The cruise and commercial maritime industries may face unique healthcare challenges that demand innovative strategies in 2025, particularly in managing infectious and communicable diseases. With increasing globalization, climate change including global warming, the resurgence of certain diseases, and heightened traveler expectations, these industries must remain vigilant to protect crew, passengers, and the global population. Policies must also assure that the vessels and crew are not considered contributors to the spread of communicable diseases.
Infectious Disease Risk Factors
The maritime environment is a perfect storm for the transmission of infectious diseases. Ships are enclosed spaces with high-density populations, shared facilities, and global itineraries. Passengers and crew may come from regions with varying disease prevalence, creating a melting pot of health risks. Ports of call in under-resourced areas further complicate risk mitigation, as ships may encounter endemic diseases like dengue, malaria, or chikungunya. Legionella can be transported from shoreside to the ships. Meanwhile, norovirus, a perennial threat, remains the leading cause of outbreaks on cruise ships.
The last genetic shift in norovirus occurred in 2016. Genetic shifts in norovirus involve significant changes in the virus’s genome, typically through recombination or the emergence of a novel variant, and they can result in more widespread outbreaks due to reduced population immunity. Are we overdue? In contrast, genetic drift refers to smaller, gradual changes in the virus’s genome over time and can lead to periodic increases in outbreaks, but not to the degree as a shift. Norovirus activity has been high in 2024. There is currently no vaccine against Norovirus despite many companies including Vaxart (oral) and Takeda working to develop one.
We have seen that the possibility of a pandemic always exists and the commercial maritime industry, extended time at sea, limited access to healthcare, and diverse crew compositions introduce specific vulnerabilities. The COVID-19 pandemic underscored the importance of preparedness, as vessels became hotspots for rapid disease spread and faced prolonged port restrictions. Telemedicine access through AP Companies should be reviewed now as well as access to PPD supplies, medicine chest reviews, and immunization polices. PEME programs should be reviewed and strengthened as should wellness and mental health programs.
Emerging Infectious Disease Threats
In 2025, climate change and global mobility are amplifying the risks of emerging infectious diseases. Global warming is reshaping the geographic distribution, seasonality, and intensity of many infectious diseases. Rising temperatures have expanded the range of vector-borne illnesses Mosquitoes), such as Malaria, Zika, Chikungunya and Dengue, into temperate regions. We may see increases in West Nile, Yellow Fever and Lyme (ticks) disease. Warmer coastal waters may yield increases in cholera and vibrio. Newly identified or less common pathogens, such as zoonotic diseases from increasing human exposure to animal-borne diseases. including hantavirus, pose unpredictable challenges, particularly for vessels traveling through biodiverse regions.
Preparedness and Response Challenges
For cruise ships, enhanced pre-boarding health screenings, improved onboard medical facilities, and real-time disease surveillance systems are now industry standards. However, managing an outbreak mid-voyage requires swift containment measures, often at odds with the expectations of a carefree vacation. Commercial vessels face different obstacles. Ships with small crews lack the medical infrastructure of cruise ships, and telemedicine serves as a primary lifeline for health crises. Assuring a healthy crew is critical to operations as well as planning for unexpected illness or accidents, including vaccination programs tailored to regional risks and robust health education.
Looking Forward: Solutions for 2025
Proactive strategies are essential to meet these challenges including close monitoring for onboard illness and partnerships with global health organizations to strengthen disease surveillance and response capabilities. Integrating AI-driven analytics into maritime health management can further improve risk assessment and predict disease trends. The key theme for 2025 is to prioritize prevention, rapid response, and innovation to safeguard the health of their diverse populations of guests and crew while maintaining operational excellence in an increasingly interconnected world.
