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Abstract
Brotherton
JM, Delpech VC, Gilbert GL, Hatzi S,
Paraskevopoulos PD,
McAnulty JM. "A large outbreak of influenza A and B on cruise ship
causing widespread morbidity," Epidemiology
and Infection, 2003,
130:2 (April), 263-71.
In September 2000 an outbreak of influenza-like illness was
reported on a cruise ship sailing between Sydney and Noumea with over
1,100 passengers and 400 crew on board. Laboratory testing of
passengers and crew indicated that both influenza A and B had been
circulating on the ship. The cruise coincided with the peak influenza
period in Sydney. Morbidity was high with 40 passengers hospitalized,
two of whom died. A questionnaire was sent to passengers 3 weeks after
the cruise and 836 of 1,119 (75%) responded. A total of 310 passengers
(37%) reported suffering from an influenza-like illness (defined as
cough, fever, myalgia and weakness) and 528 (63%) had seen a doctor for
illness related to the cruise. One-third of passengers reported receipt
of influenza vaccination in 2000; however neither their rates of
influenza-like illness nor hospitalization were significantly different
from those in unvaccinated passengers. A case-control study also found
no significant protective effect of influenza vaccination. With the
increasing popularity of cruise vacations, such outbreaks are likely to
affect increasing numbers of people. Whilst influenza vaccination of
passengers and crew may afford some protection, uptake and
effectiveness may not be sufficient to prevent outbreaks. Surveillance
systems and early intervention measures, such as antiviral therapies,
should be considered to detect and control such outbreaks.
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