Influenza on Cruise Ships

Influenza on Cruise Ships

Cruise ships play a significant role in the acquisition and transmission of vaccine-preventable illnesses, such as influenza, so extra care is required to ensure the health and safety of passengers, as well as the residents of any port of call.

Influenza on Cruise Ships

Addressing the Challenge of Influenza on Cruise Ships

Influenza, influenza-like illness (ILI), and respiratory illness account for nearly one-third of all reported illness on board cruise ships due, in part, to several factors, including:

  • Tight quarters and enclosed spaces.
  • Guests and crew members arrive from various ports around the world that have different peak flu seasons, and;
  • The tropical origin and destinations of many cruises lack influenza seasonality typical in more northern or southern hemispheres.

According to a recent article published in the Journal of Travel Medicine;

Respiratory illness accounts for up to 29% of recorded illnesses on cruise ships, and cruise ship influenza outbreaks have been previously reported worldwide.

Although influenza seasonality typically corresponds to winter months in temperate areas of the Northern and Southern Hemispheres, cruise ship destinations can include tropical areas where influenza activity lacks well-defined seasonality.

Additionally, cruise ship environments, which often accommodate many travelers in partially enclosed settings, may facilitate influenza transmission.

Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A Recent Account of Preparedness and Response to an Ever-Present Challenge

Influenza, ILI, and respiratory illness aboard cruise ships are so prevalent that, according to the U.S. Centers for Disease Control and Prevention (CDC), reported cases outnumber even seasickness.

Most medical center visits are due to acute illnesses, of which respiratory illnesses (19%–29%); seasickness (10%–25%); injuries from slips, trips, or falls (12%–18%); and gastrointestinal (GI) illness (9%–10%) are the most frequently reported diagnoses.

Cruise Ship Travel


Preventative Measures

According to the CDC, the following recommendations should be adhered to by crew members and travelers:

  • Practice good hand hygiene. Wash hands often with soap and water. If soap and water are not available and hands are not visibly soiled, an alcohol-based hand rub can be used as an interim measure.
  • Maintain a distance of 6 feet or more from the ill person while interviewing, escorting, or providing other assistance.
  • Keep interactions with ill persons as brief as possible.
  • Limit the number of persons who interact with ill persons. To the extent possible, the ill person should receive care and meals from a single person.
  • Ask the ill person to follow good cough and sneeze etiquette and hand hygiene, and to wear a facemask if it can be tolerated.
  • If a facemask cannot be tolerated, provide tissues and ask the ill person to cover his or her mouth and nose when coughing or sneezing. Used tissues should be disposed of immediately in a disposable container (plastic bag) or a washable trash can.



References & Resources



The flu, ILI, and other non-influenza respiratory illnesses are extremely common on cruise ships--actually outnumbering reported cases of seasickness among crew and travelers--and have contributed to worldwide outbreaks in the past.

High-performance cleaning and disinfection services are absolutely mandatory for ships in port and underway.

However, with the high-capacity nature of the ship combined with confined quarters in an enclosed space, germs are going to spread, and there is little that can be done to stop them aside from adhering to high standards of personal hygiene, the two most important of which are regular handwashing and preventative vaccinations.

If you do fall ill, make certain to monitor your temperate, drink plenty of water, and avoid direct contact with crew members and other guests as much as possible, but to report your condition to the crew in the event that you feel they have escalated beyond normal cold and flu symptoms.

If you would like more information regarding the effectiveness of high-performance infection prevention and control measures, or if you would like to schedule a free, no-obligation onsite assessment of your facility's custodial needs, contact us today for a free quote!

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