IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|
Photo By: Thommen Jose

How to be healthy on a cruise

Cruise vacations are one of the most popular ways to travel. The opportunity to see multiple destinations in one relaxing, fully catered trip continues to appeal to millions of travellers every year.

Despite the luxury of the experience, there are a number of illnesses that can affect cruise travellers. Infectious diseases can spread easily on large ships where hundreds or thousands of travellers – often arriving from various destinations – are living in close quarters for an extended period of time. Illnesses that occur on ships can also have a negative health impact on host port communities where passengers disembark for sightseeing tours and on-land activities.

When taking a cruise, it’s important to be cautious of your own health and be considerate of the health of others – it only takes one sick person to affect many.

What are common illnesses found on cruise ships?

Gastrointestinal illnesses (gastroenteritis) caused by norovirus, E. coli, and salmonella can be present on cruise ships. These highly contagious viral and bacterial infections are transmitted by:

  • Ingesting contaminated food and fluids
  • Improper hand and body hygiene
  • Touching infected surfaces and objects
  • Coming into close contact with a sick person

Symptoms usually develop within 12 to 48 hours after exposure and can appear suddenly. They include vomiting, watery diarrhea, abdominal cramps, fever, headache, and nausea. The illness typically lasts 1 to 2 days, but you can be contagious anywhere from 3 days to 2 weeks after getting sick.

Respiratory illnesses such as influenza are also common on ships. The virus is transmitted among passengers through infected air droplets by sneezing or coughing. A person can be contagious 1 day before and up to 7 days after symptoms appear. Symptoms include high fever, sore throat, nasal congestion, high fever, muscle aches, headache, fatigue, and general weakness. Patients usually recover after 1 or 2 weeks, but the illness can cause complications in young children, older persons or those with a pre-existing condition.

The Hepatitis A virus is transmitted through contaminated water and food or by the fecal-oral route, and may cause severe liver damage. Hepatitis A symptoms can mimic the flu – fatigue, nausea, abdominal pain, fever, loss of appetite, and includes jaundice (skin and eyes). Symptoms appear anywhere from 2 to 6 weeks after being exposed. The illness can last up to 6 months. However, some people are long-term Hepatitis A carriers and will not exhibit any symptoms during their lifetime.

Legionnaire’s Disease is a lung infection caused by the Legionella bacteria. Passengers can acquire the infection when breathing contaminated air droplets from water found in hot tubs, hot water tanks, air conditioner and plumbing systems that are not properly cleaned and disinfected. Symptoms mimic pneumonia (cough, chills, high fever, muscle aches, and headache) and usually appear 2 to 14 days after being exposed. If caught and treated early with antibiotics, patients can make a full recovery, however it is responsible for fatalities in up to 5-30% of cases. The bacteria do not spread from person to person.

Staying well on your cruise

Before you go

  • Consult with your doctor to make sure your routine immunizations are up-to-date. We also recommend getting the Hepatitis A. Due to the different immunity status of passengers and being in a confined area, persons who are not vaccinated are also at higher risk of contracting vaccine-preventable diseases.
  • If you have any chronic illnesses such as diabetes, heart disease, or a compromised immune system, ask your health practitioner if taking a cruise holiday is right for you and what you can do to prepare.
  • Research your cruise line's reputation. Cruise companies are required to report any illnesses and evaluations are publicly available through government websites. If the ship reported illnesses in the past, find out how they dealt with it and what measures they have taken since to prevent the spread of infectious diseases.
  • Make sure your travel health insurance provides coverage for medical expenses at sea and air evacuation. Your insurance should also cover trip cancellation in case you get sick before your trip. Contagious illness can spread quickly on cruise ships – be considerate of your fellow passengers and consider postponing your trip if you get sick.

During travel

  • Wash your hands often and thoroughly. We cannot emphasize this enough! Good hand hygiene is proven to reduce illness and the spread of infectious diseases. Wash your hands with soap and water before eating, after using the toilet, touching publicly used surfaces such as door handles, hand rails, elevator buttons, and currency. Also remember to keep your hands away from your mouth and face. If you don't have access to soap and water, use an alcohol-based hand sanitizer.
  • Stay healthy and hydrated. Drink lots of water, eat healthy foods, and get regular sleep. Check out your cruise ship's exercise room and wellness schedule. Maintaining a healthy immune system and good mental health will decrease the risk of getting ill during travel.
  • The phrase “Boil it, cook it, peel it, or forget it” can help you be mindful about food and water safety. Many cruise lines have a good reputation when it comes to food preparation and handling. However, when you get off the ship make sure to eat well cooked foods or fruits that you can peel. Avoid shellfish, meat, and dairy products that have been out for a long time.
  • Practice safe sex.

What to do if I or others around me get sick?

  • If you get sick, immediately report your illness to the cruise's medical staff. They will tell you what precautions you should take to improve your health and prevent further infection.
  • If someone gets sick in your vicinity (such as vomiting or diarrhea), leave the area and notify staff.
  • Avoid shaking hands or being in close contact with other passengers. Make sure to wash your hands frequently.
  • Stay well hydrated.

More information

Last reviewed and updated: December 11, 2020.

Travel Health Journal