Epidemiology of Coronavirus Disease Outbreak among Crewmembers on Cruise Ship, Nagasaki City, Japan, April 2020

• Published in: Emerging infectious diseases Vol. 27; no. 9; pp. 2251 - 2260
• Main Authors: Maeda, Haruka, Sando, Eiichiro, Toizumi, Michiko, Arima, Yuzo, Shimada, Tomoe, Tanaka, Takeshi, Tashiro, Masato, Fujita, Ayumi, Yanagihara, Katsunori, Takayama, Hayato, Yasuda, Ikkoh, Kawachi, Nobuyuki, Kohayagawa, Yoshitaka, Hasegawa, Maiko, Motomura, Katsuaki, Fujita, Rie, Nakata, Katsumi, Yasuda, Jiro, Morita, Koichi, Kohno, Shigeru, Izumikawa, Koichi, Suzuki, Motoi, Morimoto, Konosuke
• Format: Journal Article
• Language: English
• Published: Atlanta U.S. National Center for Infectious Diseases 01.09.2021; Centers for Disease Control and Prevention
• Subjects: Body mass index; Body temperature; Causes of; Control; coronavirus disease; Coronaviruses; COVID-19; Cruise ships; Disease transmission; Epidemics; Epidemiology; Fever; Health aspects; Illnesses; Infections; Infectious diseases; Japan; Laboratories; Medical records; Monitoring systems; Outbreaks; Pandemics; Pneumonia; Public health; Quarantine; respiratory infections; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Smartphones; Statistics; Transport workers; viruses; Japan; China
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2709.204596

In April 2020, a coronavirus disease (COVID-19) outbreak occurred on the cruise ship Costa Atlantica in Nagasaki, Japan. Our outbreak investigation included 623 multinational crewmembers onboard on April 20. Median age was 31 years; 84% were men. Each crewmember was isolated or quarantined in a single room inside the ship, and monitoring of health status was supported by a remote health monitoring system. Crewmembers with more severe illness were hospitalized. The investigation found that the outbreak started in late March and peaked in late April, resulting in 149 laboratory-confirmed and 107 probable cases of infection with severe acute respiratory syndrome coronavirus 2. Six case-patients were hospitalized for COVID-19 pneumonia, including 1 in severe condition and 2 who required oxygen administration, but no deaths occurred. Although the virus can spread rapidly on a cruise ship, we describe how prompt isolation and quarantine combined with a sensitive syndromic surveillance system can control a COVID-19 outbreak.