With the cruise ship hantavirus outbreak making headlines, travelers may be wondering if it’s safe to vacation at sea right now. The Andes strain of the hantavirus is getting attention for good reason, because though only a small number people connected with the cruise contracted it, the fatality rate is 38%.

But there are other cruise-connected illnesses to consider. Physician assistant Aliza Hekman, medical director of infection prevention for the Novant Health Triad Region, explains how to reduce your chances of getting sick on a cruise.

What are the biggest health dangers on a cruise?

Norovirus. It’s a GI virus that causes nausea, vomiting and diarrhea and it’s really contagious so the cruise lends itself to spread because there’s lot of people in close quarters. Even after people feel better, they can continue to shed the virus for two weeks. It’s spread through fecal-oral transmission, which is just what it sounds like.

How do you protect yourself from norovirus on a cruise?

The main thing to remember about noroviruses is that on cruises there are typically hand sanitizing dispensers around every corner. But sanitizer won’t kill norovirus. You need to wash your hands with soap and water.

What else can you do to stay safe from norovirus?

Norovirus can live for two weeks on surfaces — think eating utensils, handrails, elevator buttons. On a cruise there are a lot of different touch points and a large amount of people in one area. If you want to be extra cautious on a cruise you can bring disinfecting wipes and clean your doorknobs and handles and things.

What are food poisoning risks on cruise ships and how can you stay safe?

E. coli is a risk, and you want to watch for undercooked food and runny eggs. Ciguatera fish poisoning is contracted by eating infected fish such as grouper, red snapper and barracuda. You can’t see it or smell it and cooking doesn’t destroy it. The only way to avoid the risk of ciguatera is to avoid eating reef fish.

Staying safe from food poisoning on a cruise also means staying safe when you stop at a port. You may want to find out about whether water is safe to drink, or just drink bottled water. And remember that ice in your Diet Coke counts. Raw vegetables are probably washed with tap water so keep that in mind. Right before you eat, try to wash with soap and water. Carry your own sanitizer with you.

What are other ways to stay healthy on a cruise?

Probably after norovirus the next risk would be respiratory illnesses. There are lots of indoor spaces on cruises: restaurants, theaters, etc. Spend your time outdoors. Get plenty of sleep and fluids and take care of yourself. Maybe hit the cruise gym instead of the bar. If you are at an assigned table with someone who is visibly ill or coughing, you could ask to be moved. Make sure you’re doing things to keep yourself rested and hydrated, and if anyone you’re traveling with falls ill, try to isolate right away.

Who should think twice before going on a cruise?

If you have a significantly immuno-compromising condition you should talk with your care provider about whether a cruise is the best thing for you.

You’re a medical professional. Would you go on a cruise?

I went on my first cruise this year! I had been nervous. It was spring break with my kids and our friends invited us. [My friend] is a physician, and we both tried it and we had a great time. Nobody got sick. I was just on high alert for any sort of GI symptoms. I knew I had to wash my hands with soap and water. I carry my own sanitizing wipes, but I didn’t go crazy.

The bottom line: It’s very easy to pick up bugs that can ruin a cruise (or worse), but if you’re careful about handwashing, you can reduce your chances of getting sick.