Investigation Update on the Amsterdam

Cruise Line: Holland America Line

Cruise Ship: Amsterdam

Voyage Dates: November 11 - December 5, 2012

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 85 of 791 (10.75%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 6 of 610 (0.98%)

Predominant symptoms: vomiting, diarrhea

Causative agent: Norovirus

Actions: In response to the outbreak, Holland America Lines and the crew aboard the ship took the following actions:

• Increased cleaning and disinfection procedures according to their outbreak prevention and response plan,
• Made announcements to notify onboard passengers of the outbreak, encourage case reporting, and encourage hand hygiene,
• Collected stool specimens from ill passengers and crew and sent them to the CDC lab,
• Made twice daily reports of gastrointestinal illness cases to the VSP, and
• Consulted with CDC on plans for their comprehensive sanitation procedures in San Diego, CA on December 5, 2012
• Provided additional staff and time for thorough public and accommodation super-sanitization cleaning and disinfection during their extended time in port,
• Planned and executed staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and
• Executed plans for terminal and transport infection control procedures.

Two (2) CDC Vessel Sanitation Program environmental health officers and an epidemiologist boarded the ship on arrival in San Diego, CA on December 5, 2012 to conduct an environmental health assessment and evaluate the outbreak and response activities. Stool specimens were collected and sent to the CDC lab for testing.