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dc.contributor.authorGravningen, Kirsten Midttun
dc.contributor.authorHenriksen, Stian
dc.contributor.authorHungnes, Olav
dc.contributor.authorSvendsen, Kristian
dc.contributor.authorMacdonald, Emily Ann
dc.contributor.authorSchirmer, Henrik
dc.contributor.authorStene-Johansen, Kathrine
dc.contributor.authorSimonsen, Gunnar Skov
dc.contributor.authorKacelnik, Oliver
dc.contributor.authorElstrøm, Petter
dc.contributor.authorBragstad, Karoline
dc.contributor.authorRinaldo, Christine Hanssen
dc.date.accessioned2022-05-13T10:30:04Z
dc.date.available2022-05-13T10:30:04Z
dc.date.issued2022-02-18
dc.description.abstractObjective: To improve understanding of SARS-CoV-2-transmission and prevention measures on cruise ships, we investigated a Norwegian cruise ship outbreak from July to August 2020 using a multidisciplinary approach after a rapid outbreak response launched by local and national health authorities. Methods: We conducted a cross-sectional study among crew members using epidemiologic data and results from SARS-CoV-2 polymerase chain reaction (PCR) of nasopharynx-oropharynx samples, antibody analyses of blood samples, and whole-genome sequencing. Results: We included 114 multinational crew members (71% participation), median age 36 years, and 69% male. The attack rate was 33%; 32 of 37 outbreak cases were seropositive 5-10 days after PCR. One PCRnegative participant was seropositive, suggesting a previous infection. Network-analysis showed clusters based on common exposures, including embarkation date, nationality, sharing a cabin with an infected cabin-mate (adjusted odds ratio [AOR] 3.27; 95% confidence interval [CI] 0.97-11.07, p = 0.057), and specific workplaces (mechanical operations: 9.17 [1.82-45.78], catering: 6.11 [1.83-20.38]). Breaches in testing, quarantine, and isolation practices before/during expeditions were reported. Whole-genome sequencing revealed lineage B.1.36, previously identified in Asia. Despite extensive sequencing, the continued transmission of B.1.36 in Norway was not detected. Conclusions: Our findings confirm the high risk of SARS-CoV-2-transmission on cruise ships related to workplace and cabin type and show that continued community transmission after the outbreak could be stopped by implementing immediate infection control measures at the final destination.en_US
dc.identifier.citationGravningen, Henriksen, Hungnes, Svendsen, Macdonald, Schirmer, Stene-Johansen, Simonsen, Kacelnik, Elstrøm, Bragstad, Rinaldo. Risk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norway. International Journal of Infectious Diseases. 2022;118:10-20en_US
dc.identifier.cristinIDFRIDAID 2018940
dc.identifier.doi10.1016/j.ijid.2022.02.025
dc.identifier.issn1201-9712
dc.identifier.issn1878-3511
dc.identifier.urihttps://hdl.handle.net/10037/25119
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalInternational Journal of Infectious Diseases
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.titleRisk factors, immune response and whole‐genome sequencing of SARS‐CoV‐2 in a cruise ship outbreak in Norwayen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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