A maritime lawyer and an infectious disease expert say the recent hantavirus concerns aboard a cruise ship highlight the responsibilities cruise operators face when contagious illnesses emerge in crowded onboard environments.
Dr. Nicole Iovine, a UF Health epidemiologist and infectious disease specialist, and maritime attorney Jack Hickey discussed the issue Monday on “Florida Matters Live & Local” as health officials monitor the Andes strain of virus connected to the Dutch-flagged MV Hondius.
While experts say the hantavirus is unlikely to trigger a COVID-style outbreak, both said cruise operators must communicate clearly with passengers and follow protocols designed to limit the spread of illness aboard ships.
“At first, when we didn't know what type of hantavirus strain it was, I wasn't very concerned, because hantaviruses are typically spread by exposure to rodent excreta,” Iovine said. “But then, when we heard it was the Andes subtype, which can spread person to person, I had more concern for the passengers but not about the potential for a large outbreak or pandemic.”
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The Centers for Disease Control and Prevention’s Vessel Sanitation Program monitors illness outbreaks aboard cruise ships operating through U.S. ports and conducts inspections focused on sanitation, food safety, water quality and medical procedures. The CDC notes that cruise ships bring large numbers of people together in confined spaces, creating conditions that can make infectious diseases easier to spread.
Still, Iovine emphasized that the Andes strain spreads far differently than COVID-19.
“The way the hantavirus can transmit really requires some kind of close contact with a person who is showing symptoms,” she said.
The doctor added that early symptoms — including fever, headache and muscle aches — can resemble common respiratory illnesses such as flu, which can complicate early identification.
Cruise lines trade group defends industry
Cruise Lines International Association, which represents most of the global cruise community, defended the industry’s health practices in a statement, saying cruise lines maintain “comprehensive health, sanitation, and medical protocols.” The CLIA also cited public health data that it says shows onboard illness rates are lower than in comparable land-based settings.
Hickey, who said he spent two decades representing cruise lines before later representing passengers, questioned that characterization.
“I don't think that the data does show that being on a cruise ship is safer than being on land,” Hickey said. “That said, I think that it is perhaps no more dangerous, if you will, in terms of infectious diseases than being in a restaurant and public place.”
He also stressed the importance of transparency when illnesses emerge aboard ships.
“The cruise lines should and need to tell passengers what's going on,” Hickey said, adding that he hoped the industry learned lessons from the early days of the COVID-19 pandemic.
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Under maritime law, cruise operators are generally expected to exercise “reasonable care under the circumstances,” Hickey said. That can include steps such as isolating sick passengers, increasing sanitation efforts and communicating health risks to travelers.
Passengers who become seriously ill aboard cruise ships may have legal recourse if they believe operators failed to act reasonably, he said.
“There are no specific guidelines as far as, ‘Do you require all employees to mask? Do you advise the passengers about what's going on? Do you isolate and quarantine people?’” he said. “The answer is, it's reasonable to do all three of those things.”
Passengers pursuing negligence claims would generally need to show the cruise line failed to take reasonable precautions and that failure contributed to illness, legal experts note.
The discussion comes as cruise ships continue drawing attention for onboard illness outbreaks, including a recent norovirus outbreak aboard Carnival Princess out of Port Everglades that, according to the CDC, sickened 102 passengers.
Similar to other crowded environments
Iovine said cruise ships are not unique when it comes to disease transmission, but they do share characteristics with other crowded environments.
“Infectious disease is spread most efficiently when people are in close proximity to one another and remain so for a particular period of time,” she said. “So that is definitely a setting on cruise ships, but it's also a setting in, say, a boarding school or in a military barracks, or if it's people at a social event.”
Hickey said the industry remains under heightened scrutiny in the wake of COVID, when several ships experienced major outbreaks and operators faced criticism over how quickly passengers were informed and isolated.
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“I hope that the cruise lines have learned,” he said, referencing early pandemic-era cruise disruptions that left some ships quarantined at sea.
Communication and response protocols remain central to how such events are judged by passengers and regulators.
Even so, Iovine reiterated, the current hantavirus concerns should not be viewed as comparable to COVID.
“This thing is not easily transmissible like COVID,” Hickey added, referring to the Andes strain.
This story was compiled from an interview by Matthew Peddie for "Florida Matters Live & Local." You can listen to the full episode here.
