Preventing and managing passenger ship outbreaks more effectively
The COVID-19 pandemic exposed major weaknesses in how passenger ships detect outbreaks and prepare for health emergencies. It stressed the need for stronger health measures to protect passengers, crews, local communities and maritime economies.
Charting a healthier course for passenger ships
The EU-funded HEALTHY SAILING(opens in new window) project responded to the demand for a comprehensive approach to preventing, detecting and managing known, expected and emerging infectious diseases on cruise ships, passenger ferries and expedition passenger ships. “By strengthening infectious disease prevention, mitigation and management, we aimed to support safer travel, protect public health and improve the resilience of passenger shipping operations for future routine public health events and emergencies,” explains project coordinator Christos Hadjichristodoulou, professor of hygiene and epidemiology at the University of Thessaly, Greece. “This will contribute to the sustainability and competitiveness of the European passenger maritime sector.”
Putting scientific evidence into practice for safer seas
HEALTHY SAILING established a robust evidence base to better understand how infectious diseases spread on passenger ships, the factors that increase risks and the effectiveness of prevention and control measures, while also delivering digital solutions to support preparedness and response. The integrated e-surveillance system (E-SS) prototype combines real-time monitoring of symptoms, laboratory test results and environmental data to detect health threats early on board. This is complemented by an AI-based prototype that supports health-related decision-making (IIS). It analyses multiple data sources, identifies potential public health threats on board, generates alerts and recommends appropriate control measures based on the level of the outbreak. An AI-based water safety plan tool strengthens the risk-based management of on-board water systems and helps prevent waterborne diseases. These tools were successfully tested and validated on real passenger ships. The project partners worked closely with passenger shipping companies to explore how best to adopt them. To further strengthen health protection in passenger shipping, HEALTHY SAILING developed an integrated e-pass system that demonstrates how wearable digital technology could support safer and more efficient passenger movement, including embarkation, disembarkation, crowd management and contact tracing during public health events. A toolkit improves the effectiveness and consistency of surface cleaning and disinfection practices on passenger ships. It combines standard operating procedures, workforce training, monitoring tools and continuous improvement mechanisms to support infection prevention. The project team identified practical strategies to reduce infection risks, highlighting the importance of adequate ventilation, effective air distribution and the targeted use of air purification technologies. The knowledge gained informed guidelines, including guidance for medical operations on expedition passenger ships, vaccination recommendations for passengers and crew, and prevention and management guidance for acute respiratory infections. Recommendations on ventilation and other mitigation measures will help to reduce the risk of airborne disease transmission in passenger ship environments. Guidelines and considerations informed by HEALTHY SAILING will be shared with the European Commission, the World Health Organization and the International Maritime Organization. The project also developed a blended learning and augmented reality training ecosystem that offers accessible and practical training resources for crew, officers and passengers.
Coordinated emergency management matters
When a hantavirus outbreak struck a Dutch expedition cruise ship in the Atlantic Ocean in May 2026, passengers and crew from over 20 countries were thrust into an international health crisis. Public health authorities and industry stakeholders used the HEALTHY SAILING guidelines and recommendations to effectively navigate the threat. “This incident underscores HEALTHY SAILING’s potential to contribute to more coordinated, evidence-based and effective management of future health threats in maritime transport,” concludes Hadjichristodoulou.
