How to stop an outbreak on board a passenger ship + test

• The pandemic revealed weak spots
• Who is behind the project
• Evidence first, tools second
• Electronic surveillance and artificial intelligence
• What else the team prepared
• A test in the Atlantic
• Why this matters for students
• Key takeaways
• Five questions: do you look after your health on the road like a savvy passenger? (test)

⇑The pandemic revealed weak spots

Cruise ships, passenger ferries and expedition ships are places where people spend a lot of time together in a limited space. The COVID-19 pandemic exposed major weaknesses in how passenger ships detect outbreaks and prepare for health emergencies. It also showed that stronger health measures are needed to protect not only passengers, but also crews, local communities and maritime economies.

The EU-funded HEALTHY SAILING project set out to respond to this need. Its team aimed to build a comprehensive approach to preventing, detecting and managing infectious diseases at sea – not only known and expected ones, but also emerging threats.

⇑Who is behind the project

The project is coordinated by Christos Hadjichristodoulou, professor of hygiene and epidemiology at the University of Thessaly in Greece. He sums up the goal like this: “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.”

The researcher also sees an economic side to the work. “This will contribute to the sustainability and competitiveness of the European passenger maritime sector,” he adds. Passenger health, in other words, is not only a matter for doctors, but for the whole industry.

⇑Evidence first, tools second

The starting point was a robust evidence base. The team looked at how infectious diseases spread on passenger ships, which factors increase the risk and how effective prevention and control measures really are. Only on this basis did the project deliver digital solutions designed to support preparedness and response on board.

The project partners also worked closely with passenger shipping companies to explore how best to adopt the new tools in everyday operations.

⇑Electronic surveillance and artificial intelligence

At the heart of the project is the prototype of an integrated e-surveillance system (E-SS). It combines real-time monitoring of symptoms with laboratory test results and environmental data. Thanks to this, health threats on board can be detected early, before a disease reaches many people.

The second pillar is an AI-based prototype that supports health-related decision-making. It analyses multiple data sources, identifies potential public health threats on board, generates alerts and recommends control measures matched to the level of the outbreak. A separate AI-based water safety plan tool strengthens the risk-based management of on-board water systems and helps prevent waterborne diseases. All these tools were tested and validated on real passenger ships.

⇑What else the team prepared

The list of results is long and covers both technology and everyday procedures:

• Integrated e-pass system – shows how wearable digital technology could support safer embarkation and disembarkation, crowd management and contact tracing.
• Cleaning and disinfection toolkit – combines standard operating procedures, staff training, monitoring tools and continuous improvement mechanisms.
• Air strategies – highlight adequate ventilation, effective air distribution and the targeted use of air purification technologies.
• Medical guidelines – cover medical operations on expedition ships, vaccination recommendations for passengers and crew, and the prevention and management of acute respiratory infections.
• Augmented reality training – a blended learning ecosystem with accessible, practical resources for crew, officers and passengers.

The guidelines and considerations developed in the project will be shared with the European Commission, the World Health Organization and the International Maritime Organization.

⇑A test in the Atlantic

The real test came in May 2026. A hantavirus outbreak struck a Dutch expedition cruise ship in the Atlantic Ocean, and passengers and crew from over 20 countries suddenly found themselves in an international health crisis. Public health authorities and industry stakeholders turned to the HEALTHY SAILING guidelines and recommendations to deal with 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.

⇑Why this matters for students

The project shows how many fields have to work together to solve a single problem. Epidemiology and hygiene meet maritime transport, data analysis, artificial intelligence, ventilation engineering and even the design of augmented reality training. For anyone choosing a degree or looking for a thesis topic, it is a good example that public health does not end at the doctor’s surgery.

There is also a more personal angle. Anyone can become a ferry or cruise passenger, for example during the holidays – and some of the project’s solutions, such as the training resources, were designed with passengers in mind, not only crews.

⇑Key takeaways

HEALTHY SAILING links hard evidence with practice: an electronic surveillance system, AI that generates alerts, e-passes, cleaning and ventilation strategies, and training are meant to ensure that an outbreak on a ship is noticed and brought under control quickly. The hantavirus outbreak of May 2026 showed that such guidelines help in a real crisis, when authorities from many countries have to coordinate their actions.

⇑Five questions: do you look after your health on the road like a savvy passenger? (test)