Are cruise ships really breeding grounds for illness?

• Recent viral outbreaks on two separate cruise ships have drawn public attention.
• Norovirus outbreaks on cruises account for only 1% of all reported cases, according to the CDC.
• The recent hantavirus outbreak is considered an outlier and does not represent a typical risk for cruise passengers.

One viral outbreak on a cruise ship was already commanding worldwide attention last week when health officials reported another on a separate vessel.

Oceanwide Expeditions’ MV Hondius was grappling with hantavirus cases that resulted in three deaths when more than 110 guests and crew members reported being ill in a norovirus outbreak aboard Princess Cruises’ Caribbean Princess. The latter marked the fourth outbreak of gastrointestinal illness on cruises to meet the Centers for Disease Control and Prevention’s threshold for public notification in 2026.

The timing may fuel a perception that cruise ships are frequently at the center of health crises. However, while certain features of the vessels are conducive to the spread of illness, experts said the events shouldn't necessarily dissuade passengers from setting sail.

Here’s what to know.

Why are cruises at the center of so many outbreaks?

The MV Hondius outbreak, which prompted a coordinated response from the World Health Organization and other international authorities, evoked aspects of the early days of the COVID-19 pandemic. In 2020, cruise ships became early sites of high-profile outbreaks, including aboard Princess Cruises’ Diamond Princess.

Unlike land-based hotels, where guests are coming and going all day, ships are a “closed environment,” according to Dr. Ian Lipkin, John Snow Professor of Epidemiology and Director of the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health. 

“If somebody is ill, whether that be somebody who's a member of a crew or staff or somebody who's a passenger, the probability that they're going to run into somebody else and communicate that is much higher than if it's only a sporadic intersection of these individuals,” he told USA TODAY.

In addition to spending an extended period of time with other people “from different places with different exposures,” the facilities tend to be more confined, added Dr. Emily Abdoler, an infectious diseases specialist and Clinical Associate Professor of Medicine at the University of Michigan Medical School. The closer the proximity, the more likely travelers could spread illness to one another via respiratory droplets or surfaces.

“If people took week-long airplane rides, I imagine we'd be talking about the same thing,” she said.

Infectious diseases spread in plenty of other settings, too. Norovirus outbreaks on cruises, for example, account for just 1% of all reported cases, according to the CDC.

“Part of it is, like, 'Oh, you're in the middle of the ocean, and this percentage of the passengers are having explosive diarrhea,' and it's easy to say what the problem is, whereas, if it is something that's from a public pool or a restaurant, it's just going to be harder to trace,” Abdoler said.

Cruise Lines International Association (CLIA), the industry’s leading trade group, told USA TODAY that its member lines “operate under strict requirements that include advanced cleaning and disinfection procedures, continuous monitoring for illness, and rapid response measures when health concerns arise.”

“These protocols are informed by international public health guidance and are regularly reviewed and updated,” the organization said in an emailed statement. Oceanwide Expeditions is not a CLIA member.

“Cruise ships are also subject to oversight and inspection by public health authorities in key jurisdictions, and CLIA-member oceangoing cruise lines are required to operate with onboard medical facilities and trained personnel equipped to manage a wide range of health situations,” the statement continued.

Can cruises repair their image?

COVID exacerbated existing image issues for cruises, according to Melissa Eaton, co-host of the business and culture podcast “We Fixed It, You’re Welcome.” 

"COVID didn't create the cruise industry’s reputation problem," the customer experience expert said. "It just exposed it because that pandemic made every outbreak look like some sort of test, and cruise incidents have become highly visible in the media, politicized, and public perception is amplified."

She added that misinformation, which may fuel skepticism around public health guidance, “raises the bar” for clarity and communication.

Whether cruise lines can recover from a crisis depends on how they respond, Eaton said. She praised Oceanwide, which has shared consistent updates on the condition of the passengers, the ship’s location and other developments.

“They’re trying to control it by providing the safety net of how they’re addressing it,” she said. “They’re taking accountability for it.”

There is a crisis-management playbook, according to Eaton. That includes protecting both customers and employees; communicating in plain language rather than legalese or other technical terms; and confirming facts quickly.

“One of the things about surviving a health crisis is moving quickly, so cruise lines should learn from this that clarity, sympathy and corrective action are central to building that trust,” she said. “Brands that overexplain, delay, lawyer up, tend to lose that chance.”

How is the hantavirus outbreak different from others on cruises?

While outbreaks of gastrointestinal illness at sea are nothing new – there were 23 in 2025 – this appears to be the first documented hantavirus outbreak tied to a cruise ship.

Hantavirus is primarily spread through exposure to the urine, droppings or saliva of infected rodents. And while officials said the confirmed cases from MV Hondius were the Andes virus, which can be transmitted from person to person, they are still working to determine the origin.

WHO official Maria Van Kerkhove previously said the organization believes the first guest to show symptoms and his wife – both of whom died – were infected on land, but that there may have also been some human-to-human transmission among “really” close contacts. Officials have emphasized that the risk to the general public is low.

Some viruses, like norovirus, are “hardy” and a very small amount can make someone sick, according to Lipkin. 

“That's not the case with hantaviruses,” he said. “People probably get a large dose that they've inhaled that's responsible for triggering this disease. Noroviruses, you know, a little dab will do you.”

Expedition cruises, like the one MV Hondius was on, also center around nature and wildlife. “There's a whole group (of infectious diseases) called zoonoses, which just means that you pick them up from animals,” Abdoler said. “And the closer contact we have with animals, the greater the potential for that spread, although what kind of contact you need varies greatly across a whole spectrum of illnesses.”

She recommended visiting a travel medicine clinic at least several weeks before a cruise, which can provide destination-specific guidance, pre-travel vaccines and more (though there is currently no vaccine for hantavirus).

Lipkin added that “this Andes virus outbreak is really an outlier,” however.

“This is not something that I would be concerned about, you know, sui generis, in thinking about taking a cruise,” he said.

Abdoler echoed that, noting there is a much higher risk of catching other kinds of viruses, like influenza, while sailing. “I don't think this particular situation should change anyone's calculation than what they've had before.”

This story was updated to refresh headlines.

Contributing: Zach Wichter, USA TODAY

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