What happened onboard the cruise ship where more than 150 people got sick?

By Lisa Marie Basile | Fact-checked by Jessica Wrubel
Published February 15, 2024

Key Takeaways

  • 154 people (129 passengers and 25 crew members) on board the Cunard Queen Victoria cruise ship reported gastrointestinal illness (including diarrhea and vomiting). There is currently no known cause. The ship is carrying 1,824 passengers and 967 crew in total.

  • The cruise line has taken actions to clean and disinfect the ship in accordance with the Centers for Disease Control and Prevention’s Vessel Sanitation Program.

  • Experts say that gastrointestinal illnesses are common on cruises, as people live in very close quarters on a cruise ship and eat from the same food sources.

Nearly 154 people presented with gastrointestinal illness on board the Cunard Queen Victoria cruise ship, which sailed from Fort Lauderdale, FL, on January 22. The ship docked in Honolulu, HI on February 12.[] 

In total, 129 passengers and 25 crew members (out of 1,824 passengers and 967 crew, respectively) experienced diarrhea and vomiting, although the cases reported are totals for the entire voyage and do not represent the number of active cases at any given port of call or at disembarkation, explains the Centers for Disease Control and Prevention (CDC). The cause is currently unknown.[]

The cruise line has disinfected the ship and protected other passengers from getting sick with outbreak prevention and response plans. They’ve also isolated the sick patients while notifying incoming passengers. 

The CDC’s Vessel Sanitation Program (VSP)—which helps the cruise ship industry prevent and control the introduction, transmission, and spread of GI illnesses on cruise ships—monitored the situation.[]

The VSP monitors cases of acute gastroenteritis (AGE) on cruise ships traveling to a port located within the US To qualify as AGE, patients must have had over three loose stools within 24 hours, in addition to vomiting and one other symptom, including fever, diarrhea, bloody stool, myalgia, abdominal cramps, or headache, the CDC says.[]

The percentage of passengers or crew with AGE must be greater than 2% for the VSP to activate an alert. The rate of AGE illness on cruise ships was on the decline between 2006 and 2019.[][] 

James H. Tabibian, MD, PhD, a gastroenterologist at Adventist Health in Glendale, CA, explains that these viruses spread wildly for a few key reasons. First, people live in very close quarters on a cruise ship. Second, widespread food contamination occurs when people eat the same food from the same source. Lastly, he says, infectious microorganisms abound. Andrew S. Boxer, MD, a gastroenterologist at Gastroenterology Associates of New Jersey, echoes Tabibian, saying there are few key virus culprits on board cruise ships, especially in the onboard hot tubs. 

“One common example is norovirus,” Dr. Boxer says. “These viruses are usually spread through a fecal-oral route."

Protecting passengers on-board a cruise ship

Passengers should prepare before boarding a cruise, says Lin H. Chen, MD, director of the Travel Medicine Center at Mount Auburn Hospital in Cambridge, Massachusetts. Dr. Chen recommends that clinicians ensure their patients are up-to-date on influenza, COVID-19, and pneumonia vaccines (as well as any other destination-specific vaccines) before their cruise date. 

“Clinicians should also advise travelers to bring self-treatment medications,” Dr. Chen advises. More so, she says, you’ll want to “remind cruise travelers to consider travel medical or evacuation insurance.”

Medical teams on board ships play a key role in preventing illness, as well, says Toufic Kachaamy, MD, FASGE, chief of medicine and director of Gastroenterology and Endoscopy at City of Hope in Phoenix, AZ. He says that cruise clinicians should ideally screen all passengers and crew before stepping onto the ship while ensuring that high-touch zones are cleaned frequently. 

“Having medical supplies and personnel to be able to handle the infections and give people prompt and proper treatment—such as hydration—if someone loses too many fluids” is critical, Dr. Kachaamy says.

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