After arriving in Sydney aboard a luxury cruise liner late last month, Ms Cherie Butcherine said the supposedly idyllic holiday had been "just a nightmare".
Ms Butcherine, along with her 11-year-old daughter, had been on an ill-fated cruise on a trip from Sydney to Cairns and back which was hit by an outbreak of a nasty gastrointestinal virus.
Describing the ship - P&O's Pacific Eden - as "worse than a one-star hotel", Ms Butcherine said her daughter became ill, but the crew were unable to cope. Several other passengers fell ill as well.
"I can't tell you how upset we are about the whole thing, and I just couldn't wait to get off the boat," Ms Butcherine told Fairfax Media. "We were just devastated to have to stay on board."
Some other passengers were equally incensed. Ms Jaimie Abbott, an Australian public relations consultant, described the ship as a "floating disaster".
But P&O insisted it had carried out a strict disinfection programme and most of the guests had a "fantastic holiday".
"It only takes a small number of cases of the common stomach bug, norovirus, for sanitation levels to be increased on board," the company said in a statement. "Stomach bugs are a fact of life in the general community and as you will see on board the level of cleaning and sanitation is second to none."
The virus-plagued journey made headlines in Australia, especially as it came just weeks after a similar outbreak which struck 182 passengers aboard a 4,700-person Royal Caribbean cruiser which docked in Sydney during the outbreak.
Such outbreaks - mainly involving the norovirus - have attracted increasing attention across the world, especially as the cruise industry continues to expand. About 73 passengers became ill on a cruise from the United States to Mexico late last month, while other outbreaks were also reported last year in various countries, including Canada and Mexico.
The outbreaks have prompted concerns about safety and hygiene aboard cruise ships, especially involving the preparation, storage and service of food.
An Australian expert on public health, Professor Peter Curson, said cruise ships have become larger due to the growth of the sector and can be "perfect breeding grounds for the spread of infectious diseases".
He said outbreaks commonly occur wherever large numbers ofpeople interact such as hospitals and restaurants, but tend to attract more attention when it happens aboard cruise ships.
"They bring together thousands of people from a wide variety of origins and backgrounds and cluster them together in confined spaces where they regularly intermingle and share basic facilities," he wrote on the ABC News website.
"Given such numbers and the wide array of recreational activities available, health security often suffers… Perhaps cruise lines should now advertise that their cruises are both adventurous and occasionally risky."
The cruise industry has adopted strict sanitation practices in recent years and ships tend to respond quickly to possible outbreaks.
International health regulations require cruise operators to declare the presence of notifiable diseases before they enter port. Outbreaks are declared when more than 3 per cent of passengers become sick, with most outbreaks traceable to a single person.
Figures collected by the United States Centres for Disease Control and Prevention show the number of outbreaks has been declining over the past decade despite an increase last year.
Though it does not cover all global outbreaks, the agency reported 12 gastrointestinal illness outbreaks on cruises last year, compared with nine in 2014, nine in 2013, 16 in 2012 and 14 in both 2011 and 2010. In both 2004 and 2006, there were more than 30 reported outbreaks.
In Australia, as in much of the world, the cruise industry is the fastest growing part of the nation's tourism sector.
Ships are rapidly growing in size, with some capable of carrying more than 5,000 passengers.
Most experts say the best way for passengers to minimise the risk is to wash hands regularly, arrive at buffet meals early or avoid them altogether and even to consider taking cruises on smaller ships.
But experts say the virus outbreaks are not keeping people away.
An expert on tourism, Professor Noel Scott, from Griffith University, said Australia and Asia, especially China, had experienced strong growth in the cruise industry and that virus outbreaks "don't seem to affect it".
"People like the convenience of cruises," he told The Sunday Times. "You can see the world out your window and relax. These things (virus outbreaks) occur but it does not appear to have much effect."
This article was first published on Jan 17, 2016.
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