In a follow-up to a report Monday of an outbreak of vomiting and diarrhea on board Royal Caribbean Cruise Line’s Legend of the Seas, federal health officials have confirmed today the etiologic cause of the outbreak is norovirus.


The Centers for Disease Control and Prevention’s (CDC) Vessel Sanitation Program (VSP) also notes that the number of cases have risen from a total 116 on Monday, to 142 (135/7) passengers and crew.

The Legend of the Seas arrived in San Diego, CA after it’s 2 week voyage Tuesday.

The CDC-VSP has  investigated five cruise ship outbreaks this year to date, four were due to norovirus, while for one, the Norwegian Pearlthe etiology is still unknown.

Norovirus is a highly contagious viral illness that often goes by other names, such as viral gastroenteritis, stomach flu, and food poisoning.

The symptoms include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people, the illness is self-limiting with symptoms lasting for about 1 or 2 days. In general, children experience more vomiting than adults do.

Norovirus is spread person to person particularly in crowded, closed places. Norovirus is typically spread through contaminated food and water, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea.

Norovirus causes more than 20 million illnesses annually and it is the leading cause of gastroenteritis outbreaks in the United States. Each year it contributes to 56,000-71,000 hospitalizations and 570-800 deaths.