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Julian Bray provides: Opinion, comment, forward thinking speculation on Travel, Cruise & Aviation: conflict zones, terrorist impact, drone (UAV) issues, safety (black boxes, emergencies), airline operations, aviation finance, political implications, and all forms of incident risk. Worked at board level with several airline and aviation groups, including Alitalia, British Island Airways, British Airways, Galileo , British Aerospace, Skyways, former CEO City firm Leadenhall Assoc. Founder CNS City News Service. Director NTN Television News (joint co. with ITV Wales TWW) Debretts People 2017 and in launch edition of PRWeek Black Book.

Direct links to a selection of television and radio contributions can be found at foot of this page. Scroll down.

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Monday, 9 May 2016

NOROVIRUS OUTBREAK TOLL ON ON ELDERLY CRUISE SHIP BALMORAL TOPS 250




Sick Ship: NOROVIRUS HIT BALMORAL










All you need to know:
http://julianbrayrecessionbuster07944217476.blogspot.co.uk/search?q=norovirus

Julian Bray Writes: A newsreader on the BBC earlier today said that Norovirus (the Winter Vomiting Bug- but no respecter  of seasons)  is common on cruise ships, well that's not strictly true there are outbreaks in many closed communities such as hospitals.
In my role as a guest lecturer on board many different cruise ships over the years.    I've witnessed several outbreaks and the work put in by ships crews to contain the outbreak. On BBC local  radio stations later today I'll explain what is involved and how you can possibly avoid it; for example stop shaking hands use fist bumps instead and be totally obsessive about frequent hand washing!




In Spain, drinking from contaminated 'bottled' office water coolers, over 4,000 persons went down with the vomiting bug. People in Catalonia in north eastern Spain were infected in April 2016 by norovirus. Local health officials claimed  the infection was caused by the consumption of contaminated bottled water.

According to the health department of the regional government of Catalonia, around 4,146 people were infected by norovirus after drinking water from office water coolers. The water was contaminated with human faecal matter..... 




There are however a greater number of outbreaks on OLDER cruise ships such as Balmoral and its not the fault of the operators, but us passengers!


 More than 250 cruise ship passengers were confined to their rooms after contracting the "winter vomiting bug" Norovirus, with crew members also succumbing to the illness. 


Cruise passengers  on board the ship Balmoral, which left from Southampton, UK, on 16 April, were confirmed to have the virus after staff from the US Center for Disease Control (CDC) boarded the vessel in the US responding to officially released mandated reports from the ships medical staff that passengers had become ill during the transatlantic voyage.


Although the virus was detected last month, an initial statement from Fred Olsen Cruise Lines stating just seven people were in isolation, however now 252 passengers of 919 on board and eight staff members have now come down with the bug, which causes vomiting and diarrhoea, and have been confined to their cabins.



_______________________________________________________________

This is taken from official government documentation:




Prior to embarkation passengers should receive a routine health questionnaire and information about the symptoms and signs of
Norovirus infection.

This should include the potential impact on other passengers and the recommendations for helping both to prevent illness and the action passengers should take if they do become ill with possible Norovirus.



The Ship’s Doctor, Ship’s Master and Senior Officers should be informed immediately of any suspected cases and the relevant Port Medical Officer and Port Health (Home Authority or next
UK port) then informed in the event of a suspected outbreak



Declaration and control of outbreak at sea


Isolate and manage cases according to enteric risk assessment


Consider need for other time limited control measures following immediate period of isolation and to inform other passengers on recommended personal hygiene to prevent spread of infection



Institute recommended environmental cleaning regime

Risk assessment and response to suspected outbreak


Initial urgent enquiry by Ship’s Doctor using a standard assessment questionnaire as a guide to identify presumptive Norovirus outbreaks
and institute immediate control measures.


Key diagnostic criteria for Norovirus outbreaks are:


1. Vomiting (prominent symptom and often projectile) in > 50% of  cases.

2. Duration of illness (12-72 hours)

3. Incubation Period (15-48 hours)

4. Passengers generally affected initially and then crew with a high degree of passenger contact





ACTION BY SHIP’S MANAGEMENT TEAM



Passengers who report relevant symptoms should have a health assessment which may result in denial of boarding.


Maintain awareness so that symptomatic patients are identified if they vomit in public places, attend the medical centre or report to their cabin attendant.



Evidence of any public or concealed vomiting or diarrhoea should be investigated and managed by immediately implementing aggressive local disinfection and isolation procedures.




Norovirus assessment questionnaire

Detailed medical questionnaires should be completed for all cases including:




The person’s name, age and gender;


The first date of clinic visit or report to staff of illness;


Passenger or crew member;


The crew member position or job on the vessel, if applicable;


Cabin number;


Restaurant meal seating information (passengers) or recent mess room usage (crew);


Details of foods / drinks eaten for 72 hours prior to onset of illness and the location(s);


Whether they have eaten/drank ashore and if so, details;


Details of activities, including tours undertaken in the last 72 hours;


Date and time of illness onset;


Illness symptoms, including number of episodes each of diarrhoea and vomiting per day.


Known contact with a confirmed case;


Whether faecal sample requested, received and submitted;


Use of anti-diarrhoeal medication; and


The presence of underlying medical conditions.


Guidance and criteria for declaration of an outbreak of Norovirus



An outbreak of infectious intestinal illness would be declared if more than 2% of passengers  and/or 2% of crew meet the case definition.


The following case definition should be used:


a) Diarrhoea (three or more episodes of loose stools in a 24 hour period)


or

b) Vomiting and one additional symptom from: one or more episodes of loose stools in a 24-hour period, abdominal cramps, headache, muscle aches and fever.

NOTE:  Nausea alone can be due to sea sickness.

_________________________________


The majority of passengers on board the ship, which is now docked in Maine USA  are from the UK, with several guests from the US, more than 25% of people on the ship contracting the virus, according to the CDC.


It is the second time the Balmoral has been hit with Norovirus, with an outbreak reported during a cruise in Scotland in 2009, with a female passenger who boarded with the virus blamed for the outbreak.


In 2016 so far, eight ships that have docked in the US, including the Balmoral, have reported outbreaks of the virus – the worst being the Balmoral – and two have reported unknown outbreaks of illness.


More than 1,100 people so far this year were recorded by US authorities as falling ill on cruise ships that had docked in the country.












JULIAN BRAY +44(0)1733 345581 Aviation Expert, Journalist & Broadcaster, Aviation Security & Airline Operations Expert, Travel / Maritime & Cruise Industry, NUJ, EQUITY, LIVE ISDN LINK, Broadcast ISDN COOBE ++44 (0)1733 345020 e&oe Old faithful NOKIA: 07944 217476 www.aviationcomment.com
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