Setting off on a dream cruise often brings to mind exciting adventures, and maybe a little sunburn or seasickness seems insignificant. However, over 150 people, including 17 Americans, find themselves stuck on a luxury cruise ship off the coast of West Africa amid concerns about hantavirus infections.
So far, at least seven passengers have reported illness, and three have passed away. This prompted a probe by the World Health Organization into the potential of this rare illness, typically linked to contact with the urine, feces, or saliva of infected rodents, being communicable to humans.
While this specific case stands out, outbreaks of infectious diseases at sea aren’t exactly new discoveries.
Earlier, around 3,700 individuals aboard the Diamond Princess were quarantined off Japan during the initial stages of the coronavirus pandemic. Nearly 700 people got infected, leading to 10 fatalities.
Dr. Omer Awan, a doctor and public health contributor, mentioned that it’s a classic case highlighting just how swiftly respiratory viruses can propagate in the close quarters typical of cruise ships.
So, why do cruise ships seem to become hotbeds for diseases? How concerning should travelers be? The Post gathered insights from seven experts to shed some light on these questions.
Why are infectious diseases likely to occur on cruise ships?
Dr. Raymond Alvarez explained that cruise ships present an “ideal” breeding ground for diseases. They’re like tightly packed, semi-closed environments where thousands share spaces, meals, air, and surfaces over extended periods.
This scenario sets the stage for various transmission pathways. Communal dining and buffets can lead to foodborne illnesses, while crowded venues and small living quarters facilitate person-to-person viral spread. Additionally, frequently touched surfaces—think handrails and elevator buttons—can serve as hotspots for germs. Even pools and hot tubs can contribute.
Another factor is the global mix of passengers. Travelers from around the world might bring in different pathogens, some potentially new to the population on board.
Dr. Jason R. Margulies, a maritime attorney, highlighted how crew members frequently change between voyages, which can allow germs to be transmitted across different groups of passengers. This is often why outbreaks can persist through multiple sailings of the same ship.
What diseases are commonly spread on cruise ships?
According to Awan, the most frequent illnesses on cruises typically target the intestines and colon, with norovirus being a prime culprit. It’s notably easy to spread through contaminated food, surfaces, and direct contact.
Bacteria such as E. coli and Salmonella are also often linked to contaminated food and water.
Dr. Jill Roberts, a molecular epidemiology expert, mentioned how easily germs can transfer among passengers on a crowded ship. A single contamination can quickly escalate into a widespread outbreak if many guests consume the tainted food.
But it’s not just gastrointestinal issues. Respiratory viruses like COVID-19 and influenza are common too, mostly due to shared air and frequent interactions, Awan noted. Given that many cruise-goers are older or have pre-existing health issues, an outbreak aboard a ship could be particularly severe compared to on land.
Which threats are less common?
Exposure to tropical diseases such as dengue fever or Zika virus during shore excursions is a possibility when cruise ships dock in tropical locales, according to Alvarez. Still, these diseases don’t typically spread onboard, as they require vectors like mosquitoes.
Legionnaires’ disease poses another risk, not transmitted from person to person but through contaminated water systems. Infamous for causing severe pneumonia, it can become aerosolized in places like hot tubs.
Furthermore, poorly maintained pools and spas could lead to skin infections. There are also rare, serious threats from animal diseases, including chickenpox and measles, which can amplify risks on cruise ships.
What is the worst-case scenario on a cruise ship?
Alvarez mentioned that the worst-case situation would involve a highly contagious airborne virus like measles spreading among a large group of vulnerable individuals. In that scenario, a single case could quickly lead to an outbreak throughout the entire ship.
This situation is particularly dire when individuals unknowingly transmit the virus prior to exhibiting symptoms, complicating detection and containment.
Modern cruise ships are venturing beyond just the Caribbean, often heading to more remote ports, which can hinder access to medical assistance. Dr. Suraj Sagar, an infectious disease specialist, pointed out that if a ship is far from the shore with limited medical resources, treatment options may dwindle, worsening outcomes.
How do cruise lines keep passengers safe and what can be done?
Despite the risks, experts argue that cruise ships aren’t intrinsically dangerous. Operators have initiated safety measures, including hygiene protocols, isolation practices, and enhanced cleaning procedures.
That said, Madad noted that these ships can still function as effective “mixing vessels.” Depending on the nature of any infections, the risks can be managed, but they aren’t eliminated entirely.
The upside is, with a few precautions, passengers can protect themselves while at sea.
First, ensuring your vaccinations are up to date before departure is crucial. It might also be beneficial to consult with a healthcare provider at your port about potential needed vaccinations.
This helps guard against serious diseases such as hepatitis and typhoid.
It’s also wise to wash your hands frequently, especially after interactions with others, using restrooms, and before meals.
If you’re visiting a buffet, it’s better to avoid sharing large platters and instead use utensils for serving.
Also, keep an eye on how long food sits out. Certain items, particularly seafood and items with mayonnaise, can pose a higher risk for foodborne illnesses if left unrefrigerated too long.
Don’t forget sunscreen, stay hydrated, and pack essentials like hand sanitizer, aloe, lip balm, and a small first-aid kit with pain relievers and allergy meds.
Finally, remember—same rules apply on the water as they do on land. If someone appears unwell, keeping your distance is a good idea.
