Geology

Pathology

Archaeology

Disease

Cruise missile

Coronavirus Infections

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Pandemic

Oceanography

Outbreak

Engineering

Virology

Geography

Aeronautics

Quarantine

Cruise

Missile

2019-20 coronavirus outbreak

Crew

Medical emergency

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Medicine

Transmission (telecommunications)

Telecommunications

MMWR Morbidity and Mortality Weekly Report

An outbreak of coronavirus disease 2019 among passengers and crew on a cruise ship led to quarantine of approximately 3,700 passengers and crew that began on February 3, 2020, and lasted for nearly 4 weeks at the Port of Yokohama, Japan (1).By February 9, 20 cases had occurred among the ship's crew members.By the end of quarantine, approximately 700 cases of COVID-19 had been laboratory-confirmed among passengers and crew.This report describes findings from the initial phase of the cruise ship investigation into COVID-19 cases among crew members during February 4-12, 2020.On February 1, a laboratory-confirmed case of COVID-19 was identified in a passenger who had developed symptoms on January 23 and disembarked on January 25, before the ship arrived in Yokohama.Another passenger with a laboratoryconfirmed case of COVID-19 had developed symptoms on January 22 and was on the ship when it arrived in Yokohama on February 3.All symptomatic passengers were tested upon arrival in Yokohama, and those with positive results were disembarked February 4 and 5.The index patient for this outbreak could not be determined.On February 5, passengers remaining on the ship were requested to observe 14-day quarantine in their cabins.Approximately two thirds of the persons on board were passengers staying in cabins located on decks 5-12.The remainder (N = 1,068) were crew members, >80% of whose cabins were on decks 2-4.Crew members remained on board the ship at all times and had not disembarked during port calls.After quarantine began, crew members continued to perform their regular duties, delivered meals to passengers, and remained in their cabins when they were not working; symptomatic crew members were required to remain in their cabins.Because the first detected cases occurred among passengers who became symptomatic on January 22 and 23, COVID-19 was likely transmitted first from passengers to crew members and subsequently spread among the crew, especially among food service workers.The first case detected in a crew member occurred in a food service worker who developed fever on February 2. A real-time polymerase chain reaction test performed by the Yokohama quarantine office laboratory was positive for SARS-CoV-2, the etiologic agent of COVID-19, and the crew member was permitted to disembark in Yokohama * Testing for COVID-19 was conducted for crew members who sought medical attention.

Initial Investigation of Transmission of COVID-19 Among Crew Members During Quarantine of a Cruise Ship — Yokohama, Japan, February 2020