because dehydration is a common problem. You already know that in most cases you canít get a refund through your travel insurance if you decide not to sail because of Norwalk-paranoia, but can you get compensation from the cruise lines if you sail and do get sick? The answer, not surprisingly, is ìit depends.î Ships that have been forced to return to port because of widespread outbreaks have usually offered refunds or rebookings to passengers on those cruises, as well as to passengers on the first sailing following a scrub-down. Several lines have also compensated passengers for their medical bills. (Good travel insurance will also cover your medical expenses.) ìContracts of carriageî on cruise line tickets generally disclaim all kinds of liability, but it canít hurt to ask for reasonable compensation as a gesture of goodwill. Some Precautions to Take While Cruising If you are nervous about the Norwalk virus on your cruise ship, here are a few precautions you can take when you cruise that should help keep you healthy: ï Wash your hands frequently with soap and water, especially before and after meals. Dry them well and (Do we really have to tell you this?) keep them out of your mouth. ï The Centers for Disease Control and Prevention notes that alcohol-based hand sanitizers do reduce the amount of microorganisms on the skin, so it canít hurt to use them occasionally as well. ï Avoid uncooked food as much as possible. ï Avoid sharing utensils and drinking glasses. ï Stick to bottled water. ï Carry a bottle of Pepto-Bismol or your relief medication of choice, just in case. ï If youíre older than 65 or have any sort of acute or chronic illness, talk to your doctor before traveling. This doesnít mean doctors will tell you not to set sail, but they may be able to offer additional precautions and preventive medications. Gina Shaw is the medical writer for The Washington Diplomat.