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The Bane of the Cruise Industry, Gastro-intestinal Illnesses,
 Now a Topic with the Hotel Industry

By Dale K. DuPont, The Miami Herald
Knight Ridder/Tribune Business News

Apr. 28, 2004 - Gastro-intestinal illnesses, the bane of the cruise industry, have struck the Las Vegas gambling district.

One casino hotel received 1,660 complaints of such illnesses between December and last week, an outbreak that drew the attention of the Centers for Disease Control. The California Hotel and Casino, where guests and players became ill, was asked to sanitize dice twice per eight-hour shift and chips and coins at least weekly, said David Tonelli, spokesman for Nevada's Clark County Health District.

"These hotel systems are where you were two years ago," Dave Forney, chief of the Centers for Disease Control's vessel sanitation program, told an annual meeting of cruise industry executives Tuesday at Port Everglades. "A lot of people are learning what you did two years ago."

CDC officials have been helping Las Vegas deal with the outbreak, and the local health department expects to have a meeting soon with casino hotel representatives to discuss public health concerns.

Over the past few years, cruise lines have reported to the CDC several thousand cases of gastro-intestinal illnesses, including the Norwalk virus or noro-virus, aboard ships. Fallout from the outbreaks as well as the Iraq war put a considerable dent in the now-recovering travel business.

Las Vegas health officials noted that not all the 1,660 complaints of gastro-intestinal illness at the California Hotel and Casino were confirmed as noro-virus. The outbreak at the hotel casino, located a block from the Las Vegas Strip, reached a peak in March and appears to be on the wane, said Tonelli.

"The California was not the source, and there was no outbreak among employees," said Rob Stillwell, spokesman for Boyd Gaming, the hotel's owner. 'We adopted most of the enhanced sanitation efforts on a permanent basis."

Because the virus is spread primarily through contact, frequently handled items such as dice, chips and coins were targeted for the sanitizing effort.

Hotels elsewhere also are being drawn into the virus fight.

"We've trained our hotels how we clean our ships and how we expect them to clean," said Barrie Clarke, head of public and environmental health marine operations at Miami-based Norwegian Cruise Line. She was referring to hotels where passengers may spend a few days before a cruise.

'It has helped us a lot, especially in South America," said Clarke.

Cruise lines themselves have had to take extra sanitation measures to deal with the virus problem, which isn't likely to go away soon.

Norwalk-type viruses are becoming more prevalent than bacterial illnesses, which come from food or water, said Dr. Elaine H. Cramer, an epidemiologist with the CDC.

The number of gastro-intestinal outbreaks on ships has gone from 6 in 2000 to 30 in 2003. Through April 15, 11 have been reported. 'We're really facing this emerging problem," Cramer said.

Ships must report to the CDC, which has jurisdiction over international cruise lines that call at U.S. ports, when 2 percent or more of passengers or crew are sick. The CDC considers 3 percent an outbreak.

The outbreaks tend to be worse in winter, when the number of cases starts to rise on land as well. The problems often start with passengers who come onboard ill and then vomit in a public space, Cramer said. Soft surfaces can retain live viruses for many days.

The CDC recommends confining sick people to their cabins until they're symptom-free for 48 hours. But that doesn't always sit well with passengers, and they may be reluctant to report the illness at all for fear of being quarantined in their cabins.

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(c) 2004, The Miami Herald. Distributed by Knight Ridder/Tribune Business News.

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