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Peer reviewedOpen accessGastroenteritis

Mitigating norovirus spread on cruise ships: a model-based assessment of diagnostic timing and isolation

Journal of Travel Medicine·

Alfredo De Bellis, Andrea Bizzotto, Lemonia Anagnostopoulos, Leonidas Kourentis, Valentina Marziano, Varvara Mouchtouri, Stefano Merler, Giorgio Guzzetta

DOI
10.1093/jtm/taaf059
PMID
40568974
PMCID
PMC12640874
OpenAlex
W4411671808
Study type
Journal article
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

Timely diagnosis and isolation substantially reduce norovirus transmission on cruise ships. Encouraging passengers to seek immediate medical care when gastrointestinal symptoms appear can improve outbreak control.

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Structured evidence summary

Research question

The study evaluated how diagnostic timing and isolation protocols affect norovirus transmission during cruise ship outbreaks.

Study design

Investigators analyzed a line-list of 121 cases from a Mediterranean cruise outbreak using Bayesian inference to reconstruct transmission chains, then calibrated a branching process model to simulate alternative isolation scenarios.

Population and setting

The outbreak occurred aboard a cruise ship visiting Mediterranean ports, with 121 cases among passengers representing a cumulative incidence of 9.7%.

Main findings

Ten percent of infected individuals caused 57% of secondary cases, with these superspreaders experiencing longer diagnostic delays (mean 83 hours versus 47 hours) and reduced symptom frequency. The 72-hour isolation protocol averted 71% of potential cases and reduced the effective reproduction number from 9.8 to 4.9. Further reductions in diagnostic delay lowered case counts and outbreak sustainability.

Public-health relevance

Timely diagnosis and isolation substantially reduce norovirus transmission on cruise ships. Encouraging passengers to seek immediate medical care when gastrointestinal symptoms appear can improve outbreak control.

Important limitations

The summary relies on abstract and metadata from a single article. Model assumptions about transmission heterogeneity and the accuracy of reconstructed transmission chains were not detailed in the abstract. Full interpretation requires review of the complete manuscript.

GIDS interpretation

This article is discoverable through classifier links for gastroenteritis, diagnostics, outbreak investigation, and transmission dynamics. It provides modeling evidence on intervention timing within a closed population setting but does not represent an active surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topicevaluates interventionhas pathogen typestudied population settinguses study design