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ES Journal of Public Health

ISSN: 2994-9637

A Primer on Food and Water Borne Illnesses When Dining Out: A Case Study on Norovirus Outbreak on a Cruiseship

  • Case Reports

  • Orien L Tulp1,2*, Frantz Sainvil1,3, Vorachoat Karunyasopon4
  • 1Professor of Medicine, Colleges of Medicine and Graduate Studies, University of Science Arts and Technology, Montserrat BWI, USA
  • 2The Einstein Medical Institute, NPB, FL, USA
  • 3Broward University, FL, USA
  • 4National University of Medical Sciences, Spain
  • *Corresponding author: Orien L Tulp, PhD, MD, FACN, CNS, Colleges of Medicine and Graduate Studies, University of Science Arts and Technology, Montserrat, BVI, USA, University of Health and Humanities, British Virgin Islands, USA, and Department of Experimental Medicine, Einstein Medical Institute, North Palm Beach, FL, USA.
  • Received: January 24, 2024; Accepted: April 12, 2024; Published: April 16, 2024


A recent outbreak of norovirus occurred approximately 24 hours into a cruise, while passengers were enroute to a Northern destination aboard a holiday cruise ship on a scheduled week-long journey. The symptoms of classic norovirus including watery diarrhea, severe abdominal cramps and nausea were quickly recognized, and the illness causation confirmed via on-board laboratory testing in the ship infirmary. Appropriate treatment prescribed by the ship’s physician, and containment was realized within a few days. Because of the limited number of passengers affected (12 out of over 1,000), and the timing of the incident, it was concluded that the origin of the infection likely occurred prior to or soon after the passengers boarded, possibly linked to a welcoming ceremony hosted by the ship’s captain during which a variety of h’odoerve style finger foods including some seafood items were made available during a buffet dinner. Following the initial outbreak, no additional cases were reported or identified, no on-board origin was confirmed, and all passengers recovered without incident and continued the cruise.


Norovirus, Food Borne Illness, Episode, Cruise Ship, Outbreak.