tetano
Editor, Senior Moderator
- Kathryn S Willebrand[SUP]1,2,*[/SUP]
, Lauren Pischel[SUP]1,2,3,*[/SUP] , Amyn A Malik[SUP]1,3[/SUP] , Samuel M Jenness[SUP]4[/SUP] , Saad B Omer[SUP]1,2,3,5[/SUP]
Background
Cruise ships provide an ideal setting for transmission of SARS-CoV-2, given the socially dense exposure environment.
Aim
To provide a comprehensive review of COVID-19 outbreaks on cruise ships.
Methods
PubMed 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.
Results
Seventy-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.
Conclusions
In 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.
full article
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.1.2002113#abstract_content
