Seasickness is one thing. But recent cruise ship outbreaks of norovirus — a contagious gastrointestinal illness known to rip through crowded spaces — have led to pretty crappy experiences for unwitting vacationers.
If you’re planning a cruise vacation this holiday season, how can you stay safe? For starters, know that such outbreaks are relatively rare on ships. A 2016 Centers for Disease Control and Prevention report found that nearly 130,000 passengers out of about 74 million contracted an acute gastrointestinal illness between 2008 and 2014.
Here, germ experts offer places to avoid so that you enjoy your trip in good health. However, if you do fall ill — norovirus symptoms include nausea, vomiting, diarrhea, body aches and chills — doctors suggest you immediately isolate yourself from other passengers and stay in your room.
“Quarantine is super old-fashioned, but it’s a really effective way of stopping an epidemic,” says Dr. Keith Roach, an internist at NewYork-Presbyterian and Weill Cornell Medicine.
Bathrooms
Norovirus can be shed through the feces of an infected person up to two weeks after their recovery, which means there’s a risk of picking it up in public restrooms. Toilet stalls are obvious hot zones — door locks, flushing handles and toilet paper dispensers may all be contaminated. If there’s no lid, flushing can cause droplets of someone else’s viral discards to splash on you.
Do your business, but take one very important step before leaving the restroom.
“As long as you’re washing your hands after, you’re going to be washing away the germs you’ve come in contact with,” says Dr. Sarah Hochman, assistant professor of infectious diseases and immunology at NYU Langone Health.
Specifically, meticulous hand-washing with plenty of water and soap — not just a squirt of Purell on the palm. Norovirus can withstand a variety of temperatures and alcohol, and it’s hard to kill on surfaces or skin. While hand-washing won’t kill norovirus, it will wash it away.
If nature isn’t urgently calling, it’s best to head to your private cabin bathroom — where you can clean the toilet handle, doorknob and sink with bleach wipes that you bring on the trip. Once you’re done, the same rules of hand-washing apply for an extra level of safety.
“Your cabin is probably the safest place to be because other people aren’t in there,” says Roach.
Dining areas
Not everyone does a great job of washing their hands after using the loo — and that’s how norovirus can make its way to other parts of the ship. If kitchen staff don’t wash their hands well enough before preparing food, that’s one mode of transmission. But they’re not always at fault, especially if meals are served buffet style.
“You’re going to have multiple people touching the serving utensils as they’re serving themselves food,” says Hochman. “If one person has the virus on their hands, that can get spread to multiple people.”
Once again, that’s why it’s crucial to wash your hands each step of the way — in this case, in between getting your food and eating it.
“You don’t know about the person who was in front of you,” says Roach.
Gaming areas
Certain cruise ships can also feature casinos, which may be a winning amenity for gambling types. But they’re also full of things that dirty hands can touch, and where norovirus can thrive. Think dice, poker chips and the handles of slot machines.
You can spend as much time there as you please, but “be careful about touching your face,” says Hochman. And, of course, wash your hands well when you’re done.
Kid-friendly gaming areas, like arcades, also can be petri dishes for norovirus.
“One kid’s going to be [playing a game], then another’s going to be touching the same fire button or joystick,” says Roach.
Besides keeping your own hands washed, keep those of your kids clean, too.
“You’re going to drastically reduce infections,” says Roach.