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5 Illnesses You Can Get on a Cruise Ship (Besides COVID)

Plus, tips on how to avoid getting sick while at sea and ports of call

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Concerns over the spread of COVID-19 have loomed over the travel industry for the last three years, but with the public health emergency coming to an end and a robust menu of preventive tools and treatments available, many of those fears are fading.

A new AARP survey shows 81 percent of adults 50-plus who plan to travel in 2023 believe it’s safe to do so now, up from 77 percent in 2021. And while interest in cruising is down slightly among the 50-plus population this year compared to last, a recent AAA survey finds that, overall, the share of travelers considering a cruise vacation in 2023 is up.

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However, the return to the skies and seas does not mean COVID-19 is no longer a threat.

“Indoor densely populated places where we’re exchanging exhaled breath with one another is still going to be a concern for me,” says Wilbur Chen, M.D., adult infectious disease physician and director of the University of Maryland, Baltimore Travel Medicine Practice.

That concern isn’t limited to COVID, either. Flu spreads in a similar way, Chen points out.

It’s important to note, though, that since the start of the pandemic, many cruise lines have invested in better air circulation systems with medical-grade HEPA filters, says travel expert Pamela Kwiatkowski, cofounder and chief insurance officer at Goose Insurance Services in Vancouver, British Columbia. “I think that’s the first step they’ve taken in terms of improving the air filtration system, which removes almost all of the airborne pathogens,” she says.

Still, plenty of bugs can lurk on busy boats. Read on to discover some common illnesses you can pick up on a cruise — and what you can do to help keep yourself healthy on your next getaway. 

1. Flu and other respiratory illnesses

Flu season spiked early this year in the U.S., along with another respiratory illness that can be particularly dangerous for older adults, respiratory syncytial virus, which is known as RSV. Cases of flu and RSV have declined from fall’s peak, data from the Centers for Disease Control and Prevention (CDC) shows, but the viruses that cause these two illnesses are still circulating in the U.S. and other parts of the globe.

“Influenza is complicated during cruise travel because, of course, people on a cruise ship — both the passengers and the crew — may come from different parts of the world, which means that the rates of influenza for your particular country may not necessarily be the same as in other places,” says Jose Lucar, M.D., an infectious disease physician and associate professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C.

According to the CDC, flu season in the southern hemisphere, which includes Australia and parts of South America and Africa, typically runs April through September. In the tropics, flu flares up throughout the year.

Staying healthy: If you haven’t rolled up your sleeve for the flu shot yet, make sure you get it at least two weeks before going on a cruise, Lucar says. The same applies to the latest COVID booster. When it comes to RSV, there isn’t a vaccine yet, but the FDA could approve one soon.

A few other tips: If you’re at high risk for flu complications, talk to your doctor about antiviral treatment and prevention before your trip, the CDC recommends. Don’t forget about high-quality face masks, which can help to tamp down the spread of respiratory illnesses. And be sure to make — and pack — a list of all the medications you take, in case you wind up needing medical care on board. “That just makes it easier for everyone, so that if there is an emergency, if you’re not able to talk really well, you can at least hand the sheet over and it’s done,” Chen says.

2. Norovirus

This is one of the most well-known bugs that can foil fun on a ship. Norovirus — marked by diarrhea, vomiting, nausea and stomach pain — is to blame for more than 90 percent of diarrheal disease outbreaks on cruises, according to the CDC. That said, norovirus outbreaks on ships account for only 1 percent of all such reported cases.

“This infection is very contagious,” Lucar says. The virus is also a “hearty” one, Chen points out. It can survive for long periods of time on surfaces and is resistant to common disinfectants.

Close living quarters, shared bathrooms, populated pools, busy buffet lines and rapid turnover of passengers make it difficult to control the spread of the virus once it hits a ship. “It’s just really the perfect scenario for transmission of highly contagious GI [gastrointestinal] pathogens,” Lucar says.

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According to the Cruise Lines International Association, the risk each year of getting laboratory-confirmed norovirus during a ship outbreak is about 1 in 5,500. The association, which says it is the largest cruise industry trade association in the world, noted on its website that crew members use strict sanitation and cleaning practices created with the CDC’s Vessel Sanitation Program. Cabins are cleaned once a day, and other common areas, such as elevators and pools, are cleaned multiple times a day.

In late February, more than 300 people aboard a Princess Cruises ship fell ill with diarrhea and vomiting, according to the CDC, though the agency didn’t cite the cause of the illness that sickened the 284 passengers and 34 crew. The Ruby Princess increased disinfection and cleaning procedures in the wake of the outbreak.

Other bugs that have popped up on boats include salmonella and E. coli. One to keep an eye on is shigella, which the CDC notes has been behind GI outbreaks on cruise ships. This bacterium causes an infection known as shigellosis, which can cause fever, stomach pain and diarrhea that can be bloody or prolonged.

Typically, the infection is treated with antibiotics, Chen says, but the CDC recently issued a warning that antibiotic-resistant strains are circulating in the U.S. Chen isn’t aware of any outbreaks of the resistant varieties on cruise ships, but it’s something to monitor.

Staying healthy: To avoid getting a GI bug, be sure to wash your hands with soap and water before eating and after going to the bathroom and coming into contact with high-touch surfaces, like doorknobs and stair railings. Hand sanitizers don’t work well against norovirus, Lucar notes.

Travel expert Kwiatkowski also recommends drinking plenty of water to keep your body running at its best. However, she advises passengers stay away from the water at ports, particularly if a passenger is vulnerable to gastrointestinal illnesses.

“Handwashing, cleaning your stateroom, watching what you eat and how much you eat, and making sure that you stay hydrated will go a long way in preventing these illnesses, from you catching them even if they are there,” she says.

Talk to a doctor or pharmacist about any medications you should pack, such as loperamide (Imodium) to help treat diarrhea or dimenhydrinate (Dramamine, Gravol) for nausea. If your immune system is compromised, your doctor may want to prescribe something ahead of your trip.

3. Measles

Although less common than respiratory and GI illnesses, measles, along with chicken pox and other vaccine-preventable diseases, can circulate on cruise ships.

Measles, a highly contagious virus that can linger in the air even hours after an infected person leaves the room, was declared eliminated from the U.S. in 2000, thanks to a successful vaccine program. But cases still pop up in the States, and the virus is common in many countries around the world.

If an unvaccinated or under-vaccinated passenger or crew member contracts the virus and brings it on board, other vulnerable people can get sick, Chen explains. (A ship was quarantined off the coast of St. Lucia in 2019 when measles was reported on board.) The same goes for chicken pox (varicella), which is similarly caused by a highly contagious virus that can circulate among unvaccinated people.

Staying healthy: To avoid these and other vaccine-preventable diseases, make sure you’re up to date on your routine vaccines before traveling. Two doses of the chicken pox vaccine are more than 90 percent effective at preventing the disease, and two doses of MMR (measles, mumps, rubella) are about 97 percent effective at preventing measles.

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4. Seasickness

Is the motion of the ocean getting to you? Seasickness, while not contagious or related to an infection, can make you feel downright miserable. The good news: Most people recover quickly from seasickness, formally known as motion sickness, and there are medications that can help.

Motion sickness — which can cause dizziness, nausea and vomiting whether you’re on a boat, in a car or on a roller coaster — occurs when the movement you see is different from what your inner ear senses. Interestingly, adults 50 and older are less susceptible than younger adults and children, the CDC notes.

Staying healthy: If you’re prone to going a little green when you travel, talk to your doctor ahead of your trip about medications that can help with symptoms. Prescription and over-the-counter antihistamines — like dimenhydrinate (Dramamine), for example — are most frequently used to treat motion sickness. 

However, antihistamines can interact with other medications and often cause drowsiness and decreased mental alertness, and the nonsedating ones appear to be less effective, the CDC says. Your doctor may also prescribe or recommend a patch that can help prevent nausea and vomiting caused by motion sickness.

Another tip: Have your physician review your current list of medications, since common pills — including some antidepressants and painkillers — can make seasickness worse, according to the CDC. 

A few other things that can help with seasickness:

  • Try lying down on your stomach, shutting your eyes or looking off into the horizon.
  • Avoid the upper levels of the boat.
  • Stay hydrated and limit alcohol and caffeine consumption.
  • Avoid smoking. Even short-term cessation reduces your susceptibility to motion sickness, the CDC says.
  • Distract yourself with music, controlled breathing or aromatherapy (try mint or lavender). Sucking on a flavored lozenge (some experts recommend a hard ginger candy) may also help, the CDC says.
  • While the CDC says the scientific data on acupressure for seasickness is lacking, it works for some. You can find wrist bands for motion sickness in many drugstores.

5. Burns and bites

A word of advice from Lucar and Chen: Don’t forget the SPF when packing for your cruise. A burn on vacation can ruin your fun in the sun and put you at higher risk for skin cancer.

“Also, if you’re going to places that have a lot of insects and mosquitoes, make sure you wear your insect repellent so that you don’t get a bunch of bites, because we also are worried about malaria, dengue, chikungunya, Zika — those sorts of things — at ports of call,” Chen says.

Staying healthy: Opt for a sunscreen with an SPF of at least 15, the CDC recommends, and be sure your bottle says “blocks UVA and UVB” or “broad spectrum” on the label.

When it comes to insect repellent, look for a spray that’s registered with the Environmental Protection Agency. Layering it with sunscreen? Put the repellent on second, over the sunscreen, the CDC advises.

To ease any health-related concerns you might have before booking a cruise, Kwiatkowski suggests using a travel agent who is a cruise line expert or contacting the cruise line to ask about their cleaning protocols and track record. “I know it sounds like a lot of work,” she says, “but travel is a big investment, and you really want to travel worry-free.”

Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.

 

Nicole Gill Council is a writer and editor of travel and diversity, equity and inclusion content for aarp.org. Previously, she was a digital planning manager and a news editor at USA Today and Gannett News Service, and a copy editor at the Los Angeles Times and Newsday.​

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