Everything You Need to Know About Getting Sick on a Cruise
Illness happens, even on the high seas.
Over the last 15 years, I’ve sailed with Royal Caribbean, Norwegian, and Disney on ships headed to the Bahamas, Virgin Islands, Haiti, Cuba, Bermuda, Brazil, and other ports. All of these cruises were memorable, but one voyage remains especially prominent in my mind: The cruise where I got really, really sick. One moment I was enjoying a festive nautical celebration with my family; the next, I was lying on the bathroom floor in abject misery.
What do you do when you’re sick on a cruise? In my case, I clambered into a wheelchair and took a trip to the ship’s infirmary, where I was treated by medics. They couldn’t say for sure what caused my sudden illness. Most likely, it was the common cruise ship stomach bug, norovirus. Ultimately, I lived to sail another day, but the incident left me with a lot of questions. Would something like this happen to me again? And if so, what would be the best course of action?
To help answer these questions, I turned to medical cruise ship experts to shed light on how likely an illness is to happen, and what precautions you can take to lower your risk on board.
What illnesses are most commonly spread on a cruise ship?
While seasickness might be the most common cruise ailment, it thankfully can’t be spread—you’re either prone to it or not. Other illnesses aren’t quite so selective.
“Ear, nose, and throat infections tend to be the most common things we see, alongside minor soft tissue injuries,” says Liz Baugh, the lead medical consultant for Scenic Group, which includes Scenic Luxury Cruises & Tours and Emerald Cruises.
According to Baugh, who trained and served as a medic in the Royal Navy and has worked in the maritime sector for 25 years; these infections “occur more commonly than norovirus or COVID.”
However, she says, norovirus does sometimes find a footing. “If something did manage to find its way onboard any cruise ship, then the likelihood is that it would be norovirus, as it is very efficient at transmitting and can live outside of the body for up to 12 days in some situations,” she says.
How likely are you to get sick on a cruise ship?
If I had my way, no one would ever get sick on vacation. But of course, travel doesn’t always go according to plan.
Fortunately, according to Marcelo Izquierdo, the medical officer onboard Metropolitan Touring’s two Galapagos expedition cruises, the likelihood of falling sick on a cruise ship isn’t that much higher than on other types of vacation.
“The possibility of getting sick is the same as if you were on any trip where you are exposed to sporadic changes in climate and tropical diseases,” he says. “If I had to give a percentage, it would be 50/50.”
Once there are sicknesses going around on board, your existing health will play a role in whether or not you contract it. “If people are tired and run down, then they are more likely to fall ill; stress doesn't help either,” Baugh says. So be sure to get enough sleep, and do your best to relax and enjoy the vacation. Baugh also says that hydration is another key factor. “Dehydration is common onboard and ashore on excursions, so [travelers] must ensure that they are adequately hydrated at all times.”
Do larger ships spread illness more easily?
Illness happens on cruise ships regardless of size or destination but the math is still going to math. Some ships are a lot smaller (for example, Scenic Group offers a 34-suite river cruise). On the other hand, Royal Caribbean’s Icon of the Seas, the largest cruise ship in the world, can carry 5,610 passengers at double occupancy. And, as Baugh puts it, “The more people on a ship, the higher the risks of getting ill.”
“On ships with more than 100 passengers, there is a greater probability of contact with people and of contracting viral diseases,” Izquierdo says.
With Scenic, Baugh estimates they see illnesses from “approximately 100 passengers per month across all four ships, which equates to approximately 4% of all travelers.”
Can you still go on a cruise if you feel sick?
It’s important to refrain from boarding a ship if you don’t feel well. If you’re already under the weather, your symptoms are unlikely to stay behind. You’ll probably spend most of your time in your room and risk infecting others, too.
For this reason, all cruise companies have a pre-boarding screening process in place to prevent someone who is sick from coming on board in the first place, and to provide treatment where necessary.
When boarding a Scenic vessel, for example, “Should a person report symptoms of a potentially communicable disease, they will be thoroughly assessed by the medical team and given medication if appropriate,” Baugh says.
In the case of a mega ship like Royal Caribbean’s fleet, all passengers are screened with a questionnaire prior to embarkation, and any positive test result or documented communicable disease symptoms will result in denial of boarding.
What happens if you get sick on a cruise?
If you do feel sick, stay in your stateroom, and not just to rest.
“Depending on the illness, they may need to isolate for a short period of time to make sure that they don't pass it on to anyone else onboard,” Baugh says of sick passengers.
If things progress and a medical opinion is needed, cruise ships are equipped with infirmaries, like the one I visited, and some cruises like Royal Caribbean even provide the option for video consultations or a medical exam in a sick guest’s own stateroom.
Izquierdo, who has been practicing medicine for 30 years, says he stocks a wide variety of medications on board to treat the most common ailments, from the flu to fractures, though it’s not exhaustive. “We do not have a pharmacy on board, but we do have the most appropriate medicines to cure and save lives,” he says.
Similarly, Baugh cautions that “medical centers on cruise ships are well equipped but they are limited in what they are able to provide.” For example, when it comes to norovirus, Baugh says they carry rehydration salts, anti-sickness medication for nausea and vomiting, and other medications. However, for COVID, they only carry symptomatic relief with typical cold and flu remedies, and not antivirals. “Anyone who is sick enough to need those would be sent ashore for further investigation and management.”
And remember, while many cruise amenities are all-inclusive, medical treatments are not.
“The majority of all cruise lines will bill for medical care onboard, so having the right insurance in place is crucial,” Baugh warns.
What can you do to avoid getting sick on a cruise?
You’ve probably practiced good hygiene on land, and the same rules apply when you’re at sea. “We recommend that people maintain excellent hand hygiene and wash their hands frequently with soap and water to ensure that any germs that they may have are not passed on to others,” Baugh says.
But beyond handwashing, a cruise is a good place to be honest with yourself about your own health and abilities. “If you have medical conditions and take medication, then discuss the itinerary with your own doctor. Be realistic about your limitations,” Baugh says.
Izquierdo agrees. “The important thing for a cruise guest is to follow the rules and instructions given on each occasion, knowing and indicating their health limitations to the personnel, to enjoy their trip to the fullest.”