No, not that stuff (well, actually, yes, that stuff too, but I definitely don’t want to know about it). One of the important tools in fighting infectious disease is disinfecting surfaces. Which brings me to a recent paper about cruise ships and cleanliness. In June 2006, 43 norovirus outbreaks occurred on thirteen vessels. Noroviruses can cause severe vomitting and diarrhea, and in children, particularly infants, can be deadly (also see Aetiology). In the paper, the authors decided to examine how often bathroom surfaces on cruise ships are cleaned:

Methods. Trained health care professionals covertly evaluated the thoroughness of disinfection cleaning (TDC) of 6 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) with high potential for fecal contamination in cruise ship public restrooms, by means of a previously validated novel targeting method.

Results. Fifty‐six cruise ships (30% of 180 vessels operated by 9 large cruise lines) were evaluated from July 2005 through August 2008. Overall, 37% (range, 4%-100%; 95% confidence interval, 29.2%-45.4%) of 8344 objects in 273 randomly selected public restrooms were cleaned daily. The TDC did not differ by cruise line and did not correlate with the Centers for Disease Control and Prevention (CDC) Vessel Sanitation Program inspection scores (r2 = .002; p = .75). More than half the vessels had overall TDC scores <30%, although several of these low‐scoring ships had near‐perfect CDC sanitation scores. The mean TDC of the 3 ships evaluated within 4 months before a NoVO [norovirus outbreak] (10.3%) was substantially less than the mean TDC of the 40 ships that did not experience NoVOs (40.4%) (p < 0.004 ).

Conclusions. An objective evaluation of public restroom environmental hygiene on 56 cruise ships found that only 37% of selected toilet area objects were cleaned on a daily basis. Low TDC scores may predict subsequent NoVO‐prone vessels. Enhanced public restroom cleaning may prevent or moderate NoVOs on cruise ships.

The very short summary:

EEWWW!!!!

So how did the researchers determine this? In the most sneakiest contact assessment method EVAH! (until the next sneakiest contact assessment method EVAH!, anyway), they put droplets of a clear sticky compound that lights up when a UV light is shone on it. This way they could determine what surfaces in bathrooms are actually cleaned (bathrooms and unwashed hands are probably the primary vectors of transmission because this is a diarrheal disease).

I don’t know why, but this methodology greatly amuses me.

Even though the findings are really gross.

Cited article: Carling et al. 2009. Cruise Ship Environmental Hygiene and the Risk of Norovirus Infection Outbreaks: An Objective Assessment of 56 Vessels over 3 Years. Clinical Infectious Diseases 49:1312-1317. DOI: 10.1086/606058