Passengers and crew members fell ill with gastrointestinal issues during two consecutive outbreaks on a Cunard Line cruise ship.

Out of 2,565 passengers on the Queen Mary 2, 223 reported feeling unwell on its current voyage, along with 44 crew members, the Centers for Disease Control and Prevention (CDC) stated. The ship set sail for a round-trip from New York on Saturday, as per CruiseMapper.

On an earlier voyage that departed from Southampton, England, on December 14, 138 of the 2,430 guests reported illness, in addition to 12 crew members, according to the health agency.

According to the CDC’s National Center for Environmental Health, cases are counted only once, even if isolation lasts into a subsequent voyage. Sick guests or crew would be counted again only if they had a different illness.

Cunard has also been operating longer, overlapping cruises this month on the Queen Mary 2, which include a two-and-a-half-week voyage that concluded Saturday and a nearly month-long sail that started December 14, as noted by CruiseMapper.

During both outbreaks, primary symptoms included vomiting, diarrhea, and stomach cramps, with the specific cause still being determined.

Cunard has stepped up cleaning and disinfecting efforts on board and isolated those who were sick, as outlined by the CDC. The company has yet to respond to YSL News’s request for information.

This situation follows recent norovirus outbreaks on two ships from Holland America Line and one from Princess Cruises earlier this month. Such illnesses are generally more prevalent in colder weather, according to the CDC.

The CDC has reported 16 outbreaks of gastrointestinal illnesses on cruise ships this year that met its criteria for public notification. Norovirus was identified as the cause in 11 of these cases.

Although cruise ships are often associated with such illnesses, they account for just 1% of all reported outbreaks.