
Health workers in protective gear evacuate patients from the MV Hondius cruise ship into an ambulance at a port in Praia, Cape Verde
Think of a cruise ship as a temporary city at sea. It has restaurants, theaters, elevators, cabins, kitchens, water systems and indoor gathering spaces.
That is great for convenience, but it also means that once an infection gets on board, it can move through the ship in ways that are hard to stop.
The Diamond Princess Covid-19 outbreak is perhaps the best-known example. In February 2020, 619 passengers and crew on the ship tested positive for the disease. Researchers found that the ship conditions made the novel coronavirus spread more easily.
Their modeling suggested that public health measures, such as isolation and quarantine, prevented many more cases, but it also showed that an earlier response would have further limited the outbreak.
Norovirus (commonly referred to as the stomach bug) is the infection most closely linked to cruise ships. In a review of previously published studies, researchers found 127 reports of norovirus outbreaks on cruise ships, with many linked to contaminated food, contaminated surfaces and person-to-person spread.
A more recent report from the CDC's Vessel Sanitation Program also showed that norovirus, which strikes 20 million Americans per year, can spread very rapidly from person to person on a cruise ship.
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