Shaking hands may be the conventional greeting for landlubbers, but on the high seas, the "forearm tap" has become popular. This greeting of knocking elbows together instead of shaking hands was encouraged by a number of cruise lines to raise awareness of the importance of personal hygiene on board ship, according to a representative for Carnival Cruise Lines.
Poor personal hygiene is the likely cause of gastrointestinal illness (gastroenteritis) on cruise ships, according to the Centers for Disease Control and Prevention (CDC). The CDC investigated 22 reports of gastroenteritis outbreaks aboard 18 cruise ships from Jan. 1, 2002, through Dec. 31, 2002. Of the 22 outbreaks, three were blamed on bacteria and seven could not be traced with certainty, but the remaining 12 were confirmed to be associated with noroviruses--a group of viruses that cause gastroenteritis, also known as Norwalk-like viruses.
Symptoms of norovirus infection include nausea, vomiting, diarrhea and stomach cramping that can last from 12 to 60 hours. The symptoms usually begin 24 to 48 hours after a virus is ingested. Although people may feel very ill and vomit frequently, norovirus infections are not considered serious in most individuals. But they may become serious in the very young, older people, and in those with weakened immune systems.
Noroviruses are found in the stool or vomit of infected people, and infection can spread in several ways:
- Eating food or drinking liquids that are contaminated with the virus
- Touching contaminated surfaces or objects and then placing your hands in or near your mouth.
- Having direct contact with another person who is infected and showing symptoms (for example, sharing foods or eating utensils).
Viruses aren't the vacationer's only cause of gastrointestinal illness. "Travelers can also get diarrhea from bacterial infections," says Renata Albrecht, M.D., the director of the Food and Drug Administration's Division of Special Pathogen and Immunologic Drug Products. Bacterial infections usually go away over time without treatment, but doctors may prescribe antibiotics to treat some and shorten the duration of the diarrhea, says Albrecht. No medications are approved for preventing bacterial infection, nor are there medications that prevent or treat noroviruses.
