How likely are you to get ill on a cruise as norovirus cases rise?
Some have branded ships as floating petri dishes – but the numbers show this is an unfair accusation
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Stomach bugs and norovirus are a regular health issue on land and sea but cruise lines seem to unfairly gain most of the attention when it comes to an outbreak.
The Centers for Disease Control and Prevention (CDC) classified 2024 as the worst year for stomach illness outbreaks on cruise ships.
It recorded 16 outbreaks last year, with norovirus or sickness bugs the cause for 11. Other causes include food poisoning.
High profile outbreaks recently include Holland America Line’s Zuiderdam, Princess Cruises’ Ruby Princess and Cunard Line’s Queen Mary 2.
These figures only cover ships that visit a US port.
P&O Cruises also faced a suspected norovirus outbreak aboard Iona in the North Sea last month.
But the 30 million or so passengers that go on a cruise each year actually face a small chance of getting ill, and you may be more at risk of catching a sickness bug on land.
In fact, data from the CDC actually shows occurrences of gastrointestinal illnesses are rare on cruise ships with a 1 in 5,500 chance compared to one in 15 on land.
Here is what you need to know about your chances of getting sick at sea.
Read more: How to avoid getting seasick on a cruise
With often thousands of people congregating in sometimes confined spaces, it is no surprise that people can get ill on a cruise.
This has created an unfortunate negative stereotype of cruising, which was compounded by the pandemic when coronavirus cases escalated among hundreds of passengers on Diamond Princess and the ship ended up quarantined in Japan for two weeks.
There have also been negative media portrayals in programmes such as HBO’s The Last Cruise documentary, which can create fear and discomfort for potential passengers – perpetuating the myth of a cruise ship being a floating petri-dish.
This term has become a bugbear for cruise YouTuber Emma Le Teace, who runs Emma Cruises.
She told The Independent: “Cruise ships are held to extremely high cleanliness standards, higher than most places on land. I used to commute to work on the train and sit in an office all day and I got sick far more often than I do now cruising once a month. They certainly don't clean offices or public transport to the same degree as cruise ships.
“The cruise industry is held to far higher standards than equivalent facilities on land, yet the media loves to make a big deal out of it whenever something happens, mostly because it is unusual.”
Despite the media coverage, CDC data suggests the most common settings for gastrointestinal illnesses are actually healthcare facilities followed by restaurants or catered events, schools and day care centres,
Nicky Kelvin, editor at large of travel tips website The Points Guy, said: “Passengers are not highly likely to become sick from hygiene related causes on a cruise due to high standards of cleanliness, as well as rigorous inspections which have been implemented since 1970.
“Concerns about norovirus on cruises are a result of ships being required to report all cases of norovirus to authorities, compared with schools or nursing homes where norovirus is rampant but do not require reports.”
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Jenni Murray, better known as CruiseMummy, is a regular passenger in her job as a cruise blogger and influencer.
She has been on more than 40 cruises and has only been ill once.
Murray told The Independent: “Cruise ships are kept spotlessly clean – much cleaner than hotels.
“You’d be hard-pressed to find a speck of dust, let alone anything grimy. I have dust mite allergies and often feel stuffy in hotels or other people’s houses, but on a cruise ship I can always breathe easily. That alone speaks volumes about how thorough the cleaning is. I’ve never seen dust or mould anywhere.
“Of course, with thousands of people in one place, some guests inevitably bring illnesses on board – norovirus being one of the most common.”
How clean are cruise ships?
When it comes to health and safety, many argue that you won’t get much cleaner than a cruise ship.
Passengers need to complete health questionnaires before boarding and disclose if they have had Covid recently, something that you are not asked when getting on a plane or going to a hotel.
Cruise lines follow the International Health Regulations of the World Health Organisation and the CDC’s Vessel Sanitisation Program (VSP).
These require that cruise ships provide health declarations detailing illnesses of individuals on board to port authorities around the globe prior to a ship’s entry. Every cruise ship receives multiple inspections each year – announced and unannounced – to support implementation of strict environmental and safety regulations.
Under the VSP, ships must get 86 out of 100 points to pass, covering cleanliness of areas such as cabins, galleys and dining rooms, swimming pools and kids’ clubs.
To comply with this, cruise ships are routinely cleaned, with crew regularly sanitising surfaces such as tables, handrails, door handles and taps. Cruise passengers are reminded to wash their hands when entering the buffet and restaurants, while hand sanitisers are readily available in public locations on a cruise ship such as by the lifts.
Members of industry trade body the Cruise Lines International Association (CLIA) also follow guidelines specifying that cruise ships must have at least one qualified medical professional available 24/7 for medical bay visits or cabin “house calls”.
CLIA managing director Andy Harmer said: “The cruise industry’s first priority is the health and safety of passengers, crew, and the communities that we visit.
“Thanks to robust and rigorous protocols that cruise lines have put in place, cruise is one of the safest forms of travel. From cleaning practices that are often unparalleled in other settings to passenger screenings, cruise lines take extensive measures to keep their guests healthy.”
What happens when there is a norovirus outbreak on a cruise?
If a passenger is hit with norovirus or other contagious illnesses, they are usually quarantined in their cabin to prevent further spread of the illness.
Murray added that things change quickly on a cruise if there is an outbreak.
She said: “I’ve experienced this on about 10 per cent of my cruises. When it happens, things like salt and pepper shakers disappear, replaced by individual sachets.
“You won’t be allowed to serve your own drinks in the buffet; crew members will do it for you. You’ll also see crew with buckets of disinfectant, scrubbing every surface between guests. If you do get sick, you’ll be ordered to stay in your cabin until you’ve been symptom-free for 24 hours – and don’t worry, room service is free.”
To prevent illness, she advises avoiding touching handrails unless absolutely necessary and pressing elevator buttons with your knuckles.
She said: “Little things like this help reduce the risk of catching anything.
“Since the pandemic, new cruise ships have been designed with extra hygiene measures in mind. Every restaurant now has handwashing sinks at the entrance, and some even have automatic hand-washing machines. Many cruise lines are also moving away from self-service buffets, with crew members plating up food instead.
“When Covid first hit, the idea of people being stuck on ships made for dramatic headlines - who could forget the Diamond Princess? But that doesn’t mean you’re more likely to catch Covid or anything else on a cruise ship. Quite the opposite. I’ve never stayed in a hotel or eaten in a restaurant where someone ensures every single person has clean hands before entering. On a cruise ship, that’s just standard practice.”
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