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

How emergency departments prepare for virus disease outbreaks like COVID-19

European Journal of Emergency Medicine

Möckel, Martin; Bachmann, Ulrike; Behringer, Wilhelm; Pfäfflin, Frieder; Stegemann, Miriam Songa.

Introduction

Acute outbreaks of novel virus caused diseases like coronavirus disease 2019 (COVID-19) challenge the national and international healthcare systems and specifically the emergency departments (EDs) as patients, even if they have only mild symptoms, intuitively present in the ED once they fear to have a serious disease. Therefore, EDs need to prepare fast and effectively to address the challenge of walk-in patients who might transmit the virus SARSCoV-2 without displaying severe symptoms themselves, to protect personnel and vulnerable patient groups who are typically present in the ED at any time like patients with immunosuppression, chronic disease and older age. The outbreak of COVID-19 in Wuhan, China and the transmission to Europe is a typical example with some lessons learned for the ED. This early report reflects the situation from a German perspective including the capital city of Berlin.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Management of IBD during the COVID-19 outbreak: resetting clinical priorities

Nature reviews. Gastroenterology & hepatology

Danese, S.; Cecconi, M.; Spinelli, A.

Comment

Since December 2019 when the 2019 novel coronavirus (2019-nCoV as it was then termed, now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the WHO) outbreak had been described in Wuhan, Hubei, China, the situation has dramatically evolved. The pandemic, as declared by the WHO, has led to >300,000 cases worldwide reported as of March 2020, in all continents, excluding Antarctica, spreading on a logarithmic scale in Europe. Italy is currently the second most affected country after China and, as of 13 March 2020, Europe was declared the centre of the pandemic. Because of the very high transmission capacity, the WHO declared the outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 infection a public health emergency of international concern.

Keywords

Clinical aspects, diagnosis, treatment

Coronavirus (Covid-19) outbreak on the cruise ship Diamond Princess

International maritime health
Volume 71, Issue 1

Dahl, E.

Introduction

The whole world has recently been following the media frenzy covering the quarantine of Diamond Princess, the first cruise ship that had an outbreak of coronavirus illness (Covid-19) on board. It developed soon after the occurrence of China’s Covid-19 outbreak, which — according to the World Health Organization (WHO) — “poses a very grave threat for the rest of the world” and should be viewed as “Public Enemy Number 1” [1]. Lasting more than 14 days, the ship quarantine is unprecedented for the cruise industry, and some maritime health issues of concern may be worth addressing already shortly after the interned passengers and crew had finally disembarked the vessel.

Keywords

coronavirus, COVID-19, outbreak, passengers, crew, cruise ship medicine