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Influenza B outbreak on a cruise ship off the São Paulo Coast, Brazil.
J Travel Med. 2014 Sep-Oct; 21(5):298-303.JT

Abstract

BACKGROUND

In February 2012, crew and passengers of a cruise ship sailing off the coast of São Paulo, Brazil, were hospitalized for acute respiratory illness (ARI). A field investigation was performed to identify the disease involved and factors associated.

METHODS

Information on passengers and crew with ARI was obtained from the medical records of hospitalized individuals. Active case finding was performed onboard the ship. ARI was defined as the presence of one nonspecific symptom (fever, chills, myalgia, arthralgia, headache, or malaise) and one respiratory symptom (cough, nasal congestion, sore throat, or dyspnea). A case-control study was conducted among the crew. The cases were crew members with symptoms of influenza-like illness (ILI) (fever and one of the following symptoms: cough, sore throat, and dyspnea) in February 2012. The controls were asymptomatic crew members.

RESULTS

The study identified 104 ARI cases: 54 (51.9%) crew members and 50 (49.1%) passengers. Among 11 ARI hospitalized cases, 6 had influenza B virus isolated in nasopharyngeal swab. One mortality among these patients was caused by postinfluenza Staphylococcus aureus pneumonia. The crew members housed in the two lower decks and those belonging to the 18- to 32-year-old age group were more likely to develop ILI [odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.09-5.25 and OR = 3.72, CI 1.25-11.16, respectively].

CONCLUSIONS

In February 2012, an influenza B outbreak occurred onboard a cruise ship. Among crew members, ILI was associated with lower cabin location and younger age group. This was the first influenza outbreak detected by Brazilian public health authorities in a vessel cruising in South American waters.

Authors+Show Affiliations

Field Epidemiology Training Program (EPISUS-SP), São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24889210

Citation

Fernandes, Eder G., et al. "Influenza B Outbreak On a Cruise Ship Off the São Paulo Coast, Brazil." Journal of Travel Medicine, vol. 21, no. 5, 2014, pp. 298-303.
Fernandes EG, de Souza PB, de Oliveira ME, et al. Influenza B outbreak on a cruise ship off the São Paulo Coast, Brazil. J Travel Med. 2014;21(5):298-303.
Fernandes, E. G., de Souza, P. B., de Oliveira, M. E., Lima, G. D., Pellini, A. C., Ribeiro, M. C., Sato, H. K., Ribeiro, A. F., & Yu, A. L. (2014). Influenza B outbreak on a cruise ship off the São Paulo Coast, Brazil. Journal of Travel Medicine, 21(5), 298-303. https://doi.org/10.1111/jtm.12132
Fernandes EG, et al. Influenza B Outbreak On a Cruise Ship Off the São Paulo Coast, Brazil. J Travel Med. 2014 Sep-Oct;21(5):298-303. PubMed PMID: 24889210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza B outbreak on a cruise ship off the São Paulo Coast, Brazil. AU - Fernandes,Eder G, AU - de Souza,Priscila B, AU - de Oliveira,Maria Emília B, AU - Lima,Gisele D F, AU - Pellini,Alessandra Cristina G, AU - Ribeiro,Manoel Carlos S A, AU - Sato,Helena K, AU - Ribeiro,Ana F, AU - Yu,Ana Lucia F, Y1 - 2014/06/03/ PY - 2013/10/06/received PY - 2013/12/08/revised PY - 2013/12/16/accepted PY - 2014/6/4/entrez PY - 2014/6/4/pubmed PY - 2015/4/1/medline SP - 298 EP - 303 JF - Journal of travel medicine JO - J Travel Med VL - 21 IS - 5 N2 - BACKGROUND: In February 2012, crew and passengers of a cruise ship sailing off the coast of São Paulo, Brazil, were hospitalized for acute respiratory illness (ARI). A field investigation was performed to identify the disease involved and factors associated. METHODS: Information on passengers and crew with ARI was obtained from the medical records of hospitalized individuals. Active case finding was performed onboard the ship. ARI was defined as the presence of one nonspecific symptom (fever, chills, myalgia, arthralgia, headache, or malaise) and one respiratory symptom (cough, nasal congestion, sore throat, or dyspnea). A case-control study was conducted among the crew. The cases were crew members with symptoms of influenza-like illness (ILI) (fever and one of the following symptoms: cough, sore throat, and dyspnea) in February 2012. The controls were asymptomatic crew members. RESULTS: The study identified 104 ARI cases: 54 (51.9%) crew members and 50 (49.1%) passengers. Among 11 ARI hospitalized cases, 6 had influenza B virus isolated in nasopharyngeal swab. One mortality among these patients was caused by postinfluenza Staphylococcus aureus pneumonia. The crew members housed in the two lower decks and those belonging to the 18- to 32-year-old age group were more likely to develop ILI [odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.09-5.25 and OR = 3.72, CI 1.25-11.16, respectively]. CONCLUSIONS: In February 2012, an influenza B outbreak occurred onboard a cruise ship. Among crew members, ILI was associated with lower cabin location and younger age group. This was the first influenza outbreak detected by Brazilian public health authorities in a vessel cruising in South American waters. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/24889210/Influenza_B_outbreak_on_a_cruise_ship_off_the_S��o_Paulo_Coast_Brazil_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/jtm.12132 DB - PRIME DP - Unbound Medicine ER -