As more is learned about the novel coronavirus that has affected over 6000 people in mainland China, travel and mass transport has been under pressure to take precautions against the spread of the disease.
Nowhere more so than in China's emerging cruise industry. On ships carrying thousands of passengers in close proximity, often over multiple days, the potential for an outbreak is being taken seriously.
Thirteen sailings have been cancelled out of Chinese ports, including ships operated by Royal Caribbean and MSC. River cruising operators on the Yangtze, who are in low season, are waiting on further developments in the outbreak to make alterations to itineraries.
Elsewhere, Victoria Cruise Lines has cancelled six river sailings across China citing operational difficulties from travel restrictions, saying: "many passengers travel through transportation hubs which have been affected by proactive measures taken by the Chinese government, creating logistical difficulties."
MFAT, the US State Department and the UK Foreign Office have issued "do not travel" advisories to Wuhan and the province of Hubei, thought to be the origin of the disease. MFAT and other travel bodies have also advised travellers to avoid unnecessary travel in relation to novel Coronavirus outbreak.
After the first incident of a possible outbreak on a ship on Tuesday, Cruise lines are making their own decisions as to whether to cancel or alter sailings out of Chinese ports.
Costa Venezia was boarded by a medical team after it docked in Shenzen on Tuesday, who checked all 4973 passengers and 1249 crew for symptoms.
Locals reported that 148 passengers were quarantined with high temperatures or being found to have recently travelled to Wuhan.
On Wednesday a Costa Cruises Spokesperson said: "The safety, security and welfare of all guests and crew are our absolute priority," and their ships have "increased health and safety measures as a matter of caution. The company adopts a specific protocol to help prevent the introduction and/or spread of any infectious diseases."
While some cruise lines are continuing scheduled itineraries, extra health screening such as temperature stations for passengers and crew have been introduced and those who have been to Hubei within the last 30 days are being refused boarding.
Here is how other cruise lines are responding to the health warnings:
Holland America Line's Westerdam sailing will now conclude in Yokohama instead of Hong Kong. The company's website says that arrangements for onward travel and accommodation will be made: "Guests who have purchased their air through Holland America Line's Flight Ease will have their return flights rebooked to depart from Tokyo, rather than Shanghai."
A sailing of Seabourn Ovation has also decided to skip Xiamen in China for Sandakan in Malaysia.
Crystal Cruises Crystal Symphony which is on a relocation from San Diego to Hong Kong has been diverted. A writer for Cruise Critic who was on the sailing reported that as of January 29 the alternative turnaround had not been announced and the captain had advised passengers that "the alternative turn-around port will be announced as soon as it is positively confirmed by Crystal's corporate headquarters."
Royal Caribbean cancelled a sailing from Shanghai to Japan Spectrum of the Seas following a "consultation with the World Health Organisation".
Star Cruises has also cancelled all sailings of SuperStar Gemini, with full refunds.
US cruise line MSC cancelled a sailing of MSC Splendida from Shanghai, where it will remain until February 1.
Genting's Dream Cruise Line has halted a turnaround cruise from Hong Kong to Guangzhou over health concerns.
Costa Cruises has massively altered its sailings from Shenzhen following the quarantine of passengers on Costa Venezia.
The cruise line has cancelled nine sailings of its fleet from Shenzen: two sailings of its Costa Serena on 25 and 31 January; Costa Atlantica on 27 and 31 January; 26 Jan and 2 Feb on Costa Venezia; and 2 Feb for Costa neoRomantica.
Continuing with caution
Some cruise lines have decided not to alter their itineraries, albeit with heightened screening measures.
Silversea says it will continue its sailings in the South China Sea unchanged, though it will be submitting crew and passengers to "enhanced health screenings before boarding."
Silversea Spirit will arrive in Hong Kong on Feb 15, as planned.
All cruises are denying boarding to residents of Wuhan or those who have travelled to Hubei in the last 30 days.
Regent Seven Seas says the Voyager will continue a Hong Kong port of call unchanged although a statement insisted the "safety, security and well-being of our guests and crew is our number one priority."
Cruise lines Regent and Norwegian cruise vessels have introduced body temperature screening stations for passengers and crew. Those people found with temperatures higher than 38 degrees Celsius will not be allowed to board.
Carnival Corp has said its brands – including Costa, Cunard, Holland America and Seabourn - will be making decisions independently though it said their "medical experts are in touch with the US Centers for Disease Control and the World Health Organizations about any recommended screenings, monitoring and protocols for our ships, which may include temperature and questionnaire screening for cruises in certain geographies, questionnaires for residents and travellers visiting certain areas, and illness screening for cases presenting to our medical centres with fever and respiratory illness while onboard."
Celebrity cruises said it would continue to monitor the situation as did the Uniworld Cruise line, which does not begin operating in China until a sailing of Uniworld Tauck in April.
Cunard's Queen Mary 2 and Queen Elizabeth are monitoring ahead of calls in China.