Tests Show the Nurse Isolated on Carnival Magic Did Not Have Ebola

 

Carnival Magic got the "all clear" on Sunday as a guest on the ship's Oct. 12 cruise tested "negative" for the virus. // Photo by Carnival Cruise Lines

Good news to start the week? Michael Mierzwa, Galveston's port director, told news media at the port Sunday that blood samples taken Saturday from a female guest in isolation on Carnival Magic had tested "negative" for the Ebola virus.

Thus, the multi-day drama that captured international media attention appeared to end without incident at the Texas port. Carnival Magic departed late Sunday afternoon for its next Caribbean cruise.    

Certainly Carnival officials, other cruise lines, many travel agents and the Cruise Lines International Association, the cruise industry's trade group, were all relieved at the positive outcome. “CLIA is very pleased that the passenger, who was asymptomatic, has tested negative for Ebola and was safely disembarked with her loved one at the Port of Galveston today," said Christine Duffy, CLIA's president and CEO.

Duffy commended Carnival and the public health authorities for "their effective and successful response in managing this situation professionally and with transparent and regular communication to everyone onboard the ship and to the public." She also praised the ship's passengers and crewmembers for responding calmly and responsibly to the directions of the ship’s officers and public health authorities. 

Roger E. Block president of Travel Leaders Franchise Group, said, "Since the news first hit about the Dallas hospital lab worker who was onboard the cruise ship, the news media went into a feeding frenzy only to learn later that she is Ebola-free. During that time, we’ve been polling our Travel Leaders agents to learn what impact if any the relentless coverage of Ebola is having on their clients. While some agents have had some cancellations – mostly limited to a very few – the overwhelming majority of our agents have not had any.
 
"We certainly applaud CLIA for further strengthening its protocols in the wake of last week’s incident. They will now deny boarding to anyone who had physical contact with – including caring for – someone with Ebola within the 21 day incubation period for the disease.
 
"For our part, we are continually updating our agents and arming them with information they can use directly with their clients to cut through the hysteria with facts."

The Unfolding Drama

During the Oct. 12 roundtrip cruise from Galveston, the female guest, a nursing supervisor with Texas Health Presbyterian Hospital, showed no signs of Ebola. But as part of their investigation of an Ebola patient who died at that medical center, the U.S. Centers for Disease Control (CDC) learned the nurse had been potentially exposed to lab samples from that patient. 

Carnival Cruise Lines and the nurse were notified by the CDC last week while the cruise was already under way. The healthcare worker and her husband then spent the duration of the cruise "isolated" in their cabin as a precautionary measure. 

Mierzwa said the U.S. Coast Guard sent a helicopter to the ship as it was sailing in the Gulf of Mexico on Saturday. The chopper dropped supplies and protective gear; it also then picked up blood samples from the woman. Mierzwa confirmed the chopper flew to Ellington Field in TX, where an airplane was waiting to take the samples to the Texas Department of State Health Services laboratory in Austin. 

Thus, authorities analyzed the samples so they'd know results prior to the ship's arrival in Galveston. Once the tests came back negative for Ebola, a CDC official traveled to Carnival Magic by boat, boarded and examined both the woman and her husband, according to Mierzwa.

Getting the All Clear

Carnival Magic docked about 4:30 a.m. Sunday at Galveston. "Healthcare authorities boarded the ship to conduct a final health screening of the lab worker from Texas Health Presbyterian Hospital," said Carnival in a statement. "Additionally, a blood test conducted by health officials has confirmed the individual is not infected with Ebola." 

Following the normal U.S. Customs & Border Protection clearance procedures for returning cruise passengers, the individual and her companion departed the ship to return home on their own. Normal disembarkation for other passengers began around 7 a.m. 

Carnival Magic docked at Galveston // Photo by Carnival Cruise Lines

No special cleaning requirements of the vessel were requested by health authorities, Carnival acknowledged.

"Nonetheless, to provide added assurance for our guests, we are undertaking a very comprehensive and aggressive cleaning and sanitizing initiative prior to guests boarding for the next voyage," the line said in its statement.

Guests for the next voyage began boarding around 1 p.m. and the ship departed as normal late Sunday afternoon. Thus ended what had become the latest Ebola precautionary watch around North America.

On Friday, fearful Mexican authorities had refused to clear the Carnival Magic to dock at Cozumel, a planned port call. After a delay of several hours waiting for permission, the line opted to send the ship back to Galveston. Guests on the sailing received a $200 onboard credit and a future cruise discount.

The drama might have actually ended a bit earlier if authorities had been able to remove the nurse from the ship. Late last week, the U.S. State Department had tried to arrange a medical evacuation.

A helicopter was expected to take the couple from the ship to an airfield in Belize, but the Belizean government refused permission for the woman to enter their country. Other guests on the ship were permitted to spend the day ashore as planned in Belize. 

Guest Reaction

Some guests on last week's Carnival Magic cruise clearly were concerned or even fearful about the situation, relaying those emotions to national media. But others seemed in good spirits.

"The crew at Carnival handled the situation with incredible calm and professionalism," said CruiseOne franchise owner Dana Garies of Parker, Colorado, who was onboard Carnival Magic. "The captain kept everyone informed and the crew went over and above to accommodate the passengers. Overall, it seemed the passengers were calm and continued to enjoy their cruise. We only missed one port, but Carnival graciously offered every passenger $200 on board credit and 50 percent off their next Carnival cruise when booked within two years. Kudos to Carnival for their expertise in handling this situation so well." 

In a note to John Heald, a popular cruise blogger and veteran Carnival cruise director, James Dunn, the Carnival Magic's cruise director, described the onboard atmosphere during the Oct. 12 cruise as “extremely positive” and said Saturday was a fun sea day.

Dunn reported that guests donated $2,000 for the line’s St. Jude charity program on Saturday afternoon with a big flash mob. Saturday evening's activities included karaoke, superstar live, Gender Showdown, Pub Quiz and a special $10,000 game of Bingo, plus the Punchliner Comedy Club and Carnival Legends performances. “The guests have been amazing,” said Dunn.

Somer Thurman, a guest on the sailing, also sent Heald a note that said: “James’ summary is exactly how it is onboard. We have had a wonderful time, been informed and the staff has been awesome. While the news media states there is panic that has absolutely not been the case.” Thurman said guests were praying for the best for the affected passenger and awaiting the test results. He also gave "kudos" to Carnival for its handling of the situation.

Carnival's president and CEO Gerry Cahill and other members of his team were on hand in Galveston to meet and mingle with Carnival Magic's guests, talk with them and listen to their comments or concerns.   

New CDC and Cruise Industry Rules 

From now on, CLIA member lines' guests must adhere to new Ebola prevention screening procedures prior to boarding. // Photo by Susan J. Young

But why did the nurse board the Carnival Magic in the first place? It's perhaps best described as a case of changing requirements. 

A statement by the U.S. State Department said Friday: “At the time the hospital employee left the country, CDC was requiring only self-monitoring. The employee had been self-monitoring, including daily temperature checks, since October 6, and has not had a fever or demonstrated any symptoms of illness. It has been 19 days since the passenger may have processed the since deceased patient’s fluid samples.” 

That was at the "tail end" of the incubation period for the virus, the time when it can develop in a person who has been exposed. And on Sunday, the nurse reached 21 days, generally considered the last day when the virus could materialize.

“She was considered of very low risk by the U.S. Centers for Disease Control, which is why there was no travel restriction on her when she boarded the ship,” said Jennifer de la Cruz, a Carnival spokeswoman on Friday. “CDC later changed their monitoring criteria and that's when we were notified she was onboard.”

Given newly issued CDC requirements, the cruise industry this week is doing more stringent screening for those boarding its ships. Had a similar situation happened this week, the nurse would have been refused boarding. 

“We would not put anyone on our ships -- passengers or crew -- who have had exposure to an Ebola patient within 21 days,” said de la Cruz on Friday. “This is now covered in our screening procedures.” 

That questionnaire covers areas such as travel history, any contact with individuals who have traveled from the West African areas of concern as well an additional question added this week that relates to having had any contact with someone who has been diagnosed with Ebola. Carnival, like other cruise lines, is requiring medical screening questionnaires of all guests prior to boarding a ship. 

"Yes" answers to the questions will trigger a secondary screening. The guest could be denied boarding. To give guests and agents a good sense of what's happening, here's a statement issued by Cruise Lines International Association (CLIA) on behalf of its member lines:

  • “CLIA and its member cruise lines have been actively monitoring the Ebola situation, along with our colleagues in the rest of the travel industry, and remain in constant contact with public health authorities. Our members continue to engage in active and enhanced health screening of embarking passengers.
  • “Working with cruise line health and medical professionals, CLIA provided its member cruise lines with a sample protocol that includes denial of boarding for all passengers and crew arriving from countries designated with a Level 3 Travel Health warning by CDC." Those countries include Guinea, Liberia and Sierra Leone. 
  • "Additional measures include denial of boarding to passengers and crew who traveled to, in or through those countries within a minimum of 21 days before embarkation."
  • “Further, we have now recommended additional 'contact screening,' in addition to travel history screening, and denial of boarding for anyone who had physical contact with, or helped care for, a person with Ebola during the same time frame."

“These measures are not static," stressed Duffy, noting that her organization and its member lines are continually evaluating the situation with Ebola and are in regular contact with public health officials to assess the need to enhance the industry’s protocols. "Out of an abundance of caution and care for the well-being of our guests and crew members, our measures typically go beyond what is technically required," Duffy noted.

She also said CLIA is actively engaged with the CDC along with other sectors of the travel industry, to assist the federal government in quickly establishing a robust protocol for identifying any member of the traveling public designated by the CDC for monitoring. “CLIA and its member cruise lines remain vigilant in our efforts to provide for the well-being of our guests and crew members," she said.    

Individual lines have also issued statements, among them Holland America Line, Seabourn Cruise Line, Princess Cruises, Norwegian Cruise Line and MSC Cruises, to name just a few. Most statements said the individual lines were following all guidelines from health authorities, including the CDC and World Health Organization.

“For instance, our protocol includes denial of boarding for all passengers and crew arriving from countries designated with a Level 3 Travel Health warning by CDC or who has come in contact with someone with Ebola in the past 21 days,” said MSC Cruises in its statement. MSC also said it doesn't have any crew from the affected countries nor does the line recruit or hire crew from those countries. 

As for cruises that take guests to ports in West Africa, there are few. Exceptions include repositioning voyages between the Mediterranean and South Africa; those are often operated by upper end lines with an international clientele seeking the exotic. While the lines are now not sailing to any Level 3 Travel Health threat countries, they've also eliminated port calls in many surrounding nations.

Regent Seven Seas Cruises, Holland America Line and Silversea Cruises had one or two voyages in the region this fall or next year but they've already changed their itineraries. West African ports were dropped, more time was added to other port calls and new ports of call were added in such destinations as Morocco or the Canary Islands. 

Last week, Costa Cruises said one of its itineraries included a port call at Dakar, Senegal on March 30, 2015, but that call will be cancelled and replaced with a stop at Fuerteventura, Canary Islands. 

Ebola will likely continue to be a worldwide issue for travel sellers. However, this week, agents can tell their clients that the cruise industry's screening requirements are now more stringent, based on newly updated CDC requirements.