I have never been convinced that passengers are always to blame for bringing gastroenteritis on board. Gastroenteritis is the medical name for food poisoning. The public are bombarded with new names like Norovirus and various others, so perhaps I should explain a bit more about this problem especially if you are going on holiday be it a cruise or whatever. But the problem can strike just as easy at home. It is a very complex subject and not easy to explain in a post. But bascially, there are viral and bacteria infections all causing the same or similar symtoms as far as the public is concerned. It is for we medics to find out which bug is causing the problem.
When I went on Oriana, I was given information about the Norwalk Virus (Norvirus). There was no information on any of the other forms of food poisoning. They say they operate a comphrehensive passenger and crew health surveillance system and meet the UK and CDC Vessel Sanitation programme standards. But it is far more complicated than that as I will attempt to explain.
Bacterial infections are the most common, especially reheated foods or half-cooked foods. Food left at room temperature, especially cream fillings, milk, processed meat and fish, may develop a heavy bacterial contamination such as shellfish. You could eat prawns on a cruise or at home and get the runs however well they are stored. Bacteria of the Staphylococcal, shigella and salmonella groups are common causes. Staphylococcal infections cause acute symptoms within two to eight hours. Salmonella and shigella bacteria infections usually comes from food handlers, flies and unhygienic cooking untensils and develops after 12 to 36 hours.
Camplyobacteria are present in contaminated poultry and fish. They are a common cause of Diarrhoea, and may produce severe abdominal pains.
Virus infections often cause both gastroenteritis and enteritis.
Bacteria infections may last for months or even years. The best way to understand this rather than any particual forms of bacteria is to understand the difference between bacteria and a virus. Bacteria can live in the ground for years whereas a virus can basically only live within it's own environment. I say basic rather than getting too technical. Viruses are not usually very robust. They are bascially protected by an outer coating. Ordinary soap destroys this coating thus destroying the virus which is why we are urged to wash our hands in soap before handling food or after going to the loo etc. Because of the nature of a virus, it is far more likely to catch it from person to person than by touching something the carrier has touched such as a handrail on a ship. It is for this reason that you cannot contract HIV for example from a toilet seat or shaking hands. But bacterial infections are a different matter. As I said, they can live for years out of the host body and are far more likely to be the cause of cross infection such as touching the same thing.
During my time at sea we always traced an outbreak of gastroenteritis back to a crew member, or the food itself how it was handled etc. Buffets were renowned for this. We also had a chef on one ship who liked to re-heat food instead of chucking it. Needless to say, we had an outbreak of food poisoning.
On modern day cruise ships a buffet is the in thing. Many passengers eat there for breakfast and lunch and afternoon tea. The conservatory on Oriana was always busy, passengers only going to the restaurant for dinner. P&O do their best to keep everything fresh, but it is an almost impossible undertaking. You can wear gloves, used a soap based gel and whatever you like. But if food is left for a while or contaminated before even coming aboard you stand no chance however good the hygiene and food storage is. And it only takes one crew member handling the food you eat even if wearing gloves to wipe his nose with his sleeve. And what about the Galley, it is as hot as hell in there. Crew in there are human, they sweat, they wipe their brow or sweat drops on to food. Sorry, but you must be realistic. Cross contamination is so easy, you will never get a foolproof system be it at sea or public eating place at home. Sandwiches at afternoon tea were dry at the edge. There is no way they can keep everything fresh all the time when catering for so many people who demand instant service at all times. They have to have food prepared in advance to cope which is where the problem begins.
The bottom line is that cruise companies are putting too much blame on the passengers bringing a bug aboard be it viral or bacteria. From past experience I would be surprised if it was brought aboard by pasengers because in many cases, the timescale just does not work out. It is possible of course with so many passengers going on cruises these days. But if you listen to P&O for example, they put ALL the blame on passengers and none on themselves. The leaflet they sent me more or less says this. But passengers do not handle all the food, just their own at buffets. This could do it of course, but I very much doubt it. During my time with P&O with never traced one single outbreak of gastroenteritis back to a passenger as the carrier.
Finally, passengers do eat excessive amounts of food on a cruise, and could well cause a tummy upset due to this. But if past experience is anything to go by and testing samples myself from shoreside eating establishents when I left the sea, cruise companies should be looking a bit closer to home than putting all the blame on the public?!. David
