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

MMWR. Morbidity and mortality weekly report
Volume 69, March 2020, Issue 12, p 347-352

Moriarty, L. F.; Plucinski, M. M.; Marston, B. J.; Kurbatova, E. V.; Knust, B.; Murray, E. L.; Pesik, N.; Rose, D.; Fitter, D.; Kobayashi, M.; Toda, M.; Canty, P. T.; Scheuer, T.; Halsey, E. S.; Cohen, N. J.; Stockman, L.; Wadford, D. A.; Medley, A. M.; Green, G.; Regan, J. J.; Tardivel, K.; White, S.; Brown, C.; Morales, C.; Yen, C.; Wittry, B.; Freeland, A.; Naramore, S.; Novak, R. T.; Daigle, D.; Weinberg, M.; Acosta, A.; Herzig, C.; Kapella, B. K.; Jacobson, K. R.; Lamba, K.; Ishizumi, A.; Sarisky, J.; Svendsen, E.; Blocher, T.; Wu, C.; Charles, J.; Wagner, R.; Stewart, A.; Mead, P. S.; Kurylo, E.; Campbell, S.; Murray, R.; Weidle, P.; Cetron, M.; Friedman, C. R.

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.

Keywords

Epidemiology