Experts weigh in on how to avoid picking up germs on your next cruise ship.
Fun, joyful images of happy cruise passengers without a care in the world can mask the dangers lurking throughout the ship. Most passengers return rested, relaxed, and perfectly healthy. However, before setting sail, it’s important to familiarize yourself with the dirtiest places on a cruise ship so you don’t end up quarantined in your cabin.
The risk of getting sick on a cruise ship is so high because so many people are confined to the same enclosed space for an extended period of time, explains Dr. Daniel Egan, an infectious disease specialist with Orlando Health Medical Group in Florida.
Norovirus, Influenza, RSV, Human Metapneumovirus, COVID-19, and Legionnaires disease are just some of the health ailments that can befall cruise-goers, Dr. Egan adds.
“Even a small number of sick passengers can expose hundreds or thousands of others in a short time,” says Dr. William Woo, a family medicine doctor with Kaiser Permanente in Southern California. Viruses in particular spread rapidly through cruise ships because many can survive on hard surfaces for days, he says. “This is why some outbreaks continue from one voyage to the next despite thorough cleaning,” Dr. Woo explains.
Some passengers try to reduce their risk by travelling outside of our normal cold and flu season, but that doesn’t necessarily help, Dr. Egan says. “They need to keep in mind that cruises include international crew and passengers, who could easily be from areas that still have these viruses circulating. For example, southern hemisphere countries would have their cold and flu season from April through September.”
However, if you are considering canceling your cruise because you are worried about getting sick, don’t ask for a refund just yet.
“None of this is to say that people should be afraid to go on cruises. They should simply be more aware of their environment,” Dr. Egan explains. “The number one way to combat all of these infections would be diligent hand hygiene.”
What Can You Do to Stay Healthy?
Simple soap and water go a long way towards protecting your health on a cruise ship.
“Wash your hands often with soap and warm water, especially before eating,” Dr. Woo advises. Moreover, while hand sanitizer is convenient and can help. “Don’t count on hand sanitizer alone as it doesn’t reliably kill all viruses and bacteria,” he adds. And don’t forget to avoid touching your face after touching shared surfaces, recommends Dr. Woo.
You can also check your cruise line’s safety score before booking, suggests Jason R. Margulies, a partner and Maritime Attorney at Lipcon, Margulies and Winkleman P.A., which has offices nationwide.
“If you’re worried about cleanliness on your cruise, I suggest you look at the inspection scores for your ship, which are conducted randomly twice each year. Scores of 86 or above are passing, and this information is available to the public,” Margulies explains.
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Hot Tubs
Hot tubs are the perfect breeding ground for bacteria. The combination of warm water, moisture, and organic material, such as skin cells, can pose a health threat, Dr. Woo explains.
“Hot tubs on cruise ships have been previously linked to Legionnaires’ disease outbreaks, a severe form of pneumonia caused by Legionella bacteria,” he says. Unfortunately, there is no easy way to tell whether a cruise ship’s hot tub is safe to use. “Even when the water looks clean, harmful bacteria can still be present, and the steam can carry bacteria into the lungs when inhaled,” Dr. Woo says.
If you think booking a cabin with a private hot tub is the answer, that’s not necessarily true. According to Dr. Woo, public hot tubs on ships are usually a safer bet because private or balcony hot tubs may not be tested or disinfected as frequently as hot tubs in public areas.
If you are on the fence about using a cruise ship’s hot tub, don’t be shy about asking when it was last cleaned, Margulies says.
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Buffets
Cruise ships are synonymous with buffets. Everyone needs to eat, but cruisers should approach buffets with caution.
“Buffets involve shared utensils like tongs, spoons, and condiment handles that are touched by
numerous people in a short period of time. If even one person has early symptoms of a stomach bug like
norovirus, those germs can quickly contaminate food and surfaces,” Dr. Woo explains.
Many cruise ships force all passengers to wash their hands before hitting the buffet to minimize risks, but it’s not foolproof. Washing your hands or using hand sanitizer after loading up your plate but before eating can help.
However, even diligent hand washing may not be enough. The food served at cruise ship buffets poses its own risks, Margulies says.
“It is commonly stored at unsafe temperatures,” he explains. If you are still concerned, stick to onboard restaurants that serve plated meals, Margulies suggests.
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Public Restrooms
Public restrooms on cruise ships get a lot of traffic.
“Viruses like norovirus can spread easily through shared surfaces like faucets, flush handles, and doorknobs, especially if handwashing is rushed or skipped,” Margulies says.
Because you can’t control whether other passengers wash after using the toilet, it’s important to wash your hands with soap for at least 20 seconds every time you use a public restroom. I usually follow up with a dose of hand sanitizer just in case! If I am close enough to my cabin, I will sometimes head back to use my own bathroom instead.
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Handrails
High-touch surfaces throughout cruise ships can become filthy.
“Even with regular cleaning, they can become contaminated again within a few minutes,” Dr. Woo explains.
Handrails on cruise ships are touched frequently throughout the day for good reason. Ships can rock, and holding onto handrails is often necessary to prevent falls. I would never skip holding onto a handrail on a cruise ship, but I always use hand sanitizer when I get to my destination and wash my hands as soon as possible.
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Elevator Buttons
Elevator buttons are another high-touch area on cruise ships. Because cruise ship elevators get so much traffic, their buttons tend to become contaminated quickly after cleaning. An easy fix is to use your elbow to push elevator buttons. I’ve also seen some people on cruise ships carry a napkin to cover their fingers before pressing elevator buttons. Nothing is foolproof but reducing how much of your skin comes into contact with germs can help.
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Casino Chips
If you gamble, watch out for casino chips. These chips may pass through dozens of hands daily, but they are probably not disinfected regularly, Dr. Woo says.
That’s not to say you shouldn’t try your hand with Lady Luck during your cruise. You can minimize your risk by avoiding touching your face while in the ship’s casino and, of course, washing your hands well after you leave.
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Self-Serve Drink Machines
Self-serve drink machines on cruise ships tend to get a lot of use. They are rarely cleaned and are usually near food services, which are another hot spot for infection, Dr. Egan explains.
Many people use their dirty hands to push buttons on the machines, Egan says. Other times, people press their used cups on the machine for a refill.
“Additionally, if people overfill their drinks, spill on their hands, and don’t wash their hands and then touch the buttons again, that could be a possible infectious source,” he explains. If you are worried, stick to drink stations where a staff member fills your cup for you.
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Door Handles
Door handles are another high-touch area on cruise ships that are hard to keep clean due to frequent use, Dr. Egan says. These “could be harboring viruses or bacteria,” he explains. If you can, use your elbow to open doors. Or find a way to cover your hand before touching a door handle; by pulling the edge of your T-shirt over your palm or covering your hand with a paper towel you keep in your pocket. If all else fails, you can wait for someone else to open the door and then follow them through.
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Passenger Cabins
You may think that you are safe from germs in your own cabin, but you would be wrong. “The remote control and phone are commonly forgotten by cleaning staff,” Margulies says.
Other high-touch areas in cabins, such as light switches and bathroom fixtures like faucets and shower handles, also pose a risk, Dr. Woo adds.
However, unlike public areas of cruise ships, it’s easier to combat risks within your cabin.
“In your own room, you can wipe down any of those light switches and other concerning spots as soon as you arrive,” Margulies recommends.