Monday, November 26, 2012

Unwanted passenger on cruise liner

Recently, the cruise liner Voyager of the Seas was struck with what appears to have been a Norovirus outbreak.   'Norovirus' is not a unique organism; there are many different strains, so you can become infected several times during your life.   Norovirus causes diarrhoea and vomiting, which in turn result in contamination of surfaces and generation of aerosols.  If you get virus particles in your mouth, you are highly likely to contract the disease, which appears to have a very high hit rate in exposed people.  (Now do you understand why I never get invitations to be an after-dinner speaker?)

 The virus may be present in the intestines before the onset of symptoms, and may remain in faeces for more than two weeks after recovery.  During all of this time, the virus can be spread. The problem is compounded when a population is effectively captive, such as in hostels or on a cruise liner.  The virus lives for quite a long time on surfaces, so door knobs, bathroom surfaces, lift buttons, soiled bed linen and clothes can be sources of virus particles.  If someone throws up in the dining room, other diners are immediately at risk from the aerosol.  Obviously, if the ill person is working in the kitchens, this is even more serious, as all exposed food and utensils may become contaminated.

The cruise line might be criticised for not promptly informing passengers waiting to board in Sydney about the problem, but the necessary disinfection of a whole ship is a major undertaking, and it appears that the line has made strenuous efforts to protect new passengers from infection.

What can you do to protect yourself?  Rigorous hand washing with soap and hot water (sing Happy Birthday to yourself twice while washing, to ensure that you spend enough time working the soap into hands and under nails) particularly after visiting the toilet or changing baby's nappy and before eating or preparing food.  Do not prepare food for others if you have diarrhoea.  Use of alcohol hand sanitisers may be beneficial, but these are not a substitute for washing.

Wash raw fruits and vegetables before eating them and be sure to cook seafoods thoroughly - Norovirus can survive temperatures of around 60 C.

If you are caring for someone who has symptoms of vomiting and diarrhoea,  handle soiled clothing carefully to avoid generating aerosols; wear rubber or disposable plastic gloves.  Use strong bleach solution to disinfect surfaces in bathrooms etc.  

Odd spot:

In the case of chlorine solutions, more is not necessarily better.  If the solution is made from bleaching powder (sodium or potassium hypochlorite), the more powder we add, the more alkaline the solution becomes.  The active component in a solution of bleach is actually hypochlorous acid.  This acid is unstable and breaks down in alkaline solution.  At pH 10, almost no hypochlorous acid is present in the solution.  Thus, a solution of hypochlorite containing 1000 ppm has a pH of 11.0 - 12.00 and has no active hypochlorous acid, while a solution with only 25 ppm has a pH of 8.0 - 9.0 and so is actually more germicidal than the higher concentration.