No one wants to get sick, especially on vacation, and Royal Caribbean implemented a program in 2023 that got rid of one of the worst illnesses people sometimes catch on cruise ships.

Within Royal Caribbean Groups' environmental stewardship report for 2023 is a section that details what the company is doing to improve public health on its ships.

The Norovirus Eradication Campaign was launched in 2023 on Royal Caribbean International and Celebrity Cruises vessels with the ultimate goal of eliminating transmission of norovirus on its ships.

Norovirus is referred to as "the stomach flu", and is easily spread from person to person.

According to the Centers for Disease Control and Prevention, there are 19 to 21 million cases of vomiting and diarrhea illnesses caused by norovirus each year. 

Norovirus is transmitted when someone ingests particles of vomit or feces from an infected person, such as through consuming food touched by an infected individual, touching contaminated surfaces and then their mouth, or placing contaminated objects on clean surfaces.

The CDC says the most common symptoms of norovirus are diarrhea, vomiting, nausea, and stomach pain. 

While only about 1% of all annual norovirus cases reported in the U.S. happen on cruise ships, the perception is it occurs more frequently due to media reports of gastrointestinal viral outbreaks on cruise ships. This is partly because health officials track illness on cruise ships, so outbreaks are found and reported more quickly on a cruise ship than on land.

You're far more likely to catch norovirus at a long-term care facility, hospital, childcare center, or school.

Regardless, because of the media attention reports of the virus on cruise ships attract, Royal Caribbean Group took action to mitigate cases.

A new approach

In June 2023, Royal Caribbean launched a norovirus eradication campaign that included a range of new protocols and policies.

The six tenants of the program were outlined in the Seastainability report:

1. Enhanced acute GI training for onboard medical teams and traveling PHOs 

2. Increased PHO oversight of our Outbreak Prevention Plan, which covers requirements like hand washing, buffet oversight and disinfectant mandates for all public areas aboard our ships

3. Switching to PDI SaniCloth Prime hospital-grade disinfectant wipes (Link contains affiliate link, which costs you nothing extra to use!)

Unlike earlier wipes, PDI wipes carry an EPA claim against norovirus, helping them play a key role in reducing acute GI cases onboard cruise ships.

4. New contactless tap technology, eliminating the need for crew to handle guest cards

5. Enhanced crew training on what to do when experiencing acute GI symptoms and how to avoid cross-contamination in food and beverage service areas

6. An update to our Safety & Quality Management system to stop self-service in buffets if the onboard norovirus rate exceeds 1.5%

According to the report, after the eradication campaign was implemented in June 2023, there was not a single norovirus outbreak onboard any Royal Caribbean International or Celebrity Cruise ship for the remainder of 2023.

It is worth noting the CDC outbreaks page does list Celebrity Constellation as having an outbreak in January 2024.

Something else trialed was the implementation of Synexis BioDefense purifiers. On eight cruise ships, these units reduced the presence of microbes associated with diseases like COVID-19, influenza and norovirus.

97.3% public health inspection scores

Another big step Royal Caribbean Group made in improving the health of guests and crew members on its ships was to invest more in its public health inspection program.

All cruise ships participate in the CDC's Vessel Sanitation Program, which has been in place since the 1970s to conduct random, unannounced inspections of ships if they wish to visit a port in the United States.

The program enforces strict health and safety guidelines, covering the cleaning of high-touch areas and the management of food storage in freezers, refrigerators, and galleys.

Royal Caribbean Group hired  new internal public health inspectors to help the ships improve their public health practices.

The team reviewed public health trends and past areas of concern to come up with recommendations to do better.

As a result of these and other improvements, the average United States Public Health Services (USPHS) inspection score was 97.3 across the fleet. In fact, 10 ships scored a perfect 100

A ship must score 85 or above to pass inspection.

Should you be concerned about getting norovirus on a cruise?

Royal Caribbean Group's eradication program is certainly a positive step, but if you're still worried about catching norovirus, the risks are low.

Even before this new initiative was put into place, the CDC acknowledges that risks are quite low on cruise ships compared to your chances of catching it elsewhere on land. In short, the math points to it being an unlikely scenario for you to encounter.

Moreover, the cruise industry as a whole was already headed to a better place prior to 2020. The rate of acute gastroenteritis illnesses on cruise ships decreased during 2006-2019 for passengers and crew, according to CDC data.

Read more: How To Avoid Getting Sick on a Cruise

The CDC advises frequent hand washing with soap and warm water for at least 20 seconds to prevent the spread of norovirus. Key times for handwashing include after using the restroom or changing diapers, and before eating, preparing food, or handling medicine.

If you want to bring something on your ship to help lower the chance of catching norovirus, Lysol and Clorox products are among the bleaches the Environmental Protection Agency lists as being effective against norovirus.  Before you buy anything, keep in mind bleach isn't allowed on cruise ships.

Read more: What can you not bring on a cruise

Instead, you could pack hydrogen peroxide wipes (just don’t flush them down the toilet). We recommend these Clorox Healthcare Hydrogen Peroxide Wipes for taking with you on your ship (Link contains affiliate link, which costs you nothing extra to use!).

About 167 guests on Royal Caribbean's Oasis of the Seas are afflicted by a stomach virus, according to Royal Caribbean officials.

WESH is reporting the guests affected by the short-lived illness are being treated by the ship's medical team with over-the-counter medication.

pic.twitter.com/WgHLtvOeIk

— Alan Thomas (@alan_thomas13) January 9, 2019

“We are bringing additional medical staff on board and we're engaging in intensive sanitary procedures to minimize the risk of any further issues,” a statement from Royal Caribbean said.

Oasis of the Seas is on a 7-night Caribbean cruise from Port Canaveral, Florida.

Hi, Dale. Unfortunately, we did experience an outbreak on the current Oasis sailing. I see you'll be boarding on Sunday, but no need to worry. We're taking all necessary precautions to ensure your safety as well. -Val

— Royal Caribbean (@RoyalCaribbean) January 10, 2019

UPDATE: The number of sick guests has increased to 277.

UPDATE: Royal Caribbean has decided to cancel the rest of the Oasis of the Seas sailing due to the outbreak. The Miami Herald is reporting that Oasis of the Seas will cut its current cruise short. Royal Caribbean said all passengers will receive full refunds for their cruise fare.

“We think the right thing to do is to get everyone home early rather than have guests worry about their health,” said Rob Zeiger, chief communications manager for Royal Caribbean. “Returning on Saturday also gives us more time to completely clean and sanitize the ship before her next sailing.”

More than 300 passengers Royal Caribbean's Independence of the Seas experienced an onset of gastrointestinal illness on the most recent 5-night Caribbean cruise.

Many news outlets are reporting on the incident, in which the passengers affected reported symptoms that included bouts of vomiting and diarrhea. Royal Caribbean said in statements to media outlets that 332 of the 5,547 passengers and crew became ill.

Photo by Mike Dinsmore

Guests were notified of the incidents during the sailing, with over-the-counter medicine provided to treat symptoms. Guests onboard also reported round the clock work by the crew to sanitize the ship throughout the duration of the sailing.

According to the Centers for Disease Control, around 20 million people are infected with Norovirus each year with less than 1 percent of out breaks occurring on cruise ships.

The Centers for Disease Control (CDC) has reported 3% of the guests and 1% of the crew aboard Royal Caribbean's Anthem of the Seas have reported being ill during the February 21 - March 4, 2016 voyage.

The CDC report shows 125 guests and 16 crew members reported symptoms, such as vomiting or diarrhea.

In response to the outbreak, Royal Caribbean and the crew aboard the ship reported the following actions:

• Increasing cleaning and disinfection procedures according to their outbreak prevention and response plan,
• Collecting stool specimens from passenger and crew gastrointestinal illness cases for testing,
• Making daily reports of gastrointestinal illness cases to the VSP,
• Sending 4 Hotel and Housekeeping Operations Managers, 3 Public Health staff, one nurse from the cruise line corporate office to oversee and assist with implementation of the sanitation and outbreak response procedures,
• Sending 10 additional internal cleaning crew and 10 contract cleaning staff and equipment to the ship to assist in the execution of the ship’s outbreak response,
• Consulting with CDC on plans for their comprehensive sanitation procedures in Bayonne, NJ, including:
  • planning staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and
  • planning for sanitation of terminal and transport infection control procedures.

Two CDC Vessel Sanitation Program environmental health officers and an epidemiologist will board the ship in Bayonne, NJ on March 2, 2016 to conduct an environmental health assessment and evaluate the outbreak and response activities. Specimens have been collected and will be sent to CDC for testing.

Anthem of the Seas voyage was cut short, but Royal Caribbean reports the reasoning was not the illness, but a forecasted storm in the path of the ship.

Some #AnthemoftheSeas guests have experienced norovirus symptoms. About 10 per day from 6,000 total pop. Didn't affect decision to return.

— RCLcorp (@RCLcorp) February 29, 2016

Australian health authorities are reporting about 182 passengers aboard Royal Caribbean's Explorer of the Seas have been sickened with a gastrointestinal virus during a recent cruise.

Royal Caribbean notified the South Eastern Sydney Local Health District of the virus.

No patients required treatment at a hospital, although paramedics were on hand when Explorer of the Seas docked at the Overseas Passenger Terminal at The Rocks just before 6am on Wednesday.

A representaive from the South Eastern Sydney Local Health District indicated the ship would undergo extra cleaning to control the outbreak prior to new passengers being able to board.

Explorer of the Seas recently arrived in Australia to begin her cruising season just last month.

Explorer of the Seas last experienced a Norovirus outbreak in January 2014.

The Centers for Disease Control is reporting Royal Caribbean's Legend of the Seas experienced an outbreak of gastrointestinal sickness that affected 114 passengers and 2 crew members.

Those affected by the sickness experience symptoms such as vomiting and diarrhea.

Legend of the Seas is currently on a two week cruise that started on March 30 and continues until April 14, 2015.

Cruise lines are required to report the total number of gastrointestinal cases, with online updates posted when they account for more than 3 percent of passengers and crew.  The outbreak on Legend of the Seas is affecting 6.53% of the passengers and 0.27% of the crew.

Royal Caribbean is undertaking direction from the CDC to inhibit the sickness and prevent further outbreaks, including increasing cleaning and disinfection procedures making announcements to notify onboard passengers and crew of the outbreak, encourage case reporting, and encourage good hand hygiene.

Once Legend of the Seas returns to San Diego, CA, Royal Caribbean will provide additional cleaning crew to complete a thorough public and accommodation super-sanitization cleaning and disinfection, plan staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and plan for sanitation of terminal and transport infection control procedures.

Royal Caribbean's Grandeur of the Seas returned home to Baltimore today a day early after a number of passengers became sick on the cruise.

Royal Caribbean spokesperson Cynthia Martinez said 193 guests(9.91 percent) and nine crew members(1.15 percent) experienced the illness, thought to be norovirus.

"Those affected by the short-lived illness are responding well to over-the-counter medication administered on board the ship," Martinez said.

The ship will undergo a ship-wide cleaning and disinfection after the guests disembark.  The terminal will also be sanitized.

When the ship was in Falmouth, Jamaica, two CDC Vessel Sanitation Program environmental health officers boarded the ship along with two epidemiologists.  They collected samples for testing and evaluated the outbreak and response activities.

Royal Caribbean is investing $2 million to help prevent Norovirus gastronomic illness from infecting their cruise ships.

Royal Caribbean has extended its contract with ByoPlanet International and added $2 million to fund the company's disinfectant technology that prevents Norovirus on ships.

Royal Caribbean bought 350 additional ByoPlanet sprayers to add to the existing 10-30 sprayers they have on each cruise ship.

The disinfectant works by spraying electrically charged disinfectants that wrap around surfaces to kill mold, odors, mildew, bedbugs, algae and parasites.

Royal Caribbean has been a partner of ByoPlanet since 2010.

Royal Caribbean's Grandeur of the Seas is dealing with a gastrointestinal sickness that has broken out on the ship for the second time in two weeks.

The Centers for Disease Control and Prevention is reporting almost 100 passengers on the Grandeur of the Seas cruise that left Baltimore on April 5th.

Royal Caribbean spokeswoman commented, "Those affected by the short-lived illness have responded well to over-the-counter medication being administered onboard the ship."

A cruise that departed Baltimore March 28 on the same ship also had an outbreak of viral illness that the CDC said was caused by norovirus. During that cruise, more than 100 passengers became ill. Fewer than a dozen crew members were sickened. 

Grandeur of the Seas is expected to return to Baltimore as scheduled Saturday morning. 

Upon its return to Baltimore, the ship is expected to be thoroughly sanitized. In addition, "two CDC Vessel Sanitation Program environmental health officers and an epidemiologist will board the ship," as part of the ongoing investigation, according to disease control officials.

The tests are in and the Centers for Disease Control (CDC) confirmed that Norovirus was indeed the culprit in over 600 cruise passengers getting sick on Royal Caribbean's Explorer of the Seas last month.

The CDC says the particular strain of Norovirus was identified as the GII.4 Sydney strain, which is named after originating in Australia.

Furthermore, the CDC confirmed today that it is the most common norovirus of about 20 different types in the country right now.  In fact, it affects many more people on land than on cruise ships.

In fact, according to the CDC, over 21 million people are infected with Norovirus each year with less than 1 percent of out breaks occuring on cruise ships.

The GII.4 Sydney strain was identified in 2012 in Sydney, Australia.

Jan Vinje, the head virologist who tested the Royal Caribbean germ samples in the CDC’s lab, said Americans should not postpone cruises because of this new norovirus strain. “When we did the math last time, and looked at the total number of voyages annually, maybe less than half a percent had outbreaks. They are perfectly safe.”