Cruise Ship Norovirus Outbreaks

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   January 16, 2018 ,   Ships and Lines

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).

Coronavirus on cruise ships - CruiseMapper CruiseMinus

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

Norovirus outbreaks on cruise ships in 2024

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

(Holland America Line) MS Koningsdam

cdc.gov/nceh/vsp/surv/outbreak/2024/Koningsdam-3-8.html

(Feb 17–Mar 24) 35-day North Pacific roundtrip from San Diego CA

passengers 98 / 2522 (3,89%), crew 12 / 961 (1,25%)

(Cunard) Queen Victoria

cdc.gov/nceh/vsp/surv/outbreak/2024/Queen-Victoria-1-29.html

(Jan 22-Feb 12) 11-day Transatlantic UK-USA (from Southampton to Fort Lauderdale)

passengers 129 / 1824 (7,07%), crew 25 / 967 (2,59%)

Celebrity Constellation

cdc.gov/nceh/vsp/surv/outbreak/2024/Celebrity-Constellation-1-12.html

(Jan 1-12) 9-day Caribbean from Tampa

passengers 68 / 2056 (3,31%), crew 7 / 945 (0,74%)

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).

Year / Number of reported cruise ship outbreaksTotal infected (passengers / crew)

2020 - 5 reports

1890 (1669 pax + 232 crew)

  • Norovirus - 790 (708 pax + 82 crew)
  • COVID - 1018 (868 pax + 150 crew)

2019 - 14 reports

1556 (1440 pax + 116 crew)

2018 - 15 reports

1177 (1099 pax + 78 crew)

2017 - 21 reports

2535 (2450 pax + 85 crew)

2016 - 23 reports

2504 (2378 pax + 126 crew)

2015 - 23 reports

2570 (2458 pax + 112 crew)

2014 - 14 reports

3530 (3354 pax + 205 crew)

2013 - 22 reports

2385 (2249 pax + 136 crew)

2012 - 34 reports

5542 (5079 pax + 463 crew)

2011 - 23 reports

1971 (1834 pax + 137 crew)

2010 - 37 reports

7101 (6799 pax + 302 crew)

2009 - 30 reports

4197 (3800 pax + 397 crew)

2008 - 39 reports

3743 (3465 pax + 278 crew)

2007 - 42 reports

4577 (4228 pax + 349 crew)

2006 - 54 reports

7215 (6567 pax + 648 crew)

2005 - 35 reports

4674 (4110 pax + 564 crew)

2004 - 42 reports

3675 (3189 pax + 486 crew)

2003 - 44 reports

3556 (3159 pax + 397 crew)

2002 - 43 reports

3530 (3211 pax + 319 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

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

(Virgin Voyages) Scarlet Lady

cdc.gov/nceh/vsp/surv/outbreak/2023/scarlet-lady_10-13.html

(Oct 8-13) 5-day Mexico and Bahamas from Miami

passengers 66 / 2198 (3%), crew 7 / 1163 (0,6%)

Celebrity Summit

cdc.gov/nceh/vsp/surv/outbreak/2023/Celebrity-Summit_5-22.html

(May 15-25)  10day Bermuda from NYC

passengers 152 / 2144 (7,09%), crew 25 / 963 (2,6%)

(Holland America) Nieuw Amsterdam

cdc.gov/nceh/vsp/surv/outbreak/2023/Nieuw-Amsterdam_5-16.html

(May 7-21) 14day Alaska from Vancouver

epidemic outbreak

passengers 246 / 1971 (12,4%), crew 38 / 826 (4,6%)

(P&O UK) Arcadia

cdc.gov/nceh/vsp/surv/outbreak/2023/Arcadia_1-3.html

((Jan 3-Apr 13) 100day World Cruise from Southampton 

passengers 88 / 1752 (5,02%), crew 20 / 815 (2,45%)

Grand Princess

cdc.gov/nceh/vsp/surv/outbreak/2023/Grand-Princess_4-18.html

(Mar 31-Apr 28) 28day Transpacific from Australia to the USA (Sydney to San Francisco)

passengers 99 / 1727 (5,73%), crew 32 / 1089 (2,94%)

Emerald Princess

cdc.gov/nceh/vsp/surv/outbreak/2023/Emerald-Princess_3-31.html

(Mar 17-Apr 1) 15day Panama Canal from Fort Lauderdale to Los Angeles

passengers 99 / 2123 (4,66%), crew 21 / 1192 (1,76%)

(RCI-Royal Caribbean) Enchantment of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2023/Enchantment-of-the-Seas_3-29.html

(Mar 23-31) 8day Florida-Bahamas from Baltimore

passengers 117 / 2362 (5%), crew 20 / 917 (2,18%)

Enchantment of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2023/Enchantment-of-the-Seas_3-19.html

(Mar 11-23) 12day Caribbean from Baltimore

epidemic outbreak

passengers 155 / 2148 (7,22%), crew 10 / 880 (1,14%)

Celebrity Equinox

cdc.gov/nceh/vsp/surv/outbreak/2023/Celebrity-Equinox_3-14.html

(Mar 9-18) 9day Caribbean from Fort Lauderdale Florida

passengers 122 / 2579 (4,7%), crew 14 / 1222 (1,1%)

Celebrity Constellation

cdc.gov/nceh/vsp/surv/outbreak/2023/Celebrity-Constellation_3-6.html

(Mar 6-17) 11day Caribbean from Tampa Florida

passengers 87 / 2062 (4,2%), crew 10 / 960 (1,04%)

Ruby Princess

cdc.gov/nceh/vsp/surv/outbreak/2023/Ruby-Princess_2-26.html

(Feb 26-Mar 5) 7day Caribbean from Galveston Texas

epidemic outbreak

passengers 284 / 2881 (9,9%), crew 34 / 1159 (2,9%)

RCI Jewel of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2023/Jewel-of-the-Seas_1-28.html

(Jan 28-Feb 3) 6day Caribbean from Port Canaveral Florida

passengers 68 / 2185 (3,11%), crew 1 / 865 (0,12%)

RCI Brilliance of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2023/Brilliance-of-the-Seas_1-16.html

(Jan 16-21) 5day Caribbean from Tampa Florida

passengers 70 / 2160 (3,24%), crew 8 / 838 (0,95%)

(Silversea) Silver Moon

cdc.gov/nceh/vsp/surv/outbreak/2022/SilverMoon_12-21.html

(Dec 21-Jan 6) 16day from South America to Florida USA (Callao Peru to Fort Lauderdale)

passengers 15 / 521 (2,8%), crew 13 / 413 (3,15%)

(P&O UK) Arcadia

cdc.gov/nceh/vsp/surv/outbreak/2022/Arcadia_12-29.html

(Dec 29-Jan 3) 5day Short Break from Southampton England UK

passengers 84 / 1986 (4,23%), crew 10 / 818 (1,22%)

Norovirus outbreaks 2022 reports

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

(CCL-Carnival Cruise Line) Carnival Splendor

cdc.gov/nceh/vsp/surv/outbreak/2022/CarnivalSplendor_5-24.html

(May 24-31) 7day Alaska roundtrip from Seattle

passengers 77 / 2109 (3,65%), crew 16 / 1079 (1,48%)

(Seabourn) Seabourn Odyssey

cdc.gov/nceh/vsp/surv/outbreak/2022/seabournodyssey_4-28.html

(April 28-May 19) 21day Panama Canal from Miami to Los Angeles

passengers 15 / 380 (3,95%), crew 5 / 347 (1,44%)

Norovirus outbreaks 2020 reports

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

(Holland America) Westerdam

cdc.gov/nceh/vsp/surv/outbreak/2020/Westerdam_3-1.html

(March 1-16) 15day Japan-Taiwan-Philippines roundtrip from Shanghai

passengers 2 / 18 (11,11%), crew 25 / 680 (3,68%)

(Royal Caribbean) Grandeur Of The Seas

cdc.gov/nceh/vsp/surv/outbreak/2020/Grandeur_3-7.html

(March 7-19) 12day Caribbean from Baltimore

passengers 98 / 1764 (5,56%), crew 7 / 798 (0,88%)

(Royal Caribbean) Grandeur Of The Seas

(Feb 20-28) 8day Caribbean from Baltimore

passengers 82 (3,35%)

(Princess) Caribbean Princess

cdc.gov/nceh/vsp/surv/outbreak/2020/Caribbean-Princess_2-16.html

(Feb 16Mar 1) 14day Caribbean from Fort Lauderdale

passengers 240 / 3039 (7,9%), crew 19 / 1162 (1,6%)

(Princess) Caribbean Princess

cdc.gov/nceh/vsp/surv/outbreak/2020/Caribbean-Princess_2-2.html

(Feb 2-16) 14day Caribbean from Fort Lauderdale

epidemic outbreak

passengers 371 / 3035 (12,2%), crew 32 / 1161 (2,8%)

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.

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

NCL Norwegian Joy

cdc.gov/nceh/vsp/surv/outbreak/2019/Norwegian-Joy_11-8.html

(Nov 8-24) 16day Panama Canal (Miami to Los Angeles)

passengers 127 / 3602 (3,5%), crew 6 / 1769 (0,3%)

AIDAdiva

cdc.gov/nceh/vsp/surv/outbreak/2019/AIDAdiva_10-3.html

(Oct 3-13) 10day Canada and New England (Montreal to NYC)

passengers 70 / 2251 (3,1%), crew 10 / 610 (1,6%)

AIDAluna

cdc.gov/nceh/vsp/surv/outbreak/2019/AIDAluna_9-28.html

(Sept 28 - Oct 12) 14day Caribbean from NYC

passengers 72 / 2166 (3,3%), crew 8 / 612 (1,3%)

AIDAdiva

cdc.gov/nceh/vsp/surv/outbreak/2019/AIDAdiva_9-5.html

(Sept 5-23) 18day Transatlantic from Rostock to NYC

passengers 117 / 2055 (5,7%), crew 8 / 610 (1,3%)

Carnival Conquest

cdc.gov/nceh/vsp/surv/outbreak/2019/Conquest_9-7.html

(Sept 7-14) 7day Caribbean from Miami

passengers 17 / 3241 (0,5%), crew 35 / 1158 (3%)

Oceania Marina

cdc.gov/nceh/vsp/surv/outbreak/2019/Oceania_Marina_3-18.html

(Mar 18-Apr 5) 18day Panama Canal from Callao-Lima to NYC

passengers 36 / 1066 (3,4%), crew 4 / 763 (0,5%)

Island Princess

cdc.gov/nceh/vsp/surv/outbreak/2019/Island_Princess_2-8.html

(Feb 8-18) 10day Panama Canal from Fort Lauderdale

passengers 101 / 2193 (4,6%), crew 9 / 905 (1%)

(Viking Ocean) Viking Star

cdc.gov/nceh/vsp/surv/outbreak/2019/Viking_Star_2-7.html

(Feb 7-14) 7day Cuba from Miami

passengers 36 / 904 (4%), crew 1 / 461 (0,2%)

(Viking Ocean) Viking Sea

cdc.gov/nceh/vsp/surv/outbreak/2019/Viking_Sea_1-18.html

(Jan 18-28) 10day Caribbean from San Juan Puerto Rico

passengers 31 / 925 (3,4%), crew 0 / 455 (0%)

Oasis Of The Seas

cdc.gov/nceh/vsp/surv/outbreak/2019/Oasis_of_the_Seas_1-6.html

(Jan 6-13) 7day Caribbean from Port Canaveral

passengers 561 / 6285 (8,9%), crew 31 / 2169 (1,5%)

(Viking Ocean) Viking Star

cdc.gov/nceh/vsp/surv/outbreak/2018/Viking_Star_Dec13-2018-Jan3-2019.html

(Dec 13-Jan 3) 21day Panama Canal from Los Angeles to Miami

passengers 28 / 917 (3,1%), crew 5 / 449 (1,1%)

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Crystal Symphony

cdc.gov/nceh/vsp/surv/outbreak/2018/Crystal_Symphony_11-8.html

(Nov 8 - Dec 2) 24day Amazon roundtrip from Fort Lauderdalepassengers 30 / 700 (4,3%), crew 17 / 585 (2,9%)

MS Volendam

cdc.gov/nceh/vsp/surv/outbreak/2018/Volendam_11-3.html

(Nov 3-18) 15day Panama Canal from San Diego to Fort Lauderdale

passengers 60 / 1285 (4,7%), crew 8 / 599 (1,3%)

AIDAprima

(Sept 22-29) 7day Mediterranean from Palma de Mallorca (Spain)

~300 total (7,5%)

(Pearl Seas Cruises) Pearl Mist

cdc.gov/nceh/vsp/surv/outbreak/2018/Pearl_Mist_9-1.html

(Sept 1-12) 11day USA and Canada (Chicago to Toronto)

passengers 6 (3,1%)

AIDAperla

(Sept 15-22) 7day Northern Europe from Hamburg

passengers 70

Regent Seven Seas Mariner

cdc.gov/nceh/vsp/surv/outbreak/2018/SevenSeasMariner_6-20.html

(June 20-30) 10day Alaska from Seward AK to Vancouver BC

passengers 38 / 652 (5,8%), crew 0 / 457

MS Zaandam

cdc.gov/nceh/vsp/surv/outbreak/2018/Zaandam_6-18.html

(June 18 - July 2) 14day Alaska from Seattle WA

passengers 95 / 1472 (6,5%), crew 18 / 591 (3,1%)

Silversea Silver Shadow

cdc.gov/nceh/vsp/surv/outbreak/2018/Silver_Shadow_5-10.html

(May 10-24) 14day Transpacific from Tokyo to Seward AK

passengers 28 / 327 (8,6%), crew 8 / 290 (2,8%)

Celebrity Infinity

cdc.gov/nceh/vsp/surv/outbreak/2018/Celebrity_Infinity_4-17.html

(April 17 - May 2) 15day Panama Canal from San Diego to Fort Lauderdale

passengers 111 / 2140 (5,2%), crew 7 / 970 (0,7%)

Cunard Queen Victoria

cdc.gov/nceh/vsp/surv/outbreak/2018/Queen_Victoria_2-21.html

(Feb 21 - Mar 9) 16day Panama Canal from Valparaiso-Santiago to Fort Lauderdale

passengers 65 / 1901 (3,4%), crew 9 / 968 (0,9%)

Azamara Quest

cdc.gov/nceh/vsp/surv/outbreak/2018/Azamara_Quest1-25.html

(Jan 25 - Feb 8) 14day repositioning from South America to USA (Puntarenas Costa Rica to San Diego)

passengers 20 / 663 (3%), crew 2 / 458 (0,4%)

Island Princess

cdc.gov/nceh/vsp/surv/outbreak/2018/Island_Princess1-8.html

(Jan 9-24) 15day Panama Canal from Los Angeles to Fort Lauderdale

passengers 71 / 2181 (3,3%), crew 7 / 898 (0,8%)

Grandeur of the Seas

(Jan 2-11) 9day Florida and Bahamas from Baltimore

46 total

Sea Princess

(Dec 21 - Jan 4) 14day New Zealand roundtrip from Brisbane Australia

~200 total

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Independence Of The Seas

cdc.gov/nceh/vsp/surv/outbreak/2017/Independence_Seas12-11.html

(Dec 11-16) 5day Caribbean from Fort Lauderdale

passengers 310 / 4160 (7,5%), crew 22 / 1398 (1,6%)

Ovation Of The Seas

(Nov 23 - Dec 7) 14day repositioning from Singapore to Sydney Australia

195 total

Celebrity Reflection

cdc.gov/nceh/vsp/surv/outbreak/2017/Celebrity_Reflection_11-27.html

(Nov 17-27) 10day Caribbean from Fort Lauderdale

passengers 173 / 3034 (5,7%), crew 3 / 1240 (0,2%)

Anthem Of The Seas

(Nov 4-11) 7day Bahamas from NYC New York

98 (total)

Celebrity Solstice

(Oct 30 - Nov 11) 12day Australia to New Zealand (Sydney to Auckland)

213 total / 3985 total

Crown Princess

cdc.gov/nceh/vsp/surv/outbreak/2017/Crown_Princess_10-25.html

(Oct 25 - Nov 8) 14day repositioning from Canada to Florida (Quebec City to Fort Lauderdale)

passengers 184 / 2957 (6,2%), crew 12 / 1172 (1%)

Lindblad National Geographic Sea Bird

cdc.gov/nceh/vsp/surv/outbreak/2017/National_Geographic_Sea_Bird_9-26.html

(Sept 26 - Oct 2)

passengers 13 / 57 (22,8%), crew 1 / 30 (3,3%)

Sun Princess

(July 31 - Aug 10) 10day New Caledonia and Vanuatu from Brisbane Australia

91 total

MS Nieuw Amsterdam

cdc.gov/nceh/vsp/surv/outbreak/2017/NieuwAmsterdam.html

(July 22-29) 7day Alaska from Vancouver

passengers 73 / 2210 (3,3%), crew 4 / 869 (0,5%)

MS Noordam

cdc.gov/nceh/vsp/surv/outbreak/2017/noordam_7-30.html

(July 30 - Aug 6) 7day Alaska from Vancouver to Seward

passengers 82 / 2143 (3,8%), crew 5 / 790 (0,6%)

MS Noordam

cdc.gov/nceh/vsp/surv/outbreak/2017/noordam.html

(July 23-30) 7day Alaska from Seward to Vancouver

passengers 138 / 2086 (6,6%), crew 4 / 803 (0,5%)

MS Volendam

cdc.gov/nceh/vsp/surv/outbreak/2017/july19_volendam.html

(July 12-1 9) 7day Alaska from Vancouver

passengers 68 / 1480 (4,6%), crew 1 / 610 (0,2%)

Celebrity Constellation

(June 15-24) 10day Mediterranean from Venice to Civitavecchia-Rome

~300 total

Coral Princess

cdc.gov/nceh/vsp/surv/outbreak/2017/march18_coral_princess.html

(March 8-18) 10day Caribbean and Panama Canal roundtrip from Fort Lauderdale

passengers 157 / 2016 (7,8%), crew 25 / 881 (2,8%)

Sea Princess

(Jan 8 - Apr 7) 90day "World Cruise" roundtrip from Brisbane Australia

pax 11

Sun Princess

  • (Jan 22 - Feb 2) 12day Papua New Guinea from Brisbane QLD
  • (Feb 2 - 16) 14day Australia to New Zealand from Brisbane
  • passengers ~90 / crew
  • passengers 173 / crew 3

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Sun Princess

(Dec 10-18) 9day Australia from Adelaide to Fremantle-Perth

na

MS Oosterdam

cdc.gov/nceh/vsp/surv/outbreak/2016/nov18_oosterdam.htm

(Nov 3-18) 16day Transatlantic from Rome-Civitavecchia to Tampa Florida

  • passengers 90 / 1843 (4,9%)
  • crew 22 / 796 (2,8%)

(Carnival fathom) Adonia / Azamara Pursuit

cdc.gov/nceh/vsp/surv/outbreak/2016/oct23_adonia.htm

(Oct 16-23) 7day Cuba from Miami

  • passengers 23 / 668 (3,4%)
  • crew 2 / 388 (0,5%)

Disney Wonder

cdc.gov/nceh/vsp/surv/outbreak/2016/may1_disney_wonder.htm

(Apr 27 - May 1) 4day Bahamas from Miami

  • passengers 131 / 2680 (4,9%)
  • crew 14 / 991 (1,4%)

Fred Olsen Balmoral

cdc.gov/nceh/vsp/surv/outbreak/2016/april16_balmoral.htm

(Apr 16 - May 20) 34day Transatlantic roundtrip to USA and Canada from Southampton (England UK)

  • passengers 252 / 919 (27,4%)
  • crew 8 / 520 (1,5%)

Oceania Riviera

cdc.gov/nceh/vsp/surv/outbreak/2016/march20_oceania_riviera.htm

(Mar 20 - Apr 3) 14day Caribbean from Miami

  • passengers 52 / 1204 (4,3%)
  • crew 0 / 776 (0%)

NCL Norwegian Gem

cdc.gov/nceh/vsp/surv/outbreak/2016/march12_norwegian_gem.htm

(Mar 12 - 22) 10day Caribbean from NYC

  • passengers 128 / 2882 (4,4%)
  • crew 7 / 1100 (0,6%)

Golden Princess

(Mar 8 - 22) 14day South Pacific Islands from Melbourne Australia

na

(Silversea) Silver Spirit

cdc.gov/nceh/vsp/surv/outbreak/2016/march3_silver_spirit.htm

(Mar 3 - 21) 18day South America from Valparaiso-Santiago to Fort Lauderdale

  • passengers 24 / 388 (6,2%)
  • crew 13 / 366 (3,6%)

Carnival Sunshine

cdc.gov/nceh/vsp/surv/outbreak/2016/february21_carnival_sunshine.htm

(Feb 21 - Mar 5) 13day Caribbean from Port Canaveral

  • passengers 118 / 3005 (3,9%)
  • crew 5 / 1142 (0,4%)

Anthem of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2016/february21_anthem_of_seas.htm

(Feb 21 - Mar 4) 12day Caribbean from Cape Liberty (New Jersey, NYC)

  • passengers 125 / 4061 (3,1%)
  • crew 16 / 1592 (1%)

(Princess/Oceania) Ocean Princess / Oceania Sirena

cdc.gov/nceh/vsp/surv/outbreak/2016/february13_ocean_princess.htm

(Feb 13 - Mar 7) 23day South America repositioning from Valparaiso to Miami

  • passengers 43 / 603 (7,1%)
  • crew 5 / 387 (1,3%)

Oceania Riviera

cdc.gov/nceh/vsp/surv/outbreak/2016/february12_oceania_riviera.htm

(Feb 12 - 22) 10day Caribbean roundtrip from Miami

  • passengers 79 / 1225 (6,5%)
  • crew 3 / 773 (0,4%)

Crown Princess

cdc.gov/nceh/vsp/surv/outbreak/2016/january3_crown_princess.htm

(Jan 8 - 18) 10day Mexico Riviera roundtrip from Los Angeles

  • passengers 180 / 3060 (5,9%)
  • crew 24 / 1168 (2,1%)

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

(P&O Australia) Pacific Eden

(Dec 16 - 28) 12day Christmas Cruise roundtrip from Sydney Australia

  • 60 passengers and crew (or 4% of all ~1500)

ms Veendam

cdc.gov/nceh/vsp/surv/outbreak/2015/december20_veendam.htm

(Dec 20 - 27) 7day Mexican Riviera roundtrip from San Diego

  • passengers 57 / 1429 (4%)
  • crew 10 / 588 (1,7%)

Caribbean Princess

cdc.gov/nceh/vsp/surv/outbreak/2015/december13_caribbean_princess.htm

(Dec 13 - 20) 7day Caribbean roundtrip from Houston Texas

  • passengers 163 / 3239 (5%)
  • crew 13 / 1154 (1,1%)

Explorer of the Seas

(Dec 2 - 16) 14day Australia to New Zealand, roundtrip from Sydney NSW

  • 182 passengers and crew
  • (or 3,9% of all 3566 passengers plus 1139 crew)

Oceania Riviera

cdc.gov/nceh/vsp/surv/outbreak/2015/dec2_oceania_riviera.htm

(18 Nov - 2 Dec) 14day Transatlantic from Barcelona to Miami FL

  • passengers 59 / 1160 (5,1%)
  • crew 10 / 776 (1,3%)

Star Princess

cdc.gov/nceh/vsp/surv/outbreak/2015/may14_star_princess.htm

(29 April - 14 May) 15day Hawaii from San Francisco

  • passengers 135 / 2588 (5,2%)
  • crew 16 / 1093 (1,5%)

Oceania Marina

cdc.gov/nceh/vsp/surv/outbreak/2015/may7_oceania_marina.htm

(21 Apr - 7 May) 16day South America (through Panama Canal) from Callao Peru to New York City

  • passengers 69 / 1185 (5,8%)
  • crew 11 / 769 (1,4%)

ms Maasdam

cdc.gov/nceh/vsp/surv/outbreak/2015/may1_ms_maasdam.htm

(17 Apr - 1 May) 14day Caribbean from Fort Lauderdale

  • passengers 67 / 1138 (5,9%)
  • crew 12 / 578 (2,1%)

Coral Princess

cdc.gov/nceh/vsp/surv/outbreak/2015/april27_coral_princess.htm

(Alaska repositioning, Apr 12 - 27) 15day Panama Canal from Fort Lauderdale to Los Angeles

  • passengers 71 / 1958 (3,6%)
  • crew 6 / 881 (0,7%)

(Royal Caribbean / Marella UK)

Legend of the Seas / Marella Discovery 2

cdc.gov/nceh/vsp/surv/outbreak/2015/april14_legend_of_seas.htm

(30 Mar - 14 Apr) 15day Panama Canal from Fort Lauderdale to San Diego

  • passengers 114 / 1763 (6,5%)
  • crew 2 / 747 (0,3%)

Celebrity Infinity

cdc.gov/nceh/vsp/surv/outbreak/2015/april13_celebrity_infinity.htm

(29 Mar - 13 Apr) 15day Panama Canal transit from Fort Lauderdale to San Diego

  • passengers 95 / 2117 (4,5%)
  • crew 5 / 964 (0,5%)

Celebrity Equinox

cdc.gov/nceh/vsp/surv/outbreak/2015/february23_celebrity_equinox.htm

(13-23 Feb) 10day Caribbean from Fort Lauderdale

  • passengers 95 / 2896 (3,3%)
  • crew 7 / 1209 (0,6%)

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Crown Princess

cdc.gov/nceh/vsp/surv/outbreak/2014/april12_crown_princess.htm

(5-12 Apr) 7day California from Los Angeles

  • passengers 122 / 3161 (3,9%)
  • crew 30 / 1176 (2,6%)

(Princess / P&O Australia) Dawn Princess / Pacific Explorer

(18 Oct - 16 Nov) New Zealand from Melbourne Australia

  • passengers 158 / 3009 (5,25%)
  • crew 14 / 1160 (1,2%)

Grandeur of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2014/april5_grandeur_seas.htm

(28 Mar - 5 Apr) 8day  Bahamas from Baltimore

  • passengers 111 / 2122 (5,2%)
  • crew 6 / 790 (0,8%)

ms Maasdam

cdc.gov/nceh/vsp/surv/outbreak/2014/march28_msmaasdam.htm

(2-28 Mar) 26day Amazon/South America from Rio de Janeiro to Fort Lauderdale

  • passengers 65 / 1096 (5,9%)
  • crew 8 / 569 (1,4%)

ms Veendam

cdc.gov/nceh/vsp/surv/outbreak/2014/february22_msveendam.htm

(8-22 Feb) Panama Canal from San Diego to Fort Lauderdale

  • passengers 114 / 1273 (9%)
  • crew 10 / 575 (1,7%)

Caribbean Princess

cdc.gov/nceh/vsp/surv/outbreak/2014/january25_caribbean_princess.htm

(25 Jan - 1 Feb) 7day Caribbean from Houston TX

  • passengers 181 / 3102 (5,8%)
  • crew 11 / 1148 (1%)

Explorer of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2014/january21_explorer_seas.htm

(21-27 Jan) 10day Caribbean from NYC (Cape Liberty / Bayonne NJ)

  • passengers 577 / 3050 (18,9%)
  • crew 49 / 1165 (4,2%)

NCL-Norwegian Star

cdc.gov/nceh/vsp/surv/outbreak/2014/january15_norwegian_star.htm

(5-19 Jan) 7day Mexican Riviera from LA

  • passengers 130 / 2318 (5,6%)
  • crew 12 / 1039 (1,2%)

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.
(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Celebrity Constellation

25 Sept - 7 Oct (Black Sea)

On Oct 5, 90+ passengers with Norovirus symptoms were taken to Burgas Municipal hospital

Celebrity Infinity

cdc.gov/nceh/vsp/surv/outbreak/2013/april1_celebrity_infinity.htm

17 Mar - 1 Apr

  • passengers 101 / 2086 (4,8%)
  • crew 17 / 927 (2%)

Celebrity Millennium

cdc.gov/nceh/vsp/surv/outbreak/2013/may10celebrity_millennium.htm

25 Apr - 10 May

  • passengers 123 / 1963 (6,3%)
  • crew 16 / 935 (1,7%)

Celebrity Solstice

cdc.gov/nceh/vsp/surv/outbreak/2013/april8_celebrity_solstice-.htm

8-26 Apr

  • passengers 178 / 2849 (6,25%)
  • crew 2 / 1188 (0,18%)

Crystal Symphony

cdc.gov/nceh/vsp/surv/outbreak/2013/may6crystal_symphony.htm

29 Apr - 6 May

  • passengers 125 / 816 (15,3%)
  • crew 22 / 571 (3,9%)

Cunard Queen Elizabeth

no data / CDC report

4 Feb - 12 Mar

  • passengers 84 / 1900+ (4,4%)
  • crew (an)

ms Veendam

cdc.gov/nceh/vsp/surv/outbreak/2013/april13_veendam.htm

13 Apr - 4 May

  • passengers 60 / 1237 (4,9%)
  • crew 10 / 574 (1,7%)

Ruby Princess

cdc.gov/nceh/vsp/surv/outbreak/2013/march10_ruby_princess.htm

3-10 Mar

  • passengers 266 / 3129 (8,5%)
  • crew 10 / 1189 (0,8%)

Vision of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2013/march8_vision_seas.htm

25 Feb - 8 Mar

  • passengers 118 / 1991 (5,9%)
  • crew 3 / 765 (0,4%)

Fred Olsen Black Watch

  1. Oct 2
  2. Sept 20
  3. Sept 8
  4. Sept 1

passengers only:

  1. 131 / 737
  2. 130
  3. 54
  4. 118

Grand Turk was bypassed as call port by several ships due to a gastrointestinal outbreak there. The cruise terminal was temporarily closed (March 26 through April 4) - according to the port schedule, there were no arrivals after March 13, 2013. The list of lines/ships that skipped the island:

  1. ms Eurodam
  2. ms Nieuw Amsterdam
  3. Ruby Princess
  4. Carnival Breeze
  5. Carnival Liberty
  6. Carnival Victory-Radiance

Grand Turk authorities didn't find the cause of the illness. The cruise terminal and the near area were thoroughly cleaned and sanitized.

itinerary changes included:

  • adding a sea day
  • rerouting ships or extending port stays in Puerto Rico and the Bahamas
  • all pre-booked Grand Turk excursions and port taxes were fully refunded in the form of OBC.

March 26 - April 4

affected voyages / changes

  1. Mar16 / to San Juan
  2. Mar17 / to San Juan
  3. Mar31 / to Nassau
  4. Mar30 / to Nassau
  5. Mar30 / to San Juan
  6. Apr1 / to Freeport

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).

(Cruise Line) Ship / CDC report linkItinerary DatesSick Passengers-Crew / All (%)

Carnival Glory

cdc.gov/nceh/vsp/surv/outbreak/2012/august8carnival_glory.htm

6-11 Aug

  • passengers 205 / 3652 (5,6%)
  • crew 3 / 1144 (0,3%)

Celebrity Constellation

cdc.gov/nceh/vsp/surv/outbreak/2012/feb11celebrity_constellation.htm

28 Jan - 10 Feb

  • passengers 102 / 1992 (5,1%)
  • crew 12 / 946 (1,3%)

Celebrity Silhouette

cdc.gov/nceh/vsp/surv/outbreak/2012/feb10celebrity_silhouette.htm

29 Jan - 10 Feb

  • passengers 178 / 2809 (6,3%)
  • crew 11 / 1236 (0,9%)

Cunard Queen Mary 2

cdc.gov/nceh/vsp/surv/outbreak/2012/january3_queen_mary_2.htm

22 Dec - Jan 3

  • passengers 204 / 2613 (7,8%)
  • crew 16 / 1255 (1,3%)

Crown Princess

cdc.gov/nceh/vsp/surv/outbreak/2014/november16_crown_princess.htm

  • 28 Jan - 4 Feb
  • 4-9 Feb
  • passengers 364 / 3103 (11,7%)
  • crew 32 / 1168 (2,7%)
  • passengers 288 / 3078 (9,4%)
  • crew 75 / 1178 (6,4%)

(Princess / P&O Australia) Dawn Princess / Pacific Explorer

cdc.gov/nceh/vsp/surv/outbreak/2012/august31_dawn_princess.htm

21 Aug - 13 Sept

  • passengers 114 / 1778 (6,4%)
  • crew 11 / 851 (1,3%)

Emerald Princess

cdc.gov/nceh/vsp/surv/outbreak/2012/december27_emerald_princess.htm

17-27 Dec

  • passengers 189 / 3235 (5,8%)
  • crew 31 / 1189 (2,6%)

Ruby Princess

cdc.gov/nceh/vsp/surv/outbreak/2012/march4ruby_princess.htm

cdc.gov/nceh/vsp/surv/outbreak/2012/october28_ruby_princess.htm

26 Feb - 4 Mar

9-28 Oct

  • passengers 129 / 3147 (4,1%)
  • crew 9 / 1179 (0,8%)
  • passengers 149 / 2971 (5%)
  • crew 14 / 1177 (1,2%)

Sun Princess

cdc.gov/nceh/vsp/surv/outbreak/2012/july21sun_princess.htm

8-21 Jul

  • passengers 201 / 1918 (10,5%)
  • crew 15 / 836 (1,8%)

(P&O UK) Aurora

cdc.gov/nceh/vsp/surv/outbreak/2012/jan26aurora.htm

4-26 Jan

  • passengers 145 / 1727 (8,4%)
  • crew 8 / 850 (0,9%)

Oceania Riviera

cdc.gov/nceh/vsp/surv/outbreak/2012/november29_oceania_riviera.htm

15-29 Nov

  • passengers 37 / 1019 (3,6%)
  • crew 13 / 767 (1,7%)

ms Amsterdam

cdc.gov/nceh/vsp/surv/outbreak/2012/december5_amsterdam.htm

11 Nov - 5 Dec

  • passengers 85 / 791 (10,8%)
  • crew 6 / 610 (1%)

Rhapsody of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2012/august31_rhapsody.htm

24-31 Aug

  • passengers 153 / 2129 (7,2%)
  • crew 6 / 812 (0,7%)

Voyager of the Seas

cdc.gov/nceh/vsp/surv/outbreak/2012/feb4voyager.htm

28 Jan - 4 Feb

  • passengers 248 / 3139 (7,9%)
  • crew 11 / 1192 (0,9%)

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?

  1. Wash your hands often (hot water and soap), especially before/after eating and after using the bathroom
  2. Limit physical contacts as much as possible, pack some extra soap, a personal disinfectant (Lysol, Pepto-Bismol), oral rehydration sachets and treatments for diarrhea
  3. 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.
  4. Drink lots of water.
  5. 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.

Cruise Ship Norovirus Outbreaks - CruiseMapper CruiseMinus

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:

  • 8 decks
  • 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.