Is getting ill on a cruise inevitable? How to avoid it

At a glance

• Your chance of getting a gastrointestinal illness on a cruise is about 1 in 5,500
• Cruise ships must follow strict CDC health regulations, including surprise inspections
• Seasickness, sunburns and colds are far more common than serious outbreaks
• Simple precautions like handwashing and hydration go a long way
• Travel insurance with cruise cover helps ease worries about medical costs

Is getting ill on a cruise inevitable?

No, in fact, far from it. While some alarmist headlines might lead you to believe that going on a cruise is essentially a one-way ticket to a mortuary (or at least a sure-fire way to pick up a stomach bug), the data tells a different story.

According to CLIA, your chance of developing a gastrointestinal illness on a cruise is about one in 5,500. Similarly, the CDC (Centers for Disease Control and Prevention) reports that cruise ships account for just one per cent of all norovirus outbreaks. You’re more likely to catch it from a restaurant on land or even from your child’s nursery.

That’s not to say the dramatic headlines about ‘mystery illnesses’ at sea come from thin air, but they rarely tell the whole story. Often, the reason we see those headlines in the first place is the cruise industry’s unusually strict health protocols. Under the CDC’s Vessel Sanitation Program, cruise lines are required to report cases of illnesses in a way that land-based venues simply aren’t.

As a result, while an outbreak at a resort might fly under the radar, one on a cruise ship is more likely to be logged with the relevant authorities and picked up by the press.

What precautions do cruise lines take?

Major cruise lines have robust protocols in place when it comes to cleanliness and responding to illnesses onboard, particularly since the COVID-19 pandemic.

Crucially, they are required to follow the CDC’s Vessel Sanitation Program, which outlines strict practices to prevent foodborne illnesses, ensure water safety and maintain high cleaning standards across cabins and public areas, including kids’ clubs.

The CDC also performs two unannounced inspections per ship each year, awarding a score out of 100. These scores are published online; if you’re planning a cruise, you can search here to see if information is available on a ship's most recent inspection.

However, note that in reality, while good hygiene practices can stop the spread of a virus, it's most frequently brought on board by an unsuspecting passenger or crew member rather than contaminated food or water, and can spread by person-to-person contact.

And of course, when hundreds or even thousands of people gather in a semi-enclosed space, viruses can spread more easily. The same is true of most major forms of transport, from planes to trains.

What happens if you get ill on a cruise ship?

Illnesses and minor accidents do happen on cruise ships, from sunburns and sprains to head colds and hangovers.

That’s why most cruise ships have qualified medical professionals and fully equipped medical centres onboard. On larger ships, these facilities can include everything from X-ray machines and ventilators to cardiac monitors.

The exception tends to be river ships. Since they’re never far from land and therefore a hospital, they don’t usually carry the same level of onboard medical equipment.

Regardless of the ship type, if a serious medical emergency occurs, such as a heart attack or stroke, crews will do their utmost to get the passenger to a hospital as quickly as possible. In some cases, that may mean the patient is airlifted for treatment.

Often, in addition to worries about their wellbeing, passengers are concerned about the potential cost of medical care at sea. The best antidote to that anxiety is comprehensive travel insurance with cruise cover. Read the small print carefully and, ideally, choose a policy that includes air ambulance services.

In the case of a contagious illness like norovirus, the CDC notes that cases are often detected, reported and responded to more quickly on a cruise ship than on land. Infected passengers are typically asked to quarantine in their stateroom, and the crew may introduce extra precautions, such as switching to individually served meals instead of buffets and increasing cleaning protocols for touchpoints like handrails and lift buttons.

Seven tips to avoid getting ill while cruising

1. Wash your hands

We know you know how to wash your hands, but even the most seasoned germ-dodgers could probably level up at sea. With hundreds or thousands of people sharing space, handwashing is still one of the best ways to avoid picking up norovirus or other common bugs.

Aim for a proper scrub: 20 seconds with soap and water. If you’re sick of the old Happy Birthday trick, try the chorus of Dancing Queen or Mr Brightside instead.

Pay extra attention after touching high-contact surfaces like bannisters or lift buttons, and try to avoid touching your face before you’ve washed your hands.

Soap and water are ideal, but when they’re not nearby, make use of the hand sanitiser stations around the ship. Or better yet, carry your own travel-sized bottle or a pack of disinfectant wipes. They’re especially useful on port excursions, where you might be eating on the go or using public transport.

2. Take precautions for seasickness

Sometimes first-timers step onboard, start feeling queasy and immediately jump to the worst-case scenario. But more often than not, it’s motion sickness, not norovirus.

It’s more common than people think. Even seasoned cruisers might not realise that some everyday medications, including certain antidepressants and birth control pills, can make you more prone to it.

Popular remedies include ginger sweets, ginger beer, anti-seasickness wristbands and over-the-counter tablets. If you’re concerned, it’s worth speaking to a pharmacist before you travel to find out what might work best for you.

There’s no one-size-fits-all fix, so it’s worth coming prepared with a few options so you can stay in control if queasiness kicks in.

You might also want to think about your cabin location. Mid-ship cabins tend to feel more stable, especially on lower decks. A balcony can be a real plus if fresh air helps settle your stomach.

3. Handle your jet lag

One of the kindest things you can do for your immune system is getting enough rest, and jet lag is a fast track to feeling run-down.

Arriving a day early is one of the best ways to get ahead of it. Not only does this give you a buffer in case of flight delays, but it gives your body time to adjust, especially if you’re flying long haul.

If arriving a day early isn’t possible, there are still ways to help your body reset. Spend time outdoors in natural light, avoid alcohol before bed and try to shift your mealtimes to local hours. These small tweaks can make a big difference to how you feel.

4. Drink lots of water

Staying hydrated is one of the simplest ways to feel your best on a cruise, especially in warmer destinations like the Mediterranean or the Caribbean. Between cocktails, coffees and long days ashore, it’s easy to forget about water, especially if you’ve got a drinks package and the mojitos are flowing.

Bringing a reusable water bottle can help you keep sipping throughout the day. It’s also more environmentally friendly than relying on single-use plastic bottles. Just remember that while tap water is typically safe to drink onboard, that might not be the case in every port, so check before you fill up when out and about on excursions. This isn’t something you want to gamble on.

5. Bring the right medications

It goes without saying that you should pack enough of any prescription medications to cover your entire cruise, plus extra in the rare case of delays.

It’s also smart to bring a small first-aid kit stocked with over-the-counter essentials for common ailments. Think ibuprofen or paracetamol, cold and flu tablets, antacids, Imodium and rehydration sachets. Add a few water-resistant plasters, antiseptic spray or wipes and insect repellent for good measure.

Even if you don’t end up needing any of it, having the basics to hand can make a big difference to your peace of mind.

6. Make sure your vaccines are up to date

It might sound like common sense, but it’s worth double-checking that your routine vaccinations are all up to date before you sail. That includes your MMR jab, tetanus shot and anything else recommended for your age and medical history.

If you’re cruising during flu season or heading to a destination with specific health advice, you might also want to consider a flu jab or other region-specific vaccines.

7. Don’t tough it out

If you start to feel unwell on your cruise, speak to the ship’s medical team. This really is a better-safe-than-sorry situation.

Firstly, it’s important for your own sake. The sooner you get medical attention, the sooner you’re likely to start feeling better. Even if you end up needing to isolate for a few days, getting help early gives you the best chance of recovering in time to salvage part of your holiday.

Just as importantly, reporting it protects other passengers and crew. You don’t want to be the person who unwittingly sparks an outbreak or puts someone more vulnerable at risk.

The truth is that perfect health isn’t guaranteed at sea or on land. All you can do is take sensible precautions and try not to worry too much. Statistically, your chances of getting seriously ill on a cruise are low.

Read next: Tips and tricks for handling seasickness