A review of COVID-19 transmission dynamics and clinical outcomes on cruise ships worldwide, January to October 2020.
Euro Surveill
; 27(1)2022 01.
Article
in English
| MEDLINE | ID: covidwho-1613509
ABSTRACT
BackgroundCruise ships provide an ideal setting for transmission of SARS-CoV-2, given the socially dense exposure environment.AimTo provide a comprehensive review of COVID-19 outbreaks on cruise ships.MethodsPubMed was searched for COVID-19 cases associated with cruise ships between January and October 2020. A list of cruise ships with COVID-19 was cross-referenced with the United States Centers for Disease Control and Prevention's list of cruise ships associated with a COVID-19 case within 14 days of disembarkation. News articles were also searched for epidemiological information. Narratives of COVID-19 outbreaks on ships with over 100 cases are presented.ResultsSeventy-nine ships and 104 unique voyages were associated with COVID-19 cases before 1 October 2020. Nineteen ships had more than one voyage with a case of COVID-19. The median number of cases per ship was three (interquartile range (IQR) 1-17.8), with two notable outliers the Diamond Princess and the Ruby Princess, which had 712 and 907 cases, respectively. The median attack rate for COVID-19 was 0.2% (IQR 0.03-1.5), although this distribution was right-skewed with a mean attack rate of 3.7%; 25.9% (27/104) of voyages had at least one COVID-19-associated death. Outbreaks involving only crew occurred later than outbreaks involving guests and crew.ConclusionsIn the absence of mitigation measures, COVID-19 can spread easily on cruise ships in a susceptible population because of the confined space and high-density contact networks. This environment can create superspreader events and facilitate international spread.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ships
/
COVID-19
Type of study:
Case report
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal subject:
Communicable Diseases
Year:
2022
Document Type:
Article
Affiliation country:
1560-7917.Es.2022.27.1.2002113
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