Norovirus outbreaks have struck four cruise ships since December 2024, sickening hundreds of passengers and crew members and resulting in one death, according to the U.S. Centers for Disease Control and Prevention (CDC).
In December alone, three separate cruise ships reported confirmed norovirus outbreaks affecting a total of 301 passengers and crew members. The affected vessels included Princess Cruises' Ruby Princess, Holland America's Rotterdam, and Holland America's Zuiderdam.
The most recent incident occurred on Holland America's Rotterdam ship, where 83 of the 2,192 passengers and 12 of the 953 crew members reported gastrointestinal illness symptoms before the ship's scheduled return to Fort Lauderdale.
"At Holland America Line, the safety and well-being of our guests and crew is our top priority," a Holland America spokesperson stated. "The cases have mostly been mild and quickly resolving."
Fatal Outbreak on P&O Cruises' Arcadia
In a more severe case, a norovirus outbreak aboard the P&O Cruises' Arcadia ship has been linked to the death of a 77-year-old British passenger. Alan Forster, a retired teacher from Paignton, England, contracted norovirus two weeks into a month-long voyage that departed Southampton on September 3, 2024.
According to CDC reports, 128 of the 1,959 passengers aboard the Arcadia experienced norovirus symptoms between September 3 and October 3. Forster's condition deteriorated rapidly, leading to collapse and suspected kidney failure.
His family has raised concerns about the medical care provided onboard. They claim that after initial treatment with intravenous fluids in the ship's medical bay, no additional interventions were offered until the ship docked in St. John's, Canada, where Forster was hospitalized due to his worsening condition.
"All we want now is some answers to help understand what happened and what can be done to prevent this horrendous and ongoing ordeal from happening to anyone else," said Dianna Forster, the deceased's wife.
Jatinder Paul, the family's legal representative, described Forster's rapid decline as "deeply concerning" and emphasized the need to investigate potential failings in onboard medical care and delays in accessing appropriate treatment.
P&O Cruises has expressed sympathy and launched an investigation into the incident. "A preliminary review indicates that when medical staff were informed of Mr. Forster's deteriorating health, care was initiated and onward specialist review and support facilitated at a shoreside hospital," the company stated.
Challenges in Controlling Norovirus on Cruise Ships
Norovirus, often referred to as the "cruise ship virus," presents unique challenges in maritime environments. The CDC notes that "norovirus can be especially challenging to control on cruise ships because of the close living quarters, shared dining areas, and rapid turnover of passengers."
The virus can be introduced to ships through contaminated food or water, or by passengers who were infected while ashore. Once aboard, the highly contagious pathogen can spread rapidly through person-to-person contact or via contaminated surfaces.
In response to outbreaks, cruise lines implement enhanced cleaning and disinfection protocols, isolate sick passengers and crew, and conduct comprehensive sanitization processes before embarking on subsequent voyages.
Prevention and Public Health Response
Dr. William Schaffner, professor of preventive medicine at Vanderbilt University School of Medicine, emphasizes that alcohol-based hand sanitizers are ineffective against norovirus. "It takes only a small amount of virus to actually infect you," Schaffner notes, adding that the virus can survive on surfaces for days or even weeks.
Thorough handwashing with soap and water remains the most effective preventive measure. The CDC monitors and investigates outbreaks on cruise ships through its Vessel Sanitation Program, which conducts unannounced inspections and works with cruise lines to implement prevention and control measures.
While norovirus outbreaks on cruise ships receive significant media attention, they represent only a small percentage of all reported norovirus outbreaks. The CDC estimates approximately 2,500 norovirus outbreaks occur annually in the United States across various settings.
As the cruise industry continues to address these challenges, health officials emphasize the importance of passenger awareness and adherence to hygiene practices to minimize the risk of infection during voyages.
