Impact of infectious diseases associated with passenger ships on ports: a systematic review

Abstract

Abstract Background In an enclosed ship environment, close contact between passengers and crew members is inevitable. As a result, passenger ships can be a suitable environment for the transmission of infections between people. In this context, it is essential to establish effective prevention and control measures to protect the health of passengers and crew members while ensuring that shipping minimizes its contribution to the global spread of disease. The aim of this review is to provide knowledge on the impact of infectious diseases on board large passenger ships on the port, the port community and other land-based operations to better understand the effectiveness of the prevention, mitigation and management (PMM) measures implemented, in particular ship-to-shore communication. Methods A systematic literature review was conducted according to the PRISMA guidelines, searching three databases and including additional articles from hand searches up to November 2023. Peer-reviewed studies of infectious disease outbreaks on large passenger ships that described ship-shore interaction, port preparedness, impact on the port community, and impact on other modes of transportation were included. Results A total of 555 publications were initially identified. Finally, 22 articles were included. Most studies reported on COVID-19 outbreaks on cruise ships; other communicable diseases reported were influenza, gastroenteritis and varicella. The articles highlighted the importance of comprehensive management plans and proactive risk assessment during infectious disease outbreaks. Conclusions Effective stakeholder collaboration, ship-to-shore communication, and coordination of medical transport, isolation, and quarantine measures are essential components of infectious disease PMM in maritime passenger shipping and ship-to-shore operations. The findings suggest that further research is needed to improve the evidence and knowledge about this important issue. Key messages • Proactive risk assessment, comprehensive management plans and effective collaboration are critical to preventing, mitigating and managing infectious diseases on passenger ships. • Overall, very little evidence of effective practices and capacities related to the interaction of passenger ships with land-based operations, stakeholders and port communities.