Going on a cruise? To cut your risk of getting sick while sailing the high seas, avoid using the ship's public bathrooms.
Stealth investigations of 56 ships in nine large cruise lines found evidence that only about 30 percent of frequently touched bathroom surfaces are disinfected daily.
Though visibly clean, public toilet seats and flush devices, stall handholds and door handles, inner restroom door handles, and baby-changing tables "on most, but not all, cruise ships" are not being cleaned and disinfected thoroughly, says Dr. Philip C. Carling of Carney Hospital in Boston.
Lack of disinfection may significantly increase risk for illness, and particularly for the severe diarrhea and vomiting caused by highly contagious Norovirus , Carling and colleagues note in the journal Clinical Infectious Diseases,.
Therefore, Carling cautions cruise passengers to minimize public restroom use, wash hands with soap and water rather than alcohol-based hand rubs, and be aware of the disease transmission potential from all publicly touched surfaces.
Carling's group enlisted 46 health professionals to check 273 randomly selected public restrooms daily during cruises between July 2005 and August 2008. The ships, most originating from U.S. ports and 82 percent from the five largest cruise lines, accommodated up to 3,600 passengers each.
Armed with handheld ultraviolet lights to pick up fluorescent traces of a transparent, but easily cleanable, solution they had sprayed on surfaces, the cleaning spies identified surfaces left uncleaned for 24 hours.
Of the 2,010 toilet seats evaluated, just 50 percent had been cleaned. Likewise, just 42 percent of toilet flush devices, 37 percent of toilet stall doors, and 31 percent of toilet stall handhold bars had been cleaned.
And only 35 percent of interior bathroom door handles and 29 percent of baby-changing tables had been cleaned.
Post-outbreak cleaning and disinfection practices on cruise ships, although important, are not enough, the researchers say. Increased efforts to prevent outbreaks with better disinfection practices obviously are needed, they said.
SOURCE: Clinical Infectious Diseases, Nov. 1
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