1887
Outbreaks Open Access
Like 0

Abstract

An outbreak of coronavirus disease (COVID-19) occurred on the Diamond Princess cruise ship making an international journey, which led to quarantine of the ship at Yokohama Port, Japan. A suspected COVID-19 case was defined as a passenger or crew member who developed a fever or respiratory symptoms, and a confirmed COVID-19 case had laboratory-confirmation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Between 3 and 9 February 2020, 490 individuals were tested for SARS-CoV-2 and 172 were positive (152 passengers (median age: 70 years; interquartile range (IQR): 64–75; males: 45%) and 20 crew (median age: 40 years; IQR: 35–48.5; males: 80%). Other than the Hong Kong-related index case, symptom onset for the earliest confirmed case was 22 January, 2 days after the cruise ship left port. Attack rates among passengers were similar across the decks, while beverage (3.3%, 2/61) and food service staff (5.7%, 14/245) were most affected. Attack rates tended to increase with age. A comprehensive outbreak response was implemented, including surveillance, provision of essential medical care, food and medicine delivery, isolation, infection prevention and control, sampling and disembarkation.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2020.25.23.2000272
2020-06-11
2024-12-09
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2020.25.23.2000272
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/25/23/eurosurv-25-23-5.html?itemId=/content/10.2807/1560-7917.ES.2020.25.23.2000272&mimeType=html&fmt=ahah

References

  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.  https://doi.org/10.1016/S0140-6736(20)30183-5  PMID: 31986264 
  2. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.  https://doi.org/10.1056/NEJMoa2001017  PMID: 31978945 
  3. Pongpirul WA, Pongpirul K, Ratnarathon AC, Prasithsirikul W. Journey of a Thai taxi driver and novel coronavirus. N Engl J Med. 2020;382(11):1067-8.  https://doi.org/10.1056/NEJMc2001621  PMID: 32050060 
  4. World Health Organization (WHO). Situation report – 141 Coronavirus disease 2019 (COVID-19) 9 June 2020. Geneva: WHO. [Accessed: 10 Jun 2020]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
  5. Ministry of Health, Labour and Welfare. [The first case of novel coronavirus infection in Japan. Tokyo: Ministry of Health, Labour and Welfare]. [Accessed: 8 Mar 2020]. Japanese. Available from: https://www.mhlw.go.jp/stf/newpage_08906.html
  6. National Institute of Infectious Diseases (NIID). [Descriptive Epidemiology of 12 Confirmed 2019-Novel Coronavirus (2019-nCoV) Cases in Japan (as of 3 February 2020)]. Tokyo: NIID; 2020. Japanese. Available from: https://www.niid.go.jp/niid/en/2019-ncov-e/2488-idsc/iasr-news/9400-481pe01.html
  7. Furukawa NW, Brooks JT, Sobel J. Evidence Supporting Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 While Presymptomatic or Asymptomatic. Emerg Infect Dis. 2020;26(7).  https://doi.org/10.3201/eid2607.201595  PMID: 32364890 
  8. Peiris JSM, Yuen KY, Osterhaus AD, Stöhr K. The severe acute respiratory syndrome. N Engl J Med. 2003;349(25):2431-41.  https://doi.org/10.1056/NEJMra032498  PMID: 14681510 
  9. Arabi YM, Balkhy HH, Hayden FG, Bouchama A, Luke T, Baillie JK, et al. Middle East Respiratory Syndrome. N Engl J Med. 2017;376(6):584-94.  https://doi.org/10.1056/NEJMsr1408795  PMID: 28177862 
  10. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7.  https://doi.org/10.1056/NEJMc2004973  PMID: 32182409 
  11. Siegel JD, Rhinehart E, Jackson M, Chiarello L, Health Care Infection Control Practices Advisory Committee. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10) Suppl 2;S65-164.  https://doi.org/10.1016/j.ajic.2007.10.007  PMID: 18068815 
  12. The Government of the Hong Kong Special Administrative Region. CHP investigates additional case of novel coronavirus infection. Hong Kong: The Government of the Hong Kong Special Administrative Region; 2020. Available from: https://www.info.gov.hk/gia/general/202002/01/P2020020100795.htm
  13. National Institute of Infectious Diseases (NIID). [Manual of laboratory diagnosis of novel coronavirus, Japan]. Tokyo: NIID. [Accessed 8 Mar 2020]. Japanese. Available: https://www.niid.go.jp/niid/ja/labo-manual.html#class0
  14. Moriarty LF, Plucinski MM, Marston BJ, Kurbatova EV, Knust B, Murray EL, et al. Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):347-52.  https://doi.org/10.15585/mmwr.mm6912e3  PMID: 32214086 
  15. Nagasaki City. The outbreak situation of the prefecture in Nagasaki-shi of new coronavirus infectious disease. [Accessed 10 Jun 2020]. Available from: https://www.city.nagasaki.lg.jp.e.jc.hp.transer.com/fukushi/450000/454000/p034301.html
  16. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382(10):970-1.  https://doi.org/10.1056/NEJMc2001468  PMID: 32003551 
  17. Bai Y, Yao L, Wei T, Tian F, Jin D-Y, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020;323(14):1406.  https://doi.org/10.1001/jama.2020.2565  PMID: 32083643 
  18. World Health Organization (WHO). Q&A on coronaviruses (COVID-19). Geneva: WHO; 2020. Available from: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
  19. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.  https://doi.org/10.1056/NEJMoa2002032  PMID: 32109013 
  20. Hoehl S, Rabenau H, Berger A, Kortenbusch M, Cinatl J, Bojkova D, et al. Evidence of SARS-CoV-2 infection in returning travelers from Wuhan, China. N Engl J Med. 2020;382(13):1278-80.  https://doi.org/10.1056/NEJMc2001899  PMID: 32069388 
  21. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382(12):1177-9.  https://doi.org/10.1056/NEJMc2001737  PMID: 32074444 
  22. Kigozi SP, Kigozi RN, Sserwanga A, Nankabirwa JI, Staedke SG, Kamya MR, et al. Malaria burden through routine reporting: relationship between incidence and test positivity rates. Am J Trop Med Hyg. 2019;101(1):137-47.  https://doi.org/10.4269/ajtmh.18-0901  PMID: 31074412 
/content/10.2807/1560-7917.ES.2020.25.23.2000272
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error