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Volume 27, Number 9—September 2021
Synopsis

Epidemiology of Coronavirus Disease Outbreak among Crewmembers on Cruise Ship, Nagasaki City, Japan, April 2020

Haruka Maeda1, Eiichiro Sando1, Michiko Toizumi1, Yuzo Arima1, Tomoe Shimada, Takeshi Tanaka, Masato Tashiro, Ayumi Fujita, Katsunori Yanagihara, Hayato Takayama, Ikkoh Yasuda, Nobuyuki Kawachi, Yoshitaka Kohayagawa, Maiko Hasegawa, Katsuaki Motomura, Rie Fujita, Katsumi Nakata, Jiro Yasuda, Koichi Morita, Shigeru Kohno, Koichi Izumikawa, Motoi Suzuki2, and Konosuke Morimoto2Comments to Author 
Author affiliations: Nagasaki University, Nagasaki, Japan (H. Maeda, E. Sando, M. Toizumi, T. Tanaka, M. Tashiro, A. Fujita, K. Yanagihara, H. Takayama, I. Yasuda, N. Kawachi, J. Yasuda, K. Morita, S. Kohno, K. Izumikawa, K. Morimoto); Fukushima Medical University, Fukushima, Japan (E. Sando, I. Yasuda); National Institute of Infectious Diseases, Tokyo, Japan (Y. Arima, T. Shimada, M. Suzuki); Disaster Medical Center of Japan, Tokyo (Y. Kohayagawa); Nagasaki Prefecture Government, Nagasaki (M. Hasegawa, K. Nakata); Nagasaki City Public Health Center, Nagasaki (K. Motomura); Northern Nagasaki Public Health Center, Nagasaki (R. Fujita)

Main Article

Table 1

Selected characteristics of crewmembers on cruise ship where a coronavirus disease outbreak occurred, by SARS-CoV-2 test result and symptomatic status, Nagasaki, Japan, 2020*

Characteristic All crewmembers Test-positive, n = 149
Test-negative, n = 474
Symptomatic Asymptomatic Symptomatic Asymptomatic
Total
623 (100)
96 (100)
53 (100)

107 (100)
367 (100)
Age, y
Median (IQR) 31 (26–40) 32 (27–39) 32 (23–42) 29 (25–35) 31 (26–41)
Distribution
10–19 3 (0.5) 1 (1.0) 1 (1.9) 0 1 (0)
20–29 271 (43) 37 (39) 20 (38) 55 (51) 159 (43)
30–39 184 (30) 36 (38) 14 (26) 33 (31) 101 (28)
40–49 123 (20) 17 (18) 15 (28) 13 (12) 78 (21)
50–59 34 (5.5) 4 (4.2) 2 (3.8) 6 (5.6) 22 (6.0)
>60
8 (1.3)
1 (1.0)
1 (1.9)

0
6 (1.6)
Sex
M 523 (84) 82 (85) 46 (87) 88 (82) 307 (84)
F
100 (16)
14 (15)
7 (13)

19 (18)
60 (16)
Nationality
Philippines 206 (33) 35 (36) 6 (11) 40 (37) 125 (34)
India 104 (17) 16 (17) 14 (26) 16 (15) 58 (16)
Indonesia 84 (13) 10 (10) 13 (25) 13 (12) 48 (13)
China 82 (13) 14 (15) 7 (13) 13 (12) 48 (13)
Italy 40 (6.4) 5 (5.2) 3 (5.7) 6 (5.6) 26 (7.1)
Other
107 (17)
16 (17)
10 (19)

19 (18)
62 (17)
Occupation category
Essential worker
Engine 75 (12) 6 (6.3) 11 (21) 10 (8.1) 48 (13)
Hotel 73 (12) 13 (14) 3 (5.7) 6 (5.0) 51 (14)
Deck 70 (11) 11 (11) 10 (19) 11 (9.4) 38 (10)
Nonessential worker
Restaurant 96 (15) 13 (14) 6 (11) 21 (20) 56 (15)
Galley 77 (12) 18 (19) 5 (9.4) 22 (21) 32 (8.7)
Housekeeping 72 (12) 8 (8.3) 7 (13) 7 (6.5) 50 (14)
Entertainment 49 (7.9) 8 (8.3) 6 (11) 13 (12) 22 (6.0)
Technician 21 (3.4) 4 (4.2) 2 (3.8) 3 (2.8) 12 (3.3)
Others
90 (14)
15 (16)
3 (5.7)

14 (13)
58 (16)
Smoking history, n = 592†
Yes
148 (25)
20 (22)
13 (28)

36 (35)
79 (23)
Underlying disease, n = 593†‡
Any 22 (3.7) 5 (5.5) 2 (4.4) 2 (1.9) 13 (3.7)
Hypertension 12 (3.0) 2 (2.2) 1 (2.2) 0 9 (2.6)
Diabetes 10 (1.7) 1 (1.1) 1 (2.2) 0 8 (2.3)
Cardiovascular disease 1 (0.2) 1 (1.1) 0 0 0
Asthma
1 (0.2)
0
0

1 (1.0)
0
BMI, n = 523†
Median (IQR) 24.1 (21.7–26.7) 23.6 (21.3–26.0) 24.7 (21.6–28.0) 23.9 (21.3–26.7) 24.1 (22.0–26.5)
Distribution
Underweight, BMI < 18.5 29 (5.5) 5 (6.2) 3 (7.5) 2 (2.0) 19 (6.3)
Normal, 18.5 < BMI < 25 278 (53) 45 (56) 18 (45) 58 (59) 157 (52)
Overweight, 25 < BMI < 30 167 (32) 22 (27) 15 (36) 27 (28) 103 (34)
Obese, BMI >30 49 (9.4) 9 (11) 4 (10) 11 (11) 25 (8.2)

*Values are no. (%) except as indicated. Symptomatic was defined as having any clinical sign or symptom of coronavirus disease (i.e., fever (>37.5°C), cough, shortness of breath, nasal congestion, sore throat, nausea or vomiting, conjunctival congestion, headache, fatigue, myalgia or arthralgia, diarrhea, olfactory dysfunction, or taste disorder [loss of taste]). BMI, body mass index; IQR, interquartile range, SARS-CoV-2, severe acute respiratory coronavirus 2. †Among crewmembers who entered data into the health monitoring system since its introduction on April 28, 2020. ‡Two crewmembers had both hypertension and diabetes.

Main Article

1These authors contributed equally to this article.

2These authors were co–principal investigators.

Page created: June 28, 2021
Page updated: August 17, 2021
Page reviewed: August 17, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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