Investigation Update on the Explorer of the Seas

Cruise Line: Royal Caribbean Cruise Line

Cruise Ship: Explorer of the Seas

Voyage Dates: January 21-31, 2014

Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 634 of 3071 (20.6%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 55 of 1166 (4.7%)

Predominant symptoms: vomiting, diarrhea

Causative agent: Norovirus

Actions: In response to the outbreak, Royal Caribbean Cruise Line and the crew aboard the ship took the following actions:

• Increasing cleaning and disinfection procedures according to their outbreak prevention and response plan,
• Making announcements to both notify onboard passengers of the outbreak and encourage case reporting,
• Collecting stool specimens from ill passengers and crew for submission to the CDC lab,
• Making multiple daily reports of gastrointestinal illness cases to the VSP,
• Preparing additional crew members to join the ship mid-voyage to assist with case management and intensified sanitation procedures,
• Consulting with CDC on plans for:
  • Passenger notification procedures and the planned delayed embarkation schedule in Bayonne, NJ on January 31, 2014,
  • Disembarkation plans for active cases, terminal and transport infection control procedures.

One CDC Vessel Sanitation Program epidemiologist, one contract epidemiologist, and one VSP environmental health officer boarded the ship in St. Thomas, USVI and are sailing on the ship as it travels back to port in New Jersey. This team is conducting an epidemiologic investigation, environmental health assessment, and evaluating the outbreak and response activities on board. One additional CDC Vessel Sanitation Program environmental health officer will board the ship upon arrival on January 29 to assist with the evaluation of the disinfection process. The team will continue the investigation and evaluation on the ship thru the boarding of new passengers for the next voyage. Five clinical specimens were shipped to the CDC lab for testing on January 26.