Infectious Diseases on Cruise Ships And How to Protect Yourself

When we think of cruise ships we envision sandy beaches, gentle breezes aboard long decks and gorgeous people at the ship pool. There’s the promised gourmet meals, tropical drinks and more fund than you can cram into a day.

What you don’t picture is a cruise spent in the bathroom or hospital. Unfortunately for many tourists that’s what they get. This is because cruise ships have become floating incubators. Yes, 4,000 people jammed onto a floating city in the middle of the Caribbean can create quite an infectious disease haven.

infectious diseases on cruise ships

In recent years many cruises have returned with a high percentage of its guests suffering from infectious disease, most often the dreaded Norovirus, known as the King of the cruise ship diseases. With 22 million people traveling by cruise liner each year, this issue requires addressing.

In fact, in one week in 2017 two separate cruise ships by Royal Caribbean – The Ovation of the Seas and Independence of the Seas – both had independent Norovirus outbreaks.

Why are we seeing this increase in infectious diseases aboard cruise ships?

There are a number of possibilities. Travelers from all over the world are suddenly brought together aboard a ship of limited size. People are herded from one meal or event to another, often in large crowds close together. The presence of so many people in semi-enclosed environments can aid in the spread of person-to-person, foodborne, or waterborne diseases.

The crew on these ships can become infected and pass it along to passengers on several different cruises, making identification of the original source difficult. Then you have shore excursions and visits to exotic ports. These can expose tourists to local diseases to which their bodies may not have been previously exposed. 

Then you have the medical care provided on ships. Not exactly the cutting edge in medicine, shipboard medical capabilities, and what is available on the ships, are often lacking.

To make matters worse, many cruises are filled with older travelers. Half of all passengers who seek medical care aboard cruise ships are over 65 years old.

The most common infections are the gastrointestinal (G.I.) disorder known as Norovirus. Over 100,000 people have succumbed to Norovirus on cruise ships.

Because of the explosion of frequency of these viruses, the United States Center for Disease Control (CDC) has developed a Vessel Sanitation Program (VSP), which now requires cruise ships to log and report the number of passengers and crew who report that they have symptoms of gastrointestinal illness (most often norovirus).

The cruise ship medical staff for all cruises that port in the U.S. must send gastrointestinal illness case reports to VSP. There were 13 reported cruises in 2016 and 11 in 2017. So far in 2018 there have been 9 reports.

One of the reasons why the Norovirus spreads so quickly aboard cruise ships is because it doesn’t take much or the virus to cause illness. It only takes as little as 20 virus particles to transmit norovirus, while most infections require 100 or 1,000 times that amount.

Considering that someone infected with Norovirus has 70 billion particles per gram of stool, one doctor has postulated that even with good bathroom hygiene someone in a restroom can easily infect everyone else in there. A Doctor Explains Why Cruise Ships Should Be Banned, https://www.thedailybeast.com/a-doctor-explains-why-cruise-ships-should-be-banned?ref=scroll, 11/19/2014.

Yes, cruise ships are now notifying passengers when there is an outbreak aboard. No, that will not prevent infection but will make everyone acutely aware that there is an outbreak.

What should you expect if you contract Norovirus? Most of the time the symptoms are stomach and intestinal upset. They can appear flu-like even though this is not related to influenza. You will likely experience nausea, vomiting, diarrhea and abdominal cramps, as well as a low-grade fever.

This generally lasts one to three days.  It is important to fight dehydration by drinking plenty of liquids and resting.

How to protect against infectious diseases on cruise ships

The best defense is vigorous and frequent hand washing. This is particularly true before eating or touching your face.  It may be quite difficult to avoid catching Norovirus once it has taken hold on a ship. The close quarters and large passenger group means everyone risks infection every time they go near other people. And on cruise ships we are always surrounded by people. One of the rarest sights aboard a cruise ship is empty space.

For most cruisers, the risk of an infectious disease while traveling is considered small. By taking precautions, tourists can minimize their chances for contracting Norovirus and other infections. If you do get sick, seek immediate medical attention onboard, drink lots of fluids, wash your hands continuously, and stay away from other passengers.