The four older guests died on the Zaandam, which was off the coast of Panama while the cruise line awaited approval to transit the Panama Canal to reach Fort Lauderdale, Holland America said in a statement.
On Thursday, a number of patients with respiratory symptoms on the ship were tested for COVID-19 and two tested positive, the company said.
The company said that as of Friday, 53 guests and 85 crew have reported to Zaandam’s medical center with influenza-like illness symptoms. There are 1,243 guests and 586 crew on board.