nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, March 25, 2011

STUDY: Cruise Ship Virus, Passengers Got It But The Crew Didn't

Interesting piece of research that looked at a norovirus outbreak from a cruise ship in 2009.

This was an epidemiologic study (Clinical Infectious Diseases, Mar 22).  The researchers sent a survey to passengers who had been on board during the outbreak.  They got a great response:  83% returned the survey.

Of those who returned the survey, 15% were classified as meeting the diagnosis for norovirus.  There were 1842 people on board, so guesstimating about those who didn't return the survey that's about 250 total cases.

Some of the findings were what you would expect from a highly contagious disease in a confined population:  greater likelihood of illness if a cabin mate was sick, increased risk from being berthed on the same deck where the outbreak began, etc

But a couple of interesting things:

--There was increased risk of disease if berthed or dining in proximity to a vomiting incident that occurred during boarding.  I assume this constituted the index case, from which the outbreak spread.  It's hard to see how this would occur:  was everyone standing around when somebody threw up?  was the clean-up not sanitizing?  How did oral transmission occur at that point...from helping the ill individual?

--Crewmembers were much less likely to get ill:  less than 1% as opposed to the 15% of passengers.  The authors speculate that separate berthing, dining, and passageways for crew could explain it....or the crew was more likely to be immune from previous illness with the virus.

This disease, and others like it, spreads so rapidly that increased sanitary measures once the outbreak is identified are not often effective.  It's too late to start frequent hand-washing and avoiding ill persons once things have gotten rolling.

There's just no substitute for good sanitation and hygiene as a lifelong habit.

Doc D

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