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

Leah F Moriarty, Mateusz M Plucinski, Barbara J Marston, Ekaterina V Kurbatova, Barbara Knust, Erin L Murray, Nicki Pesik, Dale Rose, David Fitter, Miwako Kobayashi, Mitsuru Toda, Paul T Cantey, Tara Scheuer, Eric S Halsey, Nicole J Cohen, Lauren Stockman, Debra A Wadford, Alexandra M Medley, Gary Green, Joanna J Regan, Kara Tardivel, Stefanie White, Clive Brown, Christina Morales, Cynthia Yen, Beth Wittry, Amy Freeland, Sara Naramore, Ryan T Novak, David Daigle, Michelle Weinberg, Anna Acosta, Carolyn Herzig, Bryan K Kapella, Kathleen R Jacobson, Katherine Lamba, Atsuyoshi Ishizumi, John Sarisky, Erik Svendsen, Tricia Blocher, Christine Wu, Julia Charles, Riley Wagner, Andrea Stewart, Paul S Mead, Elizabeth Kurylo, Stefanie Campbell, Rachel Murray, Paul Weidle, Martin Cetron, Cindy R Friedman
MMWR. Morbidity and Mortality Weekly Report 2020 March 27, 69 (12): 347-352
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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