CDC’s role in helping cruise ship travelers during the COVID-19 pandemic

As of April 4, 2020, CDC has updated its recommendations to help US cruise ship travelers (passengers and crew) get home as quickly and safely as possible during the COVID-19 pandemic.

CDC is working with partners as part of the Unified Command, including Coast Guard, Customs and Border Protection, port authorities, local and state health departments, and Department of State, to respond to COVID-19 aboard cruise ships.
CDC recommends that cruise ship travelers with no symptoms or mild symptoms disembark as quickly and safely as possible at US ports of entry:
- Cruise line companies must get travelers directly to their homes via chartered or private transportation.
- Commercial flights and public transportation may not be used.
Since February 2020, travelers on dozens of cruise ships have been affected by COVID-19 outbreaks. Cruise ships are often settings for outbreaks of infectious diseases because of the semi-enclosed environment and contact between travelers from many countries.
Outbreaks of COVID-19 on cruise ships pose a risk for rapid spread of disease beyond the voyage. Aggressive efforts are required to contain spread.
CDC realizes that it might be confusing for travelers when recommendations change during the COVID-19 pandemic response. The COVID-19 pandemic in the United States and globally is constantly changing. We will continue to evaluate and update our recommendations for returning cruise ship travelers as the situation evolves.

For Returning Cruise Ship Travelers

Well Travelers

Before leaving your cabin to begin ship disembarkation, put on a face mask or cloth face covering issued to you by the cruise line. Keep the face covering on from the time you leave your cabin, during disembarkation and during all air and land travel. To the extent possible, do not remove the face covering until you get to your final destination.
You should only travel with other well travelers by chartered or private transportation. Do not board a commercial flight or other public transportation.
While traveling, you should spread out if space allows (6 feet apart from non-travel companions, if possible). Sit next to your cruise ship travel companion(s) if you’re traveling with someone.
If you develop symptoms during travel, notify the medical staff of your symptoms and continue to wear your cloth face covering. If you are on a chartered flight without medical staff, tell the CDC Quarantine Station staff as soon as you disembark the plane.
When you arrive at your final destination, you should stay home for 14 days and monitor your health.

Travelers who are Ill

Before leaving your cabin, put on a face mask issued to you by the cruise line.
- Keep the mask on from the time you leave your cabin, during disembarkation and during all air and land travel.
- To the extent possible, do not remove the mask until you get to your final destination.
If you have symptoms of COVID-19 or have confirmed COVID-19, do not travel with well travelers who have no symptoms. Cabin mates with no symptoms may accompany you if they provide written consent to the cruise line ahead of time.
If you are well enough to travel, you should only travel to your home by charter flight, air ambulance, or ground ambulance, or another private vehicle that can be properly sanitized.
Your cruise line is responsible for your medical care. If you require emergency medical attention, your cruise line will coordinate with public health and U.S. Coast Guard and, if necessary, arrange for appropriate transportation to a place where you can get attention.

For Cruise Ship Companies

Cruise lines are responsible for treating all ill or infected patients, including those who need hospitalization.
For travelers who need emergency medical attention, cruise lines should coordinate with public health and U.S. Coast Guard to arrange for appropriate transportation to a place where such care can occur.

Cruise lines must arrange for disembarking travelers with no symptoms or mild symptoms to return directly to their residence by chartered or private transportation that can be properly sanitized. Commercial flights and other public transportation may not be used.
- Travelers with mild symptoms may return home alone or with other symptomatic travelers by charter flight, air ambulance, ground ambulance or other private vehicle that can be properly sanitized. Cabin mates with no symptoms may accompany ill travelers if they provide written consent to the cruise line ahead of time.

- Well travelers with no symptoms may return home alone or with other well travelers by charter flight or other private vehicle that can be properly sanitized.

Cruise ship companies should provide to all travelers, including crew, a procedural/surgical mask, cloth face covering, or non-medical mask such as a bandanna, and ask them to wear it during:
- ship disembarkation,
- transport to any flights,
- the duration of the flight(s), and
- any ground transportation until they reach their final destination.
Cruise ship companies should NOT be distributing N-95 respirator masks to passengers or crew.

Before attempting to repatriate travelers by international charter flight to the United States

Before chartering flights back to the United States, cruise lines should:
- Screen all US-bound passengers or crew who will board the US charter flight for fever (100.4° F or 38° C or higher) or feeling feverish or new or worsening cough, or shortness of breath. Symptomatic passengers should not board a charter flight with well passengers.
- Notify CDC about any passengers with COVID-19 symptoms, including confirmed or suspected COVID-19 cases.
- Obtain full approval from state and local authorities before planning for the arrival of passengers in the state where the charter flight is bound.
- Distribute general CDC COVID-19 health informationpdf icon to cruise ship passengers eligible to board a US-bound flight. Advise passengers to stay home, monitor their health, and practice social distancing for 14 days after they arrive in the United States.
- Ensure the air carrier has stocked sufficient personal protective equipment (PPE) for the flight crew.

For public health officials

The Department of State, with approval from the Department of Homeland Security, decides whether to allow chartered international flights to return with cruise ship passengers to the United States.
It is required that flights report to CDC any illnesses and deaths on domestic flights between US states and territories and on international flights arriving in the United States. If illnesses or deaths were reported on the flight, local airport responders will coordinate with the CDC Quarantine Station of jurisdiction to ensure safe assessment of the affected traveler.
CDC may notify some states through Epi-X about sick passengers on flights under some circumstances.

Cruise Ships Affected by COVID-19

These are cruise ships that had voyages with US ports, which are under US CDC jurisdiction. International voyages without US ports of call are not under CDC jurisdiction and not included.

Cruise Ships Affected by COVID-19
Ship name	Voyage Start Date	Voyage End Date
Carnival Imagination	5-Mar	8-Mar
Carnival Valor	29-Feb	5-Mar
Carnival Valor	5-Mar	9-Mar
Carnival Valor	9-Mar	14-Mar
Carnival Vista	15-Feb	22-Feb
Carnival Vista	29-Feb	7-Mar
Celebrity Infinity	5-Mar	9-Mar
Celebrity Eclipse*	2-Mar	30-Mar
Celebrity Reflection	13-Mar	17-Mar
Celebrity Summit	29-Feb	7-Mar
Crown Princess	6-Mar	16-Mar
Disney Wonder	28-Feb	2-Mar
Disney Wonder*	6-Mar	20-Mar
Grand Princess	11-Feb	21-Feb
Grand Princess*	21-Feb	7-Mar
MSC Meraviglia	1-Mar	8-Mar
Norwegian Bliss*	1-Mar	8-Mar
Norwegian Bliss	8-Mar	15-Mar
Norwegian Breakaway	29-Feb	7-Mar
Norwegian Breakaway*	7-Mar	14-Mar
Norwegian Pride of America*	29-Feb	7-Mar
Oceania Riviera*	26-Feb	11-Mar
RCCL Explorer of Seas	8-Mar	15-Mar
RCCL Liberty of the Seas*	15-Mar	29-Mar
RCCL Majesty of the Seas*	29-Feb	7-Mar
RCCL Oasis of the Seas*	8-Mar	15-Mar
RCCL Symphony of the Seas*	7-Mar	14-Mar

*CDC was notified about COVID-19-positive travelers who had symptoms while on board these ships.
For all other ships, CDC was notified about travelers who had symptoms and tested positive for COVID-19 within 14 days after disembarking. Since these travelers’ symptoms began after the voyage, the traveler might have contracted COVID-19 during the voyage; however, other sources of transmission after the voyage cannot be ruled out.