I have received a dozen inquiries in the last few days about the chances of contracting Ebola during a cruise. My thought is that the chance is slim that anyone is going to go on a cruise and return home infected with the virus.  But there are some issues that concern me.

For U.S. Travelers, Chances of Infection Are Slim at this Time

From what I have learned, it’s very difficult to contract the the virus. A cruise passenger would first have to come into close personal contact with an infected person. The infection could come from contact with the infected victim’s bodily fluids (blood, saliva, vomit, feces, urine, or semen) or through contaminated needles. This would first require travel to the affected countries in West Africa (Liberia, Sierra Leone, and Guinea) and then intimate contact with an Ebola victim.

So far, the only victim in the U.S. is Thomas Duncan who traveled to Dallas from Liberia and since died. There is a chance that the persons who he came into contact with could develop the disease, but the Centers for Disease Control (CDC) is carefully monitoring the health of all persons who possibly could have come into contact with Mr. Duncan.  

Cruise lines are prudently avoiding ports in West Africa. Holland America Line, Seabourn Cruise Line, Regent Seven Seas Cruises and Fred Olsen are dropping West African ports in Ghana, Gambia and Senegal. Princess Cruises is considering rerouting its 30-day "West Africa Adventure," according to the L.A. Times. 

Royal Caribbean does not call on any ports in West Africa, although ironically Royal Caribbean is incorporated in Liberia to avoid taxes and regulations.

Bloomberg says that the Ebola scare has lowered cruise stocks. Carnival’s stock price fell 5.5 percent, NCL was down 2.8 percent, and Royal Caribbean fell 5.9 percent even though it doesn’t sail near the affected (infected) area.

To my knowledge, there are no cruise lines which routinely hire from Liberia, Sierra Leone, or Guinea. In fact, I have never met or even heard of crew members from these countries. I anticipate that if there are any crew members from these countries, they will not be be re-hired when they return home on vacation. Miami-based cruise lines enacted such hiring freezes on crew members from affected areas during the Severe Acute Respiratory Syndrome (SARS) outbreak in the past.

But I’m Uncertain About the Future

There are some factors, though, that make me nervous about the future.

• The Centers for Disease Control (CDC) says that as many as 1,400.000 people could be infected with Ebola by January 2015.  
• The virus will get worse in the West African countries.
• Experts predict the virus to appear in Europe within the month.
• There are reports that Ebola can survive on surfaces for anywhere from a few hours to several days, depending on the type of surface, the temperature, and the amount of light. 
• According to the CDC, the average time for symptoms of Ebola to appear is 8-10 days. 
• Many travelers don’t disclose illnesses either before or during their cruises because they don’t want to be barred from the ship or confined to their cabin.   
• Some employees don’t report to the ship infirmary because they don’t want to lose their tips.

My concern is that the outbreak will continue and expand. It has already reached Spain. Jacquie Kubin writes in her article Ebola: Lessons Learned from SARS, the Flu, and HIV / AIDS that there is a 75% probability that the virus will reach France by the end of October and a 50% chance that Ebola will migrate to the U.K.

If the virus reaches Europe so quickly, future cruise travelers and employees could become infected. If those infected are booked on cruises, it is foreseeable that an infected person will fail to disclose the early symptoms of Ebola (intentionally or simply because they doesn’t know they have been infected) when they appear at the airport or terminal and then embark the aircraft or cruise ship.

We already know from noro virus cases, many cruise passengers are ill when they come to the cruise ship. Unfortunately, they sometimes lie to get on the ship, and they won’t stay in their cabins even when they are infectious.

We also know from past experiences that some crew members report to work when they are ill, including food handlers. This is documented in the CDC literature.  

Cruise ships are not prepared to handle a situation with an infected Ebola victim aboard. Any crew members called upon to clean up the vomit and diarrhea and other bodily fluids of a sick passenger would likely become infected. An infected chef or waiter shedding Ebola would be a disaster and could potentially infect hundreds of passengers.  

We have seen that cruise ships can easily be plagued by outbreaks of diseases which include not only gastrointestinal diseases, noro virus and e-coli, but measles & rubella, Legionnaires Disease, SARS and other infectious diseases.

Unlike noro virus which lasts a few days, Ebola is potentially deadly. The victim needs immediate and specialized treatment that a cruise ship can’t provide. An Ebola outbreak on a cruise ship could result in deaths as well as a public relations disaster.

Stay Tuned and Hope for the Best

There currently is no vaccine for Ebola. Clinical trials are just starting.

For the next many months, cruise lines will consider West Africa to be a no-man’s land. Until the disease is eradicated, the cruise lines must avoid the ports there. Cruise ships will continue sailing wide of West Africa until the coast is clear. Hopefully the virus will not spread to Europe and find its way onto cruise ships. 

October 17 2014 Update: Texas Hospital Worker Who Handled Ebola Samples is on the Carnival Magic

October 18 2014 Update: Cruise Industry is Completely Unprepared for Ebola Outbreak

 

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Read circular letter (No. 3484) about Ebola published by the International Maritime Organization.

Photo Credits: Top – Daily Times; Botton – CDC via AP