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Paul Kelley of Barnstable found out firsthand what happens when you get sick on a cruise ship. On a recent Viking voyage, he ate something fishy while ashore, and promptly, publicly vomited on the ship’s gangway. “You would’ve thought I was bringing a backpack full of the plague,” he said of the quick action taken by cruise ship personnel. Kelley was quarantined in his stateroom immediately, and only allowed out after he’d spent 24 hours symptom-free. He watched movies in his cabin while everyone else went sightseeing ashore. He missed out on the action, but in retrospect, Kelley appreciates the way the ship handled the situation. “They were trying to keep me from potentially infecting 2,000 other people. Nobody wants to be Patient Zero,” he says.

The really bad stuff — not so common

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Nearly 30 million passengers cruised in 2019, according to the Cruise Lines International Association. When things go terribly wrong, the whole world hears about it. Even miles out to sea, we’re all connected, so an outbreak of norovirus goes viral in seconds as passengers share the gory details. Horrifying stories of people falling overboard have made headlines recently. You might well wonder: Why would anyone — much less millions of people — go on a cruise and risk this?

Statistically, though, cruises are one of the safest forms of travel, with rates of serious crimes significantly lower than those on land, the CLIA reports. Data from the FBI supports this. Many more people catch the norovirus in health care facilities than they do on cruise ships, according to the CDC National Outbreak Reporting System. (Your chances of getting a laboratory confirmed case of norovirus during a shipboard outbreak is about 1 in 5,500, they say.) Moreover, a typical cruise ship has more than 60 inspections for safety, environmental issues, and health annually, according to the CLIA. “Cruise ships today are the safest that ever sailed due to the enhanced rules, regulations, and technical innovations that govern their design and operation,” says Brian Salerno of the CLIA. Yes, bad things happen, even on vacation. But mostly, it’s the smaller stuff that’ll get you: missing the boat, changing your plans at the last minute, getting seasick. What do you do then? We asked the experts.

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The cruise ship Crown Princess arrived in San Diego on April 10, 2014, with more than 90 sick passengers and 23 sick crew members, officials said.
The cruise ship Crown Princess arrived in San Diego on April 10, 2014, with more than 90 sick passengers and 23 sick crew members, officials said.Nelvin C. Cepeda

What to do if you must cancel your cruise last minute: Ooh boy. This will cost you. Typically, a last-minute cancellation (as in 14 days or less prior to departure) means that you will forfeit the entire cost of your cruise. “On some lines, the cancellation window extends to as much as 90 days before departure, so read your paperwork carefully, especially if you’re concerned that the timing may not work out for you to sail,” says Heidi Allison of All Things Cruise (www.allthingscruise.com). Make sure you understand the cruise line’s cancellation policies before signing on that dotted line. Even if something unforeseen happens right before your cruise embarks, such as a sudden illness or a death in the family, you’ll likely be hit with a major penalty, and you could lose out on the entire cost of the trip, she warns. Travel insurance will help reimburse you for these costs. To hedge your bets, purchase cancel-for-any-reason optional insurance coverage as part of your travel insurance package, Allison says, but, as always, read the fine print.

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If cancellation is unavoidable, contact your cruise line directly. Some require written documentation of your change of plans. Follow the proper protocol so that you can collect any refunds that are due you.

What should I do if I stay ashore too long and miss the boat? Oops! You spent too much time wandering the charming streets of Corsica and your ship has sailed. Now what? You can fix this, but it’ll cost you some coin to get back to the mother ship.

Immediately contact the port agent at the pier, says Charles Sylvia of CLIA. “The agent will notify the cruise line as well as the local consulate, who will provide the passengers with the means and resources to travel to the next port of call or return home — at their own expense.” You can avoid this scenario by booking shore excursions through the cruise line. Even if a tour is running late, the ship will wait for those passengers. You’ll probably pay more, but the payoff is peace of mind (if you’re the worrying type), and essential if you’re the tardy type. On our recent Alaska cruise, a train derailment held up passengers for an hour, but the ship didn’t leave without them.

If you’re heading off on your own, give yourself ample time to get back to the ship, including time to get lost, wait for a taxi, and so on. Allison advises taking the following things with you anytime you leave the ship: Your cellphone, with the phone numbers for the cruise line and your ship saved, and photocopies of your passport and credit cards. That way, you’ll have documentation if you need to make other travel arrangements.

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Here’s where booking your cruise through a travel agent pays off. “They are real, reachable people in case of unexpected complications, and they have a direct line to the powers that be at the cruise lines,” Allison notes.

What if I fall overboard? This is highly unlikely. Cruise ships have safeguards, such as high railings, to prevent passengers from toppling overboard. “Most people who fall off a cruise ship have actually jumped of their own accord,” Allison says. In fact, “it is virtually impossible for passengers who are acting responsibly and in accordance with cruise ship policies to fall off a cruise ship,” Salerno says. The data supports this. “In 2018, man overboard incidents resulted in one passenger fatality per 2.19 million cruise passengers — or 0.05 fatalities per 100,000 passengers,” he notes.

Not that we recommend this, but suppose you’re taking a risky selfie or reenacting that famous “Titanic” scene and plummet into the sea? Stay calm. “Cruise ships are equipped with a button that, when pushed, pinpoints the vessel’s exact location. This means that rescue teams will have a very good idea of where you went overboard,” Allison says. Your ship will remain in the area, and the crew will perform a search-and-rescue operation, she explains. The captain will notify other ships in the area so they can help with the search. The nearest maritime authority will be notified, and a plane or helicopter may also assist.

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Italian health authorities had kept passengers aboard the Costa Smeralda cruise ship, shown docked in the Civitavecchia port near Rome on Jan. 30, 2020, after a passenger from Macao came down with flulike symptoms amid the global scare about coronavirus. When the passenger tested negative, the others were allowed to disembark.
Italian health authorities had kept passengers aboard the Costa Smeralda cruise ship, shown docked in the Civitavecchia port near Rome on Jan. 30, 2020, after a passenger from Macao came down with flulike symptoms amid the global scare about coronavirus. When the passenger tested negative, the others were allowed to disembark.Andrew Medichini/Associated Press

What if I get wicked seasick, or sick in general?

“If you know you have a propensity for seasickness, book a cabin in the center of the ship, with an ocean view if possible. This will help to keep from feeling too much rocking, and having a window can help to stabilize you,” says Colleen McDaniel, editor-in-chief of Cruise Critic (www.cruisecritic.com).

Most new ships are built with stabilizers that help minimize the sensation of rocking, McDaniel notes. “We’ve heard of many cruisers who tend to get seasick on smaller boats, yet don’t have any issue onboard cruise ships. But it’s always good to be prepared, especially in the case of unpredictable weather.” Most ships have ginger and other remedies on hand, just in case. And don’t hole up in your cabin if you start to feel queasy — head to the deck for some fresh air, and keep your eyes on the horizon.

For other illnesses, cruise ships offer onboard medical facilities staffed by doctors, who can provide medications if needed. As Paul Kelley discovered, if an illness might be contagious, guests are required to stay in their cabins to protect fellow cruisers. “Cruise ship crew follows strict protocol in the case of any illnesses onboard. Keeping guests healthy is a top priority,” McDaniel says. If it’s a more serious illness, you might be asked to disembark in port in order to receive more comprehensive care than the ship can provide.

Of course, that doesn’t mean you won’t be seated next to a coughing, sneezing, germ-spewing passenger on the flight home. Oh wait, you won’t — that’s our seat. Always. Face masks, anybody?


Diane Bair and Pamela Wright can be reached at bairwright@gmail.com