Taking a Cruise: How Likely Are You to Get Sick?

After yet another high-profile case of many passengers falling ill on a ship, you might think norovirus comes standard with cruises nowadays.

Royal Caribbean’s Explorer of the Seas cut short a 10-day cruise after nearly 700 people on board were treated to something not featured on the itinerary: vomiting, diarrhea and stomach cramps. While a norovirus is suspected, the cause of sickness has not yet been determined.

It was the largest outbreak of illness on a cruise ship in 20 years, CNN says.

In the first month of 2014, there have been three major outbreaks of norovirus-like illness aboard cruise ships that dock in the U.S.

Are cruise ships floating petri dishes?

Earlier this month, 142 people aboard the Norwegian Star of the Norwegian Cruise Line were stricken with vomiting and diarrhea, according to the U.S. Centers for Disease Control and Prevention.

In addition, the Caribbean Princess from Princess Cruise Lines cut short its journey and docked at Houston on Thursday night after 162 passengers and 11 crew members became ill. Again, a norovirus appears to be at fault.

“In 2013, there were nine reported incidents — seven caused by norovirus, one by E. coli and another in November from a still-unknown cause,” the Houston Chronicle says. That’s fewer than the 16 illness outbreaks on cruise ships reported in 2012. The year 2004 was a particularly bad one, with 32 outbreaks. You can track all of the outbreaks and their causes at the CDC’s website here.

Keeping ships clean

In all fairness to the cruise industry, the number of passengers who contract norovirus or other gastrointestinal illnesses on a cruise ship is actually quite small. The Cruise Lines International Association says only 0.01 percent of passengers were afflicted with norovirus while on a cruise in 2012.

Still, the problem is big enough that the CDC developed the Vessel Sanitation Program and maintains a section on its website specifically addressing norovirus. The CDC conducts two unannounced inspections per year for each ship and has issued a 260-plus-page manual outlining proper sanitation procedures and expectations.

Unfortunately, even under the best of circumstances, cruise ships provide the perfect environment for norovirus to spread. The virus is notoriously difficult to kill, and the close confines of a cruise ship means plenty of opportunities for it to land on railings or doorknobs or in food prep areas.

If someone comes on board with norovirus already in their system, it wouldn’t necessarily take long for it to make its way across the entire ship.

Cruise line compensation varies

So, if there’s an outbreak on your trip, is the cruise line legally required to reimburse you? “For the most part, airlines and cruises are not obligated by law to compensate customers when things go badly on a trip,” Time’s Brad Tuttle says.

Cruise lines sometimes offer compensation, but there’s a wide range.

Passengers on the Caribbean Princess were offered an overnight stay in Houston and a 20 percent credit toward a future cruise, the Chronicle reports.

Royal Caribbean is offering Explorer of the Seas passengers a 50 percent refund and a 50 percent credit for a future cruise, CNN says. Those sick people ordered to stay in their rooms will get a credit for each day they were quarantined.

Would buying travel insurance help in case of an outbreak during your trip? It depends. Writes Paul Motter, editor of CruiseMates, on FoxNews.com:

Regular travel insurance will not allow you to cancel a planned cruise just because the ship has had an outbreak of norovirus on a previous cruise, unless you specifically buy a “cancel for any reason” travel insurance policy.

… Trip interruption is different, with the compensation based on a prorated per diem cost of the vacation. But if a cruise line gives the passengers compensation, … then the insurance company will not see your situation as a “loss” and will not reimburse you.

How not to lose your lunch

Norovirus is not limited to cruise ships. It’s extremely contagious and can easily spread wherever people congregate. But you can take steps to protect yourself.

  • Read the CDC’s norovirus website. For instance, it tells you that you’re most contagious while you’re sick and for three days after you recover. Norovirus remains in stool for two weeks.
  • Wash your hands often. Norovirus spreads when we touch a contaminated surface and then either put our hands near our mouth or touch something going into our mouth, such as food. The CDC recommends frequent hand washing, particularly before you eat.
  • Avoid infected people. “Some studies show it can be aerosolized. If you throw up and then flush the toilet, how much of the spray gets into the air?” Allison Aiello, who studies viruses at the University of Michigan, told NBC News.
  • Think twice about the buffet. It’s the perfect environment for the virus to jump from person to person via shared utensils. If you have to hit the buffet, try to go as soon as it opens so you are there when the food is fresh and hasn’t been picked over by hundreds of other hands.
  • Check the cruise line’s record. The CDC’s Vessel Sanitation Program also publishes inspection reports.These companies have never failed a CDC inspection during the past 10 years, says MarketWatch.
    • Costa
    • Norwegian
    • Oceana
    • Disney
    • Crystal
    • Seabourn

Have you gotten sick on a cruise? Share your story in the comments below or on our Facebook page.

Karen Datko contributed to this report. 

Stacy Johnson

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  • Y2KJillian

    In 2008 we went on a Princess cruise and I got the Norovirus (Norwalk virus) the day after we boarded. I have never had a “flu” that was worse, not even then Hong Kong flu that lasted 14 days when I was a girl. I was immediately put into the ship’s infirmary and hooked up to an IV due to dehydration, but was still having explosive diarrhea which was a horrible nightmare since I was unable to get into the restroom but had to deal with things out in the middle of the bed area that was open to anyone working there or passing by. I was released hours later, after some employee had gone through my luggage and taken all my spending money (I know, USE THE ROOM SAFES!). Then I was confined to my cabin, where I could barely manage to eat an apple a day — luckily we had hit the ship’s library the first day, so I had things to read, and lucky we had a balcony room, because boredom set in between bouts of LEAPING for the toilet…you CAN use the toilet and the tub at the same time! Though then you have to do a little cleaning of the tub. If you get my meaning. They had only cruise ads on the TV…why they had a TV is beyond me; and I was NOT supposed to have those books, considering I was informed I was now Typhoid Mary, and contagious enough that a haz-mat cleanup crew had to go over everywhere I’d been on the ship from boarding until ending up on the IV…I spent all but the last day isolated…was able to go on deck and enjoy looking at the chocolate desserts buffet…unable to eat it, however, but was happy just to be out again.
    One of the room stewards told me while I was isolated (they still came in to fluff the place up every day) that I wasn’t the only one, and that it was ALWAYS like that, someone was ALWAYS terribly sick on the cruises. He said the man next door had vomited all over one of the upholstered cabin chairs, and it had to be taken down to the lower levels to be steam cleaned. I had spread our big beach towels that we’d brought with us wherever I was, in case of “anal or oral leakage” so apparently it was a useful precaution…You had NO idea! I was washing out my underwear in the sink several times a day, as in spite of bringing twice as many pairs as we were going to be gone in days, I now was using up about ten a day. Often I had to put on a “clean” pair while they were still damp.
    I will NEVER cruise again. No way, no how. What the steward said was they they just generally don’t talk about it, and official position was that it’s not happening, but it happens on every cruise, and every cruise line, whether they pass the inspections or not.
    I will say this: I touched an ice sculpture the first day at lunch, because it was so perfect it looked like glass, and then without thinking licked my finger. I’ve always blamed MYSELF for getting sick, but maybe everyone who got sick on these latest cruises did NOT lick any ice sculptures. Maybe I was just susceptible.
    I will say this: I haven’t had the flu since. I was so sick I “should” deserve livelong immunity! HA!
    Jillian, sorry if I was too graphic.
    Oh, and compensation? I got “free” “ER” service, and a 10% discount off any subsequent cruise taken within the year…that was a safe bet I’d never use it! I didn’t and I won’t!

  • tomvell

    The frequent Norovirus (and e-coli) infections on Cruise Lines can be avoided to a certain extent if a flexible water faucet is provided for passengers to clean their bottom with water. The toilets in the ships are small and fecal matter gets on the toilet seat very often. Paperwork (rubbing with toilet paper) in the bathroom will not keep you clean at all. The rest gets on to the underwear and some people wearing very little cloth as underwear it gets on to their pants or dress. To see whether you are clean all you have to do is look at your panties or underwear and see how soiled they are. With sweating the fecal matter and bacteria gets from your soiled underwear on to seats and chairs and other surface you sit. Also people do not wash their hands well after the paperwork in the bathroom. They hold on to hundreds of rails on the cruise ships and contaminate them with bacteria which gets transferred to others’ hands. Also not washing your hands before eating with an excuse that you eat with fork and knife will not stand when you use your dirty fingers to eat fried chicken wings and other finger food. I have seen people licking their dirty fingers if some kind of sauce gets on their hands. You get the bacteria easily into your system. There is something to learn from countries like India, Iran and Malaysia about personal (bottom) cleanliness where almost all of them wash their bottom after bowel movement. I challenge you to regularly wash your butt regularly with water and see how clean you will feel and how clean your underwear will be and you can save a lot of people from contamination and illness.

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