From norovirus to rare hantaviruses, experts explain why cruise ship illnesses are attracting so much attention.
Cruise ship in the center of hantavirus outbreak dock
The cruise ship at the center of the hantavirus outbreak has arrived in Spain, and authorities have begun sending passengers back to their home countries for quarantine.
- Viral outbreaks on two separate cruise ships have recently garnered public attention.
- According to the CDC, norovirus outbreaks on cruise ships account for only 1% of all reported cases.
- The recent hantavirus outbreak is considered an outlier and is not a typical risk to cruise passengers.
The virus outbreak on a cruise ship had already attracted global attention last week, when health authorities reported an outbreak on another ship.
Oceanwide Expeditions’ MV Hondius has been grappling with a hantavirus infection that has caused more than 110 guests and crew members to become ill and three people have died after an outbreak of norovirus aboard Princess Cruises’ Caribbean Princess. The latter is the fourth gastrointestinal illness outbreak on a cruise ship that meets the Centers for Disease Control and Prevention’s standards for publication in 2026.
The timing could raise awareness that cruise ships are frequently at the center of health crises. But experts said that while certain characteristics of the ship facilitated the spread of the disease, the incident need not necessarily deter passengers from setting sail.
Here’s what you need to know:
Why are cruise ships at the center of so many outbreaks?
The MV Hondius outbreak prompted a coordinated response by the World Health Organization and other international authorities and was reminiscent of earlier aspects of the COVID-19 pandemic. In 2020, cruise ships were the site of early high-profile outbreaks, including Princess Cruises’ Diamond Princess.
Unlike hotels on land, where guests come and go throughout the day, ships are “closed environments,” said 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 someone gets sick, whether it’s a crew or staff member or a passenger, the chances of that person encountering someone else and passing it on are much higher than if these people intersect sporadically,” he told USA TODAY.
Dr. Emily Abdullah, an infectious disease expert and clinical associate professor at the University of Michigan Medical School, added that in addition to spending extended periods of time with other people “with different exposures from different locations,” facilities tend to be more enclosed. The closer the distance, the more likely it is that travelers can spread the disease to each other through respiratory droplets and surfaces.
“If people were to fly for a week, they’d be talking about the same things,” she says.
Infectious diseases also spread in many other settings. Norovirus outbreaks on cruise ships, for example, account for only 1% of all reported cases, according to the CDC.
“Part of it is like, ‘Oh, we’re in the middle of the ocean and this percentage of passengers have explosive diarrhea,’ and it’s easy to say what the problem is, but if it’s coming from a public pool or a restaurant, it just becomes more difficult to track,” Abdullah said.
Cruise Lines International Association (CLIA), the industry’s leading trade group, told USA TODAY that its member lines “operate under strict requirements, including advanced cleaning and disinfection procedures, continuous monitoring for illness, and rapid response measures if health concerns arise.”
“These protocols are based on international public health guidelines and are regularly reviewed and updated,” the group 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 major jurisdictions, and CLIA member ocean-going cruise lines are required to operate with onboard medical equipment and trained personnel capable of managing a wide range of health conditions,” the statement continued.
Can Cruise repair his image?
Melissa Eaton, co-host of the business and culture podcast We Fix It, You’re Welcome, said COVID-19 has exacerbated cruises’ existing image problems.
“COVID-19 did not create a reputational problem for the cruise industry,” the customer experience expert said. “The pandemic has only exposed that because every outbreak has looked like some kind of experiment, and the cruise ship disaster has been heavily covered in the media, politicized, and amplified public perception.”
She added that misinformation that can fuel skepticism about public health guidance “raises the bar” for clarity and communication.
Eaton said whether cruise lines can recover from the crisis will depend on how they respond. She praised Oceanwide for consistently sharing updates on the condition of passengers, the ship’s location and other conditions.
“They’re trying to control it by providing a safety net of how to deal with it,” she says. “They are taking responsibility for it.”
Eaton said there is a strategy for crisis management. This includes protecting both customers and employees. Communicate in plain language rather than legalese or other technical jargon. And quickly confirm the facts.
“Moving quickly is critical to surviving a health crisis, so cruise lines should learn from this that building trust is centered around clarity, empathy and corrective action,” she said. “Brands that overexplain, delay, or rely on lawyers tend to miss out on that opportunity.”
How is the spread of hantavirus different from other cruise ships?
Although outbreaks of gastrointestinal illness at sea are not new (there were 23 in 2025), this appears to be the first time a hantavirus outbreak associated with a cruise ship has been recorded.
Hantaviruses are primarily spread by exposure to the urine, feces, or saliva of infected rodents. And authorities said the confirmed case from MV Hondius is an Andean virus that can be transmitted from person to person, but they are still working to determine its origin.
WHO official Maria van Kerkhove previously said that while the agency believes the first symptomatic guest and his wife, who both died, were infected on land, there was “genuinely” possible human-to-human transmission between close contacts. Officials stress that the risk to the general public is low.
Lipkin said some viruses, like norovirus, are “hardy” and can cause illness even in small amounts.
“That’s not the case with hantaviruses,” he said. “People are probably inhaling large doses that cause this disease. If you apply a little bit of something, like norovirus, you’re fine.”
Expedition cruises, like the one aboard the MV Hondius, also focus on nature and wildlife. “There is a group of (infectious diseases) called zoonoses, which simply means they are transmitted from animals,” Abdullah said. “And the closer the contact with the animal, the more likely it is that the infection will spread, but the type of contact required varies widely across the spectrum of the disease.”
She recommended visiting a travel medicine clinic at least a few weeks before your cruise. There, you will be provided with destination-specific guidance, pre-travel vaccines, etc. (although there is currently no vaccine for hantavirus).
But, Lipkin added, “this Andean virus outbreak is actually an outlier.”
“This is not something I would worry about considering going on a cruise,” he said.
Abdullah similarly pointed out that the risk of contracting other types of viruses, such as influenza, while on a voyage is much higher. “I don’t think we need to change our previous calculations because of this particular situation.”
Contributor: Zach Wichter, USA TODAY
Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. Please contact us at ndiller@usatoday.com.
