Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

Leah F. Moriarty, MPH; Mateusz M. Plucinski, PhD; Barbara J. Marston, MD; Ekaterina V. Kurbatova, MD, PhD; Barbara Knust, DVM; Erin L. Murray, PhD; Nicki Pesik, MD; Dale Rose, PhD; David Fitter, MD; Miwako Kobayashi, MD, PhD; Mitsuru Toda, PhD; Paul T. Canty, MD; Tara Scheuer, MPH; Eric S. Halsey, MD; Nicole J. Cohen, MD; Lauren Stockman, MPH; Debra A. Wadford, PhD; Alexandra M. Medley, DVM; Gary Green, MD; Joanna J. Regan, MD; Kara Tardivel, MD; Stefanie White, MPH; Clive Brown, MD; Christina Morales, PhD; Cynthia Yen, MPH; Beth Wittry, MPH; Amy Freeland, PhD; Sara Naramore, MPH; Ryan T. Novak, PhD; David Daigle, MPH; Michelle Weinberg, MD; Anna Acosta, MD; Carolyn Herzig, PhD; Bryan K Kapella, MD; Kathleen R. Jacobson, MD; Katherine Lamba, MPH; Atsuyoshi Ishizumi, MPH, MSc; John Sarisky, MPH; Erik Svendsen, PhD; Tricia Blocher, MS; Christine Wu, MD; Julia Charles, JD; Riley Wagner, MPH; Andrea Stewart, PhD; Paul S. Mead, MD; Elizabeth Kurylo, MCM; Stefanie Campbell, DVM; Rachel Murray, MPH; Paul Weidle, PharmD; Martin Cetron, MD; Cindy R. Friedman, MD


Morbidity and Mortality Weekly Report. 2020;69(12):347-352. 

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Additional Ships

The Diamond Princess and Grand Princess had more than 800 total COVID-19 cases, including 10 deaths. During February 3–March 13, in the United States, approximately 200 cases of COVID-19 were confirmed among returned cruise travelers from multiple ship voyages, including the Diamond Princess and Grand Princess, accounting for approximately 17% of total reported U.S. cases at the time.[10] Cases linked with cruise travel have been reported to CDC in at least 15 states. Since February, multiple international cruises have been implicated in reports of COVID-19 cases, including at least 60 cases in the United States from Nile River cruises in Egypt (Figure 2). Secondary community-acquired cases linked to returned passengers on cruises have also been reported (CDC, unpublished data, 2020).

Figure 2.

Cruise ships with coronavirus disease 2019 (COVID-19) cases requiring public health responses — worldwide, January–March 2020