Norovirus: Well, shit.

Posted by ERV on January 18, 2012
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Well this is shitty! A cruise headed for the Falkland Islands was turned away from dock because of a norovirus infection on board:

The Falkland Islands came under further criticism Tuesday for refusing to allow a cruise ship with an outbreak of stomach flu to dock, as passengers complained about their missed travel plans and an expert called the decision an overreaction.

Tourists on the Star Princess told The Associated Press they were forced to cancel long-planned trips when officials in the disputed British territory off Argentina refused them entry Saturday, saying an outbreak could strain the archipelago’s medical resources.

Some people are characterizing this as going overboard, and may be politically motivated. It may be disappointing to the tourists, but I cant say I honestly blame the decision of the Falkland Island administrators. Others disagree:

But Norman Noah, an infectious diseases expert at London’s School of Hygiene and Tropical Medicine, described the Falklands’ decision as “over the top.”

…

“If you’re suffering from vomiting and diarrhea, you probably won’t be sightseeing,” Noah said. “Chances are you’ll be staying in your cabin by yourself.”

Thats specious. 1– People shed virus before they are symptomatic. 2– People shed virus after they have ‘gotten better’ and are no longer symptomatic. 3– People can shed virus without showing any symptoms at all (something like 30% of infections can be asymptomatic). The passengers would be using restrooms on the islands and then eating and using door handles and thumbing through merchandise in shops– this isnt like a day trip to Antarctica where everyone has to go back to the ship to potty and eat, thus the virus would be contained to the ship population. Norovirus would almost certainly spread from the ship to the population living on the islands.

The population living on the islands is ~3100. The population on the ship was ~3500.

I dont blame the islands for being wary of potentially needing to treat their own population and potentially some of the ships population for complications due to norovirus infection. Antibiotics and IV fluids they would need for other patients.

And then, its not just the population on the Falkland Islands that could be infected by that ship. If the ship infects the locals, when the next ship comes to dock, that population could get infected by the locals, and their trip is ruined too.

The Falklands has defended its decision as being made “in the wider interests of the public and tourism industry,” according to a statement from the island’s chief medical officer. “An outbreak in the Falkland Islands would put enormous pressure on our limited medical resources and jeopardize other scheduled cruise visits,” the statement said.

*shrug* Exactly.

Was that decision a shitty one to make? Yes. But I dont think it was unreasonable, nor do I think it had anything to do with politics. Its just a shitty virus.

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Comments

  1. #1 starskeptic
    January 18, 2012

    Yeah – I think I gots to agree with you on this one, Abbie…

  2. #2 Karen
    January 18, 2012

    While I feel it was very unfortunate for the passengers who were hoping to visit their father’s graves, I think refusal to dock was the best decision.

    And I just finished reading your linked 2009 post on Norovirus and am bummed that you can get it again! I was hoping once you had it, that was all she wrote!

  3. #3 Poodle Stomper
    January 18, 2012

    I wholeheartedly agree with the decision. Sucks to be the passengers but 1) it’s not going to kill them to stay on board, and 2) they need to do so for the good of the people on the island. Better cruise next time.

  4. #4 Jason
    January 18, 2012

    Abbie, you wrote:
    “And then, its not just the population on the Falkland Islands that could be infected by that ship. If the ship infects the locals, when the next ship comes to dock, that population could get infected by the locals, and their trip is ruined too.”

    But that chain of reasoning could be applied to *any* common port, including the one from which the ship initially departed. All things being equal, They may have not take any ships for awhile. I’m not sure that health-wise, or economically, that was the best option?

    Also, your title made me laugh out loud in lab.

  5. #5 theshortearedowl
    January 18, 2012

    Cruise ships are like locust swarms for the islands they visit – they descend, consume all the resources, and then move on. Bigger islands may profit; on smaller ones, sometimes people can’t buy groceries until the next cargo ship comes in. Big up the Falklands for standing up for their own people.

  6. #6 cynical1
    January 18, 2012

    “Antibiotics and IV fluids they would need for other patients.”

    Ummmm…………why would you give them antibiotics for a viral infection?

  7. #7 Russell
    January 18, 2012

    Theshortearedowl has it right, about the impact of large cruise ships on small islands. I prefer islands that don’t get the large ships. But the other side of that is that many island economies need the money, and go to great length to provide portage and get the ships. Island economies are difficult.

  8. #8 ERV
    January 18, 2012

    cynical1– Post-viral bacterial secondary infections.

    There is some suggestion that these are more lethal than the bacteria on its own, eg norovirus then E. coli is more lethal than E. coli on its own. Has nothing to do with bacterial load– something to do with the innate immune system being on edge.

    So a case of food poisoning you might have ‘let run its course’ on its own becomes an infection you need to treat, if that person just had a norovirus infection.

    But I iz not an MD. Just being hypothetical :)

  9. #9 Thanny
    January 18, 2012

    The cruise line will have to provide a partial refund, which explains why they (or their insurance provider) would automatically decry the decision.

    As for cruise ships in general acting like swarms of locusts, that’s bunk. These islands both depend on the tourism income from cruise ships, and dictate how many can dock in a given time period. Right now Bermuda, for example, is restricting the number of ships that can dock pretty severely.

    Any island that was hurt economically by cruise ship visits would halt them entirely.

  10. #10 Jason
    January 18, 2012

    Thanny, I don’t think that’s true, though maybe because it’s not weather related. I can say from personal experience that, while on a cruise, we were not allowed to go to Grand Caymon because the water was too rough so we got another day at sea. There was no extra port and no refund…

    Maybe they would if it wasn’t weather related?

  11. #11 Justicar
    January 18, 2012

    eye sea wut ewe dad thar.

  12. #12 WBenson
    January 18, 2012

    Jan 18 2012: 11 Kulina Indian children from villages near Sta. Rosa, Acre, Brazil dead from suspected rotavirus infections. Report (in Portuguese) at oaltoacre.com. The newspaper’s motto is: “Your Journal from the Frontier.”

  13. #13 theshortearedowl
    January 18, 2012

    Any island that was hurt economically by cruise ship visits would halt them entirely.

    I – briefly – lived on an island that did. But I don’t know what planet you’re living on that the people with the power to do things like say no to a cruise ship always do what is in the best interests of the people who are hurt by them. Anyone who has been privy to the politics of small islands will know what I mean.

  14. #14 Prometheus
    January 18, 2012

    “Some people are characterizing this as going overboard….”

    *golf clap*

  15. #15 Paul Burnett
    January 20, 2012

    During the 1917-1918 flu pandemic, in the Pacific and other places, some islands that let the mail boat or other boats land were literally wiped out. Some islands that didn’t let boats land survived unscathed.

  16. #16 scramton
    January 21, 2012

    Who’s playing tonight? Shitty Beatles. Are they any good? No, they suck.