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Transmission of SARS-CoV-2 Associated with Cruise Ship Travel: A Systematic Review.
Rosca, Elena Cecilia; Heneghan, Carl; Spencer, Elizabeth A; Brassey, Jon; Plüddemann, Annette; Onakpoya, Igho J; Evans, David; Conly, John M; Jefferson, Tom.
  • Rosca EC; Department of Neurology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu 2, 300041 Timisoara, Romania.
  • Heneghan C; Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
  • Spencer EA; Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
  • Brassey J; Trip Database Ltd., Glasllwch Lane, Newport NP20 3PS, UK.
  • Plüddemann A; Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
  • Onakpoya IJ; Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK.
  • Evans D; Li Ka Shing Institute of Virology, and Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
  • Conly JM; Departments of Medicine, Microbiology, Immunology & Infectious Diseases, and Pathology & Laboratory Medicine, Synder Institute for Chronic Diseases and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB T2N 4N1, Can
  • Jefferson T; Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK.
Trop Med Infect Dis ; 7(10)2022 Oct 09.
Article in English | MEDLINE | ID: covidwho-2071794
ABSTRACT

BACKGROUND:

Maritime and river travel may be associated with respiratory viral spread via infected passengers and/or crew and potentially through other transmission routes. The transmission models of SARS-CoV-2 associated with cruise ship travel are based on transmission dynamics of other respiratory viruses. We aimed to provide a summary and evaluation of relevant data on SARS-CoV-2 transmission aboard cruise ships, report policy implications, and highlight research gaps.

METHODS:

We searched four electronic databases (up to 26 May 2022) and included studies on SARS-CoV-2 transmission aboard cruise ships. The quality of the studies was assessed based on five criteria, and relevant findings were reported.

RESULTS:

We included 23 papers on onboard SARS-CoV-2 transmission (with 15 reports on different aspects of the outbreak on Diamond Princess and nine reports on other international cruises), 2 environmental studies, and 1 systematic review. Three articles presented data on both international cruises and the Diamond Princess. The quality of evidence from most studies was low to very low. Index case definitions were heterogeneous. The proportion of traced contacts ranged from 0.19 to 100%. Studies that followed up >80% of passengers and crew reported attack rates (AR) up to 59%. The presence of a distinct dose-response relationship was demonstrated by findings of increased ARs in multi-person cabins. Two studies performed viral cultures with eight positive results. Genomic sequencing and phylogenetic analyses were performed in individuals from three cruises. Two environmental studies reported PCR-positive samples (cycle threshold range 26.21-39.00). In one study, no infectious virus was isolated from any of the 76 environmental samples.

CONCLUSION:

Our review suggests that crowding and multiple persons per cabin were associated with an increased risk of transmission on cruise ships. Variations in design, methodology, and case ascertainment limit comparisons across studies and quantification of transmission risk. Standardized guidelines for conducting and reporting studies on cruise ships of acute respiratory infection transmission should be developed.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Tropicalmed7100290

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Tropicalmed7100290