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Kitaya S, Baba H, Okamoto M, Sakamoto M, Nakayama A, Takei Y, Seike I, Takei K, Oshima K, Tokuda K, Shiga T, Kanamori H. Severe pneumonia due to Legionella and SARS-CoV-2 co-infection necessitating medical evacuation from a cargo ship. J Travel Med 2023; 30:taad067. [PMID: 37158457 DOI: 10.1093/jtm/taad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Abstract
Cargo ships are at risk of disease outbreaks like Legionella and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to their cramped and shared conditions. A case of medical evacuation due to co-infection of Legionella pneumophila with SARS-CoV-2 highlights the need for international infection control guidelines, information networks and molecular epidemiological approaches for identifying infection routes.
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Affiliation(s)
- Shiori Kitaya
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Hiroaki Baba
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan
| | - Masahiro Sakamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan
| | - Asami Nakayama
- Department of Laboratory Medicine, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan
| | - Yumiko Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Issei Seike
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Kentarou Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Kengo Oshima
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Koichi Tokuda
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Takuya Shiga
- Intensive Care Unit, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan
| | - Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
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Kordsmeyer AC, Mojtahedzadeh N, Heidrich J, Militzer K, von Münster T, Belz L, Jensen HJ, Bakir S, Henning E, Heuser J, Klein A, Sproessel N, Ekkernkamp A, Ehlers L, de Boer J, Kleine-Kampmann S, Dirksen-Fischer M, Plenge-Bönig A, Harth V, Oldenburg M. Systematic Review on Outbreaks of SARS-CoV-2 on Cruise, Navy and Cargo Ships. Int J Environ Res Public Health 2021; 18:ijerph18105195. [PMID: 34068311 PMCID: PMC8153346 DOI: 10.3390/ijerph18105195] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
The confined environment of a ship promotes the transmission of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) due to close contact among the population on board. The study aims to provide an overview of outbreaks of SARS-CoV-2 on board of cruise, navy or cargo ships, to identify relevant outbreak management techniques, related problems and to derive recommendations for prevention. Four databases were searched. The study selection included reports about seroprevalences or clinically/laboratory confirmed infections of SARS-CoV-2 on board ships between the first of January, 2020 and the end of July, 2020. A total of 37 studies were included of whom 33 reported outbreaks of SARS-CoV-2 on cruise ships (27 studies referred to the Diamond Princess). Two studies considered outbreaks on the Grand Princess, three studies informed about Nile River cruises and one study about the MS Westerdam (mention of multiple outbreaks possible in one study). Additionally, three studies reported outbreaks of SARS-CoV-2 on navy vessels and one study referred to a cargo ship. Problems in handling outbreaks resulted from a high number of asymptomatic infections, transportation issues, challenges in communication or limited access to health care. Responsible operators need to implement infection control measures which should be described in outbreak management plans for ships to prevent transmission risks, including, e.g., education, testing strategies, communication lines, social distancing and hygiene regulations.
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Affiliation(s)
- Ann-Christin Kordsmeyer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
- Correspondence:
| | - Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Jan Heidrich
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Kristina Militzer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Thomas von Münster
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Lukas Belz
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Hans-Joachim Jensen
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Sinan Bakir
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Esther Henning
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Julian Heuser
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Angelina Klein
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Nadine Sproessel
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Axel Ekkernkamp
- Department of Trauma and Reconstructive Surgery and Rehabilitative Medicine, Medical University Greifswald, 17475 Greifswald, Germany; (S.B.); (E.H.); (J.H.); (A.K.); (N.S.); (A.E.)
| | - Lena Ehlers
- Hamburg Port Health Center (HPHC), Institute for Hygiene and Environment, 20537 Hamburg, Germany; (L.E.); (J.d.B.); (S.K.-K.); (M.D.-F.)
| | - Jens de Boer
- Hamburg Port Health Center (HPHC), Institute for Hygiene and Environment, 20537 Hamburg, Germany; (L.E.); (J.d.B.); (S.K.-K.); (M.D.-F.)
| | - Scarlett Kleine-Kampmann
- Hamburg Port Health Center (HPHC), Institute for Hygiene and Environment, 20537 Hamburg, Germany; (L.E.); (J.d.B.); (S.K.-K.); (M.D.-F.)
| | - Martin Dirksen-Fischer
- Hamburg Port Health Center (HPHC), Institute for Hygiene and Environment, 20537 Hamburg, Germany; (L.E.); (J.d.B.); (S.K.-K.); (M.D.-F.)
| | - Anita Plenge-Bönig
- Infectious Diseases Surveillance Center, Institute for Hygiene and Environment, 20539 Hamburg, Germany;
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
| | - Marcus Oldenburg
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (J.H.); (K.M.); (T.v.M.); (L.B.); (H.-J.J.); (V.H.); (M.O.)
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