The Kitchen

Many cruise ships get passing health grades from federal inspectors, but even ships with perfect scores are at risk for outbreaks of illness.

Cruise ships, housing thousands of people in close quarters for long stretches of time, provide an ideal environment for the rapid spread of contagious diseases. Not a year goes by without news stories detailing outbreaks aboard cruises, often of a particularly nasty and highly contagious bug called norovirus. Characterized by nausea, vomiting and diarrhea, norovirus spreads extremely quickly through person-to-person contact as well as through contaminated food, water or infected surfaces.

Norovirus is by no means limited to cruise ships. In fact, the Centers for Disease Control and Prevention reports the bug sickens 19 million to 21 million people every year in the United States, and only 1 percent of all reported outbreaks occur on cruise ships. But even though they are far more likely to contract norovirus on land, people continue to associate cruise ships with norovirus. This is in part because cruise outbreaks must be reported to the federal government and information about them is easily accessible on the CDC’s website, sometimes leading to vivid news reports. Norovirus cases at restaurants, hotels or schools are typically reported first to local health authorities rather than directly to the federal government.

“On an airplane, if one of the restrooms is contaminated and the virus hits days later, the passengers are scattered and no one’s there to connect the dots,” said Andrew O. Coggins Jr., a cruise industry expert and professor of management at Pace University. “On the other hand, on a cruise ship... everyone’s going to be in close proximity and it’s going to be noticeable.”

Certain aspects of cruise ships increase the likelihood of an outbreak: close living quarters in what is essentially a sealed environment; large groups of people embarking on the ship who could potentially be carrying diseases caught on land; shared public spaces, buffet lines and food. It’s a top priority for the CDC and cruise lines to properly maintain sanitation standards. Hygiene measures like hand washing and quick diagnostic tools can help keep diseases from spreading. Cruise ships have hand sanitizer pumps throughout, as well as signs advising passengers to wash their hands “as often as possible.”

Twice a year, each ship that makes port in the U.S. is inspected by a team from the CDC’s Vessel Sanitation Program, which grades a ship on a 100-point scale. Scoring below 86 is considered failing. In recent years, only a few ships have failed. But even ships that pass sometimes suffer outbreaks. Critics often blame contaminated food or water, but according to the CDC there is no consensus on the causes of norovirus outbreaks.

The Pool

Almost every year, a child drowns in a cruise ship pool, most of which have no lifeguards.

Just this week a ten-year old girl was pulled unresponsive from a pool on the Norwegian Gem, the latest in a tragically consistent trend of young children drowning in cruise ship pools about once a year.

Earlier this year a four-year-old Italian boy on the Royal Caribbean’s Oasis of the Seas. nearly drowned, only seven months after a six-year-old boy almost drowned on another Royal Caribbean ship. In 2014, two brothers were pulled unconscious from a pool on the Norwegian's Breakaway. Only one of them survived.

The majority of cruise ship pools are not staffed by lifeguards. Disney is the exception – the company began hiring lifeguards in late 2013 after a six-year old drowned aboard the Carnival Victory. and a four-year-old nearly drowned on the Disney Fantasy.

According to the Cruise Lines International Association, or CLIA, a trade organization of cruise lines in North America, cruise lines follow the same practice as the overwhelming majority of hotels and resorts: placing numerous “swim at your own risk” signs around their pools.

“We have highly visible signage to alert guests to the fact that a lifeguard is not on duty,” said a spokesperson from Norwegian Cruise Line, adding that Norwegian also requires that children under 12 at the pools be accompanied by an adult at all times.

Royal Caribbean follows a similar practice, noting that while it does not have lifeguards by its pools, it does have signs to notify guests of this fact. “We strongly recommend that children not be in the pool area unsupervised,” said a spokesperson for the line.

The Stateroom

While rare, crimes like sexual assaults do occur on cruise ships and passengers may not always be aware of how their rights change at sea.

When a crime occurs on land in the U.S., police and prosecutors pursue criminal investigations in relatively uniform ways, following established protocols to collect information, protect victims and preserve evidence. But the minutes, hours and days after a crime occurs on a ship can unfold very differently.

For example, instead of calling 911, crime victims on cruise ships typically alert onboard private security officers employed by the cruise line. Critics say this could lead to a conflict of interest, since these security officers are responsible both for the initial response to a crime (including deciding whether and when to report the crime and preserving the crime scene) and for protecting the reputation of the cruise line.

“On the one hand the cruise ships see it in their business interest to keep the passengers safe, therefore it is effective to have a good security regimen on board,” said Anamika Twyman-Ghoshal, an assistant professor of criminology at Stonehill College who specializes in maritime crime. “However… if the security officers are employed by the cruise line there will be concern that they can manipulate the numbers recorded or simply change how incidents are defined.”

The cruise industry insists that its first and foremost priority is to protect passengers and that cruise lines do everything they can to respond immediately to the needs of victims, secure the crime scene and preserve evidence so that law enforcement can carry out an investigation.

“Suggesting that there's a conflict of interest portrays a fundamental misunderstanding of the role of the cruise line,” said Bud Darr, senior vice president of technical and regulatory affairs at CLIA, the cruise line industry association. “I think that it’s absurd to think that the cruise line would view themselves as a criminal investigation body, and insulting to suggest that we have any less interest in criminals being prosecuted than any other responsible members of our society.”

Alerting security officers rather than calling 911 is not the only difference between cruise-based and on-shore investigations, according to the FBI. Law enforcement may not get to a ship right away. Jurisdiction issues can prevent or hold up an investigation if the ship does not enter U.S. territory. International witnesses and suspects can pose added complications.

“The fact the crime occurs on the ocean also allows easy disposal of evidence,” said FBI spokesman Christopher Allen, “including the potential disappearance of the victim’s body in the case of a homicide.”

The cruise line industry association points out that this statement is speculative and could apply to lots of situations on land, too, emphasizing that serious crime on cruise ships is extraordinarily rare compared to rates on land.

Cruise lines that make port in the U.S. are required to report crimes including homicides, assaults that result in serious injuries, sexual assaults and thefts of more the $10,000 to the FBI and the U.S. Coast Guard. Because of maritime laws, the FBI typically takes the lead in investigating them. On land, similar crimes would likely fall to state or local law enforcement. But no such reporting requirement exists for less serious crimes, like petty theft, so unless a passenger reports the crime to on-shore law enforcement, it’s as if the crime never happened.

In the weeks or months following a serious assault, passengers have very different legal options than they would have had on land. This is in part because passengers, sometimes without knowing it, effectively sign away many of their legal remedies when they book a cruise. The fine print of many cruise tickets includes clauses that place limits on the types of grievances passengers can sue for, the window of time they have to bring a lawsuit, and even the location of a trial.

“If Carnival was driving a delivery truck and rear-ended you, you’d have a whole different set of rights than you have as soon as you cross the gangway,” said attorney Aronfeld.

Many of the passengers aboard the Costa Concordia, a massive cruise ship that struck rocks and capsized off the coast of Italy in 2012, killing 32 people, found out about these restrictive tickets after disaster struck. If they were unhappy with the €11,000 Costa offered to each surviving passenger ($71,000 for loss of life), they had limited options because those amounts were specified in the fine print of their tickets. And if they did decide to sue, they couldn’t file in U.S. courts because their tickets specified all lawsuits must be brought in Italy.

There are, however, legal limits on how far these clauses can go to absolve cruise lines of responsibility. Cruise lines cannot, for example, give passengers three months to sue for an injury (they must allow at least one year). Nor can they make passengers sign waivers that immunize the cruise lines from all responsibility for injuries or death caused by negligence or other factors that are the cruise lines’ fault.

Which is exactly what happened in 2011 on Royal Caribbean’s Oasis of the Seas. A passenger sued the cruise line after suffering an injury on the "FlowRider," a simulated surfing/body boarding activity. The cruise line denied responsibility because the passenger had signed a special waiver before taking the ride giving up her right to sue. But an appellate court ruled the waiver was unenforceable and prohibited by federal maritime law.

When a crime occurs, there is no guarantee that the public will find out about it. Some alleged crimes are never reported at all, and others may see delays of months or years before they are made public, according to a 2014 report from the Government Accountability Office. For example, while cruise lines reported 959 crimes to the FBI between 2011 and 2013, only 31 crimes were made public. The vast discrepancy is in part due to a 2010 law that only required the cruise industry to publicly release statistics for crimes no longer under investigation by the FBI.

While some cruise lines have begun voluntarily disclosing alleged crimes (including those still under investigation), they are not required to do so. New legislation that would require this type of reporting has yet to be finalized.

While notoriously underreported, sexual assaults still top the list of crimes aboard cruise ships. In 2014 alone, three of the major cruise companies – Carnival, Royal Caribbean and Norwegian – reported 61 alleged rapes and other sexual assaults (these numbers reflect only allegations, not closed cases). This past April, a 25-year-old crew member pled guilty to sexually assaulting a woman while she was sleeping in her stateroom aboard the Royal Caribbean’s newest ship, Quantum of the Seas

“This crew member’s actions were completely unacceptable and a blatant violation of our policies and procedures,” said Cynthia Martinez, a spokesperson from Royal Caribbean, who also noted that the crew member is no longer employed by the cruise line.

On another Royal Caribbean ship in 2006, Sacramento native Laurie Dishman was raped in her room by a janitor posing as a security guard. According to her testimony in a Senate hearing on cruise ship crimes, when Dishman reached out to cruise personnel for help, they suggested that she be the one to collect any relevant evidence in garbage bags and bring it to them. She also testified that the cruise line personnel contaminated the scene, mishandled and destroyed evidence, delayed notifying the FBI, and delayed providing medical treatment. The FBI eventually declined to prosecute the case, citing insufficient evidence.

When asked for comment on the Dishman case, Royal Caribbean spokesperson Martinez said “I don't feel it would be appropriate for us to respond to your questions regarding Laurie Dishman. They may be best suited for the FBI or Ms. Dishman herself.”

Though allegations of sexual assault typically involve adult female passengers, over a third of those who reported sexual assaults on cruise ships in 2012 were minors. Crew members also report such attacks every year.

Just last month Rep. Doris Matsui, D-Calif., and Sen. Richard Blumenthal, D-Conn., two lawmakers who have pushed for stricter regulations of cruise ships, urged the Coast Guard to certify Victim’s Advocates for cruise lines to make sure victims know their rights and that cruise lines are in compliance with the laws.

The Rape, Abuse & Incest National Network has also urged lawmakers to set stricter reporting requirements for sexual assaults on cruise ships and to make more resources available to victims. The organization has published a guide for how to protect yourself on a cruise ship and what to do if you are sexually assaulted on board.

The Stairs

Accidents and injuries – mostly related to falls – happen occasionally on cruise ships and can affect crew members as well as passengers.

By far the most common accidents that people suffer on cruise ships are trips and falls. While “Caution: Watch Your Step” signs are ubiquitous, ships are often in motion and sometimes slippery, and passengers are sometimes under the influence of alcohol, which is available in abundance on board.

“A cruise ship is not just a floating city, it’s a rocking, wet, moving city,” said attorney Aronfeld, “People trip and fall all the time.”

Other accidents that affect many passengers at a time – like fires or shipwrecks – are rare but occur once in a while. An engine room fire on the Carnival Triumph shut down power (and working toilets) to the entire ship in 2013, stranding over 3,000 passengers for days on the what was soon dubbed the “Poop Cruise.” Last year, a fire on Oceania's Insignia killed three people and hospitalized five more – not passengers, but contractors and crew members.

Crew members, who are typically from developing countries in Asia, the Caribbean and Latin America, face a special set of challenges at sea. Even if they work on cruise ships that frequent U.S. ports, they are for the most part not protected by U.S. labor laws. That’s because most cruise lines, even Disney and Carnival, are not registered in the United States. Instead, the majority of cruise lines register their ships in countries like the Bahamas and Panama, and it is the labor laws in these countries that determine crew members’ rights and protections. Critics refer to these registrations as “flags of convenience,” a practice they say lets ship owners take advantage of low taxes, minimal regulation and cheap labor.

All crew members have some legal protections set forth by a 2006 international law called the Maritime Labor Convention. Sometimes referred to as the Seafarer’s Bill of Rights, the convention lays out rights to decent working conditions, from hours and wages to medical care and health and safety protections. The majority of countries where cruise ships are flagged have ratified the convention (the U.S. has not yet). Some countries even outperform the U.S. in implementing these regulations.

And cruise ships may be a better place to work than other sorts of vessels. According to the ITF, a global federation of transport workers unions, cruise ship workers seldom endure the sorts of hardships involving wages or basic rights violations as the crews of cargo and container ships.

“When seafarers who work on cruise ships make a complaint, it is more often about victimization, sexual harassment, cultural misunderstanding, fatigue, loneliness, long working hours, disputes with onboard managers or share of service charges or tips,” said Fabrizio Barcellona from the ITF Seafarers’ division, “rather than complaints about wages.”

The Deck

People going overboard is a persistent problem for cruise lines.

This past February, 21-year-old Cameron Smook, a student at Virginia Tech who was scheduled to graduate in the spring, fell off the Carnival Glory in the middle of the night. Despite a three-day search and rescue effort by the Coast Guard, he was never found. A few months before that, a 22 year old fell off the Royal Caribbean’s Oasis of the Seas and was rescued a few hours later by a Disney cruise that happened to be sailing by.

It is exceedingly rare for a passenger to fall off a cruise ship. According to data compiled by Ross Klein, a cruise critic who tracks media reports of passengers overboard, 22 people went overboard in 2014, out of roughly 21 million who took cruises. The cruise industry attributes most of these unfortunate cases to either reckless behavior or intentional acts like suicide. Cruise lines have implemented extensive video surveillance equipment aboard, but in the rare cases that passengers fall or jump from ships, this footage can be too little, too late to save them.

New technology could speed the detection of people falling into the sea. So-called “man-overboard” detection systems use a combination of radar and infrared sensors to detect when a human body has fallen off the ship. Combined with an alarm to alert the crew, proponents say these systems could save lives.

Most cruise ships have not yet installed these detection systems, however. And they don’t have to – the laws that protect passengers’ safety on board do not require it. Cruise lines caution that the systems are not yet reliable and may lead to too many false positives.

Safety experts counter that such technology offers the best available hope for saving lives.

“Cameras serve a good forensic purpose if they happen to catch the exact location of a rape or pickpocket, but they haven’t done anything to prevent or help rescue people going overboard,” said Marianne Molchan, a seaport and ship security expert who has written about man-overboard systems. “In my opinion, there is [detection] technology out there that's been tested in ship environments … and no one is talking about it.”

Congresswoman Matsui and Sen. Blumenthal have advocated making these systems mandatory, calling for the Coast Guard to require all cruise lines to install man-overboard systems on their ships with both an alarm and a video capture feature.