Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020
Authors: Leah F. Moriarty, Mateusz M. Plucinski, Barbara J. Marston, Ekaterina V. Kurbatova, Barbara Knust, Erin L. Murray, Nicki Pesik, Dale Rose, David Fitter, Miwako Kobayashi, Mitsuru Toda, Paul T. Canty, Tara Scheuer, Eric S. Halsey, Nicole J. Cohen, Lauren Stockman, Debra A. Wadford, Alexandra M. Medley, Gary Green, Joanna J. Regan, Kara Tardivel, Stefanie White, Clive Brown, Christina Morales, Cynthia Yen, Beth Wittry, Amy Freeland, Sara Naramore, Ryan T. Novak, David Daigle, Michelle Weinberg, Anna Acosta, Carolyn Herzig, Bryan K Kapella, Kathleen R. 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 Weidle, Martin Cetron, Cindy R. Friedman, Casey Barton Behravesh, Adam Bjork, William Bower, Catherine Bozio, Zachary Braden, Mary Catherine Bertulfo, Kevin Chatham-Stephens, Victoria Chu, Barbara Cooper, Kathleen Dooling, Christine Dubray, Emily Curren, Margaret A. Honein, Kathryn Ivey, Jefferson Jones, Melissa Kadzik, Nancy Knight, Mariel Marlow, Audrey McColloch, Robert McDonald, Andrew Klevos, Sarah Poser, Robin A. Rinker, Troy Ritter, Luis Rodriguez, Matthew Ryan, Zachary Schneider, Caitlin Shockey, Jill Shugart, Margaret Silver, Paul W. Smith, Farrell Tobolowsky, Aimee Treffiletti, Megan Wallace, Jonathan Yoder, Pennan Barry, Ricardo Berumen, Brooke Bregman, Kevin Campos, Shua Chai, Rosie Glenn-Finer, Hugo Guevara, Jill Hacker, Kristina Hsieh, Mary Kate Morris, Ryan Murphy, Jennifer F. Myers, Tasha Padilla, Chao-Yang Pan, Adam Readhead, Estela Saguar, Maria Salas, Robert E. Snyder, Duc Vugia, James Watt, Cindy Wong, Meileen Acosta, Shai Davis, Beatrix Kapuszinsky, Bela Matyas, Glen Miller, Asundep Ntui, Jayleen Richards
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

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.