Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020
Leah F. Moriarty, Mateusz M. Pluciński, Barbara J. Marston, Ekaterina V. Kurbatova, Barbara Knust, Erin L. Murray, Nicki Pesik, Dale A. Rose, David L. Fitter, Miwako Kobayashi, Mitsuru Toda, Paul T. Canty, Tara Scheuer, Eric S. Halsey, Nicole J. Cohen, Lauren J. Stockman, Debra A. Wadford, Alexandra Medley, Gary Green, Joanna J. Regan, Kara Tardivel, Stefanie White, Clive Brown, Christina Morales, Cynthia Yen, Beth Wittry, Amy Freeland, Sara K. Naramore, Ryan T. Novak, David Daigle, Michelle Weinberg, Anna M. Acosta, Carolyn Herzig, Bryan K. Kapella, Kathleen 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 J. Weidle, Martín S. Cetron, Cindy R. Friedman, CDC Cruise Ship Response Team, Solano County COVID-19 Team, CDC Cruise Ship Response Team, Casey Barton Behravesh, Adam Bjork, William A. Bower, Catherine H. Bozio, Zachary Braden, Mary Catherine P. Bertulfo, Kevin Chatham‐Stephens, Victoria Chu, Barbara M. Cooper, Kathleen Dooling, Christine Dubray, Emily J. Curren, Margaret A. Honein, Kathryn N. Ivey, Jefferson M. Jones, Melissa Kadzik, Nancy Knight, Mariel Marlow, Audrey McColloch, Robert H. McDonald, Andrew Klevos, Sarah Poser, Robin A. Rinker, Troy Ritter, Luis López Rodríguez, M. J. Ryan, Zachary Schneider, Caitlin Shockey, Jill Shugart, Margaret Silver, Paul W. Smith, Farrell A. Tobolowsky, Aimee Treffiletti, Megan Wallace, Jonathan S. Yoder, P.J. Barry, Ricardo Berumen, Brooke Bregman, Kevin Campos-Campos, Shua J. Chai, Rosie Glenn-Finer, Hugo Guevara, Jill K. Hacker, Kristina Hsieh, Mary Kate Morris, Ryan Murphy
Abstract
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.