Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway
Objective: To improve understanding of SARS-CoV-2-transmission and prevention measures on cruise ships, we investigated a Norwegian cruise ship outbreak from July to August 2020 using a multidisciplinary approach after a rapid outbreak response launched by local and national health authorities. Meth...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222001047 |
| _version_ | 1818127656134115328 |
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| author | Kirsten Gravningen Stian Henriksen Olav Hungnes Kristian Svendsen Emily MacDonald Henrik Schirmer Kathrine Stene-Johansen Gunnar Skov Simonsen Oliver Kacelnik Petter Elstrøm Karoline Bragstad Christine Hanssen Rinaldo |
| author_facet | Kirsten Gravningen Stian Henriksen Olav Hungnes Kristian Svendsen Emily MacDonald Henrik Schirmer Kathrine Stene-Johansen Gunnar Skov Simonsen Oliver Kacelnik Petter Elstrøm Karoline Bragstad Christine Hanssen Rinaldo |
| author_sort | Kirsten Gravningen |
| collection | DOAJ |
| description | Objective: To improve understanding of SARS-CoV-2-transmission and prevention measures on cruise ships, we investigated a Norwegian cruise ship outbreak from July to August 2020 using a multidisciplinary approach after a rapid outbreak response launched by local and national health authorities. Methods: We conducted a cross-sectional study among crew members using epidemiologic data and results from SARS-CoV-2 polymerase chain reaction (PCR) of nasopharynx-oropharynx samples, antibody analyses of blood samples, and whole-genome sequencing. Results: We included 114 multinational crew members (71% participation), median age 36 years, and 69% male. The attack rate was 33%; 32 of 37 outbreak cases were seropositive 5-10 days after PCR. One PCR-negative participant was seropositive, suggesting a previous infection. Network-analysis showed clusters based on common exposures, including embarkation date, nationality, sharing a cabin with an infected cabin-mate (adjusted odds ratio [AOR] 3.27; 95% confidence interval [CI] 0.97-11.07, p = 0.057), and specific workplaces (mechanical operations: 9.17 [1.82-45.78], catering: 6.11 [1.83-20.38]). Breaches in testing, quarantine, and isolation practices before/during expeditions were reported. Whole-genome sequencing revealed lineage B.1.36, previously identified in Asia. Despite extensive sequencing, the continued transmission of B.1.36 in Norway was not detected. Conclusions: Our findings confirm the high risk of SARS-CoV-2-transmission on cruise ships related to workplace and cabin type and show that continued community transmission after the outbreak could be stopped by implementing immediate infection control measures at the final destination. |
| first_indexed | 2024-12-11T07:20:49Z |
| format | Article |
| id | doaj.art-319b39f43a5d4b14b84e06e87ecc7438 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T07:20:49Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-319b39f43a5d4b14b84e06e87ecc74382022-12-22T01:16:05ZengElsevierInternational Journal of Infectious Diseases1201-97122022-05-011181020Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in NorwayKirsten Gravningen0Stian Henriksen1Olav Hungnes2Kristian Svendsen3Emily MacDonald4Henrik Schirmer5Kathrine Stene-Johansen6Gunnar Skov Simonsen7Oliver Kacelnik8Petter Elstrøm9Karoline Bragstad10Christine Hanssen Rinaldo11Norwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, Norway; Corresponding author: Norwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, Norway.Department of Microbiology and Infection Control, University Hospital of North Norway, 9019 Tromsø, Norway; UiT The Arctic University of Norway, 9019 Tromsø, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayUiT The Arctic University of Norway, 9019 Tromsø, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayDepartment of Cardiology, Akershus University Hospital, 1478 Nordbyhagen, Norway; Department of Clinical Medicine, Campus Ahus, University of Oslo, 1478 Nordbyhagen, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayDepartment of Microbiology and Infection Control, University Hospital of North Norway, 9019 Tromsø, Norway; UiT The Arctic University of Norway, 9019 Tromsø, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayNorwegian Institute of Public Health, PB 222 Skøyen, 0213 Oslo, NorwayDepartment of Microbiology and Infection Control, University Hospital of North Norway, 9019 Tromsø, Norway; UiT The Arctic University of Norway, 9019 Tromsø, NorwayObjective: To improve understanding of SARS-CoV-2-transmission and prevention measures on cruise ships, we investigated a Norwegian cruise ship outbreak from July to August 2020 using a multidisciplinary approach after a rapid outbreak response launched by local and national health authorities. Methods: We conducted a cross-sectional study among crew members using epidemiologic data and results from SARS-CoV-2 polymerase chain reaction (PCR) of nasopharynx-oropharynx samples, antibody analyses of blood samples, and whole-genome sequencing. Results: We included 114 multinational crew members (71% participation), median age 36 years, and 69% male. The attack rate was 33%; 32 of 37 outbreak cases were seropositive 5-10 days after PCR. One PCR-negative participant was seropositive, suggesting a previous infection. Network-analysis showed clusters based on common exposures, including embarkation date, nationality, sharing a cabin with an infected cabin-mate (adjusted odds ratio [AOR] 3.27; 95% confidence interval [CI] 0.97-11.07, p = 0.057), and specific workplaces (mechanical operations: 9.17 [1.82-45.78], catering: 6.11 [1.83-20.38]). Breaches in testing, quarantine, and isolation practices before/during expeditions were reported. Whole-genome sequencing revealed lineage B.1.36, previously identified in Asia. Despite extensive sequencing, the continued transmission of B.1.36 in Norway was not detected. Conclusions: Our findings confirm the high risk of SARS-CoV-2-transmission on cruise ships related to workplace and cabin type and show that continued community transmission after the outbreak could be stopped by implementing immediate infection control measures at the final destination.http://www.sciencedirect.com/science/article/pii/S1201971222001047Outbreak investigationCruise shipCOVID-19EpidemiologyImmunityWhole-genome sequencing |
| spellingShingle | Kirsten Gravningen Stian Henriksen Olav Hungnes Kristian Svendsen Emily MacDonald Henrik Schirmer Kathrine Stene-Johansen Gunnar Skov Simonsen Oliver Kacelnik Petter Elstrøm Karoline Bragstad Christine Hanssen Rinaldo Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway International Journal of Infectious Diseases Outbreak investigation Cruise ship COVID-19 Epidemiology Immunity Whole-genome sequencing |
| title | Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway |
| title_full | Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway |
| title_fullStr | Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway |
| title_full_unstemmed | Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway |
| title_short | Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway |
| title_sort | risk factors immune response and whole genome sequencing of sars cov 2 in a cruise ship outbreak in norway |
| topic | Outbreak investigation Cruise ship COVID-19 Epidemiology Immunity Whole-genome sequencing |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222001047 |
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