Investigation Update on the Ruby Princess

Cruise Line: Princess Cruises

Cruise Ship: Ruby Princess

Voyage Dates: October 9 – 28, 2012

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 149 of 2,971 (5.02%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 14 of 1,177 (1.19%)

Predominant symptoms: vomiting, diarrhea

Causative agent: Norovirus and Enterotoxigenic E. coli (ETEC)

Actions: In response to the outbreak, Princess Cruises 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 made plans to send them to the CDC lab,
• Made twice daily reports of gastrointestinal illness cases to the VSP,
• Consulted with CDC on plans for their comprehensive sanitation procedures in Fort Lauderdale, FL on October 28, 2012, and
• Executed plans for terminal and transport infection control procedures.

A CDC Vessel Sanitation Program environmental health officer and an epidemiologist boarded the ship on arrival in Fort Lauderdale, FL on October 28, 2012 to conduct an environmental health assessment and evaluate the outbreak and response activities. Ship crew completed a super-sanitation turn around between disembarking and embarking passengers. Stool specimens were sent to the CDC lab for testing, which revealed that this outbreak was caused by Norovirus and Enterotoxigenic E. coli (ETEC).