Tips to Avoid Norovirus on a Cruise Ship​

Norovirus is a common disease – an estimated 1.8 million Australians catch it every year and very few of them are on a cruise. It’s not something to fear, or something that should stop you from jumping on a cruise ship, but it pays to know how to protect yourself.

Outbreaks on cruise ships tend to happen because passengers live in close quarters. Norovirus is also commonly spread in places such as residential care facilities, hospitals, schools, childcare centres, shopping centres and sporting venues. But, perhaps unfairly, it tends to be the cruise ship cases that create headlines.

Below is all you need to know about the virus if it strikes while you’re on a cruise ship or anywhere else. 

What is norovirus?

Norovirus can come under many names, while more technically it refers to a group of related viruses that can cause intestinal infection, you’ll often hear it synonymously with a stomach bug, food poisoning, gastro, and other similar terms.

The spread of the virus generally happens through contamination of food or beverages, direct skin contact with an infected person, contact with a surface that has lingered contamination, and aerosol spread through virus particles. 

Brian Labus, an assistant professor in the Department of Epidemiology and Biostatistics at the UNLV School of Public Health, explains how the disease spreads on Health.com.

“You have to swallow the virus to get sick. That can be through consuming contaminated food or touching a contaminated surface and then touching your mouth or not washing your hands before you eat.”

Symptoms are generally nausea, vomiting, stomach cramps, diarrhoea, headaches, and sometimes light fever and chills. The disease rarely escalates but gives an increased risk of dehydration, so it’s important to try and maintain intake of fluids and electrolytes. 

To formally diagnose norovirus, a stool sample and laboratory test are needed, but generally is just diagnosed through assessment of symptoms, and further testing is not required.

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Are cruise ships of a particular risk?

Dr. Sarah E. Hochman, a hospital epidemiologist and the section chief of infectious diseases at NYU Langone Health’s Tisch Hospital told USA Today that cruise ships aren’t necessarily risker than other similar environments, it’s more so that congregated and enclosed environments will always carry more risk for spread of disease.

“There’s not something special or unique about cruise ships. It’s really any type of congregate setting, but it’s also happening out in the community on a much smaller scale among households and household contacts. It just doesn’t come to the attention of public health as much as it does for larger congregate settings.”

It’s common to hear about outbreaks on ships, but outbreaks are relatively uncommon when weighed against the sheer number of ships sailing every day around the world. Cruise lines are also required to report gastrointestinal illness cases to state health authorities in Australia or to agencies like the CDC’s Vessel Sanitation Program, in the case of ships calling at US ports. That means outbreaks that would likely go unreported in other settings get public attention on cruise ships.

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How to avoid getting Norovirus on your cruise?

• Regularly wash your hands with soap and water for at least twenty seconds. If you’ve been in contact with a contaminated surface, this will prevent you from spreading the disease to yourself and others. Hand sanitiser is not as effective as handwashing at preventing norovirus specifically, so use soap and water where it’s available, not just an antibacterial gel.
• Encourage everyone in your travel party to maintain this practice too – if one member of your group contracts the virus, it’s much more likely to spread to the rest of you.
• How strict you want to be comes down to personal risk tolerance. Avoiding crowds, close-contact activities and buffet dining will lower your chances of contracting the virus, but these are also part of what makes a cruise a cruise. Realistically, the risk on any given sailing is low, and good personal hygiene is the most effective way to reduce your own risk without giving up the parts of the holiday you’re there for.

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You’ve got norovirus – what now?

• If you can keep water down, drink it. Small, frequent sips help maintain hydration. Electrolyte-based drinks will also help replace what you’ve lost – opt for a drink designed for rehydration rather than a sugary sports drink, though if that’s all you have, it’s still better than nothing.
• Do your bit to prevent the virus spreading. Avoid public spaces and touching any of the ship’s food if you suspect you have norovirus, and disinfect anything you think you may have touched, such as bathroom surfaces or door handles near your cabin. Contact ship staff so they can assist you and help disinfect affected areas. Contagion can sometimes persist for up to two weeks after symptoms clear, so keep up your personal hygiene well after you’re feeling better.
• Once you start feeling better, ease back into eating rather than going straight for a big, greasy meal. Start with small, bland, easy-to-digest foods – plain crackers, toast, bananas, plain rice or plain chicken. It’s also worth avoiding dairy for a couple of days, particularly if you’re already sensitive to it, and sugary or caffeinated drinks, which can worsen symptoms.
• Medical advice generally isn’t required, and the virus typically passes within one to three days. If symptoms escalate – for example, severe dehydration or a high fever – contact a doctor. Healthdirect’s guidance is to see a doctor if you have diarrhoea lasting more than two days, signs of dehydration, a fever, severe abdominal or rectal pain, or diarrhoea that’s bloody or black. Note that some anti-diarrhoeal medications, such as Pepto-Bismol, can turn your stool black on their own – that alone isn’t cause for concern.
• Over-the-counter medications can help reduce diarrhoea and nausea, but check with a pharmacist or healthcare professional before taking them, particularly alongside other medications.