At least two-hundred and nineteen passengers and crew became ill, experiencing vomiting and diarrhea, from a gastrointestinal illness aboard Princess Cruises’ Ruby Princess which has returned this morning to Galveston, Texas following a cruise to the Caribbean.

199 of 2,881 (6.61%) of the passengers reported ill during the cruise, as well as 20 of 1,159 (1.73%) of the crew members on the ship.

The Centers for Disease Control and Infection (CDC) has not come to a conclusion as to the “causative agent” behind these gastrointestinal illnesses (GI). The CDC data regarding this GI outbreak indicates that “epidemiologists and environmental health officers” are now boarding ship to begin an investigation once the cruise ship is back in a U.S. port.

The Ruby Princess was the site of an early major outbreak of COVID-19 in Australia when infected passengers were allowed to disembark in Sydney in 2020. At least 900 passengers and crew later tested positive for COVID-19, and 28 people died.

There have been four GI outbreaks on cruise ships which meet the CDC’s reporting requirements in 2023, including the cases on the Ruby Princess. Royal Caribbean’s Jewel of the Seas and the Brilliance of the Seas had GI outbreaks in late January of 2023 involving a total of around one-hundred and fifty passengers and crew. Over 100 passengers and crew members on P&O Cruises’ Arcadia experienced vomiting and diarrhea which the CDC attributed to norovirus. The CDC could not determine the “causative agent” for the GI outbreak on the Royal Caribbean cruise ships.

Unfortunately, the CDC is never able to conclude the precise mechanism of infection regarding shipboard outbreaks like this even if they eventually determine that norovirus was involved. I am not aware of a single time when the CDC has pinpointed the precise cause of a cruise ship disease GI outbreak. The public is left with the “blame game” of wondering whether the cruise ship food or water was contaminated, or the outbreak was caused by a sick galley worker, or was brought aboard by sick passengers and then spread because of inadequate hygiene and poor cleaning procedures.

Several years ago, Time magazine published an article entitled The 13 Worst Norovirus Outbreaks on Cruise Ships. The overall winner of Time’s top 13 list was Princess Cruises which had five outbreaks on its brand alone: Crown Princess (January 2010) with 396 ill; Crown Princess (February 2012) – 363; Ruby Princess (March 2013) – 276; Coral Princess (February 2009) – 271; and Sun Princess (July 2012) – 216.

 Princess and Holland America Line historically have the sickest cruise ships in the cruise industry’s fleet.

If the cruise lines don’t flat out accuse the passengers of being the problem, there will always be an implication that the passengers must not have washed their hands.

The amazing thing about the cruise industry is the frenzy activity when the ships come to port. A tremendous amount of provisions are brought aboard at every port, literally hundreds of thousands of pounds of beef, chicken, pork, fish and shellfish as well as every fruit and vegetable under the sun. Hundreds of thousands of gallons of water are pumped into the ship. The crew members get on and off the ship and of course the passengers do as well.

Was the food and/or water served to passengers on the ship contaminated? Did the passengers or crew eat contaminated food ashore?  Were the hands of a crew member involved in food preparation infected?

Proving exactly how the virus appears on a cruise ship is a difficult scientific process. But no one is engaged in such testing. Yes, the Centers for Disease Control (CDC) test to determine whether the gastrointestinal illness is due to noro or e-coli, but that’s where the testing stops.

Whoever is to blame, the crew members, of course, always pay the price, by having to wipe and scrub and spray everything in sight for long 12+ hour days to try to disinfect a ship longer than three football fields.

Irrespective of the blame-game, don’t call us if you get sick on a cruise. Proving where the virus came from, or that the cruise line was negligent, is virtually impossible to prove, especially since the CDC conducts no epidemiological analysis and sometimes can’t even figure out whether the outbreak is due to norovirus, e-coli or something as exotic as shigella sonnei or cyclospora cayetanensis

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We suggest reading Norovirus Nightmare: Cruise Industry Plays the “Blame-the-Passenger” Game.

March 8, 2023 Update:

Travel Weekly (Australia) coved the story and cited Cruise Law News:

March 8, 2023 Update:

The CDC now reports that there were over 300 passengers and crew members infected during the cruise.