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Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection

When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013 by f...

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Autores principales: Mouchtouri, Varvara A, Verykouki, Eleni, Zamfir, Dumitru, Hadjipetris, Christos, Lewis, Hannah C, Hadjichristodoulou, Christos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718393/
https://www.ncbi.nlm.nih.gov/pubmed/29162205
http://dx.doi.org/10.2807/1560-7917.ES.2017.22.45.16-00576
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author Mouchtouri, Varvara A
Verykouki, Eleni
Zamfir, Dumitru
Hadjipetris, Christos
Lewis, Hannah C
Hadjichristodoulou, Christos
author_facet Mouchtouri, Varvara A
Verykouki, Eleni
Zamfir, Dumitru
Hadjipetris, Christos
Lewis, Hannah C
Hadjichristodoulou, Christos
author_sort Mouchtouri, Varvara A
collection PubMed
description When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013 by five seagoing cruise ships were analysed to identify attack rate thresholds for early outbreak detection. The overall incidence rate of AG was 2.81 cases per 10,000 traveller-days (95% confidence interval (CI): 0.00–17.60), while the attack rate was 19.37 cases per 10,000 travellers (95% CI: 0.00–127.69). The probability of an outbreak occurring was 11% if 4 per 1,000 passengers reported symptoms within the first 2 days of the voyage, and this increased to 23 % if 5 per 1,000 passengers reported such within the first 3 days. The risk ratio (RR) for outbreak occurrence was 2.35, 5.66 and 8.63 for 1, 2 and 3 days’ delay of symptoms reporting respectively, suggesting a dose–response relationship. Shipping companies’ policies and health authorities’ efforts may consider these thresholds for initiating outbreak response measures based on the number of cases according to day of cruise. Efforts should focus on ensuring travellers report symptoms immediately and comply with isolation measures.
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spelling pubmed-57183932017-12-20 Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection Mouchtouri, Varvara A Verykouki, Eleni Zamfir, Dumitru Hadjipetris, Christos Lewis, Hannah C Hadjichristodoulou, Christos Euro Surveill Surveillance and Outbreak Report When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013 by five seagoing cruise ships were analysed to identify attack rate thresholds for early outbreak detection. The overall incidence rate of AG was 2.81 cases per 10,000 traveller-days (95% confidence interval (CI): 0.00–17.60), while the attack rate was 19.37 cases per 10,000 travellers (95% CI: 0.00–127.69). The probability of an outbreak occurring was 11% if 4 per 1,000 passengers reported symptoms within the first 2 days of the voyage, and this increased to 23 % if 5 per 1,000 passengers reported such within the first 3 days. The risk ratio (RR) for outbreak occurrence was 2.35, 5.66 and 8.63 for 1, 2 and 3 days’ delay of symptoms reporting respectively, suggesting a dose–response relationship. Shipping companies’ policies and health authorities’ efforts may consider these thresholds for initiating outbreak response measures based on the number of cases according to day of cruise. Efforts should focus on ensuring travellers report symptoms immediately and comply with isolation measures. European Centre for Disease Prevention and Control (ECDC) 2017-11-09 /pmc/articles/PMC5718393/ /pubmed/29162205 http://dx.doi.org/10.2807/1560-7917.ES.2017.22.45.16-00576 Text en This article is copyright of The Authors, 2017. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Surveillance and Outbreak Report
Mouchtouri, Varvara A
Verykouki, Eleni
Zamfir, Dumitru
Hadjipetris, Christos
Lewis, Hannah C
Hadjichristodoulou, Christos
Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title_full Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title_fullStr Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title_full_unstemmed Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title_short Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
title_sort gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection
topic Surveillance and Outbreak Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718393/
https://www.ncbi.nlm.nih.gov/pubmed/29162205
http://dx.doi.org/10.2807/1560-7917.ES.2017.22.45.16-00576
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