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February 12, 2014

How Navy ships prevent norovirus outbreaks

Daily Briefing

CNN's Aaron Cooper this week explained how the United States Navy—with 323,000 active duty service members housed in tight quarters—is able to prevent the spread of highly contagious infections that recently have caused havoc on commercial cruise ships.

Last month, a norovirus outbreak sickened nearly 700 passengers and crew members onboard Royal Caribbean's Explorer of the Seas. The fast-moving, highly contagious infection hit again days later on Princess Cruises' Caribbean Princess ship, causing gastrointestinal symptoms in 178 passengers and 11 crew members.

Norovirus may have sickened hundreds aboard cruise ship

A similar outbreak would devastate a Navy ship, says Capt. Jim McGovern, commanding officer of the USS Iwo Jima. "If we had a norovirus that took out 700 sailors, we obviously would be operationally ineffective, combat ineffective—but even a smaller number, a smaller outbreak of, say, 100 would devastate our operational capability," he told Cooper, adding that outbreaks of just 10 or 20 people are taken very seriously.

To prevent that from happening on deployment, the Iwo Jima's 3,200 marines and sailors are medically screened and vaccinated prior to being allowed on the vessel. "The idea is to prevent somebody from getting ill. Once you do become ill from one of these highly contagious organisms, you are really chasing it then," says Vice Adm. Matthew Nathan, who serves as Surgeon General of the Navy.

Once onboard, sailors are required to report to sickbay if they feel sick—with no exceptions. "If they are particularly stoic and don't want to come to us for whatever reason, their supervisor will make them come," says senior medical officer Sean Sullivan. If symptoms of a virus are confirmed, the sailor will be isolated to prevent the spread of infection to the rest of the ship's inhabitants.

What infectious disease can teach us about chronic care

Rigorous, daily cleaning routines also are a key part of the Navy strategy to thwart infectious diseases, including foodborne illnesses. Preventive medicine technician Aaron Ferguson inspects the ship's kitchens several times a day to ensure workers' "hands are clean, uniforms are clean, they have hairnets on properly, making sure their lines are clean, so there is not dirt buildup or anything like that which could get people sick," he says.

Nathan notes that the risk of infection is lower on a Navy ship simply by not having certain "creature comforts" that cruise ship passengers expect. "If you have a ship whose main center of gravity is social gatherings, food places, dancing areas places for libations, and gating on decks and swimming pools—all of those things that sailors wish they had, but don't have on our Navy ships—then I think it is a much more challenging environment to control the spread of a highly contagious virus" (Cooper, CNN, 2/11).

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