Clean-up for World's Largest Cruise Ship As Virus Strikes Again

The world's largest cruise ship was due to sail out of Miami yesterday after workers spent two days trying to scrub away all traces of a gastrointestinal virus that had made hundreds of people ill on two earlier voyages.

The cleansing of the Royal Caribbean's Freedom of the Seas came after the Centres for Disease Control (CDC) recommended special sanitising of all high contact areas. Two doctors and 45 extra cleaning staff will also be on board as the ship sails the Caribbean.

Health experts said the cleaning included any surface that regularly comes into contact with human hands. "It could be everything from door handles to elevator buttons to poker chips, from the money itself that changes hands to the railings on staircases," said David Forney, who heads the Vessel Sanitation Programme at the Centres for Disease Control in Atlanta. "It just goes on and on and on."

The first outbreak on Freedom of the Seas occurred last month when more than 380 passengers became ill. Although the ship was cleaned before its next sailing, more than 100 passengers and crew were infected by the virus last week.

Other cruise lines have also been affected. Princess Cruises' Sun Princess underwent a special cleansing after calling at Port Everglades, Florida, at the weekend with 97 infected passengers. On Monday Holland America's Zaandam arrived in San Diego, California, carrying 68 stricken passengers and crew.

Norovirus, the US version of the winter vomiting disease, takes its name from Norwalk, Ohio, where the first outbreak was identified at a school in 1968. It is a complex of viruses that cause vomiting, cramps and diarrhoea. It spreads through contaminated foods and liquids as well as surfaces, and is unusually hardy, lingering on surfaces.

Incidence of the disease is up across the US, with recent outbreaks at nursing homes in the Miami area, a biker bar in upstate New York, wedding parties in South Dakota, and a high school in Virginia.

Cruise ships are vulnerable because of the large number of people in a relatively small place - Freedom of the Seas carries a total of 5,370 passengers and crew. While cruise operators discourage patrons from sailing while unwell, offering refunds if they reschedule, many travellers are loth to give up a trip booked months ahead.

So far this year, the CDC has registered outbreaks on 33 cruise ships, compared with 18 last year. "At this time of year, we will probably continue to see increased levels of illness on the ships, just because we are seeing that on land," Mr Forney said.