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Cruise ships transport a significant number of people in confined spaces over an extended period than other modes of transportation, thereby presenting a unique environment to elevate human-to-human transmitted infections. The overcrowded public rooms, congested accommodations, standard food supplies, and shared sanitary facilities encourage the transmission of infectious diseases by affected persons and through contaminated food, water and surfaces. A novel coronavirus (COVID-19) originating from Wuhan, China in November 2019 spread globally. Unfortunately, Diamond Princess is the first cruise ship on board to have an outbreak of COVID-19 with 3711 passengers and crew members. It began from Yokohama on January 20, 2020, and was supposed to return to Yokohama on February 3 2020. An 80-year-old male passenger, who debarked in Hong Kong on January 25 2020, tested positive for COVID-19 on February 1. Diamond Princess was immediately ordered to stay in the ocean and follow quarantine measures near Yokohama from February 3 onwards. Several other cruise ships such as the Grand Princess, MS Westerdam, Zaandam, etc. had COVID-19 outbreaks onboard. The failure to isolate the crew at the very beginning of quarantine resulted in further transmission of the virus to the passengers and crew. In conclusion, the compact conditions in the cruise ships with high population density amplified the transmission of COVID-19, mainly driven by contact rate and mixing effects.
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