As July approaches, millions of people are preparing to embark on a cruise.

Notteboom T, Pallis A, and Rodrigue J-P. Policy & Maritime Shipping. In: Port Economics, Management and Policy. Routledge. 2022.

Summer is, after all, the most popular season for going on a cruise in the Northern Hemisphere.

Ito H, Hanaoka S, and Sugishita K. Seasonality of the global cruise industry. Maritime Transport Research. 2023;5

While people love to explore the world via floating resort for the ease of travel and variety of onboard activities, cruise ships also come with a handful of health risks, including infectious disease outbreaks, foodborne illnesses, and seasickness.

Tardivel K, White S, Treffiletti A, et al. Cruise Ship Travel: CDC Yellow Book 2024. Centers for Disease Control and Prevention. May 1, 2023.

This shouldn’t stop people from going on the trip—after all, evidence suggests that cruise vacations can boost well-being and life satisfaction—but it’s worth taking extra precautions before and during the journey.

Lyu J, Mao Z, Hu L. Cruise experience and its contribution to subjective well-being: A case of Chinese tourists. International Journal of Tourism Research. 2018;20(2):225–235.

Here are the health dangers to be aware of if you’re taking a cruise this summer—and some tips for staying healthy on the open seas.

The most common health issues reported on cruise ships

Vicki Sowards, RN, MHI, Director of Clinical Resources with the travel medicine provider Passport Health, says the most common illnesses reported on cruises are gastrointestinal (GI) infections such as norovirus and respiratory infections like COVID or influenza.

CDC. Norovirus. 2019.

Before the pandemic, varicella, the germ that causes chickenpox, was also frequently reported on cruise ships.

Tardivel K, White S, Treffiletti A, et al. Cruise Ship Travel: CDC Yellow Book 2024. Centers for Disease Control and Prevention. May 1, 2023.

CDC. Chickenpox (Varicella). October 21, 2022.

These diseases can quickly spread from person to person, especially on a cruise ship where people often socialize in dining areas, bars, and shows, Sowards says. 

People might contract an infectious pathogen while visiting a port, reboard, and then unknowingly pass it to other people. “The close quarters and cramped nature of being on a cruise lends itself to the spread of contagious pathogens,” Scott Roberts, MD, Assistant Professor at Yale School of Medicine, tells MDLinx. 

Sailing across choppy waters may also lead to nausea, vomiting, and dizziness.

Takov V, Tadi P. Motion Sickness. In: StatPearls. January 2024.

“Seasickness is a common experience for up to a quarter of all people on a cruise ship,” says Thomas Gut, DO, Associate Chair of Medicine at Staten Island University Hospital. Additionally, fractures and lacerations aren’t uncommon, as a ship’s sudden, unpredictable movements can lead to falls, research suggests.

Jacobs L. Help Your Patients Stay Healthy on Their Cruise Vacation: Suggestions for Primary Care Physicians from a Cruise Ship Physician. Perm J. 2019;23:18–3030.

People with underlying health conditions, including serious allergies, diabetes, and heart disease, may experience complications such as hyperglycemia, closed airways, or stroke, according to the Centers for Disease Control and Prevention (CDC).

Tardivel K, White S, Treffiletti A, et al. Cruise Ship Travel: CDC Yellow Book 2024. Centers for Disease Control and Prevention. May 1, 2023.

How to stay healthy while taking a cruise

It’s tough to predict what might happen when traveling, which is why health providers recommend securing travel insurance in the event that the unexpected occurs. Some health insurance providers cover healthcare costs abroad, but many do not. If that’s the case, people should buy insurance before they travel. “They give some peace of mind about what would happen if you or a loved one needed to be urgently transported off the cruise for medical attention,” Dr. Gut says. 

Sowards recommends staying up-to-date with routine vaccinations—ideally, at least a month before your plans.

CDC. Travel Vaccines to Protect Your Family. April 25, 2023.

Visit a nearby health clinic or ask your primary care doctor about getting the latest jab of the COVID and influenza vaccines. Travelers can also visit a travel medicine clinic and inquire about other immunizations that are recommended, depending on where their ship plans to dock. For example, many countries suggest getting immunized against typhoid and hepatitis A before entering. In addition, if visiting a location that has mosquitoes and other disease-carrying bugs, it’s crucial to bring insect repellent and get the necessary medications that provide protection against diseases like malaria.

People with chronic health conditions should consult with a doctor and talk about what to do if they experience any challenges or complications on the cruise.

Jacobs L. Help Your Patients Stay Healthy on Their Cruise Vacation: Suggestions for Primary Care Physicians from a Cruise Ship Physician. Perm J. 2019;23:18–3030.

Healthcare providers should encourage their patients to bring all necessary medication devices and medications in their carry-on bag, not their checked luggage. There may be additional medications that can be prescribed as a contingency plan. 

Sowards also recommends being intentional about the kinds of foods and beverages you consume while visiting other countries. “While off the ship and being an adventure eater, [tourists] should eat from the vendor who is serving hot food,” she says. Avoid salads, skip the ice—freezing does not kill viruses and bacteria, says Sowards—and snack on fruits that can be peeled, the CDC states.

CDC. Travelers’ Health: Food and Drink Considerations When Traveling.

It’s also important to check bottled and canned beverages for a seal before drinking. “People are known to tamper with bottles and fill [them] with tap water,” says Sowards.

For those prone to seasickness, bring a supply of over-the-counter (OTC) motion sickness pills, such as diphenhydramine (Benadryl), dimenhydrinate (Dramamine), or scopolamine.

CDC. Travelers’ Health: Motion Sickness.

Ginger candy may also help alleviate nausea, according to Dr. Gut. Sowards recommends packing a first-aid kit that includes ibuprofen, acetaminophen, decongestants, antihistamines, loperamide, and, finally, an electrolyte powder for treating dehydration in case you happen to fall ill. People should check in with their doctor first to ensure that it’s safe for them to take these OTC medications. 

Finally, if you start to feel sick during your cruise, try to stay in your cabin to avoid spreading the illness to other people and fueling an outbreak. “A single person who enters the cruise sick risks spreading a contagious disease to many other passengers,” says Dr. Roberts. Consult with a doctor—either on the ship or at a local port—as there may be treatments that can aid recovery. “Trying to shake off some mild symptoms while on a cruise not only puts the vacationer at risk, but it can [also] hurt many others,” says Dr. Gut.