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| Meta Title | Cruise Ship Illness Frequently Asked Questions | Vessel Sanitation Program | CDC |
| Meta Description | Find answers to common questions about gastrointestinal illness outbreaks, inspections, and more. |
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| Boilerpipe Text | Find answers to common questions about gastrointestinal illness outbreaks, our inspections, and more.
Note that cruise ships under our jurisdiction are those with international voyages with a stop at a U.S. port. Other organizations handle cruise ships outside our jurisdiction.
Norovirus and gastrointestinal (GI) illness
Gastrointestinal illnesses, like those caused by norovirus, are very contagious. They can spread quickly in closed and semienclosed environments, such as cruise ships. People joining the cruise ship may bring the virus to other passengers and crew.
Outbreaks
are found, reported, and responded to more quickly on a cruise ship than on land. There are several reasons why:
People who work on cruise ships are required to immediately notify medical staff of their symptoms. This helps outbreaks get detected more quickly than on land, where these requirements for workers are rarely in place.
In addition, cruise ships are required to report cases of certain illnesses. This also helps outbreaks get detected earlier than on land.
Finally, VSP can start an outbreak response without waiting for laboratory results confirming specific pathogens. Most health departments on land, however, have to wait for laboratory results before responding.
Passengers can also help prevent illnesses from escalating into outbreaks by following our tips for healthy cruising. These include notifying medical staff if they are sick, washing their hands, and more.
Passengers can take several steps to prevent illness:
Tell the cruise ship's medical center if they are sick.
Wash their hands often (and not rely on hand sanitizer).
Drink plenty of water and get plenty of rest.
Leave the area if they see someone get sick (vomiting or diarrhea).
Learn more in our
tips
for healthy cruising.
Diapers, including swim diapers and swim shorts, are not leak proof. They might hold in solid feces, but germs can still get into the water. Some cruise ships have designated pools or waterparks suitable for use by children who are in diapers or who are not completely toilet trained. These facilities are designed with extra protective measures.
If your child is vomiting or having diarrhea, take them to the medical center so they can evaluate their symptoms. Assuming it is just seasickness could lead to spreading a contagious illness to others. Let cruise staff know about any episodes of vomiting or diarrhea—including your own—so cruise staff can ensure proper cleaning and sanitation.
Yes. In addition to GI illness, VSP addresses other public health issues on cruise ships, including controlling
Legionella
, managing pests and insects, and ensuring clean air and water.
CDC also tracks
other issues
on cruise ships. Learn about other
common health concerns
and what you can do to prevent illness.
Gastrointestinal illnesses, including those caused by norovirus, are very contagious. If the medical center advises you to stay in your cabin (isolate), it is important to do so. Isolation is only recommended for certain symptoms for a short period of time. It is difficult to spend part of your vacation isolating, but it helps prevent illnesses from escalating to outbreaks that affect the whole cruise ship.
In addition, isolating when sick with certain symptoms helps protect groups that are more at risk if they get sick, especially young children, older adults, and people with weakened immune systems. Isolating also helps prevent events from being canceled and other implications of outbreaks.
If you get sick, even if it's after a cruise, go to the doctor. Make sure to tell them that you recently traveled on a cruise. If you test positive for certain pathogens that we track, the health department will notify us of a positive result. This is so we can follow-up with the cruise line if there is a potential outbreak.
Gastrointestinal Outbreaks
An outbreak is when 3% or more of a cruise ship's passengers or crew have specific gastrointestinal symptoms. Explore our outbreak information on
specific ships
.
If you don't see your cruise ship posted, there could be several reasons why:
The number of sick passengers or crew might not have reached the 3% threshold for qualifying as an outbreak.
The outbreak could have gone undetected. People might not have notified the medical center about being sick.
The cruise ship might be outside our jurisdiction. We address cruise ships with international voyages with a stop at a U.S. port. Other organizations handle outbreaks outside our jurisdiction.
It takes time to find the specific germ that caused an outbreak (also known as the causative agent). When an outbreak occurs, people are asked to provide stool or vomitus samples if they have certain symptoms. These samples are tested to determine the causative agent.
Sometimes we can't determine the causative agent because people did not provide samples or their symptoms started after a voyage ended.
VSP can recommend a cruise ship stop sailing, but this is rarely needed. Gastrointestinal illness outbreaks are almost always addressed without such measures. We monitor cases, and, when they start to go up, we review the ship's outbreak response and prevention plans. Cruise ships implement the plans to stop illness spread.
Public health inspections
To protect public health, VSP evaluates several areas on board:
Food safety practices to prevent foodborne illness and outbreaks
Processes and procedures to ensure the quality and safety of water used for drinking, preparing food, bathing, and swimming
HVAC systems to improve indoor air quality
Cleaning practices for cabins, common areas, and childcare centers to remove germs and sanitize surfaces
Pesticide use and other strategies to manage insects and pests that can carry disease
Medical center procedures for handling sick passengers and crew members
Equipment and layout in food areas, water systems, and other areas to allow for easy cleaning
Learn more about our
inspections
.
Cruise ships under our jurisdiction are subject to two unannounced inspections each year. We inspect cruise ships to determine how well they are operating and maintaining
public health standards
. If a cruise ship sails outside of the United States for an extended period, it may not be inspected twice a year. It will be inspected again when it returns to the United States.
Yes. Cruise ships are responsible for correcting all violations. Cruise ships must correct certain
critical
violations immediately. Some violations can be corrected during the inspection, while others may take longer to correct. Each cruise ship submits a corrective action statement describing how violations were corrected.
People sometimes assume that we will recommend a cruise ship not sail if it fails an inspection. While VSP can recommend a cruise ship stop sailing, this is rarely needed.
Cruise ships are responsible for correcting all violations noted in inspections, and critical violations must be corrected immediately. In addition, cruise ships that fail inspections are reinspected within a reasonable period.
If you can't find a cruise ship in our
inspection database
, it's likely the ship is not in our jurisdiction.
Note: When cruise ships sail outside the United States for an extended period, they will not appear in our database. However, if they return, they are inspected and added back to the database.
No-sail recommendation
Is it very rare for VSP to recommend a cruise ship not sail. We would only do so if there are
imminent public health risks
. Our inspection program aims to identify and address these risks before they become problematic. Examples of imminent public health risks:
Inability to properly chlorinate potable (drinking) water
Inability to keep food within safe temperatures
Inadequate facilities for cleaning and sanitizing food equipment
Inability to properly dispose of solid or liquid waste
Inability to control an infectious disease outbreak
If a cruise line refuses to follow a no-sail recommendation, it can become a no-sail order.
July 15, 2025 |
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# Cruise Ship Illness Frequently Asked Questions
July 15, 2025
For Everyone
## Key points
- Find answers to common questions about gastrointestinal illness outbreaks, our inspections, and more.
- Note that cruise ships under our jurisdiction are those with international voyages with a stop at a U.S. port. Other organizations handle cruise ships outside our jurisdiction.
## Norovirus and gastrointestinal (GI) illness
[Expand All](https://www.cdc.gov/vessel-sanitation/faq/index.html)
### Why do people associate illness with cruise ships?
Gastrointestinal illnesses, like those caused by norovirus, are very contagious. They can spread quickly in closed and semienclosed environments, such as cruise ships. People joining the cruise ship may bring the virus to other passengers and crew.
[Outbreaks](https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html) are found, reported, and responded to more quickly on a cruise ship than on land. There are several reasons why:
- People who work on cruise ships are required to immediately notify medical staff of their symptoms. This helps outbreaks get detected more quickly than on land, where these requirements for workers are rarely in place.
- In addition, cruise ships are required to report cases of certain illnesses. This also helps outbreaks get detected earlier than on land.
- Finally, VSP can start an outbreak response without waiting for laboratory results confirming specific pathogens. Most health departments on land, however, have to wait for laboratory results before responding.
Passengers can also help prevent illnesses from escalating into outbreaks by following our tips for healthy cruising. These include notifying medical staff if they are sick, washing their hands, and more.
### What can passengers do to help prevent illness onboard?
Passengers can take several steps to prevent illness:
- Tell the cruise ship's medical center if they are sick.
- Wash their hands often (and not rely on hand sanitizer).
- Drink plenty of water and get plenty of rest.
- Leave the area if they see someone get sick (vomiting or diarrhea).
Learn more in our [tips](https://www.cdc.gov/vessel-sanitation/communication-resources/tips-for-healthy-cruising.html) for healthy cruising.
### Why can't children in diapers use pools on ships?
Diapers, including swim diapers and swim shorts, are not leak proof. They might hold in solid feces, but germs can still get into the water. Some cruise ships have designated pools or waterparks suitable for use by children who are in diapers or who are not completely toilet trained. These facilities are designed with extra protective measures.
### My child is throwing up. Isn't it just seasickness?
If your child is vomiting or having diarrhea, take them to the medical center so they can evaluate their symptoms. Assuming it is just seasickness could lead to spreading a contagious illness to others. Let cruise staff know about any episodes of vomiting or diarrhea—including your own—so cruise staff can ensure proper cleaning and sanitation.
### Does CDC address other illnesses on cruise ships?
Yes. In addition to GI illness, VSP addresses other public health issues on cruise ships, including controlling *Legionella*, managing pests and insects, and ensuring clean air and water.
CDC also tracks [other issues](https://www.cdc.gov/port-health/php/maritime-guidance/recommendations-for-cruise-lines-to-help-reduce-risk-of-measles-transmission.html) on cruise ships. Learn about other [common health concerns](https://wwwnc.cdc.gov/travel/page/cruise-ship) and what you can do to prevent illness.
### Why do I need to stay in my cabin if I'm sick with gastrointestinal illness?
Gastrointestinal illnesses, including those caused by norovirus, are very contagious. If the medical center advises you to stay in your cabin (isolate), it is important to do so. Isolation is only recommended for certain symptoms for a short period of time. It is difficult to spend part of your vacation isolating, but it helps prevent illnesses from escalating to outbreaks that affect the whole cruise ship.
In addition, isolating when sick with certain symptoms helps protect groups that are more at risk if they get sick, especially young children, older adults, and people with weakened immune systems. Isolating also helps prevent events from being canceled and other implications of outbreaks.
### What should I do if I get sick after a cruise?
If you get sick, even if it's after a cruise, go to the doctor. Make sure to tell them that you recently traveled on a cruise. If you test positive for certain pathogens that we track, the health department will notify us of a positive result. This is so we can follow-up with the cruise line if there is a potential outbreak.
## Gastrointestinal Outbreaks
[Expand All](https://www.cdc.gov/vessel-sanitation/faq/index.html)
### I think my voyage had an outbreak. Why isn't it posted?
An outbreak is when 3% or more of a cruise ship's passengers or crew have specific gastrointestinal symptoms. Explore our outbreak information on [specific ships](https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html).
If you don't see your cruise ship posted, there could be several reasons why:
- The number of sick passengers or crew might not have reached the 3% threshold for qualifying as an outbreak.
- The outbreak could have gone undetected. People might not have notified the medical center about being sick.
- The cruise ship might be outside our jurisdiction. We address cruise ships with international voyages with a stop at a U.S. port. Other organizations handle outbreaks outside our jurisdiction.
### Why don't you know what caused an outbreak?
It takes time to find the specific germ that caused an outbreak (also known as the causative agent). When an outbreak occurs, people are asked to provide stool or vomitus samples if they have certain symptoms. These samples are tested to determine the causative agent.
Sometimes we can't determine the causative agent because people did not provide samples or their symptoms started after a voyage ended.
### Does VSP stop cruise ships from sailing if they have a GI outbreak?
VSP can recommend a cruise ship stop sailing, but this is rarely needed. Gastrointestinal illness outbreaks are almost always addressed without such measures. We monitor cases, and, when they start to go up, we review the ship's outbreak response and prevention plans. Cruise ships implement the plans to stop illness spread.
## Public health inspections
[Expand All](https://www.cdc.gov/vessel-sanitation/faq/index.html)
### What areas does VSP inspect on board?
To protect public health, VSP evaluates several areas on board:
- Food safety practices to prevent foodborne illness and outbreaks
- Processes and procedures to ensure the quality and safety of water used for drinking, preparing food, bathing, and swimming
- HVAC systems to improve indoor air quality
- Cleaning practices for cabins, common areas, and childcare centers to remove germs and sanitize surfaces
- Pesticide use and other strategies to manage insects and pests that can carry disease
- Medical center procedures for handling sick passengers and crew members
- Equipment and layout in food areas, water systems, and other areas to allow for easy cleaning
Learn more about our [inspections](https://www.cdc.gov/vessel-sanitation/php/our-role/public-health-inspections.html).
### How often are cruise ships inspected?
Cruise ships under our jurisdiction are subject to two unannounced inspections each year. We inspect cruise ships to determine how well they are operating and maintaining [public health standards](https://www.cdc.gov/vessel-sanitation/communication-resources/operational-inspections.html). If a cruise ship sails outside of the United States for an extended period, it may not be inspected twice a year. It will be inspected again when it returns to the United States.
### How are cruise ship inspections scored?
We use a 100-point scale to score cruise ships:
- Inspectors use the [current Vessel Sanitation Program (VSP) *Environmental Public Health Standards*](https://www.cdc.gov/vessel-sanitation/php/guidance/index.html).
- Inspectors deduct points for a single, significant violation or for patterns of similar violations.
- Cruise ships fail inspections when they score 85 or below.
- We post all [inspection reports and scores](https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx).
### Are cruise ships required to correct violations?
Yes. Cruise ships are responsible for correcting all violations. Cruise ships must correct certain **critical** violations immediately. Some violations can be corrected during the inspection, while others may take longer to correct. Each cruise ship submits a corrective action statement describing how violations were corrected.
### What happens if a cruise ship fails an inspection?
People sometimes assume that we will recommend a cruise ship not sail if it fails an inspection. While VSP can recommend a cruise ship stop sailing, this is rarely needed.
Cruise ships are responsible for correcting all violations noted in inspections, and critical violations must be corrected immediately. In addition, cruise ships that fail inspections are reinspected within a reasonable period.
### Why can't I find a cruise ship in the inspection database?
If you can't find a cruise ship in our [inspection database](https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx), it's likely the ship is not in our jurisdiction.
Note: When cruise ships sail outside the United States for an extended period, they will not appear in our database. However, if they return, they are inspected and added back to the database.
## No-sail recommendation
[Expand All](https://www.cdc.gov/vessel-sanitation/faq/index.html)
### When would VSP recommend a cruise ship not sail?
Is it very rare for VSP to recommend a cruise ship not sail. We would only do so if there are **imminent public health risks**. Our inspection program aims to identify and address these risks before they become problematic. Examples of imminent public health risks:
- Inability to properly chlorinate potable (drinking) water
- Inability to keep food within safe temperatures
- Inadequate facilities for cleaning and sanitizing food equipment
- Inability to properly dispose of solid or liquid waste
- Inability to control an infectious disease outbreak
If a cruise line refuses to follow a no-sail recommendation, it can become a no-sail order.
## Resources
- [Norovirus communication resources](https://www.cdc.gov/norovirus/communication-resources/index.html)
## On This Page
- [Norovirus and gastrointestinal (GI) illness](https://www.cdc.gov/vessel-sanitation/faq/index.html#cdc_faqs_cat1-norovirus-and-gastrointestinal-gi-illness "Norovirus and gastrointestinal (GI) illness")
- [Gastrointestinal Outbreaks](https://www.cdc.gov/vessel-sanitation/faq/index.html#cdc_faqs_cat2-gastrointestinal-outbreaks "Gastrointestinal Outbreaks")
- [Public health inspections](https://www.cdc.gov/vessel-sanitation/faq/index.html#cdc_faqs_cat3-public-health-inspections "Public health inspections")
- [No-sail recommendation](https://www.cdc.gov/vessel-sanitation/faq/index.html#cdc_faqs_cat4-no-sail-recommendation "No-sail recommendation")
- [Resources](https://www.cdc.gov/vessel-sanitation/faq/index.html#cdc_faqs_res-resources "Resources")
## Related Pages
- [Vessel Sanitation Program](https://www.cdc.gov/vessel-sanitation/about/index.html)
- [Stay Healthy on Your Cruise](https://www.cdc.gov/vessel-sanitation/communication-resources/index.html)
- [Outbreaks](https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html)
[View All Vessel Sanitation Program](https://www.cdc.gov/vessel-sanitation/site.html#gen)
[Stay Healthy on Your Cruise](https://www.cdc.gov/vessel-sanitation/communication-resources/index.html)
July 15, 2025
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| Readable Markdown | - Find answers to common questions about gastrointestinal illness outbreaks, our inspections, and more.
- Note that cruise ships under our jurisdiction are those with international voyages with a stop at a U.S. port. Other organizations handle cruise ships outside our jurisdiction.
Norovirus and gastrointestinal (GI) illness
Gastrointestinal illnesses, like those caused by norovirus, are very contagious. They can spread quickly in closed and semienclosed environments, such as cruise ships. People joining the cruise ship may bring the virus to other passengers and crew.
[Outbreaks](https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html) are found, reported, and responded to more quickly on a cruise ship than on land. There are several reasons why:
- People who work on cruise ships are required to immediately notify medical staff of their symptoms. This helps outbreaks get detected more quickly than on land, where these requirements for workers are rarely in place.
- In addition, cruise ships are required to report cases of certain illnesses. This also helps outbreaks get detected earlier than on land.
- Finally, VSP can start an outbreak response without waiting for laboratory results confirming specific pathogens. Most health departments on land, however, have to wait for laboratory results before responding.
Passengers can also help prevent illnesses from escalating into outbreaks by following our tips for healthy cruising. These include notifying medical staff if they are sick, washing their hands, and more.
Passengers can take several steps to prevent illness:
- Tell the cruise ship's medical center if they are sick.
- Wash their hands often (and not rely on hand sanitizer).
- Drink plenty of water and get plenty of rest.
- Leave the area if they see someone get sick (vomiting or diarrhea).
Learn more in our [tips](https://www.cdc.gov/vessel-sanitation/communication-resources/tips-for-healthy-cruising.html) for healthy cruising.
Diapers, including swim diapers and swim shorts, are not leak proof. They might hold in solid feces, but germs can still get into the water. Some cruise ships have designated pools or waterparks suitable for use by children who are in diapers or who are not completely toilet trained. These facilities are designed with extra protective measures.
If your child is vomiting or having diarrhea, take them to the medical center so they can evaluate their symptoms. Assuming it is just seasickness could lead to spreading a contagious illness to others. Let cruise staff know about any episodes of vomiting or diarrhea—including your own—so cruise staff can ensure proper cleaning and sanitation.
Yes. In addition to GI illness, VSP addresses other public health issues on cruise ships, including controlling *Legionella*, managing pests and insects, and ensuring clean air and water.
CDC also tracks [other issues](https://www.cdc.gov/port-health/php/maritime-guidance/recommendations-for-cruise-lines-to-help-reduce-risk-of-measles-transmission.html) on cruise ships. Learn about other [common health concerns](https://wwwnc.cdc.gov/travel/page/cruise-ship) and what you can do to prevent illness.
Gastrointestinal illnesses, including those caused by norovirus, are very contagious. If the medical center advises you to stay in your cabin (isolate), it is important to do so. Isolation is only recommended for certain symptoms for a short period of time. It is difficult to spend part of your vacation isolating, but it helps prevent illnesses from escalating to outbreaks that affect the whole cruise ship.
In addition, isolating when sick with certain symptoms helps protect groups that are more at risk if they get sick, especially young children, older adults, and people with weakened immune systems. Isolating also helps prevent events from being canceled and other implications of outbreaks.
If you get sick, even if it's after a cruise, go to the doctor. Make sure to tell them that you recently traveled on a cruise. If you test positive for certain pathogens that we track, the health department will notify us of a positive result. This is so we can follow-up with the cruise line if there is a potential outbreak.
Gastrointestinal Outbreaks
An outbreak is when 3% or more of a cruise ship's passengers or crew have specific gastrointestinal symptoms. Explore our outbreak information on [specific ships](https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html).
If you don't see your cruise ship posted, there could be several reasons why:
- The number of sick passengers or crew might not have reached the 3% threshold for qualifying as an outbreak.
- The outbreak could have gone undetected. People might not have notified the medical center about being sick.
- The cruise ship might be outside our jurisdiction. We address cruise ships with international voyages with a stop at a U.S. port. Other organizations handle outbreaks outside our jurisdiction.
It takes time to find the specific germ that caused an outbreak (also known as the causative agent). When an outbreak occurs, people are asked to provide stool or vomitus samples if they have certain symptoms. These samples are tested to determine the causative agent.
Sometimes we can't determine the causative agent because people did not provide samples or their symptoms started after a voyage ended.
VSP can recommend a cruise ship stop sailing, but this is rarely needed. Gastrointestinal illness outbreaks are almost always addressed without such measures. We monitor cases, and, when they start to go up, we review the ship's outbreak response and prevention plans. Cruise ships implement the plans to stop illness spread.
Public health inspections
To protect public health, VSP evaluates several areas on board:
- Food safety practices to prevent foodborne illness and outbreaks
- Processes and procedures to ensure the quality and safety of water used for drinking, preparing food, bathing, and swimming
- HVAC systems to improve indoor air quality
- Cleaning practices for cabins, common areas, and childcare centers to remove germs and sanitize surfaces
- Pesticide use and other strategies to manage insects and pests that can carry disease
- Medical center procedures for handling sick passengers and crew members
- Equipment and layout in food areas, water systems, and other areas to allow for easy cleaning
Learn more about our [inspections](https://www.cdc.gov/vessel-sanitation/php/our-role/public-health-inspections.html).
Cruise ships under our jurisdiction are subject to two unannounced inspections each year. We inspect cruise ships to determine how well they are operating and maintaining [public health standards](https://www.cdc.gov/vessel-sanitation/communication-resources/operational-inspections.html). If a cruise ship sails outside of the United States for an extended period, it may not be inspected twice a year. It will be inspected again when it returns to the United States.
Yes. Cruise ships are responsible for correcting all violations. Cruise ships must correct certain **critical** violations immediately. Some violations can be corrected during the inspection, while others may take longer to correct. Each cruise ship submits a corrective action statement describing how violations were corrected.
People sometimes assume that we will recommend a cruise ship not sail if it fails an inspection. While VSP can recommend a cruise ship stop sailing, this is rarely needed.
Cruise ships are responsible for correcting all violations noted in inspections, and critical violations must be corrected immediately. In addition, cruise ships that fail inspections are reinspected within a reasonable period.
If you can't find a cruise ship in our [inspection database](https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx), it's likely the ship is not in our jurisdiction.
Note: When cruise ships sail outside the United States for an extended period, they will not appear in our database. However, if they return, they are inspected and added back to the database.
No-sail recommendation
Is it very rare for VSP to recommend a cruise ship not sail. We would only do so if there are **imminent public health risks**. Our inspection program aims to identify and address these risks before they become problematic. Examples of imminent public health risks:
- Inability to properly chlorinate potable (drinking) water
- Inability to keep food within safe temperatures
- Inadequate facilities for cleaning and sanitizing food equipment
- Inability to properly dispose of solid or liquid waste
- Inability to control an infectious disease outbreak
If a cruise line refuses to follow a no-sail recommendation, it can become a no-sail order.
July 15, 2025 |
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