Journal Article

Cruise Ships: High-Risk Passengers and the Global Spread of New Influenza Viruses

Joy M. Miller, Theresa W. S. Tam, Susan Maloney, Keiji Fukuda, Nancy Cox, James Hockin, Daniel Kertesz, Alexander Klimov and Martin Cetron

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 2, pages 433-438
Published in print August 2000 | ISSN: 1058-4838
Published online August 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313974
Cruise Ships: High-Risk Passengers and the Global Spread of New Influenza Viruses

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In 1997, passengers on North American cruises developed acute respiratory illnesses (ARIs); influenza was suspected. We reviewed 1 ship's medical records for 3 cruises: cruise 1 (31 August to 10 September 1997), cruise 2 (11–20 September 1997), and cruise 3 (20–30 September 1997). Medically attended ARI was defined as any 2 of the following symptoms: fever (temperature, ≥37.8°C) or feverishness, sore throat, cough, nasal congestion, chills, myalgia, and arthralgia. During cruise 2, we collected nasopharyngeal swabs for viral culture from people with ARI and surveyed passengers for self-reported ARI (defined as above except feverishness was substituted for fever). The outbreak probably began among Australian passengers on cruise 1 (relative risk, 3.3; 95% confidence interval, 1.89–5.77). Of 1284 passengers on cruise 2, 215 (17%) reported ARI, 994 (77%) were aged ≥65 years, and 336 (26%) had other risk factors for respiratory complications. An influenza strain not previously identified in North America was isolated. We concluded that an “off-season” influenza outbreak occurred among international travelers and crew on board this cruise ship.

Journal Article.  4039 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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