TIPS FOR STAYING HEALTHY ABOARD SHIP.

Byline: -- Eric Noland

There was some rough sailing for the cruise industry at the end of 2006.

When the Carnival Liberty journeyed from Rome to Florida in early November, gastrointestinal illness afflicted 536 of 2,804 passengers and 143 of 1,166 crew members -- that's more than 17 percent of everyone aboard.

A few weeks later, Royal Caribbean's Freedom of the Seas suffered outbreaks of norovirus on back-to-back Caribbean cruises and was slapped with a rare ``no-sail recommendation'' by the Centers for Disease Control's Vessel Sanitation Program. The ship was kept in port for two days for a thorough scrubbing, and the cruise line's next itinerary was shortened from seven days to five.

Norovirus -- which refers to a group of viruses that can cause stomach distress, usually manifested in vomiting and diarrhea -- is just as common on land as on cruise ships, the CDC reports, but the close quarters can cause it to spread rapidly, and the capsule environment of a ship results in a more glaring public focus. (If five people come down with the bug after eating in a U.S. restaurant, they might self-medicate and ride it out, and no one is the wiser; also, unlike the cruise ships, the restaurants are not required to report such incidents.)

The CDC's Vessel Sanitation Program regularly inspects ships and issues sanitation scores based on a 100-point scale. Anyone contemplating taking a cruise would be wise to check the most recent score of a particular ship, or the outbreak incidences of a particular cruise line.

Simply visit the VSP's home page, www.cdc.gov/nceh/vsp, and click on ``Green Sheet'' for ship inspection scores. Click on ``Cruise Ship Outbreak Summaries'' for details about troubles on recent cruises.

The VSP inspects ships with foreign itineraries that call at U.S. ports and carry 13 or more passengers. It intervenes whenever 2 percent or more of the total number of passengers and crew is afflicted with gastrointestinal illness. Thirty-seven cruises fell into this category in 2006 -- 12 of those in the months of November and December alone.

Beyond being discriminating in choosing a cruise line or ship, there are other preventive measures that can be taken once you're underway.

Keep your hands clean. The CDC's No. 1 recommendation is frequent hand washing. This should be done before and after eating, and after touching a lot of surfaces in public areas. Try to avoid touching your mouth, nose or eyes until you've washed your hands. And if you can stand forgoing the buffet on your voyage and opting for table service instead, you might do yourself a favor by not handling all those serving tongs. (Some cruise lines ask passengers who have been ill to stay out of the buffet line for the remainder of a voyage.)

Be sensible when you go ashore. Many nations don't maintain the same sanitation standards for water and food preparation that are commonplace in the United States. A margarita might sound heavenly, but where did the water come from to make that ice? A beer, a bottled soda or bottled drinking water might be a better choice.

This might seem to be a no-brainer, but the CDC also recommends leaving an area if you see someone get sick, because of the risk from airborne contaminants. The incident should be reported to ship staff, too.

On a December sailing to the Caribbean on the Crystal Serenity, it was comforting to learn that this line isolates for 48 hours any passenger who has been felled by gastrointestinal illness. (We noticed that no over-the-counter remedies are available in the gift shop, which leaves a passenger little option but to call in the ship's medical staff.)

Such unfortunates are essentially confined to quarters, but by all accounts it's a pretty comfortable detention -- with access to DVDs, books and games from the ship's library, and the full dinner menu provided for room-service orders. Further, a commensurate portion of a passenger's fare is rebated.

In another precaution, passengers are asked not to shake hands with the ship's officers at the bon voyage and end-of-cruise cocktail parties.

The Serenity's last inspection score by the VSP provided another layer of reassurance: a perfect 100.