key: cord-0846416-wbsaqozm authors: Willebrand, Kathryn S; Pischel, Lauren; Malik, Amyn A; Jenness, Samuel M; Omer, Saad B title: A review of COVID-19 transmission dynamics and clinical outcomes on cruise ships worldwide, January to October 2020 date: 2022-01-06 journal: Euro Surveill DOI: 10.2807/1560-7917.es.2022.27.1.2002113 sha: f6c60aa4521f293f3a5217eb0564e6f22341359c doc_id: 846416 cord_uid: wbsaqozm 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. Disney Cruise Lines or public health agencies about the total number of cases on this ship. The Miami Herald reports a total of 260 COVID-19 cases -229 among crew, 31 among guests -associated with the Disney Wonder. Celebrity Eclipse: The Celebrity Eclipse disembarked from San Francisco, CA, USA on March 1st. Passengers report that the crew staff had concerns about passengers who were experiencing COVID-19-like symptoms at the beginning of the cruise. However, cruise activities proceeded normally until the CDC's No Sail order was passed on March 15th. After this date, the ship reversed course near Chile to return to port in the US. On March 21st, cruise management hosted an event to honor healthcare professionals working to combat the COVID-19 pandemic, crowding passengers and crew onto the ship deck. On March 30th, passengers disembarked in San Francisco [7] . It is unclear when the initial cases were identified, but one day after disembarking passengers were notified via email of potential exposures on the ship [8] . There were 78 cases reported to be associated with this outbreak, though the Miami Herald reports a total of 123 cases associated with this ship. Carnival Valor: A single case was denoted by Miami Herald for each voyage, as the total number of cases per voyage could not be validated. They report 132 total cases associated with this cruise ship. Thousands of cruise ship passengers told to self-isolate due to Cruise ship stranded off Uruguay says 60% onboard have Covid-19 COVID-19: in the footsteps of Ernest Shackleton They absolutely did not care': Crew members sue Celebrity Cruises over virus response. The Miami Herald Pullmantur Horizon Crew Reports COVID-19 Positive Cases Onboard The Maritime Executive. Fifty-Seven New COVID-19 Cases on Costa Atlantica. The Maritime Executive Passengers sue Celebrity over 'heightened risk' of COVID-19 exposure 1 passenger, 3 crew members on Celebrity Eclipse cruise ship test positive for COVID-19 Ruby Princess, Cruise Liner Cruise Mapper Ovation of the Seas Fact Sheet Royal Caribbean Cruises. Royal Caribbean Cruises Black Watch Itinerary Royal Caribbean's Explorer of the Seas -March 8, 2020 Sunday @ 10:00 pm On board the world's biggest cruise ship RMS Queen Mary 2 Ship Cruise ship bound for Italy had 36 coronavirus cases during Marseille stop Covid-19: Costa Luminosa cruise ship docks in Marseille Carnival Executives Knew They Had a Virus Problem Coronavirus: Fears on cruise ship docked at Italian port after case confirmed. The Local COVID-19 Update on Ruby Princess and Celebrity Solstice cruises Coronavirus COVID-19 case link to Sun Princess cruise ship that visited Kangaroo Island. The Island 14 crew have COVID-19, Royal Caribbean captain says, after passengers got off in Miami. Mia Third Crew Member from the Oasis of the Seas Dies Due to COVID-19. Cruise Law News A third crew member from Royal Caribbean's Oasis of the Seas dies from COVID-19 Two Royal Caribbean Oasis of the Seas crew members die of COVID-19 in two days MSC Opera Status: 200 crew onboard, 7 positive for COVID-19 at home Circus performer from Seattle trapped aboard Persian Gulf cruise ship due to coronavirus lockdown Zaandam cruise ship with COVID-19 on board docks in Florida after 12 days at sea Governor Says State Will Accept Florida Residents from Cruise Ship Stricken with Coronavirus. The Weather Channel Get us the hell off': Nearly 250 Canadians aboard ship with passengers Zaandam cruise ship gets permission to cross Panama Canal and head to Port Everglades. Miami Herald Four passengers died on Zaandam cruise ship Coast Guard blocks Coral Princess from docking in Port Everglades until it has a plan Austin woman tests positive for COVID-19 over a week after being quarantined on cruise No information. No way off. 100,000 crew members remain in cruise ship limbo for months Jamaicans from Marella Discovery 2 who tested positive for COVID-19 blame gov't for them contracting virus. Radio Jamacia News. 2020 5/21/2020. 79. Mumbai Mirror. 750 seafarers stuck on ships can now disembark Coronavirus: Thousands on cruise ship allowed to disembark after tests The Associated Press. Passengers leave Hong Kong cruise ship after coronavirus quarantine lifted Passengers quarantined on cruise ship are desperate to escape coronavirus that infected 64 fellow travelers After Intense Bargaining TUI Cruises Begin Seafarers' Repatriation, 9 Seafarers Infected. Maritime POst COVID-19 outbreak on Royal Caribbean ship delays homecoming for Trinidadian crew. Miami Herald 5 more COVID-19 cases push the figure up to 123. These 5 and 1 earlier today all came from the 308 who returned on the Enchantment of the Seas cruise ship on Friday Cruise lines told ship workers to carry on as normal as the coronavirus spread. Now, many crew members are infected or unemployed 7 crew members on cruise ship at Honolulu Harbor test positive for COVID-19. Hawaii News Now. 2020 4/8/2020. 90. macronews.com. COVID-19 chaos: MSC Fantasia passengers 'kept in the dark' until day of disembarkation As cruise ships sail on, crews fear COVID-19 infection Mexico allows 46 British passengers to leave cruise ship Yucatan reports two COVID-19 related deaths Costa Cruises work to bring back stranded ships Multiple cruise ships are left stranded as coronavirus cases increase Passengers Fell Ill With Coronavirus. And the Ship Sailed On Coronavirus-infected cruise ship stranded at sea for weeks to dock in Cuba Virus-hit cruise ship MS Braemar docks in Cuba after Caribbean odyssey French passengers sue Costa Cruises over virus ship ordeal Virus-Affected Costa Magica Cruise Ship In Caribbean Carrying 38 Russians -Embassy Desperate cruise employees say they're losing hope amid reports of overboard deaths 2-year-old passenger on Norwegian Bliss tested positive for coronavirus Positive COVID Crew Cases Rise to Nine on Costa Favolosa and Costa Deliziosa Civitavecchia Porto -Tre marittimi di Costa positivi al test Covid-19 in pochi giorni MSC Cruises cancels cruises across eight ships -see the full list A cough, a cruise ship and a Westmoreland County case of coronavirus Crew member aboard Celebrity Infinity raises concerns over whether cruise ship unnecessarily put crew at risk Two Royal Caribbean cruise crew members test positive for coronavirus in Galveston Leaked audio reveals that crew members on Cunard Line's MS Queen Victoria cruise ship off the coast of England have been asked to quarantine in their rooms because of COVID-19 cases CDC cleared them to disembark in Miami anyway MSC passenger's Covid-19 results released by NICD. Northern Natal News TRAVELLING ON THE MSC ORCHESTRA AFTER PASSENGERS TEST POSITIVE FOR COVID-19 Un crucero con 450 ocupantes, en cuarentena en el puerto de Barcelona por dos posibles positivos Tripulantes del crucero atrapado por el Covid: «Estamos bien, pero queremos volver a casa 103 passengers from Silver Shadow cruise ship flown to US after coronavirus ordeal. USA Canadian man dies from COVID-19 in Brazil hospital after being taken off cruise ship Idoso passa mal em cruzeiro, e navio com centenas de pessoas atracado no Recife é isolado por suspeita de coronavírus Violent protests meet cruise ship full of Kiwis, Australians at Réunion Island Thousands may have been exposed to coronavirus on Princess cruise ship Coronavirus in Ohio: First COVID-19 case confirmed in Columbus 5th case of COVID-19 in Waterloo region went on plane with symptoms, public health says Royal Caribbean cruise ship arrive in Gulfport to disembark crew members Cruise Ship Crew Members Lost in COVID-19 Pandemic COVID-19 Update: 17 More Recoveries, 4 New Imported Cases Recorded Three Puerto Rican Crew Members Are Repatriated Aboard The MS Marina More Cruise Ships Reach Port. The Maritime Executive Crew are stuck on Miami cruise ships with COVID-19 spreading A doctor has died on the Norwegian Gem, two weeks after crew members saw another body loaded into an ambulance A cruise ship that had at least one passenger test positive for COVID-19 may be coming to Eastport Apart from one COVID-19 case on aborted Paul Gauguin cruise, everyone else tests negative Queen Mary 2 stocks up, leaves Durban after dropping off 6 South Africans CDC's role in helping cruise ship travelers during the COVID-19 pandemic 2020 Virgin Voyages crew member dies on ship, Coast Guard says. Another in cruise industry deaths Asymptomatic SeaDream Guest Tests Positive for COVID-19 After Arriving in Denmark Hundreds of crew members stuck on cruise ship for 40 days off Florida coast Four Additional Royal Caribbean Crew Members with COVID-19 Symphony of the Seas Crew Member Dies from COVID-19. Cruise Hive