The winter months bring endless joys: the holiday season, quality time with friends and family, and an overall festive feeling, just to name a few. However, this time of year also comes with the threat of flu season (typically at its worst between December and February), COVID-19 cases peaking and an onslaught of other unpleasant viruses. If you’re thinking of taking a cruise to escape the cold weather — or snag a great “wave season” deal — you may be concerned about catching a bug on board and ruining your vacation.
Thankfully, cruise lines take their passengers’ health seriously, and they strive to provide a sanitary environment on all ships. To keep track of onboard conditions, the Centers for Disease Control and Prevention conducts unannounced health inspections throughout the year on various ships as part of its Vessel Sanitation Program, at the request of the cruise lines.
“The cruise industry is one of the most vigilant industries for sanitation and public health protocols, including cruise lines’ voluntary participation in the CDC’s Vessel Sanitation Program. Cruise ships are routinely cleaned and sanitized with a frequency that is nearly unparalleled in other settings,” says Anne Madison, spokesperson for the Cruise Lines International Association. “The VSP provides a level of federal scrutiny that is unprecedented within the travel and hospitality industry — there is no similar federal program for hotels, airlines or restaurants.”
The program inspects conditions on cruise ships in eight major areas, including the onboard medical center; the potable water systems; galleys and dining rooms; swimming pools and hot tubs; housekeeping procedures; pest management; child activity centers and HVAC systems. VSP inspections typically last six to eight hours, and ships under the CDC’s jurisdiction may be inspected twice per year (if and when they are docked in a U.S. port). Ships receive a score of up to 100 (considered to be “perfect”); any score less than 85 is labeled “unsatisfactory.”
To help you make informed decisions, U.S. News reviewed CDC data for 18 popular cruise providers and identified the cruise lines with the highest average VSP ship scores between October 2022 and July 2024. We then converted those scores into our own health ratings on a five-point scale to determine the top five cleanest cruise lines. Health ratings are a key scoring component factored into the U.S. News Best Cruise Lines rankings. Check out our 2025 rankings to learn more about the top cruise lines in each category, and read on to see which cruise lines received the highest health ratings.
Celebrity Cruises
Health Rating: 4.9/5With a near perfect health rating, Celebrity Cruises takes pride in its cleaning practices. The line requires passengers to fill out a health questionnaire prior to embarkation, and it reserves the right to deny boarding to anyone who shows signs of a communicable illness. All Celebrity ships are cleaned frequently throughout each voyage with EPA-certified, alcohol-based products. Elevators, escalators and other high-touch areas are sanitized every two hours, while gangway rails are cleaned every 20 to 30 minutes during high-traffic periods. Housekeeping staff cleans cabins daily, and the ships frequently utilize black light technology to confirm sanitary conditions. In 2024, Celebrity Equinox and Celebrity Ascent received perfect VSP inspection scores.
Viking Ocean Cruises
Health Rating: 4.9/5Like Celebrity, Viking Ocean Cruises maintains an exceptionally high health rating thanks to its rigorous cleaning protocols. The line completes health scans on all incoming passengers prior to boarding, and all ships are deep cleaned daily. Viking’s ocean ships also contain industry-first sanitization robots that use UV-C light to clean public areas across the vessels. If passengers do fall ill, they can visit upgraded onboard medical centers. Of the line’s most recent VSP ship inspections, Viking Sky received a perfect score in December 2023.
Holland America Line
Health Rating: 4.8/5Holland America Line strives to keep its guests healthy by frequently sanitizing all public and private spaces throughout its ships. Hand sanitizer dispensers and hand-washing stations are available on every ship, and the cruise line’s air filtration systems have been upgraded. In the event of an illness outbreak, the line initiates enhanced cleaning protocols and isolates sick passengers on board to stop the spread (whether they are sick with something like norovirus or COVID-19). Holland America Line‘s most recent perfect VSP ship score was for Eurodam in May 2023; in 2024, Eurodam, Nieuw Amsterdam and Nieuw Statendam all received VSP scores of 99 (out of a possible 100).
Oceania Cruises
Health Rating: 4.8/5High-scoring Oceania Cruises works to keep its public areas, cabins, behind-the-scenes spaces and high-touch surfaces clean throughout each voyage. The line sanitizes its interior spaces using hypochlorous acid, which eliminates viruses, bacteria and spores. Additionally, hand sanitizer stations are available on board. There is a medical facility on each ship where guests can receive treatment and medications for common illnesses. The following Oceania ships received perfect VSP scores in 2023: Vista, Regatta and Riviera. Of the line’s seven ships, only Insignia has been inspected so far in 2024; it received a VSP score of 97.
Disney Cruise Line
Health Rating: 4.7/5Disney Cruise Line scores high marks for its health rating; a relief for those traveling with the littlest cruisers. The line requires all guests and crew members to complete health questionnaires before their cruise, and housekeeping staff cleans all staterooms twice daily. Public area cleaning measures pay special attention to high-touch surfaces, like doorknobs, elevator buttons, handrails and kids clubs. In 2024, Disney Fantasy received a perfect score from the VSP, while Disney Dream and Disney Magic received almost-perfect 2024 scores of 99 out of 100.
How to prevent getting sick on your cruise
While cruise ship cleaning protocols play an important role in the spread of germs, the line’s onboard practices (and the health of fellow cruisers) are ultimately out of passengers’ control. However, there are a number of ways you can attempt to keep yourself healthy during your trip.
U.S. News editor and registered dietitian Elaine Hinzey emphasizes the importance of eating nutritious foods to keep your immunity at its best.
“Although vitamin gummies and drink mixes will only go so far once you’ve already been exposed to a bug, a nutritionally balanced diet — followed long-term — will encourage illness resistance. So you’ll want to start eating plenty of vitamin C-rich produce — like citrus fruits, kiwi, bell peppers and broccoli — well before you sail,” she recommends.
The good news is eating well at sea doesn’t have to be hard; you can even make healthy choices as you load up your plate at the buffet. “Don’t be shy about flavoring those salads and stir-fries. Fresh garlic, shallots, ginger and turmeric are just a few examples of the alliums, herbs and spices that increase immunity,” says Hinzey. “The healthy fats, vitamin E and selenium in nuts and seeds — such as almonds and sunflower seeds — might also help you fend off any illnesses on deck.”
And of course, you may want to put a limit on your daily cocktail consumption and late-night partying while on board. “The importance of getting plenty of rest, drinking plenty of water, avoiding overconsumption of alcohol and frequent handwashing once you’re on board can’t be overemphasized. No amount of blueberries or kale will compensate for dehydration, fatigue or poor hygiene,” says Hinzey.
Other common-sense practices, like using hand sanitizer or washing your hands often and avoiding crowded indoor spaces (if possible) can help slow the spread of diseases. For an extra level of protection, you may also consider skipping the onboard buffet to limit your exposure to high-touch surfaces, like serving spoons and drink machines. Before sailing, be sure that your routine vaccinations are up to date (especially as required by any international destinations you will be visiting).
How to prepare for illness before you sail
To make sure you’re prepared in the event you fall ill, be sure to add over-the-counter medications like cold medicine, cough drops or fever reducers to your cruise packing list. These drugs (and any prescription medications you may need) should be packed in your carry-on bag for easy access.
If you know you are especially susceptible to shipboard bugs, you may want to consider purchasing cruise insurance before you begin your voyage. In addition to covering issues like trip cancellations and lost luggage, cruise insurance provides protection for medical emergencies and transportation to nearby hospitals in the case of serious illness or injury. This is especially useful for international itineraries, as your standard U.S. health insurance or Medicare may not be accepted by onshore medical facilities in other countries.
What to do if you get sick on board
“Occurrences of GI illnesses are rare on cruise ships (1 in 5,500 chance) compared to other settings (1 in 15 on land),” says Madison. “According to information on the CDC website, the most common settings for GI [illnesses] are healthcare facilities, followed by restaurants or catered events, schools, daycares. By comparison, spread in cruise ship settings is far less common (only 1% of all cases), but CDC requires it be reported nonetheless.”
Still, despite your best efforts, there is always a chance you may wake up one morning with an upset stomach, a congested nose or an elevated temperature. If this happens, don’t panic. Every cruise carrier has some sort of medical center on board, though the size of the staff and facility will vary by ship. Trained providers are well-equipped to help you through common shipboard bugs like the flu, gastrointestinal illnesses (90% of which are caused by norovirus) and COVID-19. (Just keep in mind: Visiting the clinic on board will cost money, and it will typically be an out-of-pocket expense.)
Thankfully, around 95% of cruise ship illnesses can be managed or treated on board, so you should be able to get back to your fun-filled vacation once you’re feeling better (depending on your particular condition and the cruise line’s isolation rules). If more serious symptoms arise, the staff will arrange for medical assistance on land at the closest port — or transportation by an emergency helicopter or boat, in the most extreme cases.
Why Trust U.S. News Travel
Nicola Wood loves a good cruise getaway and understands the importance of keeping herself (and others) healthy while on board — especially after getting stuck on a cruise ship in March 2020 amid the COVID-19 pandemic. She used her personal experiences, researching skills, guidance from health and cruise industry experts, and CDC data to write this article.
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The 5 Top Cleanest Cruise Lines for 2025 originally appeared on usnews.com
