Descriptive study of COVID-19 outbreak among passengers and crew on Diamond Princess cruise ship, Yokohama Port, Japan, 20 January to 9 February 2020

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 25; no. 23; p. 1
• Main Authors: Yamagishi, Takuya, Kamiya, Hajime, Kakimoto, Kensaku, Suzuki, Motoi, Wakita, Takaji
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 11.06.2020; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Aged; Betacoronavirus; China; Coronavirus; Coronavirus Infections - epidemiology; COVID-19; Cruise lines; Diamond; Disease Outbreaks; Disease prevention; Disease transmission; Epidemics; Hong Kong; Humans; Infectious diseases; Japan; Male; Middle Aged; Outbreaks; Pandemics; Pneumonia, Viral - epidemiology; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Ships; Hong Kong; China; Japan; COVID-19; cruise ship; novel coronavirus; quarantine; Diamond Princess
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2020.25.23.2000272

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.