CASE STUDY OF NOROVIRUS OUTBREAKS ON CRUISE SHIPS: ENGINEERING AND PUBLIC HEALTH RESPONSES

Abstract

Norovirus  (NoV)gastroenteritis epidemics on cruise ships can impact numerous individuals, incapacitate susceptible travelers, interrupt holidays, and result in economic detriment to the cruise industry. The objective was to identify risk variables associated with NoV epidemics on cruise ships and evaluate the efficacy of preventative and control strategies. The research performed a comprehensive literature review by searching the PubMed and Scopus files and grey literature for research articles and reports detailing NoV epidemics aboard cruise ships from 2000 to 2025.A meta-analysis of NoV incidence among travelers and flight personnel was conducted.Information from 48 epidemics across 25 cruise ships between 2000 and 2025 was sourced from 15 papers and five states, revealing a mean prevalence (assault rate) of 8% for guests and 3% for crew members.Person-to-person dissemination was the predominant method in 38 of the 46 epidemics, occurring exclusively in 15 instances and as a component of multiple transmission channels in 25 cases.The presence of an unwell cabin companion constituted the predominant risk factor.Six epidemic studies indicated inadequate cleanliness, whilst four indicated appropriate hygiene within the cruise environment.Behavioral hazards among travelers were examined in three of the thirteen studies. The results suggest a necessity for behavioral therapies to enhance personal cleanliness, illness reporting, and adherence to isolation protocols, as well as a reevaluation of existing methods of isolation that place symptom and asymptomatic persons in the same chamber.