Recently someone about to embark on a cruise said she’d read that in order to avoid catching a contagious bug she should avoid the lido buffet because food handlers had dirty hands.    Wrong!  Since there seems to be plenty of media coverage about hundreds of passengers getting sick during their cruise, it’s time to re-run an article telling you how to avoid catching a bug that could ruin your cruise.  In all likelihood, when a bug shows up on a cruise ship a passenger walked aboard with it.

I asked Brian Rosenthal, MD, MPH (Master of Public Health), who teaches at Columbia University’s Mailman School of Public Health in New York.  He’s also an avid cruiser who has sailed the world aboard all types of cruise ships.

As a public health physician who has sailed aboard dozens of cruise ship,  Dr. Rosenthal’s advice is timely.

AC:  Who is responsible when passengers get sick aboard ship?

DR: There are times when an infectious agent has been isolated on a ship and the cruise line is responsible.  An example is Legionnaires Disease, which is rare.

And, there is always the potential for bacterial food contamination such as e-coli but due to the CDC’s stringent inspections, it hasn’t been reported in many years.  Cruise Lines have become very vigilant about waterborne and shipborne diseases so the reported incidences is rare.   People used to get sick on ships all the time but we just didn’t know what the organisms were.  Now that we know, the media has a heyday with it.

But in the instance of Norovirus, passengers bear the brunt of passing the disease along.

AC: Why Do Outbreaks of Norovirus Happen Aboard Ship So Often?

DR. I don’t think this is a new illness but that we’re hearing about it more often.  I’m sure the outbreaks aboard ship aren’t any higher than they are on land.   There just hasn’t been much coverage of the disease on land.

The thing about ships is that because you’re in a confined space the rate of exposure is statistically greater.  Contrast Disney World.  People aren’t staying in the same hotels or eating in the same restaurants as they are aboard a cruise ship.

AC:  How Can We Avoid Getting a shipborne illness?

DR: There are certain universal precautions that are even more important when you’re aboard a ship.  As important as washing your hands, you have to learn to KEEP YOUR HANDS AWAY FROM YOUR EYES, NOSE AND MOUTH. This is a normal human condition.  If you sit at a restaurant and watch people eat for five minutes you’ll see what I mean.  Most viruses are not spread by hand to hand contact alone.  They are spread by hand  to hand to mouth (or eyes or nose).  If you had it just on your hands, you wouldn’t get sick.

Shaking hands with the Captain or anyone else won’t get you sick assuming you have no cuts on your hands.  Of course one must be careful about where one puts one’s hands.   If you’re able-bodied, don’t use the banisters or railings if you don’t need to.   This is true in any public space, not just ships …. Train stations, malls.

If you have children it’s an entirely different matter.  All kids put their hands in their mouth — that’s what children do.  And when they play in groups beit a nursely school or a ship, it’s problemmatic.  If your child does become sick, take a lot of precautions that he or she is the only patient in the family.

And, it is as important that you wash BEFORE you eat as it is after you go to the bathroom which is why the hand sanitizers in food lines are a great idea.

AC: Does the Fear of a Shipborne Illness stop you from Cruising?

DR: Absolutely not!  Everytime out go outside your home is a rish.  You must weigh this against the benefits of having a wonderful time and sharing experiences with family and friends.