Get Away With Fran

November 2, 2009

Cruise ships and norovirus and dirty bathrooms

Filed under: Cruise — admin @ 7:59 am

I have been a defender of cruise lines when they get blamed for norovirus outbreaks, because it’s a bit unfair they have to report such outbreaks when shopping malls, and apartment buildings and other places where lots of people may get contagious stomach viruses do not.

But a new study out today has me saying yuck, yucky, yuck.

A team of researchers from Boston University School (BUSM), Carney Hospital, Cambridge Health Alliance and Tufts University School of Medicine, have found “widespread poor compliance” with regular cleaning of public restrooms on cruise ships. The study appears in the November 1st issue of Clinical Infectious Diseases, and is the first study of environmental hygiene on cruise ships.

The health care professionals set out to evaluate the thoroughness of disinfection cleaning of six standardized objects (toilet seat, flush handle or button, toilet stall inner handhold, stall inner door handle, restroom inner door handle, and baby changing table surfaces) – all with high potential for fecal contamination in cruise ship public restrooms.

And they found that only 37 percent of the 273 randomly selected public restrooms that were evaluated on 1,546 occasions were cleaned daily – yuck, yucky yuck. Although some objects in most restrooms were cleaned at least daily, on 275 occasions no objects in a restroom were cleaned for at least 24 hours.

According to the study, the toilet seat was the best-cleaned object, with the least cleaned the baby changing table. Disturbingly, 19 objects in 13 ships were not cleaned at all during the entire five-to-seven-day monitoring period.

And perhaps even more disturbingly, the researchers say the thoroughness of cleaning did not differ by cruise line (they did not say which lines they evaluated).

And washing your hands may not help. “Although hand hygiene with soap after toileting may diminish the transmission of enteric pathogens via bathroom door knobs or pulls, hand washing is unlikely to mitigate the potential for any of the other toilet area contact surfaces to serve as a source of transmission of enteric pathogens,” said lead author Philip Carling, MD, a professor of clinical
medicine at BUSM.

He adds your washed hands can become contaminated when you leave the bathroom as only 35% of exit knobs were cleaned daily. Note: Use hand sanitizer before you eat!

Although the thoroughness of disinfection cleaning was 30 percent on more than half of the ships, near-perfect cleaning was documented on several vessels, according to the researchers, meaning cruise ship bathrooms can in fact be cleaned.

Of course the reason the researchers were interested in the first place was because despite twice a year santitation monitoring by the United States Centers for Disease Control and Prevention, 66 ships experienced NoV infection outbreaks between 2003 and 2008.

Or maybe the researchers just wanted to cruise.


  1. Does the study detail and outline what cruise lines? The 20+ ships I have been in, I have maybe been in one or two public bathrooms that were not sparkling clean. Great read. Thank you!

    Comment by Doug Parker — November 2, 2009 @ 8:10 am

  2. I am trying to confirm which ships. Have a call out.

    Comment by admin — November 2, 2009 @ 8:25 am

  3. Here is what the study says regarding the ships:
    The convenience sample of 56 cruise ships was evaluated from
    July 2005 through August 2008. All ships belonged to large
    multivessel cruise lines and had participated in the CDC’s National
    Center for Environmental Health Vessel Sanitation Program
    (VSP) [2] for 4 years. Fifty-three ships were United
    States flagged, and 54 originated from US ports. From 1 to 15
    ships from each of 9 cruise lines were evaluated, with 46 of the
    vessels (82%) belonging to the 5 largest cruise lines.

    Comment by admin — November 2, 2009 @ 10:07 am

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