Investigation Update on the Freedom of the Seas

Cruise Line: Royal Caribbean Cruise Line

Cruise Ship: Freedom of the Seas

Voyage Dates: 11/26-12/3/06

Number of ill passengers out of total number of passengers: 338 of 3823 (8.84%)

Number of ill crew out of total number of crew: 46 of 1402 (3.28%)

Predominant symptoms: diarrhea and vomiting

Actions: Royal Caribbean Cruise Line (RCCL) and the crew aboard the ship took the following actions to respond to the outbreak:

• increased cleaning and disinfection procedures,
• collected stools specimens for analysis,
• informed incoming passengers of the elevated number of ill people,
• provided daily updates about the illness to VSP,
• sent senior RCCL environmental health specialists to sail on the December 3-10th voyage to assist the ship with cleaning and disinfection planning and operational procedures.

VSP staff boarded the ship on December 3 to conduct a targeted environmental health investigation and an epidiomlogical review.

During the December 3-10th voyage, the number of ill passengers and crew were still higher than expected. On December 10th, CDC staff boarded the ship in Miami to conduct a targeted environmental health assessment, monitor cleaning and disinfection procedures, and discuss operation procedures with staff ship.

On December 10th, VSP staff recommended that the ship not sail for 48 hours due to three consecutive voyages with a higher than expected number of ill people and the time needed to properly clean and disinfect the ship.

Actions as of December 10th: RCCL took the following actions:

• staffed the ship with 45 additional staff to assist during the non-voyage period, in addition to the 1,399 crew already performing cleaning and disinfection procedures,
• collected stool specimens for analysis,
• informed oncoming passengers of the elevated number of ill people,
• developed a CDC approved disembarkation plan that included:
  • cleaning of terminals and buses,
  • separation plan for ill people,
• developed a CDC approved cleaning and disinfection plan for the 48 hours between voyages.

While the ship was not sailing, VSP staff monitored the ships cleaning and disinfection procedures.