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Originally published January 29, 2014 at 11:54 AM | Page modified January 29, 2014 at 2:33 PM

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Staying healthy on a cruise

More than 650 passengers were sickened on a recent Royal Caribbean cruise. Yet ship illness, while dramatic, is not all that common.


Tampa Bay Times

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Royal Caribbean’s Explorer of the Seas is due in New Jersey on Wednesday with a load of sick, unlucky passengers.

Rampant intestinal ailments on cruise ships are reported regularly, and the tales of dream trips cut short are dramatic. You will hear them on the nightly news as the healthy passengers get interviewed by journalists after they disembark the big ship.

But know this: The number of people who get sick on cruises is minuscule. In 2013, 21.3 million people hit the high seas, according to Cruise Lines International Association. (That number is expected to jump to 21.7 million this year.) About 2,300 of them were felled onboard by gastrointestinal ailments. That’s roughly .01 percent of all people who cruised.

So chances are you’ll be just fine, though that’s not much consolation to the people who lose out on a tropical idyll. The Explorer of the Seas truncated its 10-day Caribbean cruise because more than 650 passengers and crew became sick with symptoms including vomiting and diarrhea. The norovirus is suspected, but further tests will pinpoint the outbreak.

Here’s the issue with cruise ships and illness: A lot of people are confined in tight communal areas, touching the same surfaces such as stair railings and bathroom door handles. If someone boards the ship sick and isn’t an obsessive hand washer (nor are you), germs get spread around. Sometimes people don’t know they are sick until a few days later.

Robert N. Jenkins, former travel editor of the Tampa Bay Times and now a freelance writer, has been on 60 cruises. Only once did he hear that passengers had gotten sick and that was on the last day.

Since Jenkins started cruising, antibacterial wipes and spray dispensers have become standard all around the ships. Sometimes crew members are stationed at the entries of restaurants to provide a squirt of Purell. At events where passengers mingle with the officers, there is no handshaking.

Staying well

For many travelers the mere threat of getting sick is enough to keep them on shore, and those thinking about going still have questions about how to stay well. Among them might be:

What is the norovirus and how is it spread?

Norovirus is a broad term for viruses that cause inflammation of the stomach lining and intestines. The result is cramping, nausea, vomiting and diarrhea. A low-grade fever, chills, headache, muscle fatigue and aches can also be present. The illness is passed on by touching contaminated surfaces or sharing glasses.

How can passengers prevent infection?

Wash hands with hot water and soap regularly, and take advantage of the antibacterial wipes and sprays available around the ship. If a crew member hands you a wipe, use it. Christopher Elliott, consumer advocate and ombudsman for National Geographic Traveler magazine, said he heard of someone refused entry to the buffet because she wouldn’t accept the wipe.

He also advises against cruising from January to March, the height of the virus season. “There are far fewer outbreaks of norovirus in the summer. The outbreaks are cyclical. You’ll notice them much more at this time of year.”

Why cruise ships and not hotels and theme parks, where lots of people gather and touch the same surfaces?

Elliott said that is a misconception. There are outbreaks at day care centers, hotels, restaurants and any kind of institution where a lot of people are together. The difference is, people leave those places and go home to be sick. “On a cruise ship, you’ve got a lot of people with nowhere to go, plus everyone has email and texts to let everyone know.”

Compensation from cruise lines

How do the cruise lines respond afterward? Can you get your money back?

In the case of Explorer of the Seas, Royal Caribbean said all passengers would get a 50 percent refund of their fare and a 50 percent credit on a future cruise. Unless there’s a mechanical failure, full refunds are rare.

“The cruise lines don’t want you to leave unhappy. They are quick to apologize; quick to issue onboard credit for a future cruise but they don’t want to give money back,” Elliott said.

If you buy “cancel-for-any-reason” insurance you will get a portion of your money back if you cancel before the trip. Once you have sailed, the situation becomes more complicated, Elliott said. Each policy is different; ask a lot of questions before purchasing.

Andrew O. Coggins Jr, a cruise industry expert and professor at Pace University in New York, agrees that offering the option to cancel without penalty to sick passengers is more difficult than it appears.

“Passengers usually travel with others so such a policy would have to include all the affiliated passengers. Then there’s the issue of fraud and proof of illness. However, if such a policy could avoid one or two norovirus incidents it may be worth the effort and expense,” he said.

However, he said, if the cruise lines could find better ways to dissuade sick people from boarding, they could avoid the bad publicity.

Inspection reports

The Centers for Disease Control and Prevention conducts regular inspections of cruise ships. Sanitation reports of each ship can be read at cdc.gov/nceh/vsp.

Explorer of the Seas’ latest inspection was July 25, 2013, and it received 98 of 100 points.

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