• January 20, 2003
• Vol. 59
• No. 2

Rough Seas

By Steve Helling

Norwalk Virus Roils the Cruise Business—and, An Expert Says, Could Come to a Theater or Daycare Center Near You

It sickens 23 million Americans each year. But before the Norwalk virus KO'd more than 1,200 passengers on cruise ships in the past three months—including a suspected outbreak off the Bahamas in late December—hardly anyone had heard of it. "The vast majority of cases go undiagnosed because people just assume they ate a bad potato salad," says David Forney, chief of the Vessel Sanitation Program for the Centers for Disease Control.

As peak cruise season begins, the bug's profile may get even bigger. But Norwalk also thrives in homes, restaurants, public rest rooms and other confined places. Forney, 52, discussed the germ with contributor Steve Helling.

Why "Norwalk"?

It's named for Norwalk, Ohio, where the first recorded outbreak occurred more than 30 years ago. The symptoms include cramps, vomiting and diarrhea—and it comes on suddenly, often striking 24 to 48 hours after exposure and lasting the same amount of time. The illness generally isn't life-threatening. The main danger is dehydration. Keep drinking water.

How does it spread?
From hand to mouth. On a cruise ship people touch everything, from tokens in casinos to handrails. In movie theaters they touch the armrest, then eat popcorn.

How can people protect themselves?
Wash your hands frequently—including the backs, wrists and under the fingernails—for at least 20 seconds. Antibacterial wipes won't work. Norwalk is a virus, not a bacteria.

If the cruise lines are scrubbing their ships, why are there new outbreaks?
New passengers can bring the virus aboard, and though the ships are cleaned, the docks and ports are not.

Would you go on a cruise?
Absolutely, but I'd wash my hands. A lot.