What if norovirus was a deadly killer, would we wash our hands then?

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Dead patient in OR
Dying is a hell of a price to pay for eating with your fingers

We mean seriously deadly, like cancer,  typhoid, or the Black Death.

Would we see still loads of cruise ship passengers repeatedly coming down with norovirus?

Again & again, norovirus 2.0

Because it’s happened again – and keeps on happening. The latest “Old England to New England” voyage of a lifetime by Fred Olsen Line’s cruise ship Balmoral has just docked Stateside with a report of hundreds down with this pernicious vomiting bug.

Predictably because it’s the most likely cause, the cruise line reckon the virus was probably brought on board by a passenger. In the close quarters of a cruise ship, any outbreak is difficult to contain, with the result that 252 victims have been reported – slightly more than the 7 claimed by the cruise line.

We say predictable because norovirus is highly contagious and spreads most easily by direct contact. It only requires 10 norovirus cells to infect someone – so anyone coming aboard a ship after a long day’s sight-seeing, touching all kinds of things with little or no opportunity to wash hands, could be Patient Zero.

Always the blame game

That said, Balmoral’s operators may also not be entirely blameless. The vessel is old by cruise ship standards – launched originally in 1988 as Crown Odyssey for Royal Cruise Line – and has been hit by norovirus six times since 2009.

Yes, norovirus could quite easily have been brought on board by any passenger over the years – anybody eating a sandwich ashore with unwashed hands could have been the carrier – but repeated outbreaks every year begin to look like the ship itself could be cause, despite intensive “barrier cleaning” between voyages.

Check out any ship at the dock and maintaining hygiene is an immediate and obvious problem. On every mooring rope are cone-shaped metal plates – rat guards to prevent disease-carrying rodents stowing away.

Sure those sweeping angular lines are impressive, but inside the hull they mean all kinds of tight, irregularly shaped spaces that are difficult to access and even more difficult to keep clean. Of necessity, some spaces are not accessible at all – like deep down under the deck plates, where oil-laden water sloshes round the bilges.

The ultimate survivor

No good against an adversary like norovirus – able to survive for days and even months on hard surfaces. Or even years in still water – perhaps not the bilges, but how about the drinking water tanks?

And just how thorough are those between voyage “barrier cleans” anyway? A cruise ship costs around £1.5 million per day just to keep afloat,  so how much time can its owners afford to have it docked for cleaning?

Bear in mind that turnaround time between cruises can be as short as eight hours – in which the ship has to be cleaned out, re-victualled, refuelled, new linen loaded and  made up, the works.

Come on gang! The meter’s running, let’s get this sucker back to sea ASAP.

Hmm, makes you wonder what “barrier cleaning” is, hey?

How clean is “clean” in 8 hours?

There is also “terminal cleaning” which looks the better option – variously defined as removing all detachable objects, cleaning lighting and air duct surfaces in the ceiling, then cleaning everything downward to the floor.

Items removed – fomites such as furniture, carpets, drapes, table cloths, cutlery, taps, basins, playing cards, poker chips, books, bottles, glasses, coasters and all bar hardware – are thoroughly sanitised before being returned.

Uh huh, not exactly easy in eight hours.

Then there is the issue of HOW the ship is cleaned – how long exposure time the disinfecting agents have to be sure of killing the norovirus. From studies by the CDC, not everything works – not bleach, not glutaraldehyde , not ethanol, not quats, not steam.

Nor do all techniques – not applied everywhere, not enough contact time, not effective at killing the microorganisms involved.

You missed a bit

Take just one instance.

Handrails.

Passengers spend a lot of time clutching the ship’s rail, excited about arrivals, excited about departures – or simply hanging on to look cool, sipping their piña coladas in the sunset. Does someone really go round and wipe down all the ship’s rails – and all the deck chairs come to that – or do they get forgotten, being outside on the deck?

Why does no-one seem to be taking this seriously? Norovirus is ALREADY a killer that takes down 200,000 people every year – usually through dehydration or electrolyte imbalance. Imagine it up there with cancer, typhoid and Black Death.

How would it be if we saw some heavyweight death numbers – mostly from people not washing their hands – and the rest from things not being cleaned thoroughly enough?

Because norovirus is not going to go away. It’s going to continue to mutate and proliferate – until in nuisance value alone it does the numbers, clobbering productivity and generally making life unliveable.

Sorted, sort of

OK, so the ship sort of gets cleaned and goes back into service – and another outbreak happens ten months from now – dirty hands coming aboard, or spreading out from the unprocessed air gap under the linen storage on “D” deck?

So they scrap the ship and build a new one, the problem isn’t going to go away.

Not unless we learn to wash our hands before they ever go anywhere near our mouths. And we start using properly effective measures to eliminate all germs from enclosed spaces – including under linen storage and in bilge openings.

All it takes is to mist up the air space with ionised hydrogen peroxide penetrating everywhere – and germs are electrostatically attracted like iron filings to a magnet, oxidised to nothing in seconds flat.

Maybe they’ll even get sensible and build a spray system in – exactly like the sprinkler system already used for fires. Imagine that, a self-sterilising cruise ship – able to decontaminate itself completely in just hours while in port for turnaround – or disinfect selected areas completely at will, while still out on voyage.

And if we still haven’t learned to wash our hands?

Feed everybody Cornish pasties. That thick crust round the edge was invented specially for tin miners to grab hold and eat safe – even though their hands were coated in deadly arsenic from the tin ore.

Not so deadly any more after hydrogen peroxide, no norovirus either.

Though pasties might get monotonous on a seven-day cruise.

Picture Copyright: hedgehog / 123RF Stock Photo

Originally posted 2016-05-09 17:31:06.