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(Feb. 23) -- What is it about cruise ships and sickness?
On Sunday, 326 of the more than 1,800 passengers on the Mercury, a Celebrity Cruise ship en route to the Caribbean, complained of stomach trouble, vomiting and diarrhea -- in other words, of having a great vacation!
Just a few days earlier, one passenger each on two other ships -- the Carnival Freedom and the Zuiderdam -- were airlifted to a Key West hospital after complaining of stomach illness. The U.S. Centers for Disease Control and Prevention tracks gastrointestinal illnesses aboard many cruise ships, and each year since 2002, there have been about 15 or more outbreaks each year, affecting thousands of passengers annually.
Ted S. Warren, AP
Hundreds of passengers on the Mercury, a Celebrity Cruise ship on its way to the Caribbean, complained of stomach illnesses on Sunday. Here, the ship is docked in 2006 following another outbreak that affected more than 100 passengers.
The close quarters and noroviruses, "the most common cause of epidemic nonbacterial gastroenteritis in the world," are to blame. Food or water is contaminated, and in the enclosed confines of a cruise ship, the pathogen quickly spreads from person to person.
"Once an outbreak starts, crew members might serve as reservoirs for the virus, and ships take on new passengers every week or two, which makes it easier for a single outbreak to extend across consecutive cruises," Daniel Engber explained in Slate, writing after a 2006 outbreak. More than 23 Americans get noroviruses each year, and not just on cruise ships. Any confined space -- hospitals, restaurants, schools -- is susceptible to outbreaks.
The American cruise industry is a behemoth, generating "$38 billion in total U.S. economic output in 2007," according to one report, and growing despite the recession. It was predicted that about 13.5 million people would take cruises in 2009 alone. Over a recent eight-year period, 147,000 cruise passengers were diagnosed with a gastrointestinal illness -- so the risk is relatively small, though on 80 percent of all voyages at least one passenger or crew member get a confirmed case of illness. In 2008, Imperial Majesty was rated the healthiest cruise line; Cruise West was rated the sickest.
Getting sick not only can ruin a vacation, but it also can add additional financial strains. As a necessary precautionary measure, cruise lines can deny passengers from boarding if they are believed to be sick. And while they often provide refunds or vouchers for a future trip, they don't normally refund the travel arrangements made to get to port.
A perfectly healthy cruise passenger can also be forced to disembark alongside the sick, if an infected ship pulls into port early. But at least you're healthy. The testimonies of those struck ill aboard cruises can be harrowing. And while noroviruses rarely kill, other illnesses, including Legionnaires' disease, have taken the lives of cruise passengers in the past.
Again, such fatalities represent a microscopic fraction of cruise goers. But each reported outbreak recalls the words of the late novelist David Foster Wallace, who provided a multitude of reasons to avoid taking a cruise in his hilarious 1996 Harper's essay, "Shipping Out: On the (nearly lethal) comforts of a luxury cruise."
In one passage, Wallace was talking about the corrosive properties of the sea on the physical properties of the ship. But he may as well have been referring to passengers writhing with illness when he wrote:
"Here's the thing: A vacation is a respite from unpleasantness, and since consciousness of death and decay are unpleasant, it may seem weird that the ultimate American fantasy vacation involves being plunked down in an enormous primordial stew of death and decay."
