Passengers boarding the Grandeur of the Seas arrived Saturday at the port of Baltimore carrying their luggage, hopes for a relaxing vacation and, in some cases, extra vitamins to ward off illnesses that have plagued the ship's last two voyages.
"We're very concerned, especially because it's been onboard twice," said Gwen Rivera of Millersville, Pa., who planned to make her 13-year-old son, Brock, swallow some Vitamin C as soon as they boarded the Royal Caribbean cruiseliner.
Her apprehension was shared by many passengers after learning that the Grandeur of the Seas had been struck by a second outbreak of a gastrointestinal illness in the past two voyages.
The latest viral attack struck nearly 100 passengers who fell ill with vomiting and diarrhea on a seven-day cruise that departed April 5 from Baltimore to the Bahamas. In a statement, Royal Caribbean said the illness was "thought to be norovirus" and passengers "affected by the short-lived illness responded well to over-the-counter medication administered onboard the ship."
Upon its return on Saturday morning, the cruiseline company said the 916-foot, 2,100-passenger ship would be thoroughly sanitized while two Centers for Disease Control and Prevention Vessel Sanitation Program environmental health officers and an epidemiologist would go onboard investigating the cause of the outbreak. The ship's departure to the Bahamas was delayed by two hours on Saturday for the extra cleaning, and all guests boarding Saturday were expected to receive a letter asking if they have had "gastrointestinal symptoms" within the last three days, the company said.
The company said if passengers were uncomfortable taking the voyage, staff would assist them in rescheduling their trip — though some said Saturday they weren't given that option or weren't aware of it before arriving at the port.
A similar outbreak affected more than 100 passengers on a cruise that left Baltimore on March 28.
The norovirus is highly contagious and one of the most common causes of food-borne illnesses. It can be transmitted through food or water or by touching contaminated surfaces, according to the CDC.
Kellogg Schwab, a Johns Hopkins University Bloomberg School of Public Health professor who has studied norovirus since 1989, including assisting the CDC on cruise outbreaks, said cruise ships are prime locations for large outbreaks
"You get a lot of different people coming into a confined environment where they are eating food, there are a lot of buffets, things like that," he said.
The spread is further eased by the characteristics of the norovirus microorganisms, he said.
A tiny number of organisms can make a large number of people sick. The organisms have a short incubation period, so people generally get sick within eight to 24 hours of exposure. They can survive on surfaces — studies have found it on elevator buttons, handrails and serving utensils — for many days and remain infectious. The norovirus — considered a "fecal-to-oral virus" — causes "explosive" illness, and can spread in tiny amounts of bodily fluids.
Cruise lines have put a vast amount of time and effort into perfecting protocols for preventing outbreaks, Schwab said, but passengers also have to be willing to be careful and clean as well.
"I just think people need to wash their hands," said Erika Bailey of Lancaster, Pa., who also boarded the ship Saturday afternoon along with several family members who were celebrating Bailey's uncle and aunt's 50th anniversary.
She said she wasn't too worried but also said she came prepared. "I have sanitizer," she said. "I wash my hands pretty frequently."
Family member Brian K. Smith said he was confident that Royal Caribbean was taking the right steps to ensure passengers wouldn't get sick a third time.
"I know that they face a lot of trouble, so I know this is the safest ship in the fleet today because they stand to lose too much business if anything else happens," he said.
Alan Konlande, a Washington, D.C., passenger, agreed.
"I feel very confident," he said. "I feel the cruiseline is taking great measures to keep us safe by stocking hand sanitizer and cleaning the ship. If people are sick on land, they bring it on the cruise. It's not about the cruise ship."
But others, such as Dale Irwin of North Haledon, N.J., were not as confident.
"This is our third one," he said, "and I think it's going to be the last."