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Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A Recent Account of Preparedness and Response to an Ever-Present Challenge.
J Travel Med. 2015 Sep-Oct; 22(5):306-11.JT

Abstract

BACKGROUND

During spring 2014, two large influenza outbreaks occurred among cruise ship passengers and crew on trans-hemispheric itineraries.

METHODS

Passenger and crew information for both ships was obtained from components of the ship medical records. Data included demographics, diagnosis of influenza-like illness (ILI) or acute respiratory illness (ARI), illness onset date, passenger cabin number, crew occupation, influenza vaccination history, and rapid influenza diagnostic test (RIDT) result, if performed.

RESULTS

In total, 3.7% of passengers and 3.1% of crew on Ship A had medically attended acute respiratory illness (MAARI). On Ship B, 6.2% of passengers and 4.7% of crew had MAARI. In both outbreaks, passengers reported illness prior to the ship's departure. Influenza activity was low in the places of origin of the majority of passengers and both ships' ports of call. The median age of affected passengers on both ships was 70 years. Diagnostic testing revealed three different co-circulating influenza viruses [influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B] on Ship A and one circulating influenza virus (influenza B) on Ship B. Both ships voluntarily reported the outbreaks to the Centers for Disease Control and Prevention (CDC) and implemented outbreak response plans including isolation of sick individuals and antiviral treatment and prophylaxis.

CONCLUSIONS

Influenza activity can become widespread during cruise ship outbreaks and can occur outside of traditional influenza seasons. Comprehensive outbreak prevention and control plans, including prompt antiviral treatment and prophylaxis, may mitigate the impact of influenza outbreaks on cruise ships.

Authors+Show Affiliations

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.Los Angeles County Public Health Laboratory, Downey, CA, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26031322

Citation

Millman, Alexander J., et al. "Influenza Outbreaks Among Passengers and Crew On Two Cruise Ships: a Recent Account of Preparedness and Response to an Ever-Present Challenge." Journal of Travel Medicine, vol. 22, no. 5, 2015, pp. 306-11.
Millman AJ, Kornylo Duong K, Lafond K, et al. Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A Recent Account of Preparedness and Response to an Ever-Present Challenge. J Travel Med. 2015;22(5):306-11.
Millman, A. J., Kornylo Duong, K., Lafond, K., Green, N. M., Lippold, S. A., & Jhung, M. A. (2015). Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A Recent Account of Preparedness and Response to an Ever-Present Challenge. Journal of Travel Medicine, 22(5), 306-11. https://doi.org/10.1111/jtm.12215
Millman AJ, et al. Influenza Outbreaks Among Passengers and Crew On Two Cruise Ships: a Recent Account of Preparedness and Response to an Ever-Present Challenge. J Travel Med. 2015;22(5):306-11. PubMed PMID: 26031322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A Recent Account of Preparedness and Response to an Ever-Present Challenge. AU - Millman,Alexander J, AU - Kornylo Duong,Krista, AU - Lafond,Kathryn, AU - Green,Nicole M, AU - Lippold,Susan A, AU - Jhung,Michael A, Y1 - 2015/06/02/ PY - 2015/6/3/entrez PY - 2015/6/3/pubmed PY - 2016/6/9/medline SP - 306 EP - 11 JF - Journal of travel medicine JO - J Travel Med VL - 22 IS - 5 N2 - BACKGROUND: During spring 2014, two large influenza outbreaks occurred among cruise ship passengers and crew on trans-hemispheric itineraries. METHODS: Passenger and crew information for both ships was obtained from components of the ship medical records. Data included demographics, diagnosis of influenza-like illness (ILI) or acute respiratory illness (ARI), illness onset date, passenger cabin number, crew occupation, influenza vaccination history, and rapid influenza diagnostic test (RIDT) result, if performed. RESULTS: In total, 3.7% of passengers and 3.1% of crew on Ship A had medically attended acute respiratory illness (MAARI). On Ship B, 6.2% of passengers and 4.7% of crew had MAARI. In both outbreaks, passengers reported illness prior to the ship's departure. Influenza activity was low in the places of origin of the majority of passengers and both ships' ports of call. The median age of affected passengers on both ships was 70 years. Diagnostic testing revealed three different co-circulating influenza viruses [influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B] on Ship A and one circulating influenza virus (influenza B) on Ship B. Both ships voluntarily reported the outbreaks to the Centers for Disease Control and Prevention (CDC) and implemented outbreak response plans including isolation of sick individuals and antiviral treatment and prophylaxis. CONCLUSIONS: Influenza activity can become widespread during cruise ship outbreaks and can occur outside of traditional influenza seasons. Comprehensive outbreak prevention and control plans, including prompt antiviral treatment and prophylaxis, may mitigate the impact of influenza outbreaks on cruise ships. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/26031322/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/jtm.12215 DB - PRIME DP - Unbound Medicine ER -