Cruise: How to protect yourself from diseases such as gastrointestinal

Cruises remain a controversial topic for many vacationers, but those who have decided to take a cruise naturally want to ideally have a carefree dream trip. The last thing you want is gastrointestinal problems. However, large cruise ships, where so many people live in close quarters, are considered particularly problematic. Many passengers use the same rooms and pools, touch the same objects, and share a buffet. Communal restrooms also increase the risk of infection.

This year, an unusually high number of norovirus outbreaks occurred on cruise ships in the first few months. The U.S. Centers for Disease Control and Prevention (CDC) recorded twelve outbreaks by mid-May. By comparison, 15 outbreaks confirmed to be caused by norovirus were recorded in all of 2024. Even then, the U.S. Centers for Disease Control and Prevention reported a record number and one of the worst norovirus years in a decade.

Gastrointestinal outbreaks on cruise ships are categorized as such when at least 3 percent of travelers or crew report symptoms of gastrointestinal illness.

In addition to norovirus, E. coli bacteria can also cause diarrhea on a cruise. However, the stress of travel preparation, the time change, and the change in climate also play a role.

"We ask our guests to contact us in case of illness, regardless of the type, before or at the start of their trip," a spokeswoman for Aida Cruises explained in response to a query. Vacationers should also be sure to obtain the entry and health recommendations from the respective tour operator in advance.

The US Centers for Disease Control and Prevention (CDC) recommends these preventive measures:

• Wash your hands: Vacationers should regularly clean their hands of potential germs, not just before and after using the restroom, but also during and after their trip. Disinfectants can help, but they are no substitute for soap and water.
• Avoid contact with sick people: Anyone who sees vomit or encounters sick fellow travelers should carefully keep their distance. This advice may sound unsympathetic, but it's necessary to contain the spread.
• Drink plenty, but only clean water: Especially when going ashore in countries with low hygiene standards, travelers should only drink water from their own bottle.
• Be careful with street food and buffets: An exotic snack from a street vendor carries the risk of ending your dream trip in the hospital shortly after consumption. But buffets are also not without their risks: Raw or undercooked foods are not recommended.
• Report illness: As already mentioned, anyone who feels ill should inform the cabin crew immediately. This can prevent the spread of the disease.
• Take time out: Seniors aren't the only ones who should make sure they give their bodies enough rest. Breaks strengthen the immune system.
• Special rules apply to children: For hygiene reasons, small children who cannot yet go to the toilet independently or who wear diapers are not allowed in the pools on cruise ships.

Self-treatment for traveler's diarrhea is of limited use, especially on board a cruise ship. Some medications for acute diarrhea virtually paralyze the intestines and can even be dangerous. It's better to follow the advice of the medical staff on board the ship.

It's extremely important to drink plenty of fluids. The well-known cola and pretzel stick therapy helps, according to the Center for Travel Medicine (CRM), but it's not enough. Drinks should contain sugar, salt, and potassium so the body can retain fluids.

Adult travelers can better protect themselves against cholera and travelers' diarrhea by receiving two oral vaccinations one to six weeks apart.

You can find a detailed list of recommended vaccinations against the notorious cruise diseases at the Federal Foreign Office, for example.

Bad news for passengers whose cruise was ruined by norovirus. The Rostock District Court ruled in a judgment (47 C 201/12): A gastrointestinal illness does not constitute a travel defect. For affected passengers, the decision means that they cannot claim either a refund of the travel price or compensation. The case is based on a 2014 case in which first a man and then his wife developed a gastrointestinal illness on a Mediterranean cruise and were unable to go ashore. The couple received €200 from the tour operator for the inconvenience. However, the couple sued for reimbursement of the travel price and medical expenses – and their claim was dismissed by the district court. Accordingly, illness does not constitute a travel defect, but rather a "realization of the general risk of life."

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