It has been a rough couple of months for the cruise industry.
In January, the Costa Concordia capsized off the coast of Tuscany, Italy, leaving 17 dead and 16 missing. Early this month, two Princess Cruises ships cut short their journeys and returned to Fort Lauderdale's Port Everglades because outbreaks of the flulike norovirus.
While the Costa Concordia is seen as a rare accident, the outbreaks of sickness on cruise ships give pause to many potential passengers.
"It's definitely something that is on my mind," says Oak Brook's Sarah Jardine, who is preparing to take a Disney Cruise Line to the Bahamas in March. "What's scary about it is that you're captive. You can't get away like you could leave a resort."
Passengers can take steps to protect their health while cruising. Just ask Erica Silverstein, who said that when she tells people that she writes about cruises for smartertravel.com, they often ask her how frequently she falls ill. Her answer is never.
To avoid catching the norovirus, which has symptoms that include nausea, vomiting, diarrhea and cramping, Silverstein advises passengers to regularly wash their hands with soap and hot water, particularly before and after meals, after using the restroom, even after touching their faces.
Ships are stocked with anti-bacterial lotion dispensers, which guests should use, Silverstein said.
Silverstein also tells passengers to avoid person-to-person contact whenever possible. She adds that some people bring their own soap on board, along with cans of Lysol.
Princess Cruises spokeswoman Julie Benson said that "norovirus is the most common illness in circulation, second to the common cold."
"We have people getting on board from all over the world, all around the country. Some may be carrying the virus," Benson said.
When norovirus cases are reported on board, Princess Cruises staff members immediately activate extra cleaning protocols, she said.
Crews disinfect all frequently touched surfaces, including elevator buttons, handrails and gym equipment. They halt self-service at buffets. They remove salt and pepper shakers from tables.
"We make announcements to the passengers, and we give written advisories to each cabin," said Benson, adding that passengers are advised to use the bathrooms in their cabins rather than public facilities. "Lastly, we encourage passengers experiencing symptoms to please report to the medical center."
Reporting outbreaks is much of the reason that cruises can be stigmatized as floating norovirus centers. Because outbreaks on cruise ships must be officially reported to the federal Centers for Disease Control and Prevention — and in some cases the outbreaks force the ships to return to port — media coverage shines a bright light on cases like the recent Princess outbreaks.
Last year, there were 14 norovirus outbreaks on cruises departing from the United States, CDC spokesman Jay Dempsey said.
Outbreaks are defined as situations when 3 percent of passengers and crew on a vessel display symptoms of gastrointestinal illness. Three outbreaks have been reported this year.
The CDC conducts scheduled and surprise inspections of cruise ships. When outbreaks occur, specialists from the agency work in tandem with ship crews to mitigate the problem and, as with the case of the two recent Princess Cruises, possibly return to port.
Silverstein said the public's awareness of norovirus cases on cruises is increasing, thanks to media coverage and the prevalence of social media, where one sick passenger's horror story can scare many potential passengers away.
But she cautioned against overreacting to the problem. Getting sick is "pretty easy to avoid just by using general hygiene," Silverstein said.
You can't get away from other passengers determined to vacation regardless of their state of health.
"Whenever you board a cruise, they ask if you've been sick recently," says Mary Lynne Artese, of Burr Ridge, a veteran of dozens of cruises. "I always wonder if people really tell the truth on those things."