The Holidays and upcoming winter are a popular time to go on a cruise. Especially since there’s nothing to worry about when you’re on a cruise. There are NO: meals to fix; house to clean; repairs to make; work to obsess over. The only concerns may be an outbreak of stomach flu (viral gastroenteritis) or a Titanic-like occurrence – both very low risk, right? Yes, for the Titanic-like happening; but for the outbreak – think again.

A recent study was published in Clinical Infectious Diseases (2009 Nov 1; 49:1312) in which a team of 46 medical professionals evaluated the cleanliness of  the public restrooms in 52 cruise ships over a three year period. Obviously, this was a covert operation.  The clever way that they were able to check for cleanliness included the application of a gel to objects in several restrooms at the start of each cruise by a team member; the gel was colorless and fluorescent (visible under ultraviolet light) and was easily removable by the light application of water. The restrooms were examined daily by the team member, and the gel was reapplied if it had been washed away.

Cleanliness varied widely from ship to ship, with scores from 100% to less than 5%! Although toilet seats were the best-cleaned objects overall, they were cleaned only 50% of the time. The handholding rails next to the toilets were often overlooked.  Baby-changing tables were the least cleaned objects, being cleaned less than 30% of the time.

In the event of an outbreak of gastroenteritis on a ship, the team member present on that ship was able to compare the cleanliness in the bathrooms before and after the outbreak.  Not surprisingly, those ships that had an outbreak had significantly lower cleanliness scores (measured before the outbreak) than did the ships with no outbreaks. However, the ships with the outbreaks had better cleanliness scores after the outbreak than they did before.

Moral of the story: don’t be complacent in thinking that your cruise ship is very clean as a matter of course. Better yet, consider booking a cruise on a ship that has just had an outbreak as the staff will be much more attuned to the importance of regular cleaning and sanitation! And – always wash your hands frequently.