Investigation Update on the Balmoral

Cruise Line: Fred Olsen Cruise Lines

Cruise Ship: Balmoral

Voyage Dates: World Cruise 5 January, 2010 to 4 February 2010 (#1001 - U.S. voyage segment), with 21 April 2010 as end of complete world cruise

Number of passengers who have reported gastrointestinal illness (GI) during the voyage out of total number of passengers onboard: 293 of 1,163 (25.19%)

Number of crew who have reported gastrointestinal illness during the voyage out of total number of crew onboard: 17 of 519 (3.28%)

Predominant symptoms: diarrhea and vomiting

Actions: In response to the outbreak, the crew onboard the ship have implemented infection control and outbreak response procedures and has submitted case documentation for review to the Vessel Sanitation Program.

Only 16 passenger cases from the total 293 reported illness in the 15 days prior to the ships first U.S. arrival in the port of Los Angeles on 1 February, and no additional passenger or crew illness cases were reported since 27 January.

The ship departed Dover, England on 5 January as the start of a world cruise, with stops in Funchal, Madiera, St. Lucia, Castries, Bridgetown, Barbados, Willemstad, Curacao, Cartagena, Colombia, Panama Canal, PTO. Caldera, Costa Rica, and Cabo San Lucas, Mexico prior to arrival in Los Angeles, California and San Francisco, CA (4-6 February 2010).

VSP did not institue an onboard response to this outbreak, but has requested submission of clinical specimens for laboratory analysis from the ship and continues to receive updates of any new cases reporting.