@article{oai:nagasaki-u.repo.nii.ac.jp:00026893,
 author = {Maeda, Haruka and Sando, Eiichiro and Toizumi, Michiko and Arima, Yuzo and Shimada, Tomoe and Tanaka, Takeshi and Tashiro, Masato and Fujita, Ayumi and Yanagihara, Katsunori and Takayama, Hayato and Yasuda, Ikkoh and Kawachi, Nobuyuki and Kohayagawa, Yoshitaka and Hasegawa, Maiko and Motomura, Katsuaki and Fujita, Rie and Nakata, Katsumi and Yasuda, Jiro and Morita, Koichi and Kohno, Shigeru and Izumikawa, Koichi and Suzuki, Motoi and Morimoto, Konosuke},
 issue = {9},
 journal = {Emerging Infectious Diseases},
 month = {Sep},
 note = {In April 2020, a coronavirus disease (COVID-19) outbreak occurred on the cruise ship Costa Atlantica in Nagasaki, Japan. Our outbreak investigation included 623 multinational crewmembers onboard on April 20. Median age was 31 years; 84% were men. Each crewmember was isolated or quarantined in a single room inside the ship, and monitoring of health status was supported by a remote health monitoring system. Crewmembers with more severe illness were hospitalized. The investigation found that the outbreak started in late March and peaked in late April, resulting in 149 laboratory-confirmed and 107 probable cases of infection with severe acute respiratory syndrome coronavirus 2. Six case-patients were hospitalized for COVID-19 pneumonia, including 1 in severe condition and 2 who required oxygen administration, but no deaths occurred. Although the virus can spread rapidly on a cruise ship, we describe how prompt isolation and quarantine combined with a sensitive syndromic surveillance system can control a COVID-19 outbreak., Emerging Infectious Diseases, 27(9), pp. 2251-2260; 2021},
 pages = {2251--2260},
 title = {Epidemiology of Coronavirus Disease Outbreak among Crewmembers on Cruise Ship, Nagasaki City, Japan, April 2020},
 volume = {27},
 year = {2021}
}