Going on a cruise? Watch out for the notorious norovirus

If you’ve ever spent a day crawling back and forth between your bed and the bathroom – secretly wishing you were dead just so that the vomiting and diarrhea would stop – chances are, you suffered from norovirus.

Under a microscope, the virus looks a bit like a fuzzy ball, perhaps something that could hang from a Christmas tree. It loves summer camps, cruise ships, hospitals, college dorms – anywhere where lots of people are sharing bathrooms and other spaces. And when it strikes in close quarters, it can spread quickly, sickening dozens, or even hundreds, of people.

New York City real estate agent Sienam Lulla has some terrible memories involving this virus.

She was hit on a cruise ship, after she had spent four months planning what she thought would be the ultimate Caribbean dream trip for her husband, Vik, and their two boys– Ari, who was five, and Devon, who was three.

“They were absolutely thrilled,” Lulla says. “We had done a cruise a year back with their grandparents and they had really, really enjoyed that, so they had been asking, especially the five year old, he had been asking when we should go on a cruise again.”

When the time came, they flew to Florida, where they boarded the ship. Everything was great until day two. Seinam noticed something was off when they sat down to dinner.

“I ate the appetizer and I wasn’t feeling very good after that,” she says. “And I couldn’t eat the rest of my dinner. I went back to my room, and I was very sick.”

She was projectile vomiting, her stomach was in pain, and she had diarrhea. “The whole night it was me, the bed, and the bathroom,” she says.

The next day, she couldn’t get out of bed. And that continued until day four, when she finally began to feel better. And then, the virus struck again.

This time it hit her 5-year-old son, who went through the same cycle–violent vomiting, diarrhea, and an inability to eat anything. By day five, he started to feel better–and the virus struck his three-year-old brother. The younger boy was still sick when the cruise ended two days later.

“If you get infected with norovirus, it came from another person,” said epidemiologist Aron Hall at the Centers for Disease Control and Prevention. “Through direct contact with that person or that person’s fecal matter ends up in your food, or in your water, or left on a surface that you go and touch and then put your hands in your mouth.”

Hall says there are about 20 million cases each year in the U.S., and those infections lead to about 700,000 hospitalizations and more than 800 deaths–mostly in young children and those over 65. There are no treatments, except for treating the symptoms–mainly dehydration–and waiting it out.

“Anybody who has been infected by norovirus and gotten sick from it will tell you there is nothing good about it,” said Ken Cadwell, a microbiologist at New York University’s School of Medicine. Cadwell studies stomach bugs and their interactions with the immune system, and he is investigating some redeeming qualities of this awful virus.

“We recently found that a mouse norovirus can be beneficial and act as part of the intestinal environment and serve a role similar to bacterial members of the microbiome. A big question for us is how is the norovirus functioning this way and how can it be beneficial? Is it different from the way bacteria are beneficial?”

Cadwell is trying to figure out when the norovirus is a benign actor – and what turns it into a hostile agent.

And as for the awful vomiting and diarrhea that comes with this virus – Cadwell says nobody knows why that happens. It could be that the body is trying to clear out the virus–a defensive reaction–but the mechanism is not yet understood.

And you can catch this virus over and over again. Because–just like flu–there are many types. Developing a vaccine could be tricky says Cadwell:

“Ideally, you would have to make a vaccine that could target many of these norovirus strains, probably starting with the most common circulating ones.”

Seinam Lulla says she’s managed to stay clear of the virus since her ruined trip.

“This was the most horrific experience of my life. And I’ve grown up in India, it’s a tropical country, we get a lot of stomach bugs over there because of the monsoon season and stuff, but this has got to be the absolute worst. I’ve never been hit with anything that bad.”

She swears she will never take a cruise again.