Cruise Ship Travellers
Cruise travel involves specific health risks due to the close, shared environment onboard. Passengers from different regions gather in often crowded and enclosed spaces, which can increase the spread of communicable diseases through direct contact, respiratory droplets, airborne transmission, and contaminated food or water. Individuals with chronic illnesses, immunocompromised persons, elderly, pregnant women, and children should take extra precautions and seek medical advice before embarking on a cruise trip.
Infectious disease health risks
Gastrointestinal illnesses: Over 90% of gastrointestinal illness outbreaks on cruises with an identified cause are attributed to norovirus. Its ability to spread easily is linked to factors such as a very low infectious dose, efficient person-to-person transmission, lack of long-term immunity, and the absence of a vaccine. Other outbreaks have been associated with contaminated food or water, involving pathogens such as Campylobacter, Clostridium perfringens, and enterotoxigenic Escherichia coli.
Respiratory illnesses: Respiratory illnesses are the most common medical concerns reported during cruise travel, including COVID-19, influenza, respiratory syncytial virus (RSV), and Legionnaires’ disease. Passengers who develop respiratory symptoms should promptly report to the ship’s medical staff and follow recommended isolation measures.
Other vaccine-preventable diseases: Although most cruise passengers come from countries with established routine vaccination programmes, many crew members originate from low- or middle-income regions where immunisation coverage may be lower. As a result, outbreaks of vaccine-preventable diseases, such as hepatitis A, measles, meningococcal disease, mumps, pertussis, rubella, and chickenpox, have been reported on cruises.
Vector-borne and rodent-borne diseases: Some cruises’ ports of call include destinations where vector-borne and rodent-borne diseases (e.g. dengue fever, Japanese encephalitis, malaria, yellow fever, Zika virus infection, hantavirus infection, leptospirosis) are known to be endemic.
Non-infectious health risks
Cruise travel may involve stressors such as varying weather and environmental conditions, as well as unaccustomed changes in diet and physical activity levels. Seasickness is also a common complaint affecting up to 25% of travellers.
Travel preparation
The following checklist summarizes recommended cruise travel preparations and health behaviours for cruise ship travellers:
Pre-travel
- Get up to date with your vaccinations
- Check the Travel Health Service website for outbreaks on cruises
- Consult family doctor or the Travel Health Centres of the Department of Health before cruise travel
- Contact the cruise line to cancel your trip if you feel unwell before departure
- Plan the type and length of the cruise trip according to personal health conditions
- Notify the cruise line of additional health needs (e.g. dialysis, supplemental oxygen, wheelchair)
During Travel
- Avoid contact with people who are ill
- Maintain good personal and environmental hygiene at all times during the voyage
- Maintain good fluid intake and avoid alcohol consumption
- Immediately notify the ship’s medical staff and follow their health advice if you feel unwell during the voyage (e.g. fever, cough, vomiting, diarrhoea, etc.)
- Wear a mask in crowded or poorly ventilated indoor areas
- Take preventive measures to avoid mosquito bites, especially during port visits where vector-borne diseases are endemic or epidemic and where exposure is likely
You may also refer to the “Travel Health Tips” section for further information on Healthy Travel.