Experts Race To Write Guidance To Contain First Ship-Borne Hantavirus Outbreak

As the cruise ship hit ​by a hantavirus outbreak sails towards Tenerife, World Health Organization officials are racing to draw up step-by-step guidance for what should happen ‌next for the nearly 150 passengers when they finally reach land on Sunday.

MV Hondius, a Netherlands-registered specialist cruise vessel

The hantavirus outbreak – which has killed three people among at least eight suspected or confirmed infections - is the first ever recorded on a cruise ship, so some new protocols are needed.

Half a dozen current and former WHO officials and hantavirus experts said the outbreak could be managed by adapting ​standard public health steps, like isolating sick passengers or those who may have been in contact with them. None of the passengers ​on the ship now have symptoms, the ship's operator has said.

TIPS FROM ARGENTINA

Officials are also seeking tips from Argentina, where ⁠a previous outbreak of the Andes virus, the same strain as on the ship, was snuffed out in 2019. “If we follow public health measures and ​the lessons we learned from Argentina ... we can break this chain of transmission. This doesn't need to be a large epidemic,” Abdi Rahman Mahamud, director ​of the WHO's alert and response coordination department, said.

He said the focus was on isolation for sick people, and monitoring and quarantining for other passengers, subject to national government decisions.

The WHO may also recommend that some people with links to the outbreak take their temperature daily for at least 42 days as the Andes strain has a long incubation ​period, Anais Legand, WHO technical officer for viral threats, said at an online briefing on Friday.

National authorities may also be asked to set up regular ​contact with those people, and give them a phone number to call if they feel at all unwell, she added.

Passengers are being split into high-risk and low-risk contacts ‌based on ⁠their interactions with sick travellers, the WHO said. Contact-tracing is also key for any who have left the ship already.

The Andes hantavirus is known to spread through close and prolonged contact, and chiefly when a patient is already symptomatic. That information is based largely on the one outbreak where the Andes virus spread between people in Argentina in 2018-19, in which 34 people were infected and 11 died.

“We essentially learned that once you implement basic measures of social ​distancing, that are essentially very simple – ​stay home when you are not ⁠feeling well – that diminished the circulation and the outbreak burned out,” said Gustavo Palacios, a professor at Icahn School of Medicine at Mount Sinai, in the United States, who is originally from Argentina and a co-author of a ​key paper on that outbreak.

He and others have been advising WHO on the outbreak since May 2, he ​said, adding he hoped ⁠more attention would now be paid to the risks of hantaviruses, which can have fatality rates of up to 50%.

SOME PLANS IN PLACE

Some governments are already making plans: the UK government said on Friday morning it would repatriate its citizens on a flight under strict infection-control measures, and then passengers would be asked to isolate for ⁠45 days, ​with testing as required.

Krutika Kuppalli, associate professor of medicine at the University of Texas Southwestern ​Medical Center in the U.S., who formerly worked on mpox protocols at the WHO, said measures could be taken from previous outbreaks.

“It’s the same principle as for measles, or Ebola. Contact tracing ​doesn’t change,” she said.

The WHO said late on Thursday it was still finalizing guidelines.

Reporting by Jennifer Rigby; additional reporting by Sriparna Roy; Editing by Andrew Heavens

CDC Extends Cruise Line Health Rules Until Mid-January

WASHINGTON (AP) — Federal health officials on Monday extended for nearly three more months its rules that cruise ships must follow to sail during the pandemic.

The U.S. Centers for Disease Control and Prevention said the extension makes only “minor modifications” to rules already in effect. The agency said that after Jan. 15, it plans to move to a voluntary program for cruise companies to detect and control the spread of COVID-19 on their ships.

The current regulations, called a conditional sailing order, were scheduled to expire on Nov. 1.

The CDC imposed the first no-sail order on cruise lines in March 2020, after most companies sailing in U.S. waters had agreed to suspend voyages. The CDC issue technical guidelines for the industry five months later, and began approving trial sailings this spring.

Cruises have since sailed from Florida and other parts of the country. Most lines require adult passengers to show proof of vaccination against COVID-19.

The CDC noted on Twitter that since it first issued restrictions on sailing, cruise lines have developed and implemented health and safety protocols to manage COVID-19 and have resumed cruising.

A cruise industry trade group pledged to continue working with CDC on health measures on board ships. It cited the CDC announcement as evidence that lines have made a successful — if only partial — return since the pandemic shut down the industry worldwide.

Laziza Lambert, a spokeswoman for the Cruise Lines International Association, said in a statement that, “Cruising has successfully resumed in the United States” with measures that have limited the risk of COVID-19 for passengers and crew members. She said the CDC announcement shows that the health agency and the Biden administration “recognize the cruise industry’s successful resumption of operations.”

Industry officials have complained that the government took a much tougher stance against cruising — shutting it down entirely last year — than it took toward airlines and other parts of the travel industry.

Royal Caribbean To Require A Negative Covid-19 Test Before All U.S. Sailings 5+ Nights

Royal Caribbean is adding a new requirement for sailings from the United States that will require proof of a negative Covid-19 test result in order to sail.

With increasing Covid-19 case counts around the country, Royal Caribbean has announced the policy change "in an abundance of caution".

All guests over the age of 2 will be required to provide a negative Covid-19 test, regardless of vaccine status, prior to boarding on sailings 5-night or longer.

The new policy is effective for all U.S. sailings between July 31 and August 31.

The test must be administered no more than three days prior to sailing and proof of negative results must be shown at check-in. Either PCR or antigen tests are acceptable.

The results can be printed out, or can be presented on your phone, such as the email result from your test provider. Costs associated with this test are the guests' responsibility.

There are no other changes to requirements and policies previously announced by Royal Caribbean.

Example of the new policy shared on Royal Caribbean's website

In a statement by the cruise line, the change is being done as a precaution, "This is an additional layer of precaution to ensure the safety of everyone onboard. We will continue to monitor public health circumstances as they evolve and make necessary adjustments to our protocols."

Here is a copy of the full statement Royal Caribbean made:

In an abundance of caution, and to ensure that our guests, crew and the communities we visit remain healthy we are requiring all guests over the age of 2, regardless of vaccine status, to provide a negative COVID-19 test prior to boarding on sailings 5-night or longer. This new policy is for all sailings in the U.S. from July 31 to August 31. The test must be administered no more than three days prior to sailing and proof of negative results must be shown at check-in.

All other testing requirements and policies are still in place. This is an additional layer of precaution to ensure the safety of everyone onboard. We will continue to monitor public health circumstances as they evolve and make necessary adjustments to our protocols.

Prior to this change, unvaccinated passengers were required to get multiple Covid-19 tests, but not vaccinated passengers.

Unvaccinated passengers were required to get tested at the terminal prior to embarkation and onboard prior to disembarkation.

Royal Caribbean requires negative test results for passengers sailing on Adventure of the Seas from Nassau, Bahamas, but this is the first time since sailings restarted that a test result for all passengers has been implemented in the United States.

For at least cruises on sailings this weekend, there may be a short-term option to get tested near the cruise port.

Guests sailing on Odyssey of the Seas for the July 31st sailing will have an option to show up to the port and get off-site testing completed nearby. It is not clear which other sailings will have this opportunity as well.

The cruise industry is not the only business making changes to ensure the safety of their customers.

Walt Disney World announced this week it would require face masks again for its customers while indoors, and Lollapalooza will require either proof of vaccination or a negative test for the viral infection within the past three days.

Source: https://www.royalcaribbeanblog.com/

Air On Board Cruise Ships 'Is Twice As Bad As At Piccadilly Circus'

Breath of fresh air? Passengers on the sundeck of P&O’s Oceana. Photograph: Greg Balfour Evans/Alamy

A C4 Dispatches investigation reveals how ultra-fine particles emitted by cruise liners’ engines are worrying both medical scientists and environmentalists

Passengers on cruise ships could be exposing themselves to dangerous levels of pollution, according to an investigation by Channel 4’s Dispatches team that found some public areas on the ships’ decks were more polluted than the world’s worst-affected cities.

The undercover investigation, which will be broadcast tonight at 8pm, focused on the levels of “ultra-fine particles” found in the air on and around cruise ships, from the fuel the ships’ engines burn. These particles are so small – around a thousandth of the width of a human hair – that they can enter the bloodstream via the lungs.

More than 1.9 million people from the UK travel on a cruise each year and there is growing concern among the scientific community about the health risks.

Dispatches used a P-Trak ultrafine particle counter to measure the ultra-fine particulates suspended in the air on board P&O Cruises’ ship Oceana. The Oceana is more than 250 metres long, 15 storeys high and can carry more than 2,000 passengers.

The device found 84,000 ultra-fine particulates per cubic centimetre on the deck downwind of, and directly next to, the Oceana’s funnels. That’s more than double the amount found at London’s Piccadilly Circus, where the number of ultra-fine particulates per cubic centimetre was 38,400.

Speaking to the Guardian, Dr Matthew Loxham, a specialist in air pollution at the University of Southampton, said these were the levels of pollution you would expect to find in cities such as Delhi or Shanghai. As for the health risks, there is, he says, cause for concern.

'One cruise ships emits as much particulates as a million cars, so 30 ships pollute as much as all the cars in the UK'

Daniel Rieger, environmentalist

“From a scientific point of view, we know that pollution causes adverse health effects even in the short term,” he said. “On a ship deck, you’re exposed to higher levels of pollution so you may get symptoms such as runny nose, cough, dry eyes or a higher risk of asthma attacks. For those that are predisposed, there may be a higher risk of stroke or heart attack.”

However he added that it is difficult to quantify the increase in risk for individual passengers.

“If you had a large enough number of people, you would be likely to see a quantifiable increase,” he said. “But it’s difficult to say with individuals. Asthmatics, particularly, might find it harder to breath, need their medication more, or find the air triggers an asthma attack.”

Large ships run on heavy fuel oil, which is legally permitted to contain 3.5% sulphur – that’s 3,500 times what is permitted in road fuel. In EU ports and waters, ships are legally required to switch to a cleaner diesel, but even this, capped at 0.1% sulphur, is allowed to contain up to 100 times more sulphur than road fuel.

Loxham said: “If the cruise ships are complying with the law and there is still this level of pollutants, the question really is: are these laws fit for purpose?”

As well as impacting on the health of passengers, crew and those who live beside docks, cruise ships are also having an impact on the global environment.

John Maggs, president of the Clean Shipping Coalition, told Dispatches: “Most large ships burn heavy fuel oil. It’s a residual product from the refining industry, so after the refiners have produced the petrol and diesel we put in our cars, they’re left with what is essentially a waste product. It’s called residual fuel, or heavy fuel oil.”

From an environmental point of view, it’s bad because of the air pollution caused by the very high sulphur content. The shipping industry, however, has traditionally liked it because it’s much cheaper than other fuels.”

Also speaking to the Dispatch team, Daniel Rieger of the German environment association NABU (Nature And Biodiversity Conservation Union) said: “Ships cause not only greenhouse gas emissions, but also sulphur oxides, nitrogen oxides and particulate matter. Per day one cruise ship emits as much particulate matter as a million cars. So 30 cruise ships pollute as much as all the cars in the United Kingdom.”

Responding to the Dispatches team, P&O Cruises said: “Since 2005 we have reduced our fuel consumption by … 28%, with the accompanying reduction in air emissions.”

It added that the Oceana is to be fitted with exhaust gas cleaning systems, which are already “installed on 60 ships across its brands… This action significantly improves the quality of air emissions… Soot and particulate matter reductions in excess of 80% have been achieved.”

P&O also said that in 2014 it had reduced CO2 emissions by 20% and “has renewed its goal to continue reducing the rate”.

It said: “The health, safety and welfare of guests and crew across all our ships is our absolute highest priority… We recognise that there is a public interest… related to particulate matter and related health issues”.

By Will Coldwell