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Laboratory-based respiratory virus surveillance pilot project on select cruise ships in Alaska, 2013-15.
J Travel Med. 2017 Sep 01; 24(6)JT

Abstract

Background

Influenza outbreaks can occur among passengers and crews during the Alaska summertime cruise season. Ill travellers represent a potential source for introduction of novel or antigenically drifted influenza virus strains to the United States. From May to September 2013-2015, the Alaska Division of Public Health, the Centers for Disease Control and Prevention (CDC), and two cruise lines implemented a laboratory-based public health surveillance project to detect influenza and other respiratory viruses among ill crew members and passengers on select cruise ships in Alaska.

Methods

Cruise ship medical staff collected 2-3 nasopharyngeal swab specimens per week from passengers and crew members presenting to the ship infirmary with acute respiratory illness (ARI). Specimens were tested for respiratory viruses at the Alaska State Virology Laboratory (ASVL); a subset of specimens positive for influenza virus were sent to CDC for further antigenic characterization.

Results

Of 410 nasopharyngeal specimens, 83% tested positive for at least one respiratory virus; 71% tested positive for influenza A or B virus. Antigenic characterization of pilot project specimens identified strains matching predominant circulating seasonal influenza virus strains, which were included in the northern or southern hemisphere influenza vaccines during those years. Results were relatively consistent across age groups, recent travel history, and influenza vaccination status. Onset dates of illness relative to date of boarding differed between northbound (occurring later in the voyage) and southbound (occurring within the first days of the voyage) cruises.

Conclusions

The high yield of positive results indicated that influenza was common among passengers and crews sampled with ARI. This finding reinforces the need to bolster influenza prevention and control activities on cruise ships. Laboratory-based influenza surveillance on cruise ships may augment inland influenza surveillance and inform control activities. However, these benefits should be weighed against the costs and operational limitations of instituting laboratory-based surveillance programs on ships.

Authors+Show Affiliations

Division of Global Migration and Quarantine, 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, GA, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Alaska Division of Public Health, State Virology Laboratory, USA.Alaska Division of Public Health, State Virology Laboratory, USA.Influenza Division, Centers for Disease Control and Prevention, GA, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Alaska Division of Public Health, Section of Epidemiology, USA.Institute of Cruise Ship Medicine, USA.Health Services, Holland America Group, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29088487

Citation

Rogers, Kimberly B., et al. "Laboratory-based Respiratory Virus Surveillance Pilot Project On Select Cruise Ships in Alaska, 2013-15." Journal of Travel Medicine, vol. 24, no. 6, 2017.
Rogers KB, Roohi S, Uyeki TM, et al. Laboratory-based respiratory virus surveillance pilot project on select cruise ships in Alaska, 2013-15. J Travel Med. 2017;24(6).
Rogers, K. B., Roohi, S., Uyeki, T. M., Montgomery, D., Parker, J., Fowler, N. H., Xu, X., Ingram, D. J., Fearey, D., Williams, S. M., Tarling, G., Brown, C. M., & Cohen, N. J. (2017). Laboratory-based respiratory virus surveillance pilot project on select cruise ships in Alaska, 2013-15. Journal of Travel Medicine, 24(6). https://doi.org/10.1093/jtm/tax069
Rogers KB, et al. Laboratory-based Respiratory Virus Surveillance Pilot Project On Select Cruise Ships in Alaska, 2013-15. J Travel Med. 2017 Sep 1;24(6) PubMed PMID: 29088487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laboratory-based respiratory virus surveillance pilot project on select cruise ships in Alaska, 2013-15. AU - Rogers,Kimberly B, AU - Roohi,Shahrokh, AU - Uyeki,Timothy M, AU - Montgomery,David, AU - Parker,Jayme, AU - Fowler,Nisha H, AU - Xu,Xiyan, AU - Ingram,Deandra J, AU - Fearey,Donna, AU - Williams,Steve M, AU - Tarling,Grant, AU - Brown,Clive M, AU - Cohen,Nicole J, PY - 2017/03/28/received PY - 2017/09/01/accepted PY - 2017/11/1/entrez PY - 2017/11/1/pubmed PY - 2018/2/24/medline KW - Point of entry KW - cruise ship respiratory surveillance KW - influenza surveillance KW - respiratory surveillance JF - Journal of travel medicine JO - J Travel Med VL - 24 IS - 6 N2 - Background: Influenza outbreaks can occur among passengers and crews during the Alaska summertime cruise season. Ill travellers represent a potential source for introduction of novel or antigenically drifted influenza virus strains to the United States. From May to September 2013-2015, the Alaska Division of Public Health, the Centers for Disease Control and Prevention (CDC), and two cruise lines implemented a laboratory-based public health surveillance project to detect influenza and other respiratory viruses among ill crew members and passengers on select cruise ships in Alaska. Methods: Cruise ship medical staff collected 2-3 nasopharyngeal swab specimens per week from passengers and crew members presenting to the ship infirmary with acute respiratory illness (ARI). Specimens were tested for respiratory viruses at the Alaska State Virology Laboratory (ASVL); a subset of specimens positive for influenza virus were sent to CDC for further antigenic characterization. Results: Of 410 nasopharyngeal specimens, 83% tested positive for at least one respiratory virus; 71% tested positive for influenza A or B virus. Antigenic characterization of pilot project specimens identified strains matching predominant circulating seasonal influenza virus strains, which were included in the northern or southern hemisphere influenza vaccines during those years. Results were relatively consistent across age groups, recent travel history, and influenza vaccination status. Onset dates of illness relative to date of boarding differed between northbound (occurring later in the voyage) and southbound (occurring within the first days of the voyage) cruises. Conclusions: The high yield of positive results indicated that influenza was common among passengers and crews sampled with ARI. This finding reinforces the need to bolster influenza prevention and control activities on cruise ships. Laboratory-based influenza surveillance on cruise ships may augment inland influenza surveillance and inform control activities. However, these benefits should be weighed against the costs and operational limitations of instituting laboratory-based surveillance programs on ships. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/29088487/Laboratory_based_respiratory_virus_surveillance_pilot_project_on_select_cruise_ships_in_Alaska_2013_15_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/tax069 DB - PRIME DP - Unbound Medicine ER -