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Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020

OPEN MMWR. Morbidity and mortality weekly report | 28 Mar 2020

LF Moriarty, MM Plucinski, BJ Marston, EV Kurbatova, B Knust, EL Murray, N Pesik, D Rose, D Fitter, M Kobayashi, M Toda, PT Canty, T Scheuer, ES Halsey, NJ Cohen, L Stockman, DA Wadford, AM Medley, G Green, JJ Regan, K Tardivel, S White, C Brown, C Morales, C Yen, B Wittry, A Freeland, S Naramore, RT Novak, D Daigle, M Weinberg, A Acosta, C Herzig, BK Kapella, KR Jacobson, K Lamba, A Ishizumi, J Sarisky, E Svendsen, T Blocher, C Wu, J Charles, R Wagner, A Stewart, PS Mead, E Kurylo, S Campbell, R Murray, P Weidle, M Cetron and CR Friedman
Abstract
An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* (1). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness (2). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well (3). Passengers on certain cruise ship voyages might be aged ≥65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection (4). During February-March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.
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* Data courtesy of Altmetric.com