2024 saw the highest number of gastrointestinal (GI) illness outbreaks on cruise ships in over a decade.
The CDC recorded 16 outbreaks aboard ships under its jurisdiction last year, marking a sharp increase from the 14 incidents reported in 2023 and significantly higher than pre-2020 levels.
2025 has also begun with several outbreaks, most recently on Holland America’s Volendam, which has seen an outbreak on its 21-night cruise that departed on 4th January.
On that ship, 53 passengers have reported symptoms so far, along with 7 crew members.
Prior to this, outbreaks of gastro illnesses were confirmed on Silversea’s Silver Ray, and Sea Cloud Cruises’ Sea Cloud Spirit.
Only the Volendam outbreak has been confirmed as norovirus so far.
Norovirus, a highly contagious virus often associated with cruise ships, was responsible for most of the 2024 outbreaks.
The virus spreads rapidly in close-contact environments like cruise ships, camps, and hotels, and is known for causing severe vomiting, diarrhoea, and stomach cramps.
In December alone, five cruise ships – including vessels from Cunard Line, Holland America, and Princess Cruises – reported outbreaks affecting hundreds of passengers.
According to CDC guidelines, outbreaks must affect at least 3% of passengers and crew for mandatory reporting.
Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, explained the virus’s resilience.
“Norovirus can persist for days on surfaces. If you touch a contaminated surface and then your mouth, you can become infected,”
Other pathogens also pose risks
While norovirus accounted for the majority of incidents, other pathogens caused illness at sea. For instance:
- Salmonella was linked to a September outbreak on Royal Caribbean’s Radiance of the Seas.
- E.coli was identified during a spring outbreak on Silversea Cruises’ Silver Nova.
- The cause of an outbreak on Royal Caribbean’s Allure of the Seas in May remains undetermined.
The CDC notes that outbreaks are identified and reported more quickly on cruise ships than on land due to stringent health protocols.
Despite the increase in reported outbreaks, the CDC cautions against drawing conclusions about a long-term trend.
A spokesperson highlighted the slowdown in cruise operations from 2020-2022, which contributed to lower case numbers during that period.
In 2019, for example, there were only 10 reported outbreaks – far fewer than in recent years.
Cruise operators emphasize that onboard outbreaks remain rare relative to overall passenger numbers.
The Cruise Lines International Association (CLIA) stated that incidents of illness onboard cruise ships are “extremely rare.”
Ships implement extensive measures to control the spread of illness, such as isolating sick passengers, deep-cleaning affected areas, and enforcing hand hygiene protocols.
However, experts like Dr. Schaffner acknowledge that norovirus’s highly infectious nature can sometimes outpace even the most rigorous interventions.
For travellers considering a cruise, Schaffner offers some key advice:
- If you’re feeling ill, stay home and rebook your cruise.
- Pay close attention to onboard hygiene instructions, especially handwashing with soap and water.
- Avoid touching your face after coming into contact with potentially contaminated surfaces.
The rise in GI illnesses on cruise ships highlights the ongoing challenges of maintaining health in close-contact settings.
For now, proactive measures like thorough handwashing, responsible travel decisions, and robust onboard health protocols remain the best defences against these viruses.
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