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10.1093/cid/ciab433

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suck abstract from ncbi


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pmid33978720      Clin+Infect+Dis 2022 ; 74 (3): 490-497
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  • Cruise Ship Travel in the Era of Coronavirus Disease 2019 (COVID-19): A Summary of Outbreaks and a Model of Public Health Interventions #MMPMID33978720
  • Guagliardo SAJ; Prasad PV; Rodriguez A; Fukunaga R; Novak RT; Ahart L; Reynolds J; Griffin I; Wiegand R; Quilter LAS; Morrison S; Jenkins K; Wall HK; Treffiletti A; White SB; Regan J; Tardivel K; Freeland A; Brown C; Wolford H; Johansson MA; Cetron MS; Slayton RB; Friedman CR
  • Clin Infect Dis 2022[Feb]; 74 (3): 490-497 PMID33978720show ga
  • BACKGROUND: Cruise travel contributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission when there were relatively few cases in the United States. By 14 March 2020, the Centers for Disease Control and Prevention (CDC) issued a No Sail Order suspending US cruise operations; the last US passenger ship docked on 16 April. METHODS: We analyzed SARS-CoV-2 outbreaks on cruises in US waters or carrying US citizens and used regression models to compare voyage characteristics. We used compartmental models to simulate the potential impact of 4 interventions (screening for coronavirus disease 2019 (COVID-19) symptoms; viral testing on 2 days and isolation of positive persons; reduction of passengers by 40%, crew by 20%, and reducing port visits to 1) for 7-day and 14-day voyages. RESULTS: During 19 January to 16 April 2020, 89 voyages on 70 ships had known SARS-CoV-2 outbreaks; 16 ships had recurrent outbreaks. There were 1669 reverse transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infections and 29 confirmed deaths. Longer voyages were associated with more cases (adjusted incidence rate ratio, 1.10, 95% confidence interval [CI]: 1.03-1.17, P < .003). Mathematical models showed that 7-day voyages had about 70% fewer cases than 14-day voyages. On 7-day voyages, the most effective interventions were reducing the number of individuals onboard (43.3% reduction in total infections) and testing passengers and crew (42% reduction in total infections). All four interventions reduced transmission by 80.1%, but no single intervention or combination eliminated transmission. Results were similar for 14-day voyages. CONCLUSIONS: SARS-CoV-2 outbreaks on cruises were common during January-April 2020. Despite all interventions modeled, cruise travel still poses a significant SARS-CoV-2 transmission risk.
  • |*COVID-19[MESH]
  • |Disease Outbreaks[MESH]
  • |Humans[MESH]
  • |Public Health[MESH]
  • |SARS-CoV-2[MESH]
  • |Ships[MESH]
  • |Travel[MESH]


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