The global worry over Ebola hit the open sea Friday as a Texas cruise passenger who might have handled lab samples from an infected patient remained isolated — though healthy — in her stateroom.
A day after the government in Belize declined to let the unidentified passenger disembark to fly back to Texas, Carnival Cruise Lines said Mexican authorities delayed permission to dock in Cozumel for so long that the Carnival Magic left to return to its home port in Galveston, Texas.
“We greatly regret that this situation, which was completely beyond our control, precluded the ship from making its scheduled visit to Cozumel and the resulting disappointment it has caused our guests,” Doral-based Carnival said in a statement.
With 4,212 passengers and 1,381 crew on board, the ship is scheduled to return to Texas on Sunday morning as scheduled. Passengers on the vessel, who have been updated with public announcements and letters, will get a credit of $200 per person and a 50 percent discount on a future cruise.
The guest in question, a lab supervisor at Texas Health Presbyterian Hospital, remains in isolation with her spouse, though Carnival said she “continues to show no symptoms of illness and poses no risk to the guests or crew on board.”
The incident was a high-profile test of plans that the cruise industry has been quietly putting into place to prepare for the deadly disease. The Cruise Lines International Association and its members have been working on recommended guidelines for the past few weeks, including one adopted Thursday: a “contact protocol” that would deny boarding to any passengers who might have had contact with or helped care for someone with Ebola within 21 days.
Other measures include denying boarding to passengers and crew arriving from countries with a “Level 3” travel health warning from the Centers for Disease Control and Prevention — Guinea, Sierra Leone and Liberia at the moment — or anyone who visited or traveled through those countries less than 21 days before boarding a ship. Guests also must answer health-related questions, which could lead to additional medical screening.
The lab supervisor boarded the Carnival Magic in Galveston on Sunday. According to the State Department and CDC, the supervisor had no direct contact with Thomas Eric Duncan, who died Oct. 8 at the hospital.
“She was not in a risk category that required restriction of movement based on CDC’s movement and monitoring guidelines,” CDC spokeswoman Kathy Harben said in an email.
The worker was self-monitoring and taking her temperature daily since Oct. 6, with normal results, Harben said.
But Harben said the woman was moved into the “active monitoring category — having her temperature taken and being monitored for symptoms by another healthcare professional — after the uncertain exposure and Ebola diagnosis of the first healthcare worker,” which the CDC confirmed late Sunday afternoon.
A second nurse who treated Duncan tested positive for Ebola on Tuesday.
Carnival said it was notified Wednesday afternoon by the CDC that one of its passengers had been in the lab at the Dallas hospital with the Ebola testing samples.
Spokeswoman Jennifer de la Cruz said Friday that 19 days had passed since the woman was in the lab with Ebola testing samples. The quarantine period is 21 days.
“She is deemed by the CDC to be very low risk,” de la Cruz wrote, adding that the CDC’s decision to isolate the passenger starting Thursday morning was made “in an extreme abundance of caution.”
The ship stopped in Belize on Thursday, and all passengers except the lab supervisor and her spouse were allowed to disembark. At that point, de la Cruz said, “the U.S. government did attempt to make arrangements to fly the guests home from Belize, but that effort was unsuccessful.”
In a briefing Friday, Marie Harf, deputy spokesperson for the U.S. Department of State, said Belize could have handled the situation “differently.”
“We had hoped that there might be a path forward here for this passenger to disembark there and come home, but that unfortunately was not the case,” Harf said.
The decision from the Belizean government — and Mexico’s hesitation Friday — came after a number of Caribbean countries and Colombia announced bans on travelers from West Africa and tightened their borders.
Speaking to CNN Friday afternoon, Carnival CEO Arnold Donald did not criticize the ports but shifted focus to the cruise industry’s level of preparedness.
“We have a lot of practices in place,” Donald said. “We’ve had incidents in the past — SARS, H1N1, we’ve had a lot of experience. … There are protocols established for everything; the CDC has protocols in place. As they expand the protocols, we follow those.”
He added: “First and foremost, health and safety for our guests and for our crew is always paramount.”
Mike McGarry, CLIA’s senior vice president of public affairs, said in an email that in the “unlikely event” a guest or crew member showed symptoms and was at risk for Ebola, they would be immediately isolated and managed by ship medical personnel, who have access to personal protection equipment. The passenger or crew member would be taken off the ship at the “closest, capable medical facility or, as appropriate, repatriated to their country of origin or the ship’s home port nation.”
Response plans are in place for cleaning rooms that might require special sanitation, he said, and disinfecting areas affected by any suspected or confirmed case of Ebola would be done “in close consultation with public health authorities.”
McGarry said shipboard procedures to prepare for the latest threat have been developed beyond existing health precautions “using guidance from public health authorities specifically with regard to Ebola.”
Miami Herald staff writer Jacqueline Charles contributed to this report.