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C.D.C. Investigating Gastrointestinal Illness on Luxury Cruise Ship

The Queen Victoria was on its way to Honolulu from San Francisco on a 107-night world cruise when more than 150 people on board reported symptoms, officials said.

A large cruise ship being guided by a tugboat at dusk near the a pier.

By Johnny Diaz

The Centers for Disease Control and Prevention is investigating an outbreak on a luxury cruise ship after more than 150 people reported symptoms of gastrointestinal illness, including diarrhea and vomiting.

The ship, the Queen Victoria, operated by Cunard Line, departed Southampton, England, on Jan. 11 on a 107-night cruise that included recent stops in Florida and San Francisco, according to the company’s website . The ship is scheduled to arrive in Honolulu on Monday.

The C.D.C. said that, as of Thursday, 129 passengers and 25 crew members had reported being ill on the ship. The agency said 1,824 passengers and 967 crew members were aboard at the time of the outbreak.

The cause of the illnesses was unknown, the agency said.

In a statement, Cunard Line, which is based in Southampton, said that “a number of guests had reported symptoms of gastrointestinal illness” on the ship, which arrived in San Francisco on Tuesday after stops in Mexico, Guatemala, Panama and Aruba.

The cruise line “immediately activated their enhanced health and safety protocols to ensure the well being of all guests and crew on board and these measures have been effective,” the company said.

In response to the outbreak, the crew of the Queen Victoria have “increased cleaning and disinfection procedures” and have “isolated ill passengers and crew,” the C.D.C. said.

The agency said that it was remotely monitoring the situation, including “reviewing the ship’s outbreak response and sanitation procedures.”

The ship left San Francisco for Honolulu on Wednesday and was traveling off the west coast of the United States on Thursday, according to the ship-tracking website Cruise Mapper .

After it arrives in Hawaii on Monday, the ship’s scheduled stops include Fiji, New Zealand and Australia.

Though intestinal illness can spread quickly on cruise ships, outbreaks are infrequent, according to the C.D.C.

One high-profile outbreak took place in 2014, when 595 passengers and 50 crew members aboard Royal Caribbean’s Explorer of the Seas fell ill with bouts of vomiting and diarrhea, forcing the ship to return early to New Jersey.

Acute gastrointestinal illnesses, including the highly contagious norovirus, are associated with cruise ships because close quarters among passengers and crew members increase the amount of group contact, the agency said.

People who are infected when they board the ship may spread viruses to other passengers and crew.

Public health officials track illnesses on cruise ships so “outbreaks are found and reported more quickly on a cruise ship than on land,” the C.D.C. said.

Johnny Diaz is a general assignment reporter covering breaking news. He previously worked for the South Florida Sun Sentinel and The Boston Globe. More about Johnny Diaz

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CDC Investigating Illness Outbreak on Luxury Cruise Ship

By Robin Foster HealthDay Reporter

cruise ship recent illness

THURSDAY, Feb. 8, 2024 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention is investigating an outbreak of gastrointestinal illness aboard a luxury cruise ship that sailed out of San Francisco on Wednesday.

More than 150 people on the Queen Victoria, operated by Cunard Cruise Lines, have reported episodes of diarrhea and vomiting since the ship first set sail in early January, the CDC said in its investigation notice . A total of 125 passengers and 25 crew have fallen ill during the course of the voyage.

Carrying a total 1,800 passengers and 970 crew members, the ship is next expected to dock in Honolulu, Hawaii, on Monday.

The cause of the outbreak remains unclear, the CDC said, but Cunard told the agency that the ship has isolated ill passengers and crew and stepped up cleaning and disinfection efforts.

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cruise ship recent illness

The reported cases are totals for the entire voyage, the CDC noted.

"Cunard confirms that a small number of guests had reported symptoms of gastrointestinal illness on board Queen Victoria," Cunard told NBC News .

"They immediately activated their enhanced health and safety protocols to ensure the well-being of all guests and crew on board. Measures have been effective,” Cunard added.

The ship first left Germany on Jan. 9 and then departed Florida on Jan. 22, according to ship tracker Cruise Mapper, the Associated Press reported. The cruise ends in Australia next month.

More information

Visit the U.S. Centers for Disease Control and Prevention for healthy cruising tips .

SOURCE: U.S. Centers for Disease Control and Prevention, investigation notice, Feb. 5, 2024; Associated Press; NBC News

Copyright © 2024 HealthDay . All rights reserved.

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Outbreak Updates for International Cruise Ships

The Vessel Sanitation Program (VSP) requires cruise ships to log and report the number of passengers and crew who say they have symptoms of gastrointestinal illness. Learn more about illnesses and outbreaks reported to VSP and find information about outbreaks of gastrointestinal illness on cruise ships.

Medical staff on cruise ships under U.S. jurisdiction must send gastrointestinal illness case reports to VSP at specific times:

  • Before arriving to a U.S. port from a foreign port. This report is required even when there are no cases of gastrointestinal illness. Cruise ship staff send this report between 24 and 36 hours before the ship arrives at a U.S. port.
  • When 2% or more of the passengers or crew have gastrointestinal illness. Cruise ship staff send this report any time the ship is in the United States or within 15 days of arriving at a U.S. port.
  • If 3% or more of the passengers or crew have gastrointestinal illness.

VSP posts cruise ship outbreaks when they meet all of the following criteria:

  • Are on ships under VSP jurisdiction (see about VSP ).
  • Are on ships carrying 100 or more passengers.
  • Are on voyages from 3-21 days long.
  • Are on voyages where 3% or more of passengers or crew report symptoms of gastrointestinal illness to the ship’s medical staff.

VSP may also post information on gastrointestinal illness outbreaks of public health significance that do not necessarily meet the above criteria.

Important Notes

Data on this page are from ship surveillance reports and from CDC-led investigations.

  • The gastrointestinal illness cases reported are totals for the entire voyage.
  • These cases do not represent the number of active (symptomatic) cases of gastrointestinal illness at any given port of call or at disembarkation.
  • CDC has not verified all the case numbers represented in the following updates.

Learn how passengers can protect themselves with these  tips for healthy cruising .

Find  more information  about gastrointestinal illness outbreaks on land and at sea.

Top of Page

*There were an unknown but significant number of passenger cases who reported their illness by phone to the medical facility onboard but were not seen in a timely manner and disembarked the ship

  • Inspection Reports
  • About Inspections
  • Cruise Ship Outbreak Updates
  • About Noroviruses on Cruise Ships
  • VSP Operations Manual   [PDF – 5 MB]
  • VSP Construction Guidelines   [PDF – 4 MB]
  • Illness Prevention Information
  • Publications

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  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
  • Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
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  • CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
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Cruise Ship Norovirus Outbreaks

CruiseMapper logo

Here are listed latest cruise ship Norovirus outbreaks on passenger ships, with information what is and how to avoid Norovirus on cruise ships, CDC reports, and news updates.

From the following links, you can skip the intro and jump directly to illness outbreaks in 2024 , 2023 , 2022 , 2020 , 2019 , 2018 , 2017 , 2016 , 2015 , 2014 , 2013 , 2012 , also read about Zika virus , Seasickness , Hospital (shipboard infirmary) and Mercy Ships (hospital ship Africa Mercy) .

Note: The following CruiseMapper link provides information on Coronavirus/COVID outbreaks on cruise ships .

Norovirus outbreaks on cruise ships in 2024

Cruise norovirus outbreaks updates.

Norovirus on ships is spread through contaminated water, foods and surfaces (public restrooms, railings, doorknobs, handles, board games-cards-puzzles-toys, etc). Norovirus withstands chlorine, prolonged exposure outside the body, as well as temperature extremes. Like a virus, Norwalk can't be effectively treated with antibiotics, making it extremely difficult to eliminate in closed environments - like cruise vessels.

Norovirus may incubate up to 48 hours before the symptoms appear. This makes it difficult to restrict an outbreak. Noro symptoms include nausea, vomiting (kids more than adults, abdominal cramps, diarrhea, general weakness, low fever, headache, muscle aches. The illness could last up to 5 days (depending on the person's age, general health, and severity of the exposure to the virus. Recovered patients can still spread the virus for up to 2 weeks.

Quarantining the ill passengers and crew to their cabins is mandatory (at least for 48 hours) to slow the outbreak's spread. Failing to comply with the crew's orders results in fines or even discharge from the ship.

CruiseMapper's Norovirus survey is based on official data from CDC.gov (USA's "Centers for Disease Control and Prevention"). CDC's "Vessel Sanitation Program" assists the cruise tourism industry in preventing and controlling the transmission and spread of gastrointestinal illnesses (Norovirus, ETEC) on passenger ships calling on US seaports.

Cruise Ship Norovirus - CruiseMapper CruiseMinus

This program operates under the authority of the Public Health Service Act (fda.gov, "Quarantine and Inspection Regulations to Control Communicable Diseases"). CDC sanitation inspections on passenger ships are conducted twice a year. Scores of 86 are considered passing. Among the issues that CDC health inspectors usually find on board and report are:

  • food debris
  • dead insects
  • insect droppings
  • records indicating crewmembers (including cooks and galley staff) working while sick (suffering from gastrointestinal disorders or with acute gastroenteritis/AGE symptoms)
  • cracked/corroded equipment
  • soiled cutting boards
  • food served undercooked
  • lack of safety instruction signs.

CDC cruise ship Norovirus reports

Cruise ship outbreaks are reported (posted on the CDC website) when the illness incident meets the following criteria:

  • The ship falls within the purview of the Vessel Sanitation Program (VSP). This means if it carries 13+ passengers and has a foreign cruise itinerary with US ports of call in it. Keep in mind, that most departures are from US-based home ports.
  • The ship cruise itinerary length is between 3 and 21 days,
  • The ship carries 100+ passengers.
  • The percentage of infected passengers or crew (cases reported to the ship's med staff) during the cruise is 3% or more. This means small outbreaks on cruise ships will not be reported to the CDC.

CDC cruise ship inspection fees are payable by the shipowner. Fees are based on the vessel's size. VSP doesn't charge fees for consultations related to shipping facilities renovations or new ships. Inspection fees are as follows.

  • Small ships (under 3000 GT / gross tons) pay USD 1500 per inspection.
  • Small ships (between 3000-15000 GT) pay USD 3000 per inspection.
  • Medium ships (between 15000-30000 GT) pay USD 6000 per inspection.
  • Large ships (between 30000-60000 GT) pay USD 9000 per inspection.
  • Extra-large ships (between 60000-120000 GT) pay USD 12000 per inspection.
  • Mega-liners (above 120000 GT) pay USD 18000 per inspection.

Note: When the itinerary doesn't include US cruise ports, the ship is not required to report to CDC, thus no official illness outbreak report would be issued.

CDC ship illness outbreak investigations

VSP (abbrev "Vessel Sanitation Program") monitors CDC's observations on illness patterns for GI (gastrointestinal) outbreaks on passenger shipping vessels ( ferries and cruise ships ).

  • VSP conducts outbreak investigations only in cases with 3% or more passengers or crew reported sick with GI symptoms. VSP may also conduct outbreak investigations in cases of unusual GI illness patterns (even if the rate is less than 3%).
  • VSP conducts outbreak investigations only on vessels visiting ports in the USA or which are within 15 days of arriving at a US port.
  • When an outbreak occurs, VSP asks for ship logs and infirmary records of reported GI cases (symptoms and timing) and illness distribution (among passengers/crew, during each day of the cruise).
  • VSP staff usually boards the vessel for epidemiological assessment, interviews, distribution and analysis of illness questionnaires, monitoring cleaning procedures.
  • Lab investigations - the onboard med staff often collects stool, vomit, blood specimens, which are then sent to land-based labs to confirm the illness cause.

During the onboard illness outbreak, VSP requires the cruise company to activate the "Outbreak Prevention and Response Plan" (vessel's response to illness cases).

During an outbreak:

  • Cleaning and disinfection frequencies are Increased.
  • Self-service buffets are stopped.
  • All infected (pax/crew) are quarantined to their staterooms/cabins
  • Clinical specimens are collected for analysis.
  • Daily updates are provided to VSP (cases counts and measures reports)
  • All passengers and crew are alerted of the illness.
  • Upon boarding on the next scheduled cruise, passengers are notified about the previous voyage's outbreak.
  • Occasionally, VSP requires the company to notify port authorities and also to perform cleaning and disinfection in cruise port terminal buildings.

Illness outbreaks on cruise ships (annual statistics)

The following statistics show the number of cruise ship illness outbreaks in recent years. You can compare the number of reports (CDC and news media sources) and the total number of infected (passengers and crew).

In 2014, Time Magazine published the article "The 13 Worst Norovirus Outbreaks on Cruise Ships". In it, the overall winner was Princess Cruises with 5 epidemic illness outbreaks:

  • Coral Princess (February 2009, infected 271)
  • Crown Princess (January 2010, infected 396)
  • Crown Princess (February 2012, infected 363)
  • Sun Princess (July 2012, infected 216)
  • Ruby Princess (March 2013, infected 276)

Norovirus outbreaks 2023 reports

Norovirus outbreaks 2022 reports, norovirus outbreaks 2020 reports, outbreaks 2019 reports.

In the following table, you can see all 2019-reported Norovirus outbreaks on cruise ships. The listed statistical data is based on CDC or news media reports. It shows the number of sick passengers and crew (with the respective percentage to all), along with the corresponding CDC report pages (if available) as outgoing links.

Note: When the itinerary doesn't include US cruise ports, the ship is not required to report to CDC, thus no official illness report would be issued.

Outbreaks 2018 reports

In 2018, the number of reported illness outbreaks on cruise ships was 15. The total number of infected was 1177 (of those 1099 passengers and 78 crew).

Outbreaks 2017 reports

In 2017, the number of reported illness outbreaks on cruise ships was 21. The total number of infected was 2535 (of those 2450 passengers and 85 crew).

Outbreaks 2016 reports

In 2016, the number of reported illness outbreaks on cruise ships was 23. The total number of infected was 2504 (of those 2378 passengers and 126 crew).

Outbreaks 2015 reports

In 2015, the number of reported illness outbreaks on cruise ships was 23. The total number of infected was 2570 (of those 2458 passengers and 112 crew).

Outbreaks 2014 reports

In 2014, the number of reported illness outbreaks on cruise ships was 17. The total number of infected was 3559 (of those 3354 passengers and 205 crew).

Outbreaks 2013 reports

In 2013, the number of reported illness outbreaks on cruise ships was 22. The total number of infected was 2385 (of those 2249 passengers and 136 crew).

  • According to CDC, in 2013 from Norovirus and similar GI (gastrointestinal) illnesses suffered a total of 1409 passengers (which is 7,5% of all passengers on the inspected cruise vessels) and 96 crew/staff members (which is 1,2% of all). With nearly 12 million cruisers departing from USA and Canada ports in 2013, the Norovirus infection rate is ~0,01% of all passengers.
  • It should be noted, that in the past years on many CDC inspections was concluded the Noro virus illness source was off the ship.

Outbreaks 2012 reports

In 2012, the number of reported illness outbreaks on cruise ships was 34. The total number of infected was 5542 (of those 5079 passengers and 463 crew).

Norovirus on cruise ships

All important things you should know about the "cruise virus".

Why do Norovirus incidents happen on cruise ships? There are more than 21 million US cases reported annually, of which 1 mill related to kids. Outbreaks happen mostly during winter months and mainly in more crowded places with close quarters. Among those are schools, hospitals, nursing homes, dormitories, prisons, big resorts, bigger passenger ships (including cruise ferries ). Norovirus is often branded as "cruise ship virus" simply because on ships health officials are required to report every gastrointestinal illness incident. This means Norovirus outbreaks are reported more quickly on ships than on land. Just for comparison, the virus can afflict as many as 3000 people per day in only one big city, which is about the passenger capacity of a typical modern cruiser.

What is Norovirus infection? It's a very common, highly contagious, ruthlessly efficient and uncomfortably bad virus affecting the stomach and large intestines. Often called "stomach flu" (the med term is "Gastroenteritis") the infection results in massive vomiting and diarrhea. Sickness outbreaks are considered as such if the percentage of infected people is over 3%. The virus is not seasonal and usually not serious (in medical terms). It hits 1 in 5 people annually and is the cause of ~50% of all foodborne illness outbreaks in the USA and for ~90% of all non-bacterial gastroenteritis worldwide.

The virus is named after an outbreak in Norwalk (OH, USA). Numerous studies confirm that a quick application of hand sanitizer doesn't kill the Norovirus. It takes about 30 sec of hard rubbing with hot water and soap (including under the nails) to wash it. This virus also mutates (changing its strains). As to its efficiency - a mere 20 particles are enough to get you.

What causes Norovirus on cruise vessels is mainly contaminated food/water. When it comes to ships, it spreads mostly through physical contact with sick people or handling contaminated objects. This includes sharing food/utensils and poor hygiene (not washing hands after bathroom use). The virus also spreads fecally, so you can catch it into the onboard laundry, or while changing diapers, etc. However, many passengers likely can blame a sick crewmember for the virus. According to a survey based on 170 inspection records on ships that docked in Florida ports in 2012, on 59 cruises violations of the required illness reporting laws were reported. A total of 130 crew had gotten sick on those voyages and didn't report their illness in the required time period.

The symptoms are nausea, vomiting, diarrhea, indigestion, abdominal cramps. Also possible are mild fever and headache. It takes 1-2 days for the symptoms to appear. The illness lasts 1 to 4 days, but some people (especially elderly) may be contagious for up to 2 weeks after recovery.

What is the treatment? What to do if you got it? Obviously, the first thing is to go to the ship's infirmary (medical center) and contact the doctor. You should drink plenty of water as dehydration is a side-effect of the illness. There is no real treatment for Norovirus - you just wait it out. A few years ago an experimental Norovirus vaccine (applied as nasal spray) was developed by the "Center for Infectious Diseases and Vaccinology" (Arizona State University). The new vaccine generates a good immune response.

How to avoid Norovirus on cruise ships?

  • Wash your hands often (hot water and soap), especially before/after eating and after using the bathroom
  • Limit physical contacts as much as possible, pack some extra soap, a personal disinfectant (Lysol, Pepto-Bismol), oral rehydration sachets and treatments for diarrhea
  • Avoid eating uncooked food (including salads and sandwiches) and food that cannot be washed (unless it can be peeled or shelled), drink only bottled liquids (preferably without ice), don't share drinks/utensils.
  • Drink lots of water.
  • Compensation for cruise illness. By contract, cruise lines are not required to compensate passengers who fall ill on cruises. However, they will compensate you if the itinerary was altered/canceled due to an illness outbreak. The deal may include up to 50% refund, up to 50% FCC (future cruise booking discount) or an option to cancel for a full refund plus reimbursement of airline change fees. If you have travel insurance, it covers cancellation due to illness. If you've been infected on the ship, it could also cover medical expenses and to compensate you for all days you're not on the ship before the cruise end.

The following "health advisory" list of recommended actions is often issued during gastrointestinal illness outbreak or on embarkation day (of the next scheduled voyage). It has important suggestions on how to avoid spreading the cruise ship virus infection.

  • It is critical that excellent standards of personal hygiene are maintained by all on board, as well as avoiding touching surfaces, such as handrails, door handles, elevator buttons, walls.
  • Report any observed evidence of vomiting or diarrhea that you may encounter on the ship.
  • Ensure that you minimize direct contact with others during this time, such as handshakes, etc.
  • Avoid touching your mouth.
  • Wash your hands frequently and thoroughly with soap for at least 20 sec and rinse them well under running water. Ensure that you follow this procedure every time you use the WC, after coughing or sneezing, and before eating, drinking or smoking.
  • Attempt to always use your own cabin toilet facilities.
  • In addition to hand washing, also use the alcohol hand gels provided where available, and in particular before eating in the self-serve buffet restaurant and outdoor food outlets.
  • Should you experience any symptoms of vomiting or diarrhea, return to your cabin and immediately report to the Medical Center or Front Office (Reception, if the infirmary is busy) by dialling 999.

Cruise ship virus procedures

What do they do about it? What actions do lines/operators/CDC actually take in response to a Norovirus cruise outbreak?

An "illness outbreak" is considered when 3% or more of all passengers report symptoms to the ship's med staff. In such cases, the CDC requires cruise lines to file a medical report.

The hotel staff is required to implement special cleaning and disinfection procedures for sanitizing the whole ship. To do that, they use stronger solvents, like Microbac, chlorine bleach, hydrogen peroxide. The Lido Deck's bistro/buffet service switches to manned stations. Often, salt-pepper shakers are taken off the tables. The crew starts offering precautionary tips. Sick passengers and crew are quarantined in their rooms, typically for at least 2 days. When Norovirus outbreaks can't be contained, cruise lines might also pull the ship out of service for a few days for sanitizing.

The CDC's "Vessel Sanitation Program" is for monitoring illness outbreaks on passenger ships carrying 100 or more guests on sailings from 3 to 21 days in length. The ship's medical staff is required by the CDC to maintain illness counts for each itinerary involving a stop at a US cruise port and to give CDC the number of all passengers/crew, plus the number of reported diarrhea cases during that voyage. This is done 24 hrs prior to arrival at any US port of call from a foreign port. And they file such reports even if the "illness number" is zero. This protocol only confirms that the CDC knows everything about it.

Other possible actions and results are red level ("Code Red") cleaning. The boarding/embarkation of new passengers is often delayed to permit more extensive disinfection of public areas and the cabins. Usually, a pre-embarkation health advisory is distributed to all boarding passengers. Additional med staff is sent to the ship in port to assist the disembarkation of infected passengers. Another possibility is the cruise ship to cancel all the itinerary's foreign ports of call and to return to its US home-port before the end of the voyage.

Some cruise lines offer hand-sanitizer dispensers near the ship's restaurants, Lido/pool deck areas and other more crowded public spaces in their effort to keep a lid on sickness outbreaks.

In February 2020, the shipowner cruise company Lindblad Expeditions announced the "Premium Purity" program with a shipwide cleaning system based on ACT CleanCoat technology. The program was rolled out fleetwide after a year trial. The innovative ship cleaning process is based on photocatalytic antibacterial spray that when activated by light kills viruses, bacteria, airborne microbes, mould. The disinfecting product and technology were developed by the Danish company ACT Global AS ( Copenhagen ). The spray is chemical-free, odourless, transparent and can be applied to all surfaces.

Zika virus on cruise ships

Zika virus (aka ZIKV) is a Flavivirus - from the genus of the viruses named West Nile, dengue, tick-borne encephalitis, yellow fever. These plus several other viruses may cause encephalitis (acute brain inflammation). In humans, Zika virus causes the Zika fever which is known to occur only within some equatorial regions. In 2014, Zika spread across the Pacific Ocean to French Polynesia, and soon to Easter Island. In 2015, Zika virus reached Central America, the Caribbean, and South America. In South America were recorded several pandemic outbreaks.

The most severe outbreaks were reported in Brazil, with an alarming surge in newborns with microcephaly. If the mother is infected, the virus may cause microcephaly in newborns. This is a neurodevelopmental disorder - babies are born with an underdeveloped head.

Generally, Zika is a mosquito-borne virus spread by Aedes aegypti (aka "yellow fever mosquito") and Aedes albopictus (aka "Asian tiger mosquito"). However, it became "cruise virus" since the decease can also result from intrauterine (contraceptive device), sexual intercourse, blood transfusion, lab exposure, organ/tissue transplantation, breast milk transmission.

In January 2016, the CDC issued travel guidance on affected countries and suggested using enhanced precautions and even postponing travel. Guidelines (specifically for pregnant women) were issued as well. Similar travel warnings were issued by other health agencies and governments. The CDC list of potentially dangerous for travel countries included (alphabetically) Barbados, Bolivia, Brazil, Cape Verde, Colombia, Ecuador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Puerto Rico, Paraguay, Salvador, Samoa, St Maarten, Suriname, Venezuela.

Cruise lines should warn their pregnant passengers of the virus. Cruise ships publish daily health and safety instructions to their passengers on how to avoid mosquito bites. Zika symptoms are fever, skin rash, pain in joints, conjunctivitis (pink eye). It typically lasts from a few days to a week. For now, the illness cannot be prevented by drugs or vaccines.

"Cruise ship virus" politics

Virus outbreaks on cruise ships are actually not that uncommon. Such viral/bacterial outbreak incidents affect the vacation experience of thousands of people, being packed up in a floating resort for many days on end. In confined spaces with frequent passenger turnover (like big capacity cruise ships), it is easy for diseases to spread - whether food- or air-borne, or otherwise. However, there's a tendency to cover up the severity of this issue.

Some of the world's most famous passenger ships are listed in the virus outbreak statistics, yet one hears so little of it in mass media news. And there is no surprise in that since the "cruise illness" news are nothing but bad publicity for the companies - which is bad for a prosperous multi-billion dollar sea travel vacation business. All major cruise line companies will do their best to keep quiet about virus outbreaks on their ships. There are passenger testimonials about quarantined ships and how badly guests have been treated by the line. Virus outbreak news speaks of a lack of proper hygiene control, badly trained staff, bad ship management. The whole responsibility goes to the shipowner (cruise line company) and its management.

Major (in some cases epidemic) illness outbreaks are among the "biggies" that can bring down the brand's reputation on the market. Cruise illness issues often result in lower booking rates and cheaper prices - which is bad for the business.

So it comes as no surprise that when CDC reports an illness outbreak on some vessel, big media sources do not immediately (or ever) respond to the news. You may hear about it on your local radio station, or on your local cable operator, but not necessarily on ABC, CNN, and often not even on Yahoo and MSN news online. It's not about the passengers' health (never been) - it's about the big money that rules our world.

So keep your hands clean, keep your mind clear, always hope for the best. Bad, if meant to happen, will happen anyway, and nothing can change it.

Seasickness on cruise ships

Seasickness is physical disorientation as a result of conflicting signals received by the brain from different body senses. Our inner ear senses the ship's irregular motion, which our eyes can't see because the floor and walls are stable. Depending on individual balance, our ability to adjust to motions varies, so not everyone experiences seasickness.

Seasickness is one of the most common "cruise illnesses". Passengers sensitive to nausea or motion sickness should consult their doctors for medical recommendations prior to departure. Drugs (like Dramamine) are effective against seasickness. At the cruise ship's Infirmary, and also at Reception Desk is provided (free of charge) Meclizine. Know that the bigger the vessel the more stable it is. Also, motion in midship-located areas (including staterooms) is highly reduced in comparison to forward and aft areas.

Seasickness manifests in different ways and is always a result of the body's attempt to correct for the conflicting inputs received from its senses. Common symptoms are cold sweat, dizziness, drowsiness, headache, nausea. When such symptoms are noticed, passengers should take precautions to prevent intensifying the disorientation. The harder the symptoms, the longer the recovery.

If seasickness symptoms are accompanied by diarrhea or fever, passengers should immediately seek medical treatment for Norovirus and avoid spreading the illness to others.

How to prevent seasickness on cruise ships (tips)

Passengers prone to motion sickness are more likely to suffer seasickness. The following prevention tips can minimize discomfort, so before the cruise:

  • choose more sheltered routes (clam waters). Open sea and ocean waters are rough and have larger swells, thus river cruises are among your best choices.
  • Choose a large liner as larger vessels are more stable and motions are minimized.
  • Book centralized/midship stateroom and/or middle deck cabin, where motions are less noticeable.
  • Get a good sleep before the voyage - an energetic, well-rested body adjusts easier to new conditions.

During the cruise tips to divert seasickness symptoms include:

  • Get involved in onboard activities - this will occupy your mind while the inner ear adjusts to equilibrium changes.
  • Avoid napping or lying down - when the body is horizontal, the ship's motion is more pronounced.
  • Avoid eating unknown foods - you don't know how your stomach may react to new food/ingredients. Avoid alcohol and acidic-fatty-spicy foods. Stay well-hydrated by drinking plenty of water.
  • Walk around to adjust the body's equilibrium to the ship's motion. When on open decks, focus on the horizon to give your eyes and body similar inputs about any tilting or other motion. Depending on the symptoms' severity, it may take several hours.
  • Often get fresh air, take deep breaths, keep your lungs clear.
  • Some herbal remedies (in tablets or teas) also can ease the symptoms, including ginger and peppermint. Their efficacy varies by person, and are best used together with other prevention methods.

Search for medical assistance - consult the ship's physician if no actions provide relief.

Cruise ship hospital (medical care)

Cruise vessels are not "hospital ships".

Navy hospital ship

Hospital ships are designated as floating medical facilities (hospitals).

Most hospital ships are navy vessels (operated by military forces) which are specifically built for use in war zones.

Attacking a hospital ship is considered a war crime, but enemy forces have the right to board them for inspections.

As of 2018, hospital ships have Brazil (6), China (5), Russia (6), USA (2), Spain (2), and India-Indonesia-Peru-Vietnam (x1).

The navies of USA, UK, Australia, China, France, Italy, Spain, Argentina, and Japan have some classes of military ships fitted with onboard hospitals.

For passengers with health concerns, medical care on cruise ships is a vital part of their travel planning. Most cruise vessels are equipped with either basic infirmary (a small clinic) or larger hospital where sick or injured passengers are treated and cared for by contractor physicians and nurses on 24-hour duty.

Shipboard hospitals as facilities and equipment vary by cruise line and vessel. Clinic's size usually depends on the ship's capacity (passengers plus crew). Generally, bigger and newer ships offer larger and better-equipped medical facilities and are served by bigger infirmary staff.

The ship's medical personnel are independent contractors. This is for limiting the cruise company's liability. There are no internationally specified regulations governing ship infirmaries and medical staffing. Each company has its own standards provided for its passengers' healthcare.

For finding the Infirmary you can use the ship deck plans . On most vessels, the medical facilities are located midship on a lower deck (for easier access and better stability) and usually among other crew facilities. Every passenger stateroom has the Infirmary's number - posted or by the cabin's phone.

Basic medical care on cruise ships

A cruise ship's medical facility can treat only passengers experiencing minor health issues - seasickness, scrapes, sunburns, etc. More severe medical emergencies can't be handled on the ship and usually require medevacs. Coast guard helicopter teams fly to the ship, hoist the passenger (accompanied by a spouse/relative and a crew nurse) and fly them to the nearest land hospital.

Infirmary's equipment and med supplies provide only emergency response and basic treatments in order to stabilize the passenger until transferred ashore.

In cases of severe emergencies, passengers with life-threatening illnesses or injuries are evacuated off the ship - either by boat (if in or near seaport) or by rescue helicopter dispatched from nearest coast guard or other station. In some cases, nearby ships with better medical facilities may assist.

Both emergency and basic care are available on the ship 24 hours a day. All treatments are paid. Outside regular opening hours fees are higher.

Like inland hospitals, medical treatments at sea are pricey. However, unlike on land, most basic travel insurance policies don't cover medical treatments on cruise ships as they are not from the patient's primary caregiver. Purchasing cruise travel insurance with health coverage (medical clauses) is highly recommended.

Shipboard medical service fees vary and are usually set by medical practitioners. General consultations incur costs similar to home visits. Prescription medications or other treatments cost extra. In most cruise ship hospitals, some supplies and medications are provided to passengers and crew for free - like aspirin, seasickness pills, small bandages.

Mercy Ships

"Mercy Ships" is a charity accredited by Better Business Bureau. It operates hospital ships since 1978 and also has currently the world's largest hospital ship (excluding navy vessels) - MV Africa Mercy.

The organization provides free humanitarian aid worldwide, including health care, community development, and health education projects, mental health, agriculture, and water development programs in mainly developing countries in Africa, Caribbean, South America, Oceania.

The organization's headquarters are in Garden Valley (Texas USA), with another 16 offices worldwide - in UK, Spain, Canada, Germany, France, Denmark, Switzerland, Belgium, Holland, Sweden, Norway, South Africa, Australia, New Zealand, South Korea.

Financial support and supplies are mainly through donations from medical companies (medications, supplies, equipment), corporations (fuel, food, building supplies), governments (port fees, drydock costs), general public and also by the crew (all volunteers on a rotational basis). The crew serves with short-term (2 weeks to 2 years) and long-term (min 2 years) contracts. Volunteer crew members occupy both medical (surgeons, dentists, nurses) and general jobs (deckhands, seamen, engineers, machinists, electricians, teachers, cooks, welders, plumbers, agriculturalists.

The crew on Mercy Ships pay all costs associated with their service - fees, travel expenses, passports, insurance, personal expenses.

As 95 of the world's top 100 largest megapolises are port cities, "hospital ships" could provide healthcare very quickly and more efficiently to large numbers of people.

MV Africa Mercy

MV Africa Mercy is a converted former rail ferry (1980-built as "Dronning Ingrid") drydock-refitted in 2007 at Cammell Laird shipyard (Hebburn, England).

The ship project started in March 1999 with the vessel's acquisition through a donation from Balcraig Foundation (UK), which purchased the boat for US$6,5 million.

Ferry's train deck was reconstructed and converted into a hospital. Project's total cost was over USD 62 million.

Africa Mercy ship (hospital ship)

Vessel details include:

  • Volume/GT tonnage 16572 tons
  • LOA length 152 m (499 ft )
  • Width 23,7 m (78 ft)
  • Draft 6 m (20 ft)
  • Powerplant 4x BW main engines plus diesel generators
  • Propulsion two shafts with controllable pitch propellers
  • Speed 19 Kn / 35 kph / 22 mph
  • Passenger capacity 484
  • Crew capacity 450
  • Fleet of 28 vehicles (used in land-based operations)
  • Annual drydock maintenance and refurbishment are done in Durban (South Africa).

As for facilities and amenities, the hospital ship has 5 operating rooms, Intensive Care Unit, an ophthalmic unit, CT scanner, X-Ray, labs, recovery ward (82 beds), a daycare center, a school (for all ages), library, launderette, convenience store, restaurant, gymnasium, shops, Starbucks Cafe (donated), satellite communications.

Africa Mercy has a total of 126 staterooms for the staff/crew. They are located on upper decks and include cabins for families, couples and single cabins.

Land-based operations ("Field Service") include mobile clinics providing screening for potential surgery patients, healthcare, dental care, also mental health programs, infrastructure projects.

More than 175 people fall ill in Celebrity Cruises norovirus outbreak

cruise ship recent illness

More than 175 people got sick with norovirus during a recent Celebrity Cruises’ sailing, the Centers for Disease Control and Prevention said.

The agency said 152 of the Celebrity Summit ship’s 2,144 passengers, as well as 25 crew members, reported being ill during its May 15 voyage, according to its website . Their main symptoms were diarrhea, vomiting, abdominal cramps and headache.

"The health and safety of our guests, crew and communities we visit are our top priority," a Celebrity spokesperson said in an emailed statement. "To maintain the highest levels of health onboard our ships, we implement rigorous safety and cleaning procedures, many far exceeding public health guidelines. Combined, these efforts allow us to maintain some of the lowest levels of community spread."

The cruise line and ship’s crew implemented heightened “cleaning and disinfection procedures according to the ship’s outbreak prevention and response plan,” notified guests and encouraged practicing good hand hygiene and reporting illness, according to the agency. They also provided reports of gastrointestinal illness cases to the CDC’s Vessel Sanitation Program twice a day during the outbreak investigation, among other steps.

Cruise ship medical facilities: What happens if you get sick or injured (or bitten by a monkey)

Cruise insurance: Should you buy it through a cruise line? Maybe not, experts say

The incident marks the third norovirus outbreak on Celebrity ships the CDC has posted this year. The line previously saw outbreaks on its Celebrity Equinox and Celebrity Constellation vessels in March. On Celebrity Equinox, 136 passengers and crew reported being ill, while 96 did so on Celebrity Constellation.

Gastrointestinal illness at sea plummeted during the COVID-19 pandemic, but cases have ticked up again as the industry has rebounded.

While norovirus is frequently associated with cruise ships, Ben Lopman, a professor of epidemiology at Emory University’s Rollins School of Public Health, told USA TODAY in February that those represent a "tiny minority of norovirus outbreaks.” The vast majority take place in health care settings like nursing homes, he said.

Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. You can reach him at [email protected].

Watch CBS News

More than 300 sickened on Ruby Princess cruise ship, CDC says

By Aliza Chasan

March 8, 2023 / 12:32 PM EST / CBS News

Hundreds of passengers and crew members fell ill while on board a Princess Cruises ship, the Centers for Disease Control and Prevention said. 

In total, 284 of 2,881 passengers on the Ruby Princess reported being sick during the voyage between Feb. 26 and March 5, CDC investigators said , and 34 of the 1,159 crew members also reported illness. The symptoms reported were vomiting and diarrhea.

The CDC's Vessel Sanitation Program epidemiologists and environmental health officers responded to the ship when it docked in Galveston, Texas on March 5, the agency said. They have not yet determined what caused the illnesses. 

Crew on the ship cleaned more frequently and used disinfection procedures once the outbreak began, the CDC said. They also collected stool samples for CDC analysis. 

Workers also directed sick passengers to isolate themselves in their rooms, a Princess Cruises spokesperson said. The company said the sickness was likely caused by norovirus, a very contagious virus that causes vomiting and diarrhea. Norovirus, which is sometimes called the "cruise ship virus," causes more than 90% of diarrheal disease outbreaks on cruise ships , according to the CDC.

The Ruby Princess has since embarked on a new voyage, the company said. The latest group of passengers, currently on a seven-day Caribbean cruise, were told about the increased illnesses on the previous trip.

The Ruby Princess has made headlines in the past as the site of several COVID-19 outbreaks , including a 2020 cruise early in the coronavirus pandemic that docked in Australia with hundreds of positive cases on board.

In recent years, the CDC monitored COVID-19 outbreaks on cruise ships. The program tracking cases ended in July of 2022. 

Aliza Chasan is a digital producer at 60 Minutes and CBSNews.com. She has previously written for outlets including PIX11 News, The New York Daily News, Inside Edition and DNAinfo. Aliza covers trending news, often focusing on crime and politics.

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300 passengers and crew fall ill on Ruby Princess cruise from Texas

Princess cruises said the cause is probably norovirus.

cruise ship recent illness

More than 300 passengers and crew on the Ruby Princess contracted a gastrointestinal illness causing vomiting and diarrhea, the Centers for Disease Control and Prevention said this week.

The Princess Cruises voyage carrying about 4,000 people ran from Feb. 26 to Sunday in the western Caribbean and docked in Galveston, Tex.

Although the CDC has not listed a specific virus, Princess Cruises said in a statement that the cause was probably norovirus.

About 10 percent of the passengers and 3 percent of the crew onboard were sick, according to the CDC.

“At the first sign of an increase in the numbers of passengers reporting to the medical center with gastrointestinal illness, we immediately initiated additional enhanced sanitization procedures to interrupt the person-to-person spread of this virus,” Princess Cruises said in a statement.

The company said the ship underwent an additional disinfection ahead of its next voyage.

The Ruby Princess incident is one of six outbreaks of a gastrointestinal illness on a cruise this year. The first was norovirus on a months-long voyage from P&O Cruises (owned by Carnival) that is sailing until April. The CDC said 86 passengers and 20 crew fell ill aboard the Arcadia . Two Royal Caribbean and Celebrity cruises also had outbreaks this year.

One side effect of cruise covid rules: Norovirus has plummeted

Outbreaks of gastrointestinal illness had been lower than in pre-pandemic years, thanks to the enhanced cleaning and safety protocols cruises were taking to prevent the spread of the coronavirus . In 2022, there were four reported outbreaks. There was one in 2021, although cruises did not begin a full return to sailing until June.

Passengers traveling in close quarters on cruises are vulnerable to the spread of viruses. Several ships were hit by coronavirus outbreaks that marked the early days of the pandemic and led to an industry-wide pause. In 2020, a Ruby Princess voyage from Sydney had the deadliest known coronavirus outbreak on any cruise ship, with 28 deaths and about 700 infections, according to the Australian Broadcasting Corp.

‘People just didn’t care’: How the Ruby Princess cruise ship became a deathtrap

In 2019, the last full year of cruising before the pandemic, the CDC reported 10 cases of gastro illnesses; eight were norovirus, and two were unknown. Cruise lines reported a total of 32 outbreaks between 2017 and 2019, though cases dropped overall since 2006.

“Norovirus can be especially challenging to control on cruise ships because of the close living quarters, shared dining areas, and rapid turnover of passengers,” the CDC says on its website . “When the ship docks, norovirus can be brought on board in contaminated food or water or by passengers who were infected while ashore.”

The CDC’s Vessel Sanitation Program has worked with the industry to monitor gastrointestinal illness since 1975, after “an excessive number” of outbreaks.

Hannah Sampson contributed to this report.

More cruise news

Living at sea: Travelers on a 9-month world cruise are going viral on social media. For some travelers, not even nine months was enough time on a ship; they sold cars, moved out of their homes and prepared to set sail for three years . That plan fell apart, but a 3.5-year version is waiting in the wings.

Passengers beware: It’s not all buffets and dance contests. Crime data reported by cruise lines show that the number of sex crimes has increased compared to previous years. And though man-overboard cases are rare, they are usually deadly .

The more you know: If you’re cruise-curious, here are six tips from a newcomer. Remember that in most cases, extra fees and add-ons will increase the seemingly cheap price of a sailing. And if you happen to get sick , know what to expect on board.

cruise ship recent illness

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CDC Reports 14th Cruise Ship Norovirus Outbreak of 2023

Andrea Santillan

Andrea Santillan

  • October 16, 2023

virgin voyages scarlet lady in nassau

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A cruise ship norovirus outbreak was reported on Virgin Voyages’ Scarlet Lady during its October 8 sailing, according to the Centers for Disease Control and Prevention (CDC).

The cruise ship reported over 70 cases of norovirus during an October 8 to 13 sailing. The ship’s next batch of passengers were alerted while sanitary measures have been adopted to prevent another outbreak.

virgin voyages terminal v portmiami

While sailing on a Riviera Maya cruise that included stops at Cozumel, Mexico, and Bimini, the Bahamas, 66 out of 2,198 passengers and seven crew members onboard the Scarlet Lady reported symptoms of the norovirus. These included vomiting, diarrhea, and stomach cramps. 

Though the virus’s origin remains unknown, news of the outbreak has been shared with the Centers for Disease Control and Prevention (CDC).

This move complied with established CDC health protocols to report gastrointestinal outbreaks affecting at least 2% of a cruise ship’s passengers and crew members of 3% of the passengers.

RELATED: Truth and Lies About Norovirus

COO for Virgin Voyages , Michelle Bentubo, assured the public of the company’s timely response, saying, “Our medical team isolated these travelers, and we immediately enacted enhanced sanitization procedures, including additional cleaning of cabins and high-contact areas around the ship. We are working closely with the CDC and their medical professionals.”

According to the cruise line , its next sailing to Grand Turk and Bimini on October 13 proceeded as scheduled. The Vessel Sanitation Program under the CDC will continue monitoring the situation, including the ship’s response to the outbreak and sanitation measures.

Ships make up a “tiny minority” of norovirus cases

cruise ship norovirus outbreak

Scarlet Lady’s October 8 voyage was the 14th sailing in 2023 to experience an outbreak of norovirus. While that may seem like a lot, an epidemiology professor told USA Today that cruise ships are only accountable for a “tiny minority of norovirus outbreaks.”

To reduce your risk of catching it, the CDC recommends washing your hands often, getting plenty of rest, drinking sufficient water, and leaving areas where people are showing symptoms. In case you get sick, report your illness to the crew. 

Over the summer, a Viking cruise ship had a noro incident with 119 guests and crew, bringing the total to over 13%.

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CDC is investigating gastrointestinal sickness on luxury cruise ship Queen Victoria

Queen Victoria Cruise Ship Returns To Its Home Port Of Southampton

SAN FRANCISCO — The Centers for Disease Control and Prevention is investigating an outbreak on a luxury cruise ship where more than 150 people have reported gastrointestinal illness, including diarrhea and vomiting.

The Queen Victoria, operated by Cunard Cruise Line, departed San Francisco Wednesday on its way from Florida to Hawaii. The ship is carrying 1,800 passengers and 970 crew members.

The cause is unknown. Cunard told the CDC that the ship increased cleaning and disinfection, and isolated ill passengers and crew.

The reported cases are totals for the entire voyage and do not represent how many people are actively sick at any one time, the CDC said.

The company did not immediately respond to an email from The Associated Press seeking more details.

The ship originated in Germany Jan. 9 and departed Florida Jan. 22, according to ship tracker Cruise Mapper. Its next stop is Honolulu, Hawaii, on Feb. 12 and ends in Australia next month.

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140 Passengers Sick with Gastrointestinal Illness on 55-Day Cruise Aboard Queen Victoria, CDC Says

According to the Centers for Disease Control, the outbreak affected 128 of the 1,824 passengers on the ship and a number of crew members

cruise ship recent illness

A gastrointestinal illness has left nearly 140 passengers traveling on the Cunard Queen Victoria cruise ship sick.

According to the Centers for Disease Control , the outbreak affected 128 of the 1,824 passengers on the ship. Amongst the crew, 25 of the 967 staff reported catching the illness. Their symptoms include diarrhea and vomiting.

The CDC reported that the cause of the illness and how it spread remains unknown.

In response the the outbreak, the CDC also confirmed in their statement that the Cunard Cruise Line and the crew aboard the ship have increased cleaning and disinfection procedures. They've also recommended that sick passengers remain isolated.

Cunard Cruise Line did not immediately respond to PEOPLE's request for comment.

Never miss a story — sign up for  PEOPLE's free daily newsletter  to stay up to date on the best of what PEOPLE has to offer, from juicy celebrity news to compelling human interest stories.

"Cunard confirms that a small number of guests had reported symptoms of gastrointestinal illness on board Queen Victoria," the company told NBC News in a statement.

"They immediately activated their enhanced health and safety protocols to ensure the well-being of all guests and crew on board. Measures have been effective,” Cunard added.

The ship's 55-day voyage began in Southampton, U.K. on January 9, according to ship tracking site Cruise Mapper . It reached Ft. Lauderdale, Florida on Jan. 22, shortly after which the spread seems to have begun, per ABC .

It is currently in San Francisco and bound for Hawaii, after which it will continue on to Australia by march 4. The Vessel Sanitation Program is also currently monitoring the situation.

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These are the cruise ships with the best — and worst — sanitation scores so far this year

  • The CDC randomly inspects cruise ships to help prevent the spread of stomach viruses. 
  • The agency has reported 13 norovirus outbreaks on cruise ships this year.
  • These are the cruise ships with the best and worst sanitation report cards in 2023 so far.

Insider Today

There's nothing like a stomach virus to ruin your vacation, as hundreds of cruise ship passengers have unfortunately learned this year.

The Centers for Disease Control and Prevention has reported 13 norovirus outbreaks on cruise ships so far in 2023. The last time the industry's yearly gastrointestinal illness outbreak total was that high was back in 2016 — and it's only July.

For the agency to report a cruise-ship outbreak, 3% or more of passengers or crew members must report symptoms of gastrointestinal illness, such as vomiting and diarrhea, to the ship's medical staff. During the most recent outbreak, a 14-day cruise aboard the Viking Neptune in June, slightly over 13% of passengers (110 of 838) reported being ill with predominant symptoms of abdominal cramps, vomiting, and diarrhea, according to the CDC.

The nasty stomach bug isn't just a cruise-ship problem, though. Norovirus cases have spiked across the United States this year, which some experts say is the result of ending COVID-19 restrictions .

"People often associate cruise ships with acute gastrointestinal illnesses such as norovirus, but acute gastrointestinal illness is relatively infrequent on cruise ships," the CDC says on its website. "Health officials track illness on cruise ships. So outbreaks are found and reported more quickly on a cruise ship than on land."

To try to help prevent the spread of stomach viruses at sea, the CDC randomly inspects cruise ships and scores them on a scale of 0 to 100 through the Vessel Sanitation Program . Inspection scores of 85 and lower are considered "not satisfactory" by the agency.

Most vessels have received scores in the high 90s — only one cruise ship, the MSC Seaside, has failed the CDC's sanitation inspection so far this year. The vessel received an unusually low score of 67 , nearly 20 points below the agency's passing grade.

An MSC Cruises representative told Insider at the time that the cruise line had launched an internal investigation based on the inspector's concerns and taken immediate corrective actions.

"MSC Cruises rigorously adheres to health protocols, and the results of this inspection do not reflect the brand's high standards," the person added.

In the past 10 years, only three other cruise ships have received sanitation scores below 70, CDC records show. Violations can include something as small as not posting a raw-eggs advisory on the omelet station or a single fly hovering in a food area. But before going on your next cruise adventure, it doesn't hurt to check out the ship's most recent sanitation rating.

These are the cruise ships with the highest and lowest sanitation scores so far this year:

The 15 cruise ships with perfect scores of 100

The 15 cruise ships with scores below a 95.

Correction: July 17, 2023 — An earlier version of this story included a photo caption that misstated how many passengers and crew members aboard the Nieuw Amsterdam reported being ill during a May voyage. It was 284 people, not 539.

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Cruise Sailing Interrupted After Suspected Cholera Outbreak

Scott Laird

  • Travel News
  • Cruises & Crossings

Gastrointestinal ailments aren’t uncommon onboard ships, but cholera isn’t a common concern onboard cruise ships or in the world’s developed economies.

Update 8:00 pm EST via Spokesperson for Norwegian Cruise Line:  “Upon Norwegian Dawn’s arrival to Port Louis Mauritius on Feb. 25, 2024, there were a small number of guests experiencing mild symptoms of a stomach-related illness.  Despite previous reports and speculations, there were no confirmed cases nor any evidence of cholera on board the vessel.  Although only six guests were being monitored due to mild symptoms of a stomach-related illness, the government of Mauritius required testing in an overabundance of caution, thereby delaying the ship’s original disembarkation scheduled for Feb. 25, 2024.

Following the results of the regulatory testing by the government of Mauritius and their confirmation that no trace of cholera was found during their testing, Norwegian Dawn has been cleared for entry into Port Louis, Mauritius, and disembarkation of all guests will commence early morning Feb. 27, 2024 local time.”

P assengers planning to board Norwegian Cruise Lines (NCL) Norwegian Dawn in Mauritius on Sunday found there was no ship for them to board. Norwegian Dawn anchored off the island nation in the Indian Ocean after authorities refused to allow it to land and disembark passengers following reports of stomach-related illnesses onboard the ship’s 12-day cruise, which had originated in South Africa. 

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Other news outlets reported the Mauritian authorities feared the stomach ailments were in fact cholera after several recent outbreaks in Southern Africa. 

In a statement, Mauritian port officials noted that “The decision not to allow the cruise ship access to the quay was taken in order to avoid any health risks. The health and safety of passengers as well as that of the country as a whole are of the utmost importance to the authorities.”

O ver 2,200 passengers expecting to embark on their cruise in Mauritius have been impacted; NCL has assisted in find accommodations and rebooking.

American journalist Suzie Dundas is one of those waiting to board the ship in Mauritius. She has been keeping a post updated about the status of the ship, noting that NCL provided hotel rooms and is covering expenses because of the delay, but that all of the planned port calls in Madagascar have been cancelled. 

Officially, it’s now being called a cholera “scare,” after Mauritian officials allowed the ship to dock in Port Louis after those passengers demonstrating symptoms were tested and found not to have cholera. Dundas notes, however, that in NCL’s communications they appeared to blame Mauritian officials for preventing the ship from docking, citing an unspecified “health issue”. In a later update, they admitted that the concern from the Mauritian officials was that the ship had been suspected to have been impacted by cholera.

The news comes on the heels of an NCL sailing earlier this month that cancelled planned scenic cruising in Antarctica . Passengers on that ship were not informed of the change in itinerary until just prior to sailing. It’s unclear whether NCL has offered any compensation for that itinerary change. Passengers on the Norwegian Dawn were offered onboard credits, plus a discount off a future NCL cruise, in addition to hotel accommodations and reimbursement of expenses, and refunds for any days missed on the shortened sailing. 

Gastrointestinal ailments aren’t uncommon onboard ships, but cholera—a bacterial infection caused by poor food or drinking water sanitation—isn’t a common concern onboard cruise ships or in the world’s developed economies. If left untreated, it can be fatal, but modern treatments are effective. 

In the United States, the Centers for Disease Control inspects passenger ships, including cruise ships calling at U.S. ports or entering US territorial waters. Passengers can search CDC inspection reports to learn if there have been any recent concerns about sanitation onboard their ship prior to booking and sailing.

Norovirus is more common than cholera on cruise ships, but widespread outbreaks still remain the exception, rather than the rule. 

The CDC advises that passengers on cruise ships can avoid both bacterial and viral infections during their travels with frequent handwashing and sanitizing, avoiding contact with passengers who appear to be sick, and isolating in their cabins when feeling unwell. Passengers should also notify the ship’s medical facilities as soon as they notice symptoms, for onboard medical facilities not only treat illness, they also track onboard trends among passengers and crew.

I was on the ship.  NCL may have known about a handful of people but a lot more people contracted "it."  Most people are not going to medical for a bout of diarreha especially if they have the right drugs with them....like me.  Yes, I had it.  I took my antibiotics and it was over in less than 12 hours.  100% back to normal.  Self quarantined for about 36 hours.  Talked to other passengers who did the same.  From everything I read, symptoms between noro-virus and Cholera are similar so it was an understandable concern give there is an significant outbreak of Cholera in South Africa and Madagascar - two of our stops.

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Cholera is a severe illness and far worse than noro virus so the symptomalogy is much worse and to confuse the two is a head scratcher. 

More than 2,000 passengers aboard ship trapped at sea due to mystery illness

Some passengers aboard a Norwegian Cruise ship were quarantined following a stomach illness that broke out on the ship, which prompted local authorities to prevent passengers from disembarking until test results were in.

The Norwegian Dawn cruise line revealed that a “small” amount of guests experienced mild symptoms of the stomach-related illness aboard the ship that began to surface last week.

Right now, it’s unclear exactly how many passengers or crew members are sick.

But of the small number of passengers who fell ill, 2,184 passengers are aboard the Norwegian Dawn, along with 1,026 crew members, according to the Mauritius Ports Authority .

The 12-day South African voyage, from Cape Town to Port Louis, was scheduled to touch down at its final destination on Feb. 25, but when the boat skipped its Reunion Island stop, it arrived at Port Louis earlier than expected, where the ship was unable to dock, according to what the Mauritius Ports Authority said Sunday.

Upon arrival, the Mauritius Ministry of Health took samples from 15 passengers on board the ship due to the health risk and isolated them aboard the vessel, the authority said .

So, until testing is finished, Mauritius will not let anyone exit or enter the ship for the next cruise until Tuesday, the cruise line said.

About 2,000 passengers were scheduled to disembark the boat Sunday but are still aboard. Some 2,279 new passengers were scheduled to board the vessel in Port Louis on Sunday but have yet to do so, according to the Mauritius Ports Authority.

To make up for that, U.S.-based Norwegian Cruise Line said it’s providing guests complimentary hotel accommodations until they are allowed to board.

Health officials should receive the test results in about 48 hours from when passengers were tested.

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2023 is the year of getting sick on a cruise

The reported occurrence of gastrointestinal diseases on cruises is worse than pre-covid.

A cruise ship seen from above

Holland America’s Nieuw Amsterdam, a cruise ship that, according to the company’s site , “celebrates historic New York City with an inspired design and art collection,” is currently traveling along the western coast of Canada for a 14-day tour to Alaska and back.

For tickets starting at $2,699 per-person , double occupancy rate, 1,970 passengers get to enjoy a spa treatments, fine meals, and pickleball at sea. For 160 of them, and 26 members of its 813-person staff, the journey also featured a gastrointestinal illness.

They aren’t alone. The Nieuw Amsterdam outbreak is the 11th to occur this year. It’s a sign—if not the most desirable one—that things are back to pre-covid levels: This is the highest number of outbreaks recorded on ships since 2018, and even then it took the whole year to get to 11.

Norovirus and more

As part of its Vessel Sanitation Program (VSP), the Centers for Disease Control and Prevention (CDC) tracks occurrences of gastrointestinal disease on board, which cruises are required to report. The cases are reported before arriving to the US from a foreign port, or whenever 3% or more of cruise passengers or crew are ill.

So far this year, 1,503 people—1,321 passengers, and 182 crew members—have come down with gastrointestinal illnesses on cruises that had the US as part of their itinerary. Most of the infections are still of unknown origin, while in three cases the outbreaks were identified as norovirus, which is a relatively common cause of gastrointestinal disease on cruises. Norovirus survives on surfaces, and it can spread easily on ships where rooms are close, buffets proliferate, and people share confined spaces.

Though it was one of the largest of the year, the outbreak on the Nieuw Amsterdam was mild, and all sick individuals were quarantined. Only on the Princess Cruises’s Ruby Princess , which had a norovirus outbreak during its mid-February trip, were there were more cases, with 234 passengers and 34 members of the crew becoming ill. Data on outbreaks on cruises is available starting from 1994, and the rate of incidence has diminished significantly since it reached a peak in the early 2000s, when outbreaks regularly surpassed 20 per year.

The number of outbreaks might also be a sign that ridership on cruise ships is returning to pre-pandemic levels. In 2019, nearly 15 million people took cruises in the US , while that number was down to only 2 million in 2021, and about 5 million in 2022.

Illness on cruises isn’t as common as it is on land

Gastrointestinal disease of this type isn’t usually serious serious—though it’s hardly fun, especially at sea. But it’s hardly exclusive to cruises: The vast majority of outbreaks happen on land, and every year there are around 2,500 outbreaks of norovirus recorded in the US, causing up to 21 million cases .

As the CDC notes , millions of people travel on cruises every year, making less than a dozen outbreaks a relatively minor concern. “Health officials track illness on cruise ships. So outbreaks are found and reported more quickly on a cruise ship than on land,” says the CDC.

Still, it’s helpful to follow basic health precautions to limit the chance of getting sick, including reporting any illness that occurs prior to joining a voyage, or while on board, frequent and washing hands , and leaving the area if someone is sick.

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Forbes

More Than 2,000 Stuck On Cruise Ship Because Of Mystery Illness

A Norwegian Cruise Line is stuck off the coast of Mauritius after some passengers on a South African voyage were quarantined after experiencing a stomach illness aboard the ship, and local authorities decided to prevent any other passengers on the massive ship from disembarking until test results come back.

The Norwegian Cruise Line said “a small number” of guests aboard the ship began experiencing mild symptoms of a stomach-related illness earlier this week.

The Norwegian Dawn was scheduled to arrive in Port Louis on Feb. 25, but after the boat skipped its Reunion Island stop it arrived earlier at Port Louis, where authorities said the ship could not dock, the Mauritius Ports Authority said Sunday.

The Mauritius Ministry of Health took samples from about 15 passengers on board the Dawn—which was on a 12-day cruise from Cape Town to Port Louis—because of the ongoing health risk and isolated them aboard the boat, according to the authority said .

Until testing is complete, Mauritius would not let anyone leave or board the ship for the next cruise until Tuesday, Norwegian said in a statement.

What To Watch For

It will take about 48 hours for health officials to receive the test results from the 15 passengers they tested.

What We Don’t Know

It’s unclear exactly how many passengers or crew members are sick. Officials only said they tested 15 individuals.

2,184. That’s how many passengers are aboard the Norwegian Dawn, along with 1,026 crew members, according to the Mauritius Ports Authority. About 2,000 passengers were scheduled to disembark the cruise Sunday but are still aboard the boat. Some 2,279 new passengers were scheduled to board the ship in Port Louis on Sunday but have not yet done so, the Mauritius Ports Authority said. U.S.-based Norwegian Cruise Line said it is providing guests complimentary hotel accommodations until “they are able to board.”

Further Reading

USA TODAY Norwegian cruise quarantined due to stomach illness cases on board

More Than 2,000 Stuck On Cruise Ship Because Of Mystery Illness

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5 Illnesses You Can Get on a Cruise Ship (Besides COVID)

Plus, tips on how to avoid getting sick while at sea and ports of call.

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Rachel Nania and Nicole Gill Council,

Concerns over the spread of COVID-19 have loomed over the travel industry for the last three years, but with the public health emergency coming to an end and a robust menu of preventive tools and treatments available, many of those fears are fading.

A new  AARP survey  shows 81 percent of adults 50-plus who plan to travel in 2023 believe it’s safe to do so now, up from 77 percent in 2021. And while interest in cruising is down slightly among the 50-plus population this year compared to last, a recent AAA survey finds that, overall, the share of travelers considering a cruise vacation in 2023 is up.

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However, the return to the skies and seas does not mean COVID-19 is no longer a threat.

“Indoor densely populated places where we’re exchanging exhaled breath with one another is still going to be a concern for me,” says Wilbur Chen, M.D., adult infectious disease physician and director of the University of Maryland, Baltimore Travel Medicine Practice.

That concern isn’t limited to COVID, either. Flu spreads in a similar way, Chen points out.

It’s important to note, though, that since the start of the pandemic, many cruise lines have invested in better air circulation systems with medical-grade HEPA filters , says travel expert Pamela Kwiatkowski, cofounder and chief insurance officer at Goose Insurance Services in Vancouver, British Columbia. “I think that’s the first step they’ve taken in terms of improving the air filtration system, which removes almost all of the airborne pathogens,” she says.

Still, plenty of bugs can lurk on busy boats. Read on to discover some common illnesses you can pick up on a cruise — and what you can do to help keep yourself healthy on your next getaway. 

1. Flu and other respiratory illnesses

Flu season spiked early this year in the U.S., along with another  respiratory illness  that can be particularly dangerous for older adults, respiratory syncytial virus, which is known as RSV . Cases of flu and RSV have declined from fall’s peak, data from the Centers for Disease Control and Prevention (CDC) shows, but the viruses that cause these two illnesses are still circulating in the U.S. and other parts of the globe.

“Influenza is complicated during cruise travel because, of course, people on a cruise ship — both the passengers and the crew — may come from different parts of the world, which means that the rates of influenza for your particular country may not necessarily be the same as in other places,” says Jose Lucar, M.D., an infectious disease physician and associate professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C.

According to the CDC, flu season in the southern hemisphere, which includes Australia and parts of South America and Africa, typically runs April through September. In the tropics, flu flares up throughout the year.

Staying healthy:  If you haven’t rolled up your sleeve for the flu shot yet, make sure you get it at least two weeks before going on a cruise, Lucar says. The same applies to the latest  COVID booster . When it comes to RSV, there isn’t a vaccine yet, but the FDA could approve one soon.

A few other tips: If you’re at high risk for  flu complications , talk to your doctor about antiviral treatment and prevention before your trip, the CDC recommends. Don’t forget about high-quality face masks, which can help to tamp down the spread of respiratory illnesses. And be sure to make — and pack — a list of all the medications you take, in case you wind up needing medical care on board. “That just makes it easier for everyone, so that if there is an emergency, if you’re not able to talk really well, you can at least hand the sheet over and it’s done,” Chen says.

2. Norovirus

This is one of the most well-known bugs that can foil fun on a ship. Norovirus — marked by diarrhea , vomiting, nausea and stomach pain — is to blame for more than 90 percent of diarrheal disease outbreaks on cruises, according to the CDC. That said, norovirus outbreaks on ships account for only 1 percent of all such reported cases.

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“This infection is very contagious,” Lucar says. The virus is also a “hearty” one, Chen points out. It can survive for long periods of time on surfaces and is resistant to common disinfectants.

Close living quarters, shared bathrooms, populated pools, busy buffet lines and rapid turnover of passengers make it difficult to control the spread of the virus once it hits a ship. “It’s just really the perfect scenario for transmission of highly contagious GI [gastrointestinal] pathogens,” Lucar says.

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According to the Cruise Lines International Association, the risk each year of getting laboratory-confirmed norovirus during a ship outbreak is about 1 in 5,500. The association, which says it is the largest cruise industry trade association in the world, noted on its website that crew members use strict sanitation and cleaning practices created with the CDC’s Vessel Sanitation Program. Cabins are cleaned once a day, and other common areas, such as elevators and pools, are cleaned multiple times a day.

In late February, more than 300 people aboard a Princess Cruises ship fell ill with diarrhea and vomiting, according to the CDC, though the agency didn’t cite the cause of the illness that sickened the 284 passengers and 34 crew. The  Ruby Princess  increased disinfection and cleaning procedures in the wake of the outbreak.

Other bugs that have popped up on boats include salmonella and E. coli. One to keep an eye on is shigella, which the CDC notes has been behind GI outbreaks on cruise ships. This bacterium causes an infection known as shigellosis, which can cause fever, stomach pain and diarrhea that can be bloody or prolonged.

Typically, the infection is treated with antibiotics, Chen says, but the CDC recently  issued a warning  that antibiotic-resistant strains are circulating in the U.S. Chen isn’t aware of any outbreaks of the resistant varieties on cruise ships, but it’s something to monitor.

Staying healthy:  To avoid getting a GI bug, be sure to wash your hands with soap and water before eating and after going to the bathroom and coming into contact with high-touch surfaces, like doorknobs and stair railings. Hand sanitizers don’t work well against norovirus, Lucar notes.

Travel expert Kwiatkowski also recommends  drinking plenty of water  to keep your body running at its best. However, she advises passengers stay away from the water at ports, particularly if a passenger is vulnerable to gastrointestinal illnesses.

“Handwashing, cleaning your stateroom, watching what you eat and how much you eat, and making sure that you stay hydrated will go a long way in preventing these illnesses, from you catching them even if they are there,” she says.

Talk to a doctor or pharmacist about any medications you should pack, such as loperamide (Imodium) to help treat diarrhea or dimenhydrinate (Dramamine, Gravol) for nausea. If your immune system is compromised, your doctor may want to prescribe something ahead of your trip.

Although less common than respiratory and GI illnesses, measles, along with chicken pox and other  vaccine-preventable diseases , can circulate on cruise ships.

Measles, a highly contagious virus that can linger in the air even hours after an infected person leaves the room, was declared eliminated from the U.S. in 2000, thanks to a successful vaccine program. But cases still pop up in the States, and the virus is common in many countries around the world.

If an unvaccinated or under-vaccinated passenger or crew member contracts the virus and brings it on board, other vulnerable people can get sick, Chen explains. (A ship was quarantined off the coast of St. Lucia in 2019 when measles was reported on board.) The same goes for chicken pox (varicella), which is similarly caused by a highly contagious virus that can circulate among unvaccinated people.

Staying healthy:  To avoid these and other vaccine-preventable diseases, make sure you’re up to date on your routine vaccines before traveling. Two doses of the chicken pox vaccine are more than 90 percent effective at preventing the disease, and two doses of MMR (measles, mumps, rubella) are about 97 percent effective at preventing measles.

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4. Seasickness

Is the motion of the ocean getting to you? Seasickness, while not contagious or related to an infection, can make you feel downright miserable. The good news: Most people recover quickly from seasickness, formally known as motion sickness, and there are medications that can help.

Motion sickness — which can cause dizziness, nausea and vomiting whether you’re on a boat, in a car or on a roller coaster — occurs when the movement you see is different from what your inner ear senses. Interestingly, adults 50 and older are less susceptible than younger adults and children, the CDC notes.

Staying healthy:  If you’re prone to going a little green when you travel, talk to your doctor ahead of your trip about medications that can help with symptoms. Prescription and over-the-counter antihistamines — like dimenhydrinate (Dramamine), for example — are most frequently used to treat motion sickness. 

However, antihistamines can interact with other medications and often cause drowsiness and decreased mental alertness, and the nonsedating ones appear to be less effective, the CDC says. Your doctor may also prescribe or recommend a patch that can help prevent nausea and vomiting caused by motion sickness.

Another tip: Have your physician review your current list of medications, since common pills — including some antidepressants and painkillers — can make seasickness worse, according to the CDC. 

A few other things that can help with seasickness:

  • Try lying down on your stomach, shutting your eyes or looking off into the horizon.
  • Avoid the upper levels of the boat.
  • Stay hydrated and limit alcohol and caffeine consumption.
  • Avoid smoking . Even short-term cessation reduces your susceptibility to motion sickness, the CDC says.
  • Distract yourself with music, controlled breathing or aromatherapy (try mint or lavender). Sucking on a flavored lozenge (some experts recommend a hard ginger candy) may also help, the CDC says.
  • While the CDC says the scientific data on acupressure for seasickness is lacking, it works for some. You can find wrist bands for motion sickness in many drugstores.

5. Burns and bites

A word of advice from Lucar and Chen: Don’t forget the SPF when packing for your cruise. A burn on vacation can ruin your fun in the sun  and  put you at higher risk for  skin cancer .

“Also, if you’re going to places that have a lot of insects and mosquitoes, make sure you wear your insect repellent so that you don’t get a bunch of bites, because we also are worried about malaria, dengue, chikungunya, Zika — those sorts of things — at ports of call,” Chen says.

Staying healthy:  Opt for a sunscreen with an SPF of at least 15, the CDC recommends, and be sure your bottle says “blocks UVA and UVB” or “broad spectrum” on the label.

When it comes to insect repellent, look for a spray that’s registered with the Environmental Protection Agency. Layering it with sunscreen? Put the repellent on second, over the sunscreen, the CDC advises.

To ease any health-related concerns you might have before booking a cruise, Kwiatkowski suggests using a travel agent who is a cruise line expert or contacting the cruise line to ask about their cleaning protocols and track record. “I know it sounds like a lot of work,” she says, “but travel is a big investment, and you really want to travel worry-free.”

Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.

Nicole Gill Council is a writer and editor of travel and diversity, equity and inclusion content for aarp.org. Previously, she was a digital planning manager and a news editor at  USA Today  and Gannett News Service, and a copy editor at the  Los Angeles Times  and  Newsday.​

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    Jul 9, 2023, 4:03 AM PDT. During a May voyage, 284 out of 2,797 passengers and crew members aboard the cruise ship Nieuw Amsterdam reported being ill, according to the Centers for Disease Control ...

  23. Norwegian Cruise Ship Quarantined, Denied Entry to Debark

    Read Also: Cruise Ship Illness - How to Protect Yourself Furthermore, all guests being held aboard Norwegian Dawn will now receive a 15% discount (in the form of a future cruise credit) for any ...

  24. Norwegian Cruise Lines Cruise Ship Interrupted off Africa After

    Gastrointestinal ailments aren't uncommon onboard ships, but cholera isn't a common concern onboard cruise ships or in the world's developed economies. Update 8:00 pm EST via Spokesperson ...

  25. More than 2,000 passengers aboard ship trapped at sea due to ...

    The Norwegian Dawn cruise line revealed that a "small" amount of guests experienced mild-symptoms of the stomach-related illness aboard the ship. More than 2,000 passengers aboard ship trapped ...

  26. Illnesses on cruises are at a record high in 2023

    The cases are reported before arriving to the US from a foreign port, or whenever 3% or more of cruise passengers or crew are ill. So far this year, 1,503 people—1,321 passengers, and 182 crew ...

  27. More Than 2,000 Stuck On Cruise Ship Because Of Mystery Illness

    The Norwegian Cruise Line said "a small number" of guests aboard the ship began experiencing mild symptoms of a stomach-related illness earlier this week.

  28. 5 Common Illnesses You Can Get on a Cruise Ship

    2. Norovirus. This is one of the most well-known bugs that can foil fun on a ship. Norovirus — marked by diarrhea, vomiting, nausea and stomach pain — is to blame for more than 90 percent of diarrheal disease outbreaks on cruises, according to the CDC.