Infectious disease on cruise ships

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Infectious disease on cruise ships is a hazard associated with cruises. Outbreaks of contagious diseases can spread quickly due to the confined cruise ship environment, reliance on shared spaces, the lack of healthcare facilities, [1] and the large number of passengers and crew members from disparate points of origin.

Contents

Outbreaks of diseases including norovirus, [2] [3] Legionnaire’s, [4] [5] [6] [7] cyclosporiasis, [8] and COVID-19 have all occurred on cruise ships. [9]

Diseases

Respiratory and gastrointestinal diseases are more likely to be communicated on cruise ships. [10]

Norovirus

Norovirus is a virus that can cause gastroenteritis [11] and is also a cause of gastroenteritis on cruise ships. [2] It is typically transmitted from person to person. [12] Symptoms usually last between 1 and 3 days and generally resolve without treatment or long term consequences. The incubation period of the virus averages about 24 hours. [13]

Norovirus outbreaks are often perceived to be associated with cruise ships. According to the American CDC, factors that cause norovirus to be associated with cruise ships include the closer tracking and faster reporting of illnesses on cruise ships compared to those on land; the closer living quarters that increases the amount of interpersonal contact and the turnover of passengers that may bring the viruses on board. [14] Outbreak investigations by the CDC have shown that transmission of norovirus among cruise ship passengers is primarily person-to-person; potable water supplies have not been implicated.[ citation needed ] In a study published in the Journal of the American Medical Association , the CDC reported that, "Perceptions that cruise ships can be luxury breeding grounds for acute gastroenteritis outbreaks don't hold water. A recent CDC report showed that from 2008 to 2014, only 0.18% of more than 73 million cruise passengers and 0.15% of some 28 million crew members reported symptoms of the illness." [15]

Ships docked in port undergo surprise health inspections. In 2009, ships that underwent unannounced inspections by the CDC received an average CDC Vessel Sanitation Program score of approximately 97 out of a total possible 100 points. [16] The minimum passing inspection score is 85. [16] Collaboration with the CDC's Vessel Sanitation Program and the development of Outbreak Prevention and Response Plans has been credited in decreasing the incidence of norovirus outbreaks on ships. [17]

Legionnaires' disease

Legionella , the bacterium which causes Legionnaires' disease, and in particular the most virulent strain, Legionella pneumophila serogroup 1, can cause infections when inhaled as an aerosol or aspirated. [4] 50 passengers across nine cruises in 1994 either contracted Legionnaire's or likely contracted the disease due to exposure to whirlpool spas contaminated with the pathogen. [4]

Enterotoxigenic Escherichia coli

Enterotoxigenic Escherichia coli is a form of E. coli and the leading bacterial cause of diarrhea in the developing world, as well as the most common cause of diarrhea for travelers to those areas. [18] Since 2008 there has been at least one reported incident each year of E. coli on international cruise ships reported to the Vessel Sanitation Program of the Centers for Disease Control, though there were none in 2015. [2] Causes of E. coli infection include the consumption of contaminated food or water contaminated by human waste. [19]

COVID-19

Cases and suspected cases of COVID-19 occurred on cruise ships in early 2020, at the beginning of the COVID-19 pandemic. [10] Authorities across the world turned away ships or quarantined them; cruise operators cancelled some port visits and ultimately suspended global cruise operations. People aboard cruise ships played a role in spreading the disease in some countries.[ citation needed ]

Outbreaks

2020s

Cruise launch yearCruise datesOwner/OperatorShipDiseaseCasesDeathsLocationNotes and References
20202 February - 16 February Princess Cruises Caribbean Princess Norovirus4030No information [20]
202016 February - 1 March Princess Cruises Caribbean Princess Norovirus2590No information [20]
20201 March - 16 March Holland America Line Westerdam Unknown270No information [20]
20207 March - 19 March Royal Caribbean International Grandeur of the Seas Norovirus1050No information [20]
202129 November - 13 December Viking Cruises Viking Sea Vibrio and E. coli1200No information [20]
202228 April - 5 May Seabourn Cruise Line Seabourn Odyssey Unknown200No information [20]
202224 May - 31 May Carnival Cruise Line Carnival Splendor Norovirus800No information [20]
202221 December - 6 January Silversea Cruises Silver Moon Unknown280No information [20]
202229 December - 3 January P&O Cruises MV Arcadia Norovirus940No information [20]
20231 January - 13 April P&O Cruises MV Arcadia NorovirusNo informationNo informationNo information [20]
202316 January - 21 January Royal Caribbean International Brilliance of the Seas NorovirusNo informationNo informationNo information [20]
202328 January - 3 February Royal Caribbean International Jewel of the Seas NorovirusNo informationNo informationNo information [20]
20232 February - 5 March Princess Cruises Ruby Princess NorovirusNo informationNo informationNo information [20]
20236 March - 17 March Celebrity Cruises Celebrity Constellation NorovirusNo informationNo informationNo information [20]
20239 March - 18 March Celebrity Cruises Celebrity Equinox NorovirusNo informationNo informationNo information [20]
202311 March - 23 March Royal Caribbean International Enchantment of the Seas NorovirusNo informationNo informationNo information [20]
202323 March - 31 March Royal Caribbean International Enchantment of the Seas NorovirusNo informationNo informationNo information [20]
202317 March - 1 April Princess Cruises Emerald Princess NorovirusNo informationNo informationNo information [20]
202331 March - 28 April Princess Cruises Grand Princess NorovirusNo informationNo informationNo information [20]
202331 March - 28 April Princess Cruises Grand Princess NorovirusNo informationNo informationNo information [20]
20236 May - 21 May Holland America Nieuw Amsterdam NorovirusNo informationNo informationNo information [20]
202315 May - 25 May Celebrity Cruises Celebrity Summit NorovirusNo informationNo informationNo information [20]
20236 June - 20 June Viking Cruises Viking Neptune NorovirusNo informationNo informationNo informationViking Cruises blamed the outbreak on an Icelandic restaurant visited by some passengers. [21] [20]
20238 October - 13 October Virgin Voyages Scarlet Lady NorovirusNo informationNo informationNo information [20]
20243 January - 12 January Celebrity Cruises Celebrity Constellation NorovirusNo informationNo informationNo information [20]
202422 January - 6 February Cunard Line Queen Victoria Unknown150+No informationNo informationAs of 8 February 2024, the disease had not been identified. [22] [20]

References

  1. ↑ Zhang, Nan; Miao, Ruosong; Huang, Hong; Chan, Emily Y. Y. (8 December 2016). "Contact infection of infectious disease onboard a cruise ship". Scientific Reports. 6 (1): 38790. doi:10.1038/srep38790. ISSN   2045-2322. PMC   5144015 .{{cite journal}}: CS1 maint: article number as page number (link)
  2. 1 2 3 CDC VSP. "Vessel Sanitation Program – Outbreak Updates for International Cruise Ships". Centers for Disease Control and Prevention. Archived from the original on 10 May 2016. Retrieved 11 February 2024.
  3. ↑ "CDC – Vessel Sanitation Program – Balmoral, April 16, 2016". Cdc.gov. Archived from the original on 14 May 2016. Retrieved 11 February 2024.
  4. 1 2 3 Jernigan, D.B; Hofmann, J; Cetron, M.S; Nuorti, J.P; Fields, B.S; Benson, R.F; Breiman, R.F; Lipman, H.B; Carter, R.J; Genese, C.A; Paul, S.M; Edelstein, P.H; Guerrero, I.C (February 1996). "Outbreak of Legionnaires' disease among cruise ship passengers exposed to a contaminated whirlpool spa". The Lancet. 347 (9000): 494–499. doi: 10.1016/s0140-6736(96)91137-x .
  5. ↑ "Cruise-Ship—Associated Legionnaires Disease, November 2003 – May 2004". cdc.gov.
  6. ↑ "EWGLinet Summary Report – December 2006" (PDF). ewgli.org. Archived from the original (PDF) on 27 November 2007.
  7. ↑ "Legionnaires' fear on cruise ship". BBC News . 30 July 2007. Retrieved 15 October 2021.
  8. ↑ Minooee, Arézou; Rickman, Leland S. (1999). "Infectious Diseases on Cruise Ships". Clinical Infectious Diseases. 29 (4): 737–743. ISSN   1058-4838.
  9. ↑ Roe, Teiva (1 August 2020). "Un cas positif de Covid a été détecté sur le paquebot de croisière le Paul Gauguin" . Retrieved 11 February 2024.
  10. 1 2 Tan, Yvette (12 February 2020). "Coronavirus: Are cruise ships really 'floating Petri dishes'?". BBC. Retrieved 11 February 2024.
  11. ↑ Ahmed SM, Hall AJ, Robinson AE, et al. (August 2014). "Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis". Lancet Infect Dis. 14 (8): 725–30. doi:10.1016/S1473-3099(14)70767-4. PMC   8006533 . PMID   24981041.
  12. ↑ Moore MD, Goulter RM, Jaykus L (April 2015). "Human Norovirus as a Foodborne Pathogen: Challenges and Developments". Annual Review of Food Science and Technology. 6 (1): 411–33. doi: 10.1146/annurev-food-022814-015643 . PMID   25884284.
  13. ↑ "Norovirus – Chapter 4 – 2020 Yellow Book | Travelers' Health". CDC. Retrieved 2019-10-08.
  14. ↑ "Facts About Noroviruses on Cruise Ships". cdc.gov. 2019-02-07. Retrieved 2019-10-08.
  15. ↑ "Cruise Ship Illness Declines". JAMA. 315 (8): 743. 2016-02-23. doi:10.1001/jama.2016.0733. ISSN   0098-7484.
  16. 1 2 "Vessel Sanitation Program: Advanced Cruise Ship Inspection Search". US Center for Disease Control. Retrieved 15 October 2021.
  17. ↑ "Travel News, Tips, and Guides". USA Today . Retrieved 2019-10-08.
  18. ↑ "WHO | Research and development". WHO. Archived from the original on 8 December 2013.
  19. ↑ "E. Coli Infections". medlineplus.gov. Retrieved 2019-10-08.
  20. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 "Cruise Ship Outbreak Updates | Vessel Sanitation Program | CDC". www.cdc.gov. 8 February 2024. Retrieved 11 February 2024.
  21. ↑ Viswanathan, Giri (11 July 2023). "After years of decline, norovirus outbreaks surge on cruise ships". CNN. Retrieved 13 February 2024.
  22. ↑ Diaz, Johnny (8 February 2024). "C.D.C. Investigating Gastrointestinal Illness on Luxury Cruise Ship". The New York Times. Retrieved 13 February 2024.
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