Ship of doom?

It has been anything but plain sailing for the cruise liner Aurora in recent days.

A virus has swept through the ship, causing vomiting and diarrhoea among passengers. The ship was turned away from Greece on health grounds. After the ship found sanctuary in Gibraltar, the Spanish government closed its border, again on health grounds, causing a minor diplomatic row between Britain and Spain.

The crew have been disinfecting the ship from top to bottom, and passengers have been forced to remain on board for four days. ‘They were sanitising the ship wearing suits and they looked like the blokes from ET, which was frightening for the kids’, said one passenger (1).

What made the outbreak on the Aurora worse was the Greek authorities’ refusal to allow perfectly well passengers off the ship to enjoy their holiday. Greek health minister Costas Stephanis said that Greece didn’t have enough time to prepare for ‘2000 people, having 25 per cent of the people being infected by the norovirus, to disembark and eat in restaurants and wander around in the city’ (2). (Though you might have thought the Greeks were used to groups of British holidaymakers invading their ports and puking in the streets.)

Why this overreaction? It is not as if the ship was stricken with some exotic and deadly new virus. This is good old-fashioned gastroenteritis, caused by a type of infection called norovirus. There is no need for treatment, other than lying in bed for a day or two until the symptoms die down.

And calling the Aurora a ‘stricken’ ship seems excessive. Up to 500 passengers fell ill – out of a total of 2600 passengers and crew. The majority of passengers are unaffected, even if the quarantine has rather cramped their style for a few days. By the time the ship docked in Gibraltar, just 11 people were still ill.

When it comes to viruses, however, it seems that maintaining a sense of proportion is out of fashion. There was a panic reaction during the SARS outbreak earlier this year – with unnecessary health measures, businesses disrupted and flights cancelled, all exacerbated by the World Health Organisation’s gloomy warnings (3).

But SARS did actually kill a fair proportion of the people who contracted it, and some of the public health measures undertaken were reasonable precautions. The ‘vomiting virus’ on the Aurora is highly unlikely to kill anyone. If some of the overreaction to SARS was a tragedy, in relation to the Aurora it has been repeated as farce.

Outbreaks of norovirus on ships are not uncommon. In September 2003, the Regal Princess, owned by Princess Cruises, cut short an Atlantic cruise after 346 passengers and crew fell ill with norovirus (4). In December 2002, another P&O ship, Oceana, was similarly affected. (5)

Having so many people in such close proximity makes it easy for disease to spread. This makes cruise ships vulnerable, but hardly any more vulnerable than a school, nursing home or tower block. But on a cruise ship – where everyone is treated by the same medical team and shares the same facilities – it is far more obvious when an infection is going around.

Amid all the fuss, the most important question has been ignored. Why would anyone pay thousands of pounds to be stuck on a ship for a fortnight with 2000 other people in the first place…?

(1) Cruise hell ship docks, The Sun

(2) ‘Worst over’ on virus cruise ship, BBC News, 1 November 2003

(3) See WHO’s to blame for the SARS panic?, by Rob Lyons

(4) Hundreds sickened aboard cruise ship, CNN, 2 September 2003

(5) Vomiting virus outbreak on liner, BBC News, 5 December 2002