Winter and the holidays are a time of year when many people living in cold climates dream of taking a cruise. This can be a very memorable experience, but not always for the right reasons. To make sure that it is enjoyable, spending a little time on risk assessment is in order. First, one must ask: “Are cruises safe”?  

The first stop to answer this question for any would-be cruiser should be the “Green Sheet Report” from the Centers for Disease Control and Prevention. This report summarizes the inspection findings conducted through its Vessel Sanitation Program (VSP). While this provides standardized information about a ship during an inspection, it does not capture data on all dangerous incidents. Nothing replaces information provided by someone who has recently been on a specific ship. There are a number of issues to be prepared for.  Clinical analytics can assist physicians in assessing risks and also in determining conditions passengers may contract while on a cruise.  Throughout this discussion, analytics from Medal’s collection that can be useful in this context are presented.


The most notorious problem on a cruise ship is a norovirus epidemic, since the virus can spread very quickly among passengers. Most ships take steps to detect an outbreak early and to contain it quickly. Other contagious infections such as influenza or measles can spread as well since there are a large number of people in close proximity to each other.

When going on a shore excursion passengers may be exposed to a wider range of other infectious diseases. Hepatitis A is highly contagious and widespread in developing countries. Some people party quite a bit, and anyone who is promiscuous should wear protection to avoid sexually-transmitted diseases (STDs).

  • Criteria for an Outbreak of Norwalk (Norovirus) GastroenteritisCriteria for an Outbreak of Norwalk (Norovirus) Gastroenteritis
  • Prevention and Control of Norovirus (Norwalk Agent) InfectionPrevention and Control of Norovirus (Norwalk Agent) Infection/li>
  • Laboratory Screening Tests for Distinguishing Malaria from Dengue Fever in a Returning TravelerLaboratory Screening Tests for Distinguishing Malaria from Dengue Fever in a Returning Traveler
  • Prevention of Viral Hepatitis A in a TravelerPrevention of Viral Hepatitis A in a Traveler

Shore Excursions

Many cruises offer short shore excursions that can cover a wide range of experiences. A person who has been on a ship for some time may experience the exotically named mal de barquement syndrome when coming ashore. A person may potentially be exposed to a variety of insects and wild animals in a jungle. Snorkeling and scuba diving introduce other hazards. And many of us are familiar with stories of a couple who gets left behind when the ship leaves without them.

  • Mal De Debarquement SyndromeMal De Debarquement Syndrome 
  • Decompression Illness (DCI) Score in a Scuba DiverDecompression Illness (DCI) Score in a Scuba Diver
  • Injuries Associated with Monkey and Primate BitesInjuries Associated with Monkey and Primate Bites

Lifestyle and Health

Life on board can be one long party if one is not seasick. Gluttony and drinking are not uncommon for people trying to unwind. A person with comorbid conditions may forget medications or stop being compliant. Since many people who cruise are older adults, medical emergencies are possible. Ships have a sickbay and protocols for offloading someone who is seriously ill, but resources are limited so delays are inevitable. It can also pose problems for a woman who is pregnant.Problems with mental illness or conflict may arise. Suicide by jumping overboard happens, with some episodes documented on YouTube.

  • Problems That May Be Encountered While Taking an Ocean Cruise While PregnantProblems That May Be Encountered While Taking an Ocean Cruise While Pregnant

Environmental Hazards

A ship at sea faces an endless list of environmental hazards. We all recall the Costa Concordia running aground despite sophisticated navigational equipment. Hurricanes can be a problem at certain times of the year. In some regions, piracy may be a real concern. Finally, fire or mechanical failures are ever-present concerns.

Bottom Line – Are Cruises Safe?

A cruise ship vacation can be a memorable experience provided you are prepared. Analytics can help physicians and travelers answer the question: “Are cruises safe?” and deal with the unexpected and unfamiliar.