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The <keyword id="22667872" type="General" weightage="100" keywordseo="mpox-outbreak" source="keywords">mpox outbreak</keyword> in <keyword id="19924003" type="General" weightage="20" keywordseo="africa" source="keywords">Africa</keyword> is yet another example of how <keyword id="20040661" type="General" weightage="20" keywordseo="infectious-diseases" source="keywords">infectious diseases</keyword>, perceived to be "someone else's problem", and affecting mainly poor, developing countries, may suddenly pose unexpected global threats. Other examples of <keyword id="22817243" type="General" weightage="20" keywordseo="neglected-diseases" source="keywords">neglected diseases</keyword> include the West Nile, Zika and Chikungunya viruses. Mpox was discovered in 1958 (in captive monkeys, hence the original misnomer "monkeypox") and the first human case was identified in 1970. Then, for decades it was largely neglected by the scientific and public health communities, regarded as an uncommon infection in remote rural areas in tropical Africa, without relevance for the rest of the world. When a massive mpox outbreak hit developed countries in 2022, increased research funding led to a surge in scientific studies. On just one medical search engine, there's been more research produced since April 2022 than in the preceding 60 years. The 2022-23 global mpox outbreak happened despite repeated calls from African researchers for increased global investment in diagnostic, therapeutic and infection prevention tools for mpox. The WHO has now declared the current upsurge of mpox in central Africa a <keyword id="21952478" type="General" weightage="20" keywordseo="public-health-emergency" source="keywords">public health emergency</keyword> of international concern. This is the highest alert level for events that constitute a public health risk to other countries and requires a coordinated international response. Mpox's recent history is yet another reminder that an infectious disease in one corner of the world should not be regarded as someone else's problem, as it can suddenly start to spread fast and far. It also highlights global inequities in resource allocation and access to vaccines, diagnostics and treatments. These were made available in many industrialised countries and helped curb the global outbreak, but are still largely lacking in most of Africa. <h2>The 2022 outbreak: a total surprise</h2>The disease has been renamed "mpox" but the name of the virus, for now, remains "monkeypox" (MPXV). It is closely related to the smallpox virus. MPXV was considered a <keyword id="21311828" type="General" weightage="20" keywordseo="zoonotic-disease" source="keywords">zoonotic disease</keyword> endemic in parts of central and west Africa. It was acquired mainly through close contact with wild mammals, especially handling bush meat, but there was no sustained human-to-human transmission. Only very occasionally were cases seen outside the endemic areas, due to infected travellers or import of infected small mammals. This changed abruptly in 2022: a massive, rapidly evolving global outbreak caused over 99,000 laboratory-confirmed cases in 116 countries. At its peak in August 2022, over 6,000 cases were reported each week. This outbreak came as a total surprise: most cases were reported from non-endemic countries, mostly in men who have sex with men, who had become infected during recent sexual encounters. Even though most cases were clinically not particularly severe and the death toll stands at just over 200, the global outbreak was declared a public health emergency of international concern by the <keyword id="19896311" type="General" weightage="20" keywordseo="world-health-organization" source="keywords">World Health Organization</keyword> on 23 July, 2022. Fortunately, case numbers soon plummeted due to a combination of behavioural changes and vaccination in at-risk groups. Modern vaccines and antiviral drugs with activity against mpox were made available in many affected high-income countries. These had been developed and stockpiled in the US and Europe, mostly in preparation for a potential bioweapon attack using a poxvirus. The global outbreak in 2022 was caused by clade II of MPXV, which is endemic in west Africa and not as virulent as clade I MPXV, which so far has only been seen in the Congo Basin. That first mpox public health emergency of international concern was declared over in May 2023. Clade II MPXV infections are still occurring globally, but the worst seems over - for now. Complacency would be misguided, as illustrated by the current mpox outbreak that is gathering steam. <h2>Upsurge in Africa</h2>The African region is experiencing an upsurge in mpox cases, which started in 2023. As the continent which includes the areas where mpox has been endemic for a long time, Africa now presents a complex mosaic. The current clade I MPXV (formerly called Congo Basin strain) is more virulent than the clade II (west African) strain, resulting in a higher case fatality rate. The ongoing outbreak has its epicentre in South Kivu province, eastern DRC, and has the potential to fuel a large pandemic. It has a distinct epidemiological pattern with sustained chains of human-to-human transmission, often via the sexual route. It may have increased transmissibility (we don't know yet). The virus which causes it is the newly defined clade Ib lineage. It displays mutations that are the hallmark of human-to-human spread that is estimated to have been happening since September 2023. Case numbers are rising rapidly, even though many suspected cases are likely not tested and thus not counted as confirmed. Complicating matters, a commonly used test was found to miss infections with this lineage of the virus. It affects mostly adults. The case fatality rate is higher than it was in the 2022 global outbreak. Already, this outbreak has resulted in mpox cases occurring in several neighbouring countries, including some (like Kenya), with no previous record of mpox. The challenge is enormous. The eastern DRC is an area beset by multiple problems. This includes natural disasters, violence and infectious diseases including measles, cholera and poliomyelitis for the DRC. In recent years the second-largest Ebola outbreak ever took place in the wider area and, despite the availability of vaccines and treatments, posed considerable challenges. <h2>What needs to happen</h2>Equitable access to diagnostic tests, vaccines and antiviral treatments requires political commitment and financial investments. Scientific investigations are needed to learn more about exposure settings, transmission routes and clinical presentations. It's important to find the best ways to make these interventions. There is no doubt that a disease in one corner of the world can suddenly become a global heath threat. It's time the global health system woke up to this reality.

Mpox outbreak in Africa was neglected - it could now turn into the next global pandemic

The World Health Organisation (<keyword id="19895006" type="General" weightage="20" keywordseo="WHO" source="keywords">WHO</keyword>) has announced that <keyword id="22989608" type="General" weightage="100" keywordseo="M-Pox" source="keywords">M-Pox</keyword> will continue to be classified as a <keyword id="21952478" type="General" weightage="20" keywordseo="public-health-emergency" source="keywords">public health emergency</keyword> of international concern (PHEIC), citing a resurgence in cases and the virus's ongoing geographic spread. The high-alert status initially declared in August, was reaffirmed following a meeting of the WHO Emergency Committee, The Express Tribune reported on Friday. The decision comes as M-Pox cases surge, particularly with the spread of the <keyword id="22875864" type="General" weightage="20" keywordseo="clade-Ib-variant" source="keywords">clade Ib variant</keyword> beyond its origin in the Democratic Republic of Congo to neighbouring African nations, Europe, and Asia. "Rising case numbers, the continuing geographic spread, and the need for a cohesive response have made it essential to maintain this emergency status," the WHO said in its statement. Confirmed cases of clade Ib have been detected in the United Kingdom, Germany, Sweden, and India, highlighting the global scale of the outbreak, reported The Express Tribune. M-Pox, a viral disease transmitted through close contact, presents flu-like symptoms and lesions. Although typically mild, it can be fatal, particularly in regions with inadequate healthcare. Over 46,000 suspected cases have been reported this year in Africa, with Congo accounting for the majority of the more than 1,000 suspected deaths. The new PHEIC declaration underscores the global threat posed by clade Ib and follows earlier alerts related to a separate strain during the 2022-2023 outbreak. In response to growing concerns, the WHO has expanded vaccine authorisations. Bavarian Nordic's <keyword id="24137585" type="General" weightage="20" keywordseo="M-Pox-vaccine" source="keywords">M-Pox vaccine</keyword> was approved earlier this year, with Japan's KM Biologics' vaccine added to the list of emergency-use vaccines in September. WHO officials have faced criticism for delays in <keyword id="21847727" type="General" weightage="20" keywordseo="vaccine-distribution" source="keywords">vaccine distribution</keyword> but stressed that vaccination remains a cornerstone of global response efforts, The Express Tribune reported. "The emergency status underscores the urgency to mount a unified global response," a WHO spokesperson stated. The organisation urged countries and health partners to collaborate on widespread vaccination campaigns and enhance public awareness to curb the virus's spread effectively.

M-Pox remains public health emergency: WHO

<ul class="summary-list"><li>The E. coli outbreak cases linked to McDonald's have widened to include 75 people in 13 states.</li><li>The CDC said it expects the real number to be higher, and that it can take weeks to identify a case.</li></ul>The <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-e-coli-outbreak-tied-quarter-pounders-2024-10">McDonald's E. coli outbreak</a> cases have increased to 75 people in 13 states as of Thursday, the US Centers for Disease Control <a target="_blank" class="" href="https://www.cdc.gov/ecoli/outbreaks/investigation-update-e-coli-o157-2024.html">said</a> in a Friday update.The CDC said it now has detailed information on 61 people who got sick, of whom 22 have been hospitalized. The one death, which was reported earlier, was an "older adult in Colorado," the health agency said.Michigan, New Mexico, and Washington are the most recent additions to the list of states where infected patients live. Colorado remains the epicenter of the outbreak, with 26 cases as of Thursday. In at least one <a target="_blank" class="" href="https://www.jsonline.com/story/news/health/2024/10/23/wisconsin-resident-contracted-e-coli-at-out-of-state-mcdonalds/75809518007/">case</a>, the infected person got sick from eating at a McDonald's in another state.<div type="image" title="A CDC map showing the states where cases of E. coli have been linked to McDonald's, as of October 24, 2024." height="553" width="737" msid="114596007" hostid="261" sizebytes="20192"></div>Officials say they <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-quarter-pounder-e-coli-outbreak-symptoms-states-2024-10">expect the real number to be higher</a> and continue to grow. Some infected patients may recover without testing, and it can take three to four weeks to confirm whether a case is part of the outbreak.The CDC reiterated that <a target="_blank" href="https://www.businessinsider.com/mcdonalds-ecoli-outbreak-investigation-update-compared-chipotle-2024-10">slivered onions and beef patties</a> used in McDonald's Quarter Pounder burgers are under investigation.McDonald's executives said in a briefing on Wednesday that the initial investigation points to contaminated ingredients, likely slivered onions, rather than the <a target="_blank" href="https://www.businessinsider.com/chipotle-hasnt-overcome-e-coli-fears-2018-3">mishandling or improper preparation of food</a>.Taylor Farms, McDonald's regional supplier of slivered onions, has issued a recall of its product, which has affected <a target="_blank" href="https://www.businessinsider.com/mcdonalds-supplier-taylor-farms-recalls-onions-amid-e-coli-outbreak-2024-10">several other restaurant brands</a>.McDonald's also said the potentially contaminated ingredients have been pulled from its restaurants, and Quarter Pounders are off the menu in impacted areas during the investigation.If you are a McDonald's worker who wants to share your perspective, please <a target="_blank" href="mailto:dreuter@businessinsider.com">contact Dominick via email</a> or text/call/Signal at 646.768.4750. Responses will be kept confidential, and Business Insider strongly recommends using a personal email and a non-work device when reaching out

More cases reported in McDonald's E. coli outbreak

The government's <keyword id="20039960" type="General" weightage="100" keywordseo="One-Health-approach" source="keywords">One Health approach</keyword> is vital for both predicting as well as preventing any future <keyword id="21218421" type="General" weightage="20" keywordseo="zoonotic-outbreaks" source="keywords">zoonotic outbreaks</keyword> (disease that jumps from animals to humans), health experts opined on Saturday, ahead of the <keyword id="135993" type="General" weightage="20" keywordseo="world-health-day" source="Orion">World Health Day</keyword> which is marked every year on April 7. This year's theme '<keyword id="21218422" type="General" weightage="20" keywordseo="my-health" source="Orion">My Health</keyword>, <keyword id="21218423" type="General" weightage="20" keywordseo="my-right" source="Orion">My Right</keyword>' focuses on equal access to quality health care. "The government's focus on the '<keyword id="6494932" type="General" weightage="20" keywordseo="one-health" source="Orion">One Health</keyword>' approach, recognising the interconnection between human, animal, and environmental health, is vital for predicting and preventing future zoonotic disease outbreaks," Dr. Rohit Garg, consultant, infectious disease, Amrita Hospital Faridabad, told IANS. The experts noted that the country's response to recent outbreaks of the Covid-19 pandemic and the Nipah virus demonstrates its evolving capacity to manage infectious diseases, adding that lessons from each event have helped the country improve its preparedness for future pandemics, including the hypothetical <keyword id="6328063" type="General" weightage="20" keywordseo="Disease-X" source="Orion">Disease X</keyword>. "India's response to recent disease outbreaks has been moulded by our experience with Covid-19. Recent moves to expand the existing network of biosafety-level 3 and 4 laboratories, to expand surveillance for respiratory viruses, invest in diagnostic infrastructure, and formulate a One Health approach towards emerging diseases are welcome and important steps towards tackling such challenges," Gautam Menon, Dean, Research and Professor of Physics and Biology, Ashoka University, told IANS. Besides ramping up testing facilities, expanding healthcare infrastructure, contact tracing during the pandemic and the vaccination drive were among India's significant measures. The latter was one of the largest globally, with India also developing an indigenous vaccine, Covaxin, alongside deploying other vaccines. "These actions highlighted the country's ability to mobilise vast resources and innovate under pressure," said Dr Rohit. Similarly, during the Nipah virus outbreaks, although more localised, India employed rapid response teams, enhanced surveillance and implemented containment measures. "India, post-pandemic, is very different in terms of capacity for pathogen surveillance and pandemic prevention or control when compared to pre-pandemic times. This is partly infrastructural, in terms of greater scientific and health capacity, but mostly structural in terms of better-defined roles for existing organisations, and creation of new multi-stakeholder institutions e.g. for OneHealth," Anurag Agrawal, Dean of Bio Sciences and Health Research at Trivedi School of Biosciences at Ashoka University, told IANS.

Ahead of World Health Day, experts reiterate importance of govt's One Health approach in preventing future zoonotic outbreaks

<ul class="summary-list"><li>McDonald's is investing $100 million into recovering from an E. coli outbreak, CNN reported.</li><li>McDonald's said the outbreak led to a drop in restaurant visits and sales.</li></ul>McDonald's is reportedly spending $100 million to lure customers back to stores following an <a target="_blank" href="https://www.businessinsider.com/mcdonalds-quarter-pounder-ecoli-outbreak-why-important-sales-2024-10">E. coli outbreak</a> linked to slivered onions served on Quarter Pounder hamburgers.$35 million of the investment is going toward marketing, including a value deal centring on the chain's chicken nuggets, according to a memo sent to employees seen by CNN.An additional $65 million will be spent on the franchisees that were worst affected by the outbreak, it said.McDonald's did not immediately respond to a request for comment from Business Insider.More than 100 people across 14 states were infected by the outbreak; 34 were hospitalized and one died, according to the US Centers for Disease Control and Prevention."Slivered onions are the likely source of illness in this outbreak," the CDC said. The supplier of the topping issued a recall.McDonald's stock is down just over 7% in the past month.<a target="_blank" href="https://www.businessinsider.com/mcdonalds-store-visits-sales-drop-e-coli-outbreak-2024-10">McDonald's said in its third-quarter earnings that store visits and daily sales also took a hit</a> as some customers stayed away from <a target="_blank" href="https://www.businessinsider.com/mcdonalds-sales-dropped-second-quarter-in-a-row-sharees-down-2024-10">its restaurants</a> during the health scare.Its new marketing campaign will reportedly include TV ads that showcase a 10 McNuggets for $1 deal that can be redeemed through the chain's app."The relevance, trust, and love for the Golden Arches has been hard-earned over nearly 70 years by our unwavering commitment to do the right thing. The past three weeks have only further exemplified that," read the memo seen by CNN that was signed by Michael Gonda, chief impact officer for North America, and Tariq Hassan, chief marketing and customer experience officer.

McDonald's is reportedly spending $100 million to help lure customers back after the E. coli outbreak

<ul class="summary-list"><li>McDonald's Quarter Pounders have been linked to an <keyword id="22099782" type="General" weightage="100" keywordseo="E-coli-outbreak" source="keywords">E. coli outbreak</keyword> in several states, the CDC said.</li><li>McDonald's said it will temporarily remove the burgers from its menus in affected areas.</li></ul>A deadly E. Coli outbreak has been linked to the <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-e-coli-outbreak-tied-quarter-pounders-2024-10">McDonald's Quarter Pounder</a>. So far, one person has died, and 10 others have been hospitalized in connection with the outbreak, which impacted 49 people across 10 states, the Centers for Disease Control and Prevention said Tuesday. McDonald's said it believes the outbreak may be linked to the slivered onions used on its Quarter Pounder. The fast-food chain said it is temporarily taking the burger off the menu in several states. "Negative <keyword id="20000858" type="General" weightage="20" keywordseo="food-safety" source="keywords">food safety</keyword> news is never welcomed by restaurants operators, especially those working to improve the brand image after getting off-sides on consumer affordability in recent years," Jon Tower, an analyst at Citigroup, said in a note to clients, according to <a target="_blank" class="" href="https://www.bloomberg.com/news/articles/2024-10-22/mcdonald-s-quarter-pounders-linked-to-e-coli-outbreak-cdc-says?srnd=homepage-americas&amp;sref=yaJhKSOh">Bloomberg</a>. Tower said McDonald's outlook depends on the company's response, which should include taking responsibility, controlling the outbreak, and overcorrecting on food safety, the outlet reported. Examining how other fast-food giants have recovered from recent health-related crises might also provide insight into how McDonald's will try to recover from the incident. <h2>How Chipotle and Wendy's came back from health-related problems</h2>Several fast-food brands have bounced back from food-safety incidents before. One of those is Chipotle, the fast-casual Mexican chain that McDonald's had a <a target="_blank" href="https://www.businessinsider.com/the-ridiculous-reason-mcdonalds-sold-chipotle-2015-5">90% stake in</a> until 2006. In 2015 and 2016, hundreds of customers reported becoming ill after eating at Chipotle outlets. Chipotle's stock price plummeted, and the company eventually agreed to pay a $25 million <a target="_blank" href="https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/chipotle-mexican-grill-agrees-pay-25-million-fine-resolve-charges-stemming-more-1100-cases-foodborne">fine</a> to settle criminal charges related to outbreaks that impacted 1,100 people between 2015 and 2018. But less than five years later, the company and its stock price had <a target="_blank" class="" href="https://www.nytimes.com/2019/07/23/business/chipotle-stock-earnings.html">recovered</a>. So what did Chipotle do? In 2016, the company <a target="_blank" class="" href="https://ir.chipotle.com/news-releases?item=122453">announced</a> a spate of <a target="_blank" class="" href="https://www.nytimes.com/2016/09/22/business/every-days-a-safety-drill-as-chipotle-woos-customers-back.html?rref=collection%2Fbyline%2Fstephanie-strom">new food-safety protocols</a> — such as rinsing produce multiple times and putting stickers on food storage containers to indicate when they were sanitized — and hired James Marsden,a professor from Kansas State University, to serve as executive director of food safety. In 2017, Chipotle <a target="_blank" class="" href="https://ir.chipotle.com/news-releases?item=122384">announced</a> its founder, Steve Ells, would be stepping down as CEO in favor of someone with "demonstrated turnaround expertise." In 2018, Brian Niccol, currently the CEO of Starbucks, <a target="_blank" class="" href="https://ir.chipotle.com/news-releases?item=122376">took over</a> as the CEO of Chipotle after a successful stint at the helm of Taco Bell. Niccol told <a target="_blank" class="" href="https://www.nytimes.com/2019/07/23/business/chipotle-stock-earnings.html">The New York Times</a> in 2019 that Chipotle had become "an industry leader" in food safety, adding: "We're doing some really progressive things on the food safety front, and we're going to have to, because we're going to stay committed to using real ingredients." Chipotle's recovery may also have hinged on expanding the business in areas unrelated to food safety. "They are exceptional in how well the brand has capitalized on digital ordering," Sara Senatore, a Bernstein analyst who followed Chipotle, told <a target="_blank" class="" href="https://www.nytimes.com/2019/07/23/business/chipotle-stock-earnings.html">the Times</a> in 2019. Wendy's dealt with a similar situation. Between July and August 2022, Wendy's restaurants were linked to an E. coli outbreak in six states, per <a target="_blank" class="" href="https://archive.cdc.gov/www_cdc_gov/ecoli/2022/o157h7-08-22/index.html">the CDC</a>. A total of 109 people were infected, with 52 hospitalized. No deaths were reported. An investigation into the incident was unable to determine the specific food source responsible for the outbreak, but 46 people reported eating romaine lettuce served on the burgers and sandwiches before falling sick, per <a target="_blank" class="" href="https://archive.cdc.gov/www_cdc_gov/ecoli/2022/o157h7-08-22/details.html">the CDC</a>. As a precaution, the fast-food chain removed romaine lettuce from menu items in the affected states. Despite the E. coli outbreak, the company's US sales <a target="_blank" class="" href="https://s1.q4cdn.com/202642389/files/doc_financials/2022/q3/2022-Q3-Press-Release.pdf">jumped 7.7% in the third quarter of 2022</a>, compared with the year prior. In its latest <a target="_blank" href="https://www.wendys.com/csr-what-we-value/reports">corporate responsibility report</a>, published in May, Wendy's said it was committed to continuously improving its food safety standards and operational procedures and has conducted over 12,000 Food Safety Assessments in its restaurants worldwide. <h2>What McDonald's should do</h2>The McDonald's case differs from similar incidents at other <keyword id="20697449" type="General" weightage="20" keywordseo="fast-food-chains" source="keywords">fast-food chains</keyword> primarily due to the iconic status of the Quarter Pounder, Alexandra Leung, the founder of <a target="_blank" class="" href="https://monogic.co/">Monogic</a>, an F&amp;B marketing and PR agency in Singapore and Hong Kong, told Business Insider. "As a classic menu item, any food safety issue involving the Quarter Pounder could significantly impact consumer trust and brand reputation, making it a more sensitive issue for McDonald's," she said. The Quarter Pounder is important to McDonald's menu — and to its brand more broadly. Menu "classics" like the Quarter Pounder <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-quarter-pounder-ecoli-outbreak-why-important-sales-2024-10">have made up a bulk of food sales</a> in McDonald's top markets in recent years. The company's stock price tumbled nearly 10% in after-hours trading on Tuesday, following the news. However, Leung said the company's well-established food safety management system and history of rigorous supplier audits may allow for a more effective response. The fast-food chain will also have to conduct thorough audits of its suppliers' practices, she said. In addition to removing any affected items from the menu, McDonald's should also communicate clearly with its customers throughout the process, Leung said. "Clear messaging about the steps being taken to ensure food safety is vital. This proactive approach will help reassure customers that their health is a top priority," Leung said. "Transparency is crucial in rebuilding trust with customers, as it demonstrates accountability and a commitment to their safety." October 24, 2024 — An earlier version of this story mentioned a product recall of the affected items, McDonald's has not confirmed an official recall.

How McDonald's can learn from other fast-food giants in recovering from the deadly E. coli outbreak

<ul><li>The CDC randomly inspects and <a href="https://www.businessinsider.com/cleanest-cruise-ships-cdc-inspections-2024-10" target="_blank">scores cruise ships</a> to prevent the spread of stomach viruses.</li><li>Vessels inspected so far in 2024 have scored an average of 95.7 out of 100. A score of 85 or less is considered unacceptable.</li><li>The dirtiest ships this year so far scored 89 or less, including one that received 62 points.</li></ul> On most exams, a "B" is considered a passing grade. For cruise ships, scoring an 85 out of 100 on the Centers for Disease Control and Prevention's <a href="https://www.businessinsider.com/cruise-ships-best-worst-sanitation-scores-list-cdc-norovirus-2023-7" target="_blank">Vessel Sanitation Program</a> review is considered a failure. The CDC has reported <a href="https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html" target="_blank">10 bacterial and viral outbreaks</a> on cruise ships since the start of 2024. Most cases have been norovirus, as these often-packed floating hotels can quickly propagate the highly contagious bug through contaminated water, food, surfaces, and people. If you're one of its unlucky victims, it could quickly ruin your vacation — the four predominant <a href="https://www.businessinsider.com/celebrity-cruises-constellation-cruise-ship-norovirus-stomach-flu-outbreak-2024-1" target="_blank">symptoms of norovirus</a>, also known as the stomach flu, are vomiting, diarrhea, nausea, and stomach pain. <div type="image" title="Radiance of the Seas, sailing near the South Franklin dock, Juneau, Alaska, in 2016. There are mountains with a blue-gray hue behind the ship." height="3680" width="7360" msid="114171501" hostid="261"></div> To mitigate these outbreaks, the CDC randomly conducts sanitary inspections on cruises without prior notice to the vessel. The public health agency then scores the ship from zero to 100, with outcomes of 85 or lower considered inadequate. The review includes checking common spaces such as kitchens, hot tubs, and children's activity centers. Obvious issues, such as vermin and improperly stored foods, will dock points. So will less-apparent issues, such as buffet handwashing stations with light sources less than 110 lux and the swimming pool's hair and lint strainer not being disinfected frequently enough. <div type="image" title="pool on Carnival Firenze cruise ship with people around the deck" height="1725" width="2300" msid="114171500" hostid="261"></div> The CDC has performed 119 inspections so far in 2024, including repeat inspections on five ships. The average score is about 95.7 — 20 vessels achieved perfect marks. But 10 vessels didn't break into the 90s range, including one that failed to pass, and Ritz-Carlton Yacht Collection's ultra-luxury <a href="https://www.businessinsider.com/photos-ritz-carltons-new-luxury-cruise-ship-sail-this-week-2022-10" target="_blank">Evrima</a>: <ol><li><keyword id="23631205" type="General" weightage="20" keywordseo="Crystal-Serenity" source="keywords">Crystal Serenity</keyword> — Crystal Cruises, scored 89 (inspected February 3)</li><li>Carnival Elation — Carnival Cruise Line, scored 89 (inspected March 14)</li><li>Adventure of the Seas — Royal Caribbean International, scored 89 (inspected January 23)</li><li>National Geographic Sea Bird — Lindblad Expeditions, scored 88 (inspected July 25)</li><li>Carnival Miracle — Carnival Cruise Line, scored 88 (inspected April 21)</li><li>MSC Magnifica — MSC Cruises, scored 86 (inspected May 17)</li><li>Evrima — Ritz-Carlton Yacht Collection, scored 86 (inspected February 9)</li><li>Carnival Breeze — Carnival Cruise Line, scored 86 (inspected March 21)</li><li>Caribbean Princess — Princess Cruises, scored 86 (inspected March 20)</li><li>Hanseatic Inspiration — Hapag-Lloyd Cruises, scored 62 (inspected September 29)</li></ol>An 11th vessel, <a href="https://www.businessinsider.com/photos-i-sailed-margairatvilles-new-cruise-ship-wont-again-2022-5" target="_blank">Margaritaville at Sea Paradise</a>, received a failing score of 83 on May 1 but passed a subsequent inspection with a 92 on July 2. The CDC performed 181 cruise inspections in 2023. Only one, MSC Seaside, hit below 85, scoring 67 when it was inspected in April 2023. However, it was reinspected three months later and received a 92. According to the public health agency's <a href="https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx" target="_blank">cruise review database</a>, since 1991, 50 ships have received scores below 85, with 75 total failed inspections. Hanseatic Inspiration is tied with Rederij Clipper Stad Amsterdam's Stad Amsterdam for the sixth-lowest score ever, though the latter most recently received 91 in 2019. The CDC's review of <a href="https://wwwn.cdc.gov/InspectionQueryTool/InspectionDetailReport.aspx?ColI=MjM2ODAxNzM%3d-CadqKFLR8PA%3d" target="_blank">Hapag-Lloyd's vessel</a> noted violations such as a maggot-infested decomposing bird under the outdoor grill and dead insects in areas with food. <h2>What the cruise lines have said</h2> <div type="image" title="Hanseatic Inspiration on water" height="2936" width="4674" msid="114171504" hostid="261"></div> A spokesperson for Hapag-Lloyd told Business Insider the score didn't reflect the company's standards. Following the inspection, the cruise line conducted an internal investigation and "intensive training sessions with external and internal trainers," it said. It plans to submit its corrective report to the CDC on time (the Vessel Sanitation Program manual states companies must submit their "corrective-action statements" within two weeks of receiving the CDC's final report). A Crystal Cruises spokesperson told BI most of <a href="https://www.businessinsider.com/crystal-2026-world-cruise-27-countries-on-luxury-ship-2024-3" target="_blank">Crystal Serenity's</a> violations were "operational items" that had since been addressed and corrected "through harmonization of procedures and additional training with our crew." <div type="image" title="The Crystal Serenity in Stockholm sailing near land." height="1725" width="2300" msid="114171508" hostid="261"></div> Similarly, a spokesperson for MSC Cruises told BI it had implemented an "improvement plan" on <a href="https://www.businessinsider.com/msc-four-month-world-cruise-photos-2023-12" target="_blank">MSC Magnifica</a> according to the CDC inspector's suggestions. Many of the changes were immediate and only needed "minor" efforts, it said. The cruise line said that it believes Magnifica's score "is not a true reflection of the ship as it is today" and that it would "welcome any future inspection." MSC noted that many of its ships frequently achieve above 90, including the MSC Meraviglia and MSC Seashore, which both received perfect marks in 2024. Carnival, Royal Caribbean, Lindblad Expeditions, <a href="https://www.businessinsider.com/ritz-carlton-second-luxury-cruise-ship-ilma-yacht-2023-3" target="_blank">the Ritz-Carlton Yacht Collection</a>, and Princess Cruises didn't respond to a request for comment. Correction: October 17, 2024 — An earlier version of this story misstated how many cruise ships had failed CDC inspections so far in 2024. Two ships failed, though one later received a passing score. The story was updated to clarify that the ship's second score was not low enough to be included on the list of lowest scores. The story also misrepresented some CDC figures. The numbers 119 in 2024 and 181 in 2023 referred to the number of CDC inspections, not the number of individual ships inspected. Similarly, 50 different ships, not 75, have received failing scores since 1991, with some doing so more than once. The story also misstated how many ships have achieved perfect scores in 2024. Twenty have done so, not 19. The story was updated to clarify that most ships in 2024 have scored at least 95, not 95 exactly.

These are the 10 dirtiest cruise ships, according to the CDC — including an ultra-luxury vessel

<ul><li>The CDC randomly inspects and scores cruise ships to prevent the spread of stomach viruses.</li><li>So far, in 2024, 20 cruise ships have received a <keyword id="20578970" type="General" weightage="20" keywordseo="perfect-score" source="keywords">perfect score</keyword>. </li><li>Norovirus can spread quickly on packed vessels.</li></ul>Cruise ships don't always have a squeaky-clean reputation for being ultra-clean. After all, there's a reason they've been infamously dubbed "floating Petri dishes." Not all floating resorts are created — or operated — equally. The Centers for Disease Control and Prevention randomly conducts sanitary inspections on cruise ships throughout the year. So far in 2024, 20 vessels have received perfect scores. At the same time, the public health agency has reported 10 bacterial and viral outbreaks — mostly norovirus — on ships since the start of the year. Half have been on ships from <keyword id="20102018" type="General" weightage="20" keywordseo="Royal-Caribbean" source="keywords">Royal Caribbean</keyword> Group's main cruise line and its Celebrity Cruises subsidiary. Overall, the number of outbreaks so far is fewer than in 2023, which saw 14 in total. <div type="image" title="img670584923f2165d716df579e" height="3680" width="7360" msid="114117469" hostid="261" caption="&amp;lt;p&amp;gt;Royal Caribbean&amp;#39;s Radiance of the Seas had two outbreaks in 2024, one from norovirus and the other from salmonella.&amp;lt;/p&amp;gt;"></div> The highly contagious norovirus, also known as the stomach flu, is the most common virus to afflict cruises. These often-packed floating hotels create the ideal environment for the highly contagious bug to spread fast, typically through contaminated water, food, surfaces, and people. Just as quickly, it can ruin your vacation — the four predominant symptoms are vomiting, diarrhea, nausea, and stomach pain. To help mitigate these incidents, the CDC's Vessel Sanitation Program regularly inspects cruise liners and scores them from zero to 100. <div type="image" title="16 Cruise liner MSC Meraviglia is berthed at a dock in Punta Langosta in Cozumel" height="1333" width="1777" msid="114117473" hostid="261"></div> The review — which includes checking common spaces such as kitchens, pools, and children's activity centers — is random and unannounced. As expected, vermin and improperly stored foods are a big no-no. But inspectors are also closely watching behind the scenes for smaller, more-nuanced details such as how frequently the hair and lint strainer in the swimming pool is disinfected or the water temperature of the dish washer. So far, in 2024, the CDC has performed 119 inspections. The majority scored above 95, and 20 (listed below) have received perfect marks: <ul><li>Carnival Spirit — Carnival Cruise Line (inspected September 3)</li><li>Zuiderdam — Holland America Line (inspected August 24)</li><li>Viking Orion — Viking Ocean Cruises (inspected August 18)</li><li>Seabourn Odyssey — Seabourn Cruise Line (inspected August 16)</li><li>Norwegian Jewel — Norwegian Cruise Line (inspected July 24)</li><li>Oceania Regatta — Oceania Cruises (inspected July 24)</li><li>Radiance of the Seas — Royal Caribbean International (inspected July 21)</li><li>MSC Meraviglia — MSC Cruises (inspected July 9)</li><li>Norwegian Bliss — Norwegian Cruise Line (inspected June 22)</li><li>MSC Seashore — MSC Cruises (inspected May 26)</li><li>Norwegian Sky — Norwegian Cruise Line (inspected May 23)</li><li>Brilliance of the Seas — Royal Caribbean International (inspected May 16)</li><li>Viking Polaris — Viking (inspected April 2)</li><li>Celebrity Equinox — Celebrity Cruises (inspected February 25)</li><li>Norwegian Breakaway — Norwegian Cruise Line (inspected February 25)</li><li>Norwegian Escape — Norwegian Cruise Line (inspected January 27)</li><li>Explora I — MSC Cruises (inspected January 25)</li><li>Disney Fantasy — Disney Cruise Line (inspected January 24)</li><li>Celebrity Ascent — Celebrity Cruises (inspected January 7)</li><li>Norwegian Gem — Norwegian Cruise Line (inspected January 2)</li></ul> This time last year, 29 ships had achieved 100. By the end of 2023, 34 vessels racked a perfect score. Correction — October 17, 2024: An earlier version of this story contained an incorrect photo caption. The causes of outbreaks on Royal Caribbean's Radiance of the Seas ship were norovirus and salmonella, the CDC found. Also, an earlier version of this story incorrectly stated there are 18 ships that have received perfect scores so far this year. There are 20. Also, so far in 2024, the CDC has performed 119 inspections, not inspections on 119 individual ships, as some were repeat inspections.

These are the cleanest cruise ships this year, according to the CDC — including 18 with perfect scores       

<ul class="summary-list"><li>Victims of the E. coli outbreak linked to McDonald's are preparing to sue.</li><li>At least one has already filed a lawsuit alleging negligence has been filed.</li></ul>Victims who have been sickened in connection to the <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-e-coli-outbreak-tied-quarter-pounders-2024-10">deadly E. coli outbreak linked to McDonald's</a> famed Quarter Pounders are already lawyering up.Top food safety attorney Ron Simon of the Houston, Texas-based law firm Ron Simon &amp; Associates told Business Insider Wednesday that his phones have been "ringing off the hook" after federal health officials reported the outbreak Tuesday."When we came to the office this morning, we had 100 intakes, 100 phone calls, and emails asking us to represent them," the veteran attorney said. "So our staff is right now going through all of those and determining which are cases."As of Wednesday afternoon, Simon's firm had already been retained by at least 12 people who, according to the attorney, recently tested positive for an E. coli infection after eating <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-quarter-pounder-ecoli-outbreak-why-important-sales-2024-10">McDonald's meals</a>.One of those people, a Colorado man, brought the first lawsuit against the fast-food giant Wednesday — and Simon says he expects his firm to file dozens more lawsuits in the coming days."We will file individual lawsuits on behalf of each of our clients," said Simon, who noted the people he is currently representing range in age from as young as 15 to 55-years-old."Each of the lawsuits will seek compensation for their lost wages, for the significant medical bills they're going to incur, and also to compensate them from the pain and suffering of becoming sick and even hospitalized," Simon said.At least three of Simon's clients have been hospitalized as a result of their E. coli infection, according to the attorney.Simon called the outbreak "a completely preventable tragedy.""If you properly test the food and your ingredients before you put them into service, before you serve them, there shouldn't be outbreaks," he said.Colorado resident Eric Stelly alleges in his lawsuit that he ate food from his local McDonald's in the city of Greeley on October 4 and two days later fell ill with E. coli symptoms, which include bloody diarrhea and vomiting.By October 8, Stelly was hospitalized and he later tested positive for the E. coli O157:H7 strain — the same E. coli strain federal health officials said was linked to the outbreak — the lawsuit, filed by Simon's firm along with the firm Meyers &amp; Flowers, LLC, says.The lawsuit, which alleges negligence by McDonald's, says that health investigators confirmed Stelly was part of the E. coli outbreak linked to McDonalds.Representatives for McDonald's did not immediately respond to a request for comment by BI.In a statement, Simon said the <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-ecoli-outbreak-investigation-update-compared-chipotle-2024-10">McDonald's-related E. coli outbreak</a> "will be one of the most significant food poisoning outbreaks this year.""Through this lawsuit and others, we will make sure that all of the victims are fully compensated for their losses, that their voices are heard, and that McDonald's and its suppliers permanently fix the health and safety violations that caused their food to become contaminated with E. coli," he said.Simon — who also filed a <a target="_blank" class="" href="https://www.businessinsider.com/boars-head-listeria-outbreak-deli-meat-death-holocaust-survivor-2024-9">wrongful death lawsuit</a> on behalf of a Holocaust survivor's family against Boar's Head in connection to the recent deli meat listeria outbreak — told BI that he expects McDonald's to settle the anticipated onslaught of claims for millions of dollars."It would be gross negligence on McDonald's part not to try to resolve these cases," Simon said. "There were clearly mistakes made in the testing process — food that was supposed to be safe was not safe. It was contaminated."The Centers for Disease Control and Prevention said Tuesday that the E. coli outbreak has so far sickened at least 49 people across 10 states and resulted in one death. The outbreak was linked to 10 hospitalizations, with most of the illnesses occurring in Colorado and Nebraska, according to the CDC.Most people impacted reported eating McDonald's Quarter Pounder hamburgers before becoming sick, the federal agency said.Investigators are working to confirm which ingredient in the hamburgers is responsible for the contamination.McDonald's said it paused the distribution of <a target="_blank" class="" href="https://www.businessinsider.com/mcdonalds-ecoli-outbreak-investigation-update-compared-chipotle-2024-10">slivered onions</a> in the Quarter Pounder and temporarily removed the burger from restaurants in the impacted areas.

Top food safety lawyer says his phones are 'ringing off the hook' after McDonald's E. coli outbreak 

<ul class="summary-list"><li>McDonald's Quarter Pounders are making people sick with E. coli, the CDC said Tuesday.</li><li>One person has died, and 10 others have been hospitalized after eating the hamburgers, the agency said.</li></ul>McDonald's shares dropped more than 9% on Tuesday after the Centers for Disease Control and Prevention said one person died and ten others were hospitalized in connection with an E. coli outbreak linked to the fast food chain's Quarter Pounders.The health agency said the "fast-moving" outbreak is primarily affecting people in Nebraska and Colorado. It added that most people affected reported eating a Quarter-Pound hamburger.The fast food chain did not immediately respond to Business Insider's request for comment.A total of 49 cases across 10 states have been reported so far, but the extent of the outbreak is "likely much higher," the CDC saidAccording to the CDC, McDonald's has pulled some ingredients from the burgers and paused Quarter-Pound sales in some states. Investigators are working to determine which ingredient is making people sick.The company's shares plunged about 9% in extended training on Tuesday following the announcement.

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