November 17, 2009 / 8:03 PM / 10 years ago

Cruise ships' public restrooms poorly disinfected

NEW YORK (Reuters Health) - Going on a cruise? To cut your risk of getting sick while sailing the high seas, avoid using the ship’s public bathrooms.

View of the cruise ship "Voyager of the Seas" carrying dozens of victims of swine flu among its 5000 passengers and crew is anchored in the bay of Villefranche sur Mer, southeastern France, July 31, 2009. REUTERS/Eric Gaillard

Stealth investigations of 56 ships operated by 9 large cruise lines found evidence that only about 30 percent of frequently touched bathroom surfaces were 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, Dr. Philip C. Carling, of Carney Hospital in Boston, Massachusetts, noted in an email to Reuters Health.

Lack of disinfection, he and colleagues note in the journal Clinical Infectious Diseases, may significantly increase risk for illness, and particularly for the severe diarrhea and vomiting caused by highly contagious Norovirus.

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 5 largest cruise lines, accommodated up to 3600 passengers each.

Armed with handheld ultraviolet lights to pick up florescent traces of a transparent, but easily cleanable solution they had previously sprayed on surfaces, the cleaning spies identified surfaces left uncleaned for 24 hours.

Of the 2010 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 are clearly needed.

SOURCE: Clinical Infectious Diseases, November 1, 2009

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