ArticleJournal of travel medicine2025
Mitigating norovirus spread on cruise ships: a model-based assessment of diagnostic timing and isolation.
Article in Journal of travel medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- From Norovirus to Andes Hantavirus: Indirect Viral Transmission and Emerging Prevention Strategies for Cruise Ship and Confined Environments.Reviews in medical virology · 2026Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAcute gastroenteritis outbreaks caused by noroviruses are a common public health issue on cruise ships. Understanding the main drivers of sustained outbreaks is critical for evaluating the effectiveness of preventive interventions such as the isolation of infected individuals.
methodsWe analysed a line-list of 121 cases from a norovirus outbreak on a cruise visiting Mediterranean ports (cumulative incidence among passengers 9.7%). We used a Bayesian inference model to reconstruct likely transmission chains, taking into account different transmission settings and the isolation of cases after diagnosis. We then calibrated a branching process model to simulate alternative isolation scenarios and estimate their effectiveness in reducing transmission.
resultsReconstructed transmission chains revealed a high heterogeneity in individual transmission, with 57% [95% credible interval (CrI): 48-65%] of secondary cases caused by 10% of infected individuals (here termed 'superspreaders'). Superspreaders exhibited longer diagnostic delays (mean 83 hours, 95% CrI: 70-96 hours) compared to other infectors (mean 47 hours, 95% CrI: 44-50 hours) and a halved frequency of vomiting and diarrhoea episodes. The 72-hour isolation protocol implemented during the outbreak averted 71% of potential cases compared to a no-intervention scenario, halving the effective reproduction number from 9.8 (95% CrI of the mean: 7.1-12.7) to 4.9 (95% CrI: 3.0-7.1). Reducing diagnostic delays further reduced the effective reproduction number, resulting in lower case numbers and probability of sustained outbreaks.
conclusionsTimely diagnosis and isolation have a remarkable impact on norovirus containment on cruise ship outbreaks. Targeted information campaigns encouraging passengers to seek immediate medical assistance upon gastrointestinal symptoms can significantly improve outbreak management.
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