The Coronavirus Outbreak Has Affected 4 Different Cruise Ships—Here's Why Illness Can Spread so Fast at Sea

One vessel has been quarantined so far, with 61 passengers who tested positive for the virus.

Cruises are, for the most part, meant to elicit feelings of relaxation—literally floating away from your landlocked responsibilities for a few days. But, for thousands of passengers aboard at least four different cruise ships, their vacations quickly turned into nightmare scenarios.

As of Friday, four major vessels—the Diamond Princess, Westerdam, World Dream, and Royal Caribbean’s The Anthem of the Seas cruise ships—have been impacted by the 2019 novel coronavirus (2019-nCoV), aka the Wuhan coronavirus.

Most affected by the outbreak is the Diamond Princess cruise ship, currently quarantined off the coast of Yokohama, near Tokyo. The ship was docked Tuesday after a former passenger tested positive for the coronavirus. Since then, 61 passengers of the 3,700 people on board have tested positive for the virus, reports CNN. The ship's quarantine is expected to last until at least February 19.

The two other ships—the Westerdam, currently in search of a port in the East China Sea; and the World Dream, docked in Hong Kong—have also come to a halt due to fears of coronavirus, per CNN. No current or former passengers on the Westerdam have been reported as having the coronavirus, nor have any current passengers on the World Dream, though eight former passengers of the cruise ship have been confirmed as having the illness.

And most recently, on Friday, the Royal Caribbean’s The Anthem of the Seas was docked near New York City, at a port in Bayonne, New Jersey, where 27 passengers were screened for the coronavirus, according to CNN. Four of those passengers were sent to the hospital for further investigation, while the other 23 were cleared.

In a statement, per CNN, Royal Caribbean confirmed that, like airlines, they too are working to help limit the spread of the coronavirus. "We continue to work in close consultation with the CDC, the WHO, and local health authorities to align with their guidance and ensure the health and wellbeing of our guests and crew."

Why do illnesses seem to spread so much faster on cruise ships—and is that the case for the coronavirus?

According to the Centers for Disease Control and Prevention, "cruise ship travel presents a unique combination of health concerns." That's largely because cruise ships bring a large amount of people together in crowded, semi-enclosed environments—and that can facilitate the spread of person-to-person, foodborne, or waterborne diseases. Per the CDC, the most frequently reported cruise ship outbreaks involve respiratory infections, GI infections like norovirus, and vaccine-preventable diseases like chickenpox.

Another big issue regarding illnesses on cruise ships is that, once a cruise is complete and one group of passengers exits the vessel, another one almost immediately sets sail. “Outbreaks on ships can be sustained for multiple voyages by transmission among crew members who remain onboard or by persistent environmental contamination,” the CDC explains. During the trip, passengers may also be exposed to illness and disease during a port visit, and bring the infection back on board.

But far as the current coronavirus outbreak goes, while the virus is more likely to spread faster via person-to-person contact in close quarters, "there's no evidence yet that coronavirus has spread more quickly on a cruise ship than it has elsewhere," Jeremy Brown, MD, director of the Office of Emergency Care Research at the National Institutes of Health and author of Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History, tells Health.

Dr. Brown also notes that cruise ships aren't the only high-risk places for contracting illness: "Hotels, college campuses, and birthday parties are other examples of the same [constrained space], and it is at any of these that infectious diseases can spread," he says.

If you are scheduled to take a cruise in the coming months (and have become increasingly worried about coronavirus—or are hesitant because of other illnesses), there are steps you can take, according to Dr. Brown, to ensure your health as much as possible.

"If you are a person with an immune system that is not fully working, you should avoid large gatherings in the winter months when viruses like influenza are widely circulating,” Dr. Brown suggests. This includes people who are being treated with chemotherapy or who need to take steroids.

Additionally, you should cover your face when you sneeze to avoid spreading germs, and wash your hands frequently. And definitely stay home if you feel under the weather, to avoid spreading your germs to others. “These simple measures are remarkably effective,” he explains—that means for preventing everything from coronavirus to the flu.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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