cdc cruise ship inspection reports

The CDC inspects and scores cruise ships — here’s what those scores mean

Editor's Note

On a cruise ship, you share common areas with a couple of hundred, or thousand, of your closest friends. It's important to know these spaces are clean and safe for every passenger.

Luckily, the Centers for Disease Control and Prevention (CDC) established the Vessel Sanitation Program to ensure cleanliness and sanitation on cruise ships . This program educates, tracks and responds to outbreaks on ships across the industry, with the main focus on gastrointestinal illnesses.

Below is an overview of what the VSP does to protect you and your loved ones from a crippling sickness that could keep you locked in your stateroom during what should be a beautiful and relaxing getaway .

Want to learn more about cruise lines, itineraries and deals? Sign up for the biweekly TPG Cruise newsletter .

What is the Vessel Sanitation Program?

The main goal of the Vessel Sanitation Program is to help the cruise industry prevent and control the introduction, transmission and spread of gastrointestinal illnesses, such as norovirus. The program operates within the CDC and is under the authority of the Public Health Service Act.

The cruise ships under VSP jurisdiction are those that have a foreign itinerary with U.S. ports and carry 13 or more passengers. The ships are given a score, with a maximum of 100. Eighty-five and below is considered a failing score.

VSP's purpose is to train cruise ship employees on public health practices. It also provides health education and reliable and current public health information to a larger audience, including the cruise ship industry, the traveling public, public health professionals, state and local health authorities and the media, according to the CDC's website .

Related reading: 15 ways that cruising newbies waste money on their first cruise

The inspection categories

Source: CDC

How often are cruise ships evaluated?

The inspections are periodical and unannounced, with the goal of inspecting operational sanitation. Under the program, cruise ships are inspected two times a year.

The CDC notes that "If a ship sails outside of the United States for an extended period, it may not be inspected twice a year, but it will be inspected again when it returns to the United States."

So rest assured, the ships will be checked if they are under the VSP's jurisdiction.

Related reading: Trip wrecked: 7 ways to prepare for any kind of travel disaster

Who got the best scores?

In the past two years, here are the cruise ships that received the maximum score of 100 and their date of inspection:

• Aurora , P&O Cruises, 09/24/2018
• Carnival Valor , Carnival Cruise Line, 02/24/2020
• Celebrity Reflection , Celebrity Cruises, 12/09/2019
• Disney Dream , Disney Cruise Line, 11/29/2019
• Disney Wonder , Disney Cruise Line, 10/20/2019
• Nieuw Amsterdam , Holland America Line, 06/17/2019
• Norwegian Sky , Norwegian Cruise Line, 12/02/2019
• Rhapsody of the Seas , Royal Caribbean International, 02/09/2019
• Ruby Princess , Princess Cruises, 08/31/2019
• Sea Princess , Princess Cruises, 08/19/2018
• Seabourn Quest , Seabourn, 11/04/2018
• Viking Sea , Viking, 10/23/2019
• Viking Sky , Viking, 02/21/2020
• Viking Star , Viking, 10/15/2018

Related reading: Which cruise brand is best for you? A guide to the most popular lines

Worst cruise ship scores

Here are the bottom nine cruise ship scores from the past two years. Remember that 85 and below is a failing grade. Click on the accompanying link to see a breakdown of each score:

• World Odyssey , CMI Ship Mgmt, 01/03/2019, score: 89
• MS Grand Classica , Bahamas Paradise Cruise Line, 10/26/2019, score: 88
• Oceania Sirena , Oceania Cruises, 01/20/2019, score: 88
• Seven Seas Mariner , Regent Seven Seas Cruises, 02/01/2020, score: 88
• Victory I , Victory I Partners, Ltd., c/o Cruise Mgmt Intl Inc, 07/31/2019, score: 88
• Kydon , Ferries Del Caribe, 06/10/2019, score: 87
• Queen Victoria , Cunard Line, 01/21/2019, score: 87
• National Geographic Sea Lion , Lindblad Expeditions, 07/06/2019, score: 86
• Norwegian Epic , Norwegian Cruise Line, 02/06/2020, score: 86

Bottom line

Nobody wants to spend the majority of their vacation doubled over in their room, while everyone else experiences once-in-a-lifetime excursions. Not only is it a waste of time and money, but it could be dangerous for your health.

Check out recent VSP scores for a cruise ship you plan to board. These scores allow you to cruise in peace, so you can take the trip of your dreams without the fear of being wracked with an illness.

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Cruise Ship Travel

CDC Respiratory Virus Guidance has been updated. The content of this page will be updated soon.

While cruising is a popular way to travel, there are some health concerns to be aware of. Find out more about health issues on cruises and steps you can take to stay safe and healthy during your trip.

If you are feeling sick before your voyage, do not travel and ask your cruise line about rescheduling or reimbursement options. If you feel sick during your voyage, report your symptoms to the ship’s medical center and follow their recommendations.

Common Health Concerns During Cruise Travel and what You Can Do to Prevent Illness

• Respiratory illnesses like influenza , COVID-19 , and the common cold. Get your annual flu shot and get up to date on your COVID-19 vaccines . Check directly with your cruise line about their COVID-19 testing or vaccination protocols before travel. If you have a weakened immune system , talk with your healthcare provider about your cruise travel plans. Wash your hands frequently or use hand sanitizer . When you cough or sneeze, cover your nose and mouth with a tissue to prevent spreading germs. Consider wearing a mask in crowded or poorly ventilated indoor areas.
• Norovirus. Symptoms of vomiting and diarrhea, primarily caused by outbreaks of norovirus, have been reported. To prevent norovirus , wash your hands with soap and water before eating and after using the bathroom, changing diapers, or touching things that other people have touched, such as stair railings. Avoid touching your face. For more information, visit CDC’s  Vessel Sanitation Program  website.
• Seasickness. Cruise ship passengers may experience seasickness or motion sickness. If you know you get seasick or think you may be likely to get seasick, talk to your healthcare provider about medicine to reduce your symptoms. Some common medications, including some antidepressants, painkillers, and birth control pills, can make seasickness worse.
• Sunburns. Apply sunscreen with SPF 15 or higher when traveling. Protecting yourself from the sun isn’t just for tropical beaches—you can get a sunburn even if it’s cloudy or cold.
• Bug bites. On your trip, use insect repellent and take other steps to avoid bug bites. Bugs, including mosquitoes and ticks, can spread diseases such as malaria, yellow fever, Zika, dengue, chikungunya, and Lyme. Many ships visit ports where these diseases are a concern.

Before Your Trip

Check CDC’s destination pages for travel health information . Check CDC’s webpage for your destination to see what vaccines or medicines you may need and what diseases or health risks are a concern at your destination.

Make sure you are up to date with all of your routine vaccines . Routine vaccinations protect you from infectious diseases  that can spread quickly in groups of people. Outbreaks of chickenpox, influenza, and COVID-19 have been reported on cruise ships.

Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries. Crew members and fellow travelers often board a cruise ship from destinations where some diseases are more common than in the United States or where vaccination is not routine.

Make an appointment with your healthcare provider or a travel health specialist  that takes place at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing your health concerns, itinerary, and planned activities with your provider allows them to give more specific advice and recommendations.

Plan for the Unexpected

Prepare for any unexpected issues during your cruise ship travels with the following steps:

Prepare a  travel health kit  with items you may need, especially those items that may be difficult to find at your destination. Include your prescriptions and over-the-counter medicines in your travel health kit and take enough to last your entire trip, plus extra in case of travel delays. Depending on your destination you may also want to pack a mask ,  insect repellent , sunscreen (SPF15 or higher), aloe, alcohol-based hand sanitizer, water disinfection tablets, and your health insurance card.

Get travel insurance.  Find out if your health insurance covers medical care abroad. Travelers are usually responsible for paying hospital and other medical expenses out of pocket at most destinations. Make sure you have a plan to  get care overseas , in case you need it. Consider buying  additional insurance  that covers health care and emergency evacuation, especially if you will be traveling to remote areas.

If you need medical care abroad, see Getting Health Care During Travel .

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel. Avoid contact with other people while you are sick.

More Information

• Cruise Ship Travel in CDC Yellow Book
• Information for Cruise Ship Travelers
• Maritime Guidance

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tag. --> Vessel Sanitation Program

The Vessel Sanitation Program (VSP) at the Centers for Disease Control and Prevention (CDC) assists the cruise ship industry to prevent and control the introduction, transmission, and spread of gastrointestinal (GI) illnesses on cruise ships. VSP operates under the authority of the Public Health Service Act (42 U.S.C. Section 264 Quarantine and Inspection Regulations to Control Communicable Diseases).

VSP is part of the National Center for Environmental Health’s Division of Emergency and Environmental Health Services .   More about VSP »

Cruise Ship Inspections Find Scores, Reports, and Corrective Actions

New Infographic! Evaluating Eight Areas on Cruise Ships

Healthy Cruising Stay Healthy On Your Cruise: Tips Online in 8 Languages

Acute Gastroenteritis on Cruise Ships AGE Outbreaks on Cruise Ships Are Relatively Infrequent

2017 and 2018 VSP Seminar Dates – Miami

2017 VSP Annual Meeting

Acute Gastroenteritis on Cruise Ships, 2008-2014

VSP 2011 Operations Manual [PDF – 4.88 MB] Changes from 2005 Version (highlighted) [PDF – 4.89 MB] Clarifications to the VSP 2011 Operations Manual [PDF – 521 KB]

VSP 2011 Construction Guidelines [PDF – 4.88 MB] Changes from 2005 Version (highlighted) [PDF – 2.92 MB] Clarifications to the VSP 2011 Construction Guidelines [PDF – 162 KB]

Construction Inspections – Letter to Cruise Industry [PDF – 631 KB]

Inspection Infographic Infographic showing the eight specific areas inspectors evaluate on ships.

Handwashing Handwashing recommendations for the cruising public.

Cruise Ship Inspection

• Inspection Scores Advanced and basic cruise ship inspection search
• Green Sheet Report A list of the most recent inspection scores
• Ship Score of 100 Cruise ship inspections with score of 100
• Variances List variances by section or cruise ship
• About Inspections Operational and construction inspections

Key Resources

Cruise Ship Outbreak Updates

Cruise Line Directory

About Noroviruses on Cruise Ships

VSP 2011 Operations Manual [PDF – 4.88 MB]

VSP 2011 Construction Guidelines [PDF – 4.88 MB]

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• National Center for Environmental Health, Division of Emergency and Environmental Health Services

These are the cruise ships with the best — and worst — sanitation scores so far this year

• The CDC randomly inspects cruise ships to help prevent the spread of stomach viruses. 
• The agency has reported 13 norovirus outbreaks on cruise ships this year.
• These are the cruise ships with the best and worst sanitation report cards in 2023 so far.

There's nothing like a stomach virus to ruin your vacation, as hundreds of cruise ship passengers have unfortunately learned this year.

The Centers for Disease Control and Prevention has reported 13 norovirus outbreaks on cruise ships so far in 2023. The last time the industry's yearly gastrointestinal illness outbreak total was that high was back in 2016 — and it's only July.

For the agency to report a cruise-ship outbreak, 3% or more of passengers or crew members must report symptoms of gastrointestinal illness, such as vomiting and diarrhea, to the ship's medical staff. During the most recent outbreak, a 14-day cruise aboard the Viking Neptune in June, slightly over 13% of passengers (110 of 838) reported being ill with predominant symptoms of abdominal cramps, vomiting, and diarrhea, according to the CDC.

The nasty stomach bug isn't just a cruise-ship problem, though. Norovirus cases have spiked across the United States this year, which some experts say is the result of ending COVID-19 restrictions .

"People often associate cruise ships with acute gastrointestinal illnesses such as norovirus, but acute gastrointestinal illness is relatively infrequent on cruise ships," the CDC says on its website. "Health officials track illness on cruise ships. So outbreaks are found and reported more quickly on a cruise ship than on land."

To try to help prevent the spread of stomach viruses at sea, the CDC randomly inspects cruise ships and scores them on a scale of 0 to 100 through the Vessel Sanitation Program . Inspection scores of 85 and lower are considered "not satisfactory" by the agency.

Related stories

Most vessels have received scores in the high 90s — only one cruise ship, the MSC Seaside, has failed the CDC's sanitation inspection so far this year. The vessel received an unusually low score of 67 , nearly 20 points below the agency's passing grade.

An MSC Cruises representative told Insider at the time that the cruise line had launched an internal investigation based on the inspector's concerns and taken immediate corrective actions.

"MSC Cruises rigorously adheres to health protocols, and the results of this inspection do not reflect the brand's high standards," the person added.

In the past 10 years, only three other cruise ships have received sanitation scores below 70, CDC records show. Violations can include something as small as not posting a raw-eggs advisory on the omelet station or a single fly hovering in a food area. But before going on your next cruise adventure, it doesn't hurt to check out the ship's most recent sanitation rating.

These are the cruise ships with the highest and lowest sanitation scores so far this year:

The 15 cruise ships with perfect scores of 100

The 15 cruise ships with scores below a 95.

Correction: July 17, 2023 — An earlier version of this story included a photo caption that misstated how many passengers and crew members aboard the Nieuw Amsterdam reported being ill during a May voyage. It was 284 people, not 539.

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The cleanest—and dirtiest—cruise ships have been announced

These ships have the lowest and highest sanitation scores, according to the CDC

When planning a cruising vacation, it’s become increasingly important to look into the cleanliness of both the cruise line and the ship before booking. With Covid-19 cases taking an upturn at the moment, and a record number of norovirus outbreaks on cruise ships this year, it’s imperative to take your health into your own hands as much as you are able.

The Centers for Disease Control (CDC) released the results of its twice-yearly Vessel Sanitation Program inspections, which alert the public to what ships are the most (and least) sanitary. The inspections focus on eight distinct areas of each ship, including the dining rooms, pools and spas, child activity centers, and medical facilities. The ships are scored on a scale out of 100 and anything 85 or below is treated as a fail.

Luckily, only one ship failed the most recent inspection, but there were a few that just scraped by. MSC Seaside had a disturbingly low score of 67, while Carnival Liberty , Carnival Pride , and Margaritaville at Sea Paradise squeezed by with scores two scores of 86 and a score of 87, respectively.

The following ships, you can breathe easy (literally), all scored perfect marks on the latest inspection:

• Royal Caribbean Allure of the Seas
• Carnival Celebration
• Carnival Panorama
• Carnival Sunshine
• Celebrity Edge
• Celebrity Millenium
• Celebrity Summit
• Disney Fantasy
• Disney Wonder
• MSC Seascape
• Norwegian Joy
• Norwegian Pearl
• Oceania Riviera
• Holland America Line Rotterdam
• Silversea Silver Moon

Other ships that still passed muster include Noordam (score of 90), Star Pride (score of 90), Le Boreal (score of 90), and Norweigan Epic (score of 89).

While even the cleanest of ships can still harbor germs, passengers can now rest assured that these ships have been vetted and cleared for launch.

• Amanda Mactas

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The Cleanest Cruise Lines, According to CDC Inspections

While keeping passengers healthy has always been a priority for cruise lines, never has the issue been important than today. 

Following the health crisis and the suspension of sailing, you should know that cruise lines are serious about cleanliness. Any sort of incident — whether a virus or not — would lead to a flurry of headlines and negative press, potentially turning some passengers away and hurting business.

Meanwhile, the government also has an interest in keeping cruise passengers healthy. That’s why they have oversight in inspecting ship cleanliness.

Vessel Sanitation Program: Health Inspections for Cruise Ships

Many people don’t realize it, but the Centers for Disease Control (CDC) operates the Vessel Sanitation Program (VSP).

This program is essentially a health inspection for cruise ships. Just like a restaurant in your town would be checked by a health inspector, ships sailing from the United States are also checked out on a regular basis. These inspections are done without prior knowledge by the cruise line.

In particular, the CDC inspections focus on eight areas:

• Medical facilities
• Water systems
• Swimming pools and whirlpools
• Galleys and dining rooms
• Child activity centers
• Hotel accommodations
• Ventilation systems
• Common areas

Cruise ships overall do well on these inspections. Scores are on a 100-point scale and tallies in the high-90s and above are common. In fact, since the start of 2022, more than 20 ships have scored perfect a perfect 100 grade.

On the other end, anything less than 86 is considered unsatisfactory . If a ship scores below this mark, they have the chance to correct the issues and be re-inspected. 

Scoring below an 86 only happens on occasion across dozens and dozens ships. Since the start of 2022 until today, we found only one ship with a failing grade.

The good news for cruise passengers is not only do ships score well when inspected, but the results are also published publicly. You can visit the CDC website and see the scores and reports for hundreds of vessels. Each report is also complete with a write-up of any issues found. No doubt any cruise ship you are sailing on will have their latest report listed.

Now, while ships tend to score well, there are some lines that seem to do better than others on a consistent basis.

Given the current environment, we know that cleanliness is important to passengers. With this in mind, we recently combed through the latest inspection scores from the CDC to determine which cruise line is the cleanest on average by the standards of the Vessel Sanitation Program.

The Average Score of Every Cruise Line

As mentioned above, the CDC lists the inspections scores for an enormous number of vessels sailing from the United States. These scores go back years. For our research, we focused only on scores from the start of 2022 through today to provide more recent information.

In addition, we looked only at those lines with at least two ships receiving scores during that time. This removes small specialty lines that might only occasionally sail from the U.S.

Using the VSP data, we looked at the most recent scores for each ship listed. From there, we averaged the scores across the entire fleet of each line — giving us a single score for each cruise line.

In total, no cruise line scored a perfect average, but every line had a score of at least 91 . The scores ranged from a low of 91.6 to a near-perfect 99.8.

You can see the results in the chart below:

As you can see, in general cruise lines score well on their inspections. That said, some do score higher marks than others.

The 3 “Cleanest” Cruise Lines According to the CDC

According to the CDC data, here are the three cruise lines that scored the highest average scores on their latest inspection reports:

Disney Cruise Line – When it comes to high scores on CDC inspections, Disney takes the top honor. With five ships, every Disney cruise ship scored well on their latest inspections. Four of the ships — Disney Fantasy, Magic, Wish, and Wonder — scored a perfect 100. Disney Dream scored the only non-perfect score… a “lowly” 99. Taken together, the five scores come out to a near-perfect 99.8 average inspection score, making Disney the cleanest cruise line based on inspection scores.

Silversea- While Disney took top honors, Silversea wasn’t far behind. The average score on this luxury cruise line was a 98.5. One thing to note is that the CDC only inspects ships sailing from the United States. If a ship doesn’t come to the U.S. often, it could be longer before another inspection. As a result, despite a 13-ship fleet, only two ships were recently inspected by the CDC.  Still, they had solid inspection scores, including a perfect 100 for the Silver Moon and a 97 for Silver Dawn. 

Celebrity – Celebrity makes a strong showing as a luxury brand that sails larger vessels than Silversea and has a much larger fleet than Disney. The cruise line came in with an average score of 98.1 across its inspections, which includes eight different ships with recent inspection scores. Celebrity Edge, Millennium and Summit all scored a 100 in their last inspections, while two others — Celebrity Beyond and Equinox — scored a near-perfect 98. The lowest score in the fleet was a still-strong 95 aboard Celebrity Reflection.

These Ships Scored Lowest at Last Inspection

Overall, the average scores of cruise lines were strong, with no line averaging below an 91. That said, there were a few lower scores on the inspection reports for individual ships in our search:

MSC Seaside: 67 (Not Satisfactory) — This ship had the lowest score listed during our search and was the only one to score below 86 (indicating “not satisfactory” according to the CDC) since 2022. That’s surprising because all other MSC ships checked by the CDC scored at least 95, with MSC Seascape scoring a perfect 100.

According to the inspection report , violations included various issues ranging from incorrect data logs on crew counts, issues with dishwashing operations, and one crew member with hamburger blood on their hands opening a cooler door, leaving the “refrigerator door handle covered in hamburger blood.”

Carnival Liberty: 86   (Satisfactory) — An 86 is a satisfactory mark according to the CDC, but it is still lower than most among the scores we analyzed. The CDC took issue with dishwashers being out of service, leaky faucets, as well as employees not reporting gastro illness soon enough after onset of symptoms.

Carnival Pride : 86 (Satisfactory) — During an inspection of Carnival Pride , the CDC inspectors found some food areas on the ship “infested with flies that were too many to count.” This went along with “old food soil” in multiple areas. 

Despite the lower scores on Liberty and Pride, Carnival overall posted high marks. The average score was 96.1, with four ships — Celebration, Magic, Panorama, and Sunshine — earning perfect scores.

How to See What Your Cruise Ship Scored

Headed on a cruise soon and want to know what your specific ship scored on its latest inspection? You can search the VSP database by ship using this page . Simply find your ship in the list and then click search. It will also allow you to see reports, which you can read to see the specific violations found on the ship.

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So 3 of the most expensive scored the lowest. hmmmmm!!

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What I Wish I Knew Before Visiting Nassau on a Cruise

11 tips cruise lines don’t want you to know (but they aren’t against the rules), cruise anxiety these facts may calm your biggest fears, hotels with cruise shuttles for every major port in america, 107 best cruise tips, tricks, secrets, and freebies, 39 useful things to pack for your cruise (including 17 you’d never think of).

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This cruise ship failed its CDC operational sanitation inspection

An MSC Cruises ship failed a recent inspection by the Centers for Disease Control and Prevention, receiving a score of 67, nearly 20 points below what the agency considers satisfactory.

The agency found numerous deficiencies during its inspection of MSC Seaside, such as flies in the bar area at the Seaside Bar, passenger sinks with no soap or a broken soap dispenser at the buffet on Deck 16, and “black filth residue” coating unopened yogurt containers in a walk-in refrigerator, among others, according to the inspection report dated April 27.

The CDC’s Vessel Sanitation Program conducts regular inspections of ships to “determine how well ships are operating and maintaining sanitation standards in accordance with the current VSP Operations Manual,” according to its website .

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“MSC Cruises rigorously adheres to health protocols, and the results of this inspection do not reflect the brand’s high standards,” a spokesperson for the line said in an email. “We launched an internal investigation based on the inspector’s concerns and took immediate corrective actions.”

Ships that have failed an inspection are inspected again “within a reasonable time period,” Dr. Erik Svendsen, director of the Division of Environmental Health Science and Practice at the CDC's National Center for Environmental Health, said in an email. If ships fail because of an imminent risk to public health, the VSP may recommend they not sail, though MSC Seaside did not fail for that reason.

Those risks include being unable to chlorinate potable water properly, having inadequate facilities for cleaning and sanitizing equipment and others.

“Most of the hundreds of cruise ships inspected by the Vessel Sanitation Program (VSP) each year pass their inspections with a ‘satisfactory’ score of 86 (out of 100) or above,” Svendsen said. “Failures are uncommon.”

The last ship to fail an inspection was Princess Cruises’ Regal Princess in 2020, receiving a score of 77, according to the CDC’s website . MSC’s Meraviglia and Seascape ships received scores of 98 and 100, respectively, during inspections in February.

Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. You can reach him at [email protected].

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Cruise Etiquette: How to Avoid Getting Sick on a Cruise

I f you’ve been on a cruise recently, you may have noticed the great lengths to which crew members go to remind passengers to wash their hands. On Royal Caribbean’s Icon of the Seas , staff dressed as hot dogs and pizza slices stand by the food hall imploring guests to disinfect before eating. On some ships, crew stationed in the bathroom repeat “washy washy" on loop while others sing catchy jingles and dole out hand sanitizer like candy.

While this may seem overkill, healthy hand washing habits can make the difference between the vacation of a lifetime and a travel horror story. From norovirus outbreaks to pandemic quarantines, it’s no secret that cruise ships are not immune (pun intended) to the occasional health scare—to the point that they’ve developed a bit of a reputation among germaphobes.

Unfortunately, the close quarters of cruise ships can make the vessels good environments for spreading a variety of ailments. But the good news is that cruise ships follow stringent health regulations and reporting requirements, and are subject to random sanitation inspections in the US.

But what can travelers do to avoid getting sick on a cruise? Sally Andrews, vice president of strategic communications and public affairs for the Cruise Lines International Association (CLIA), the world’s largest cruise industry trade association, advises that passengers exercise the same sensible health practices that they do on land. “This includes thorough and frequent hand washing, protecting the health of others if they start to not feel well, and contacting the ship’s medical staff as they would at home based on their individual health needs,” she tells Condé Nast Traveler.

For those looking for more in-depth guidance, the US Centers for Disease Control and Prevention (CDC) maintains a set of health guidelines specifically for cruise passengers. Some of the CDC’s suggestions are simply good travel advice that isn’t particularly cruise-related, like keeping up-to-date on regular vaccinations, checking with a doctor or travel health specialist if any additional vaccines or boosters might be necessary based on the itinerary's ports of call, and staying home if you feel sick in the days immediately leading up to the cruise. (Most cruise line and third-party travel insurance providers will cover cancellations if a medical provider advises you not to travel.)

Specific to cruising, the CDC recommends frequent hand washing and hand sanitizing (more often than on shore) and wearing a mask in crowded or poorly ventilated areas. Hand washing and sanitizing is particularly effective, the CDC notes, in preventing norovirus, which causes a gastrointestinal illness characterized by vomiting, stomach cramps, and diarrhea.

CLIA says that norovirus is rare on cruise ships when compared to the general risk in the US, but outbreaks do seem to be reported with some frequency. In 2023, there were 14 reports of gastrointestinal outbreaks onboard cruise ships arriving in the US (out of thousands of sailings), and all but one was attributed to norovirus.

Captain Luis Rodriguez, the acting chief of the CDC Vessel Sanitation Program, notes that the CDC reported more cruise ship outbreaks in 2023 than 2022, but there was also an increase in shoreside cases during this time. Rodriguez, who holds a graduate degree in public health, explains that the CDC directly “tracks illnesses on cruise ships, so cases are found and reported more quickly on a cruise ship than on land” (which relies on state and local health departments to collect data and report to the agency separately).

“Norovirus outbreaks commonly occur in crowded living accommodations or communities where persons are physically close,” Rodriguez says. “Pathogens that cause norovirus outbreaks can spread quickly in closed and semi enclosed environments, such as a cruise ship.” In short, any crowded space comes with higher transmission risks, and since the reporting requirements of illnesses on cruise ships are so stringent, outbreaks can appear more common than they actually are.

In order to help prevent and control the spread of gastrointestinal illnesses on cruises, all ships are subject to inspection by the CDC when operating in US ports and territorial waters. The inspection results (including every nitty gritty detail) are publicly available on the CDC website —curious passengers can check out how their ship performed during past inspections by using the site's search function.

Because cruise line medical staff track the number of illnesses and likely causes, it’s important that travelers alert the onboard medical team when they feel unwell. This not only allows for accurate reporting to authorities, it also gives onboard teams a chance to prevent disease from spreading by beefing up sanitation protocols during the sailing.

But even passengers who take precautions to avoid transmittable illnesses can be subject to the oldest of seagoing maladies—the old mal de mer, or seasickness , chief among them. Thankfully, most modern cruise ships have sophisticated stabilizer systems which significantly curtail pitch and roll, even in rough seas—leaving many would-be sufferers almost unaware of any movement from the ship at all.

Seasickness is caused by an imbalance between the perception and realities of motion, and conventional wisdom is to keep the horizon in the line of sight. Travelers particularly prone to motion sickness or worried about being affected might prefer balcony staterooms for this reason. There are also a number of over-the-counter medications, available in pill or patch form, that travelers can take with them to treat seasickness. If a bout of nausea catches a passenger by surprise, ship medical staff generally carry a generous supply on board.

If you do get sick on a cruise, rest assured that international maritime law requires virtually all passenger ships to employ a medical doctor onboard. The 50-plus major cruise lines that belong to CLIA go a step further and are required to train clinical staff members in advanced life support, and additionally have defibrillators, cardiac monitors, X-ray machines, and lab equipment onboard.

At the end of the day, cruise ship crew members and passengers each do their part to keep everyone on board happy and healthy during their sailing. Just remember, washy washy!

Condé Nast Traveler does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.