Norovirus on Cruise Ships: What Older Travelers Need To Know
Falling ill while traveling is never fun. It can ruin your vacation on land or sea, although getting sick on a cruise ship is probably worse.
Yes, I’m not imagining it. Reports of norovirus on cruise ships have become more frequent in recent years. Whenever I hear a report about a norovirus outbreak on a cruise ship, I worry about my next cruise. Should I or shouldn’t I?
Stories abound of passengers getting norovirus, feeling awful, being confined to their cabins, receiving treatment in ship infirmaries, and occasionally even requiring medical evacuation.
Adding insult to injury, passengers miss out on the enjoyment of the cruise. They can also find themselves saddled with exorbitant medical bills if they don’t have adequate travel insurance or their health insurer doesn’t cover healthcare at sea.
USA Today recently reported that nearly 150 cruise passengers and crew became sick with gastrointestinal symptoms on three ships. All three ships (Holland America Eurodam, Holland America Zuiderdam, and Lindblad Expeditions’ National Geographic Sea Lion) enhanced their sanitation protocols.
Thus far, this brings the total number of reported outbreaks of gastrointestinal illness on cruise ships to 16 in 2025, involving nine different cruise lines. By comparison, 18 outbreaks were reported in all of 2024 and only 14 the year before.
Norovirus Basics: What Older Cruisers Need To Know
These are the basics any older traveler needs to know about norovirus:
What Is Norovirus?
Norovirus is a common and highly contagious virus that causes vomiting and diarrhea.
The first strain of the virus was identified in 1968 after an outbreak in an elementary school in Norwalk, Ohio. As a result, it was named the “Norwalk virus” but is also variously referred to as Norovirus, a “stomach bug” or “stomach flu.”
How Common Is Norovirus?
According to the CDC, 2,500 norovirus outbreaks are reported annually in the United States.
Although the virus usually isn’t severe, it accounts for 900 deaths each year in the U.S., mostly among adults ages 65 and over.
How And Where Does It spread?
Norovirus spreads rapidly, passing from an infected individual to others through contact with contaminated food, water, objects or surfaces.
Outbreaks are more likely to occur in environments where large groups of people are in close contact, such as hospitals, nursing homes, schools, daycare facilities, catering halls, and cruise ships.
Cruise ships account for a small percentage of overall cases, less than 1 percent.
According to the Centers for Disease Control and Prevention (CDC), norovirus is more prevalent during the winter months, from November to April, in countries north of the equator, and from May to September in countries south of the equator.
What Are The Symptoms of Norovirus? How Long Do They Last?
Norovirus is a nasty bug. Its symptoms include nausea, vomiting, stomach cramps, and diarrhea. It can also cause low-grade fever, chills, and body aches, leaving people feeling miserable.
The diagnosis is usually based on the symptoms, but stool tests are sometimes used to confirm the diagnosis.
The virus typically lasts between 24 and 48 hours but it often lasts longer in older adults or those with a compromised immune system. People can remain contagious for at least three days after they recover, sometimes longer.
How is Norovirus treated?
There is no specific medicine to treat the virus; it usually resolves on its own within a few days.
Instead, the emphasis in caring for someone with the virus involves managing their symptoms and preventing complications, especially severe dehydration.
The NIH National Institute for Diabetes and Digestive and Kidney Diseases (NIDDKD) recommends:
- Drinking plenty of fluids to prevent dehydration and loss of electrolytes.
- Getting adequate rest.
- In some cases, taking over-the-counter medicines for diarrhea and/or fever.
- Modify your diet by sticking to a BRAT diet—bananas, rice, apple sauce and toast—and avoid dairy.
If there are signs of severe dehydration or bloody diarrhea, an infected individual should see a doctor for treatment.
Can The Spread of Norovirus On Cruise Ships Be Prevented?
Preventing norovirus or reducing its spread on cruise ships requires government, cruise lines and passengers working together.
The USA Today article suggests that a new norovirus strain has been identified on land and will likely find its way on ships. Moreover, this year’s draconian cuts at the Department of Health and Human Services may diminish the efficacy of CDC surveillance programs. In April 2025, the CDC fired all 200 staff members at the Division of Environmental Health Science and Practice, which oversees the Vessel Sanitation Program.
Are Older Cruisers More At Risk for Norovirus?
The short answer: Yes.
“It really can affect anybody. However, it’s the folks at the extreme ends of the age spectrum who are at greatest risk,” said Robyn F. Chapman, MD, MPH, a family physician in Cincinnati, in an article about norovirus published by the American Medical Association.“
In the case of older people, Chatman attributes the elevated risk to having weakened immunity and more health issues.
What Can Older Travelers Do To Prevent Norovirus?
Telling me not to cruise is a non-starter. Here’s what we can do:
Keep news reports in perspective.
Norovirus can be anywhere. However, we tend to hear about it on cruise ships due to the CDC’s strict reporting requirements.
Ships under the Vessel Sanitation Program must report outbreaks when 3% or more passengers or crew report GI symptoms to the ship’s medical staff.
Practice good hand-washing hygiene, on ship and shore.
Wash your hands often, especially before eating or after using the toilet. I make it a practice to wash my hands every time I enter or leave my stateroom or enter a dining venue.
Don’t shake hands with everyone you meet on the ship.
Don’t touch surfaces unnecessarily.
Use hand sanitizer when soap and water aren’t available (e.g., on a shore excursion), but remember that soap and water are more effective than sanitizers.
Avoid touching your face (eyes, nose or mouth) unnecessarily.
Stay healthy.
Get plenty of rest to build up your immune system before and during your voyage.
Stay hydrated.
Don’t spread the virus knowingly.
If you have symptoms, self-isolate and report them to the ship’s medical team.
Choose your cruise line wisely.
You have to depend on the cruise line and crew to prevent the virus through cleaning and disinfection and lessen the spread after it occurs so exercise care in choosing your line.
Before you book, check out the Vessel Sanitation Program website, which was still operational as this post was written.
No empirical evidence supports my suspicion, but I feel more comfortable on smaller ships with fewer passengers and more public spaces than on mega-cruises.
Older Adults and Norovirus: The Bottom Line
A meta-analysis of studies of norovirus in older adults found that this group faces a heightened risk of severe norovirus symptoms and complications. (Complications can include sepsis, aspiration pneumonia and cardiac events.) Notably, approximately 90% of norovirus-related deaths in the United States occur in individuals aged 65 and above. Adults 85 years and older are at the most significant risk (although healthcare settings are the most common environment for fatalities).
Older adults have weaker immune systems and are more susceptible to more severe symptoms, which ups the risk of rapid dehydration.
However, every type of travel entails different risks and the odds of contracting norovirus on a cruise are slim, especially for older people in relatively good health. In many cases, these odds can be lessened with a hefty dose of awareness and prevention.
Save to Pinterest!!
