We can get sick anywhere, at any time, but a key question is if this is amplified on cruise ships? Cruise ships can be a hotbed for germs and viruses that spread from person to person because of their shared, closed, and confined spaces. This has been highlighted now more than ever, and how we travel or even if we travel in 2020/2021 is a question on everyone’s minds. Many may be worried about boarding a ship or even an aeroplane as outbreaks such as norovirus and the recent Covid-19 are easily spread due to the close contact you have with other passengers. Therefore, for the cruise line industry to return to business, they will need to implement appropriate measures to help prevent the rapid spread of many highly transmittable infections.

Common infections

The most frequently reported cruise ship outbreaks involve respiratory infections, gastrointestinal infections such as norovirus and vaccine preventable infections such as chickenpox. (1) In recent months, we also seen Covid-19 spread rapidly on cruise ships between passengers and crew members. A study in the Journal of Travel Medicine proposed that if prevention measures such as isolation and quarantine had not been implemented on the Diamond Princess ship when Covid-19 hit, 79% of those on board would have been infected. (2) According to the World Health Organization (WHO), if there is an outbreak of norovirus on a cruise ship, more than 80% of passengers can be affected. (3) This exemplifies how easily infections can spread as a corollary of ships crowded, confined environment.

“The virus [norovirus] can spread in food or water or from person to person; it is highly infectious and in an outbreak on a cruise ship, more than 80% of the passengers can be affected.”


Appropriate IPC measures from the cruise line industry

It is important to highlight the appropriate infection control measures that should be in place on cruise ships to make them safe environments. The WHO have stated that to prevent or reduce outbreaks of gastroenteritis caused by norovirus, ships have enhanced food and water sanitation measures and disinfection of surfaces. More ships are also providing hand gel dispensers at strategic locations throughout the ship and passengers and crew are urged to use them. However, due to the current pandemic, infection prevention and control measures will need to be heightened as we move forward in the new world.

As a result of Covid-19, there has been a temporary suspension of cruise ship travel. However, in response to this virus, they adopted measures including rigorous screening protocols, enhanced sanitation measures and the availability of onboard medical care and treatment. (4) For the return to service, Royal Caribbean International have stated that they are laser-focused on additional safety enhancements. They are developing a future boarding screening process and updated health protocols, however, measures have not been finalized yet. To make the necessary improvements, Royal Caribbean International are collaborating with government health authorities, the Cruise Lines International Association, and their own team of medical experts. (5)

A joint effort from both staff and passengers

It is imperative for cruise ships to implement the appropriate measures to prevent infections. However, there will need to be a joint effort from both staff and passengers. Many experts have highlighted the importance of hygiene in the new world as it is one of the most effective mechanisms to avoid illnesses. Our hands play a crucial role in the spread of infections; therefore, hand hygiene is one of the most powerful tools to reduce the spread of Covid-19, norovirus and other common infections. The cruise ship industry needs to encourage passengers and crew to engage in frequent and proper hand hygiene practices by supplying them with the appropriate training and resources.

A solution for hand hygiene training

Avoiding infections on cruise ships may be difficult, but there are some key measures that can help. SureWash has delivered quality hand hygiene training to healthcare workers for over 10 years. However, because of the importance of hand hygiene for everyone, we are now supporting organisations in different industries. Employers have the responsibility to help keep staff and passengers safe and healthy, and quality hand hygiene is a key defence mechanism from infections. All cruise lines can deliver training to crew members using the SureWash GO or the SureWash APP. The app can also be used to train and educate all passengers to ensure everyone on board is aware of the importance of hand hygiene and knows how to wash their hands correctly.
For further information, please visit https://surewash.com/contact-us/


1. Centre for Disease Control and Prevention, “Cruise Ship Travel”: https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-by-air-land-sea/cruise-ship-travel

2. Journal of Travel Medicine, “COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures”: https://academic.oup.com/jtm/article/27/3/taaa030/5766334

3. World Health Organization, “Sea Travel Advice”: https://www.who.int/news-room/q-a-detail/sea-travel-advice

4. Cruise Lines International Associations, “Update on Cruise Industry Response to Covid-19” : https://cruising.org/news-and-research/press-room/2020/april/clia-covid-19-toolki

5. Royal Caribbean International, “ Health and Travel Advice” : https://www.royalcaribbean.com/cruise-ships/itinerary-updates