Beth Knowles and her family left on a Caribbean cruise in late December, but they missed every port. They got too sick to disembark during a norovirus outbreak on board. Knowles got an email from Cunard Line one day before their Dec.

Last year, there were 16 outbreaks on cruise ships, from norovirus, salmonella, E. coli or other unidentified pathogens that cause gastrointestinal symptoms such as diarrhea or vomiting. That's the largest number of cruise ship outbreaks in 12 years.

In December alone five cruise ships from Cunard, Holland America Line and Princess Cruises, all Carnival-owned brands, reported norovirus outbreaks affecting hundreds of passengers. An outbreak is declared when 3% or more of a ship's passengers and crew come down with gastrointestinal problems.