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<ul><li>The CDC randomly inspects and <a href="https://www.businessinsider.com/cleanest-cruise-ships-cdc-inspections-2024-10" target="_blank">scores cruise ships</a> to prevent the spread of stomach viruses.</li><li>Vessels inspected so far in 2024 have scored an average of 95.7 out of 100. A score of 85 or less is considered unacceptable.</li><li>The dirtiest ships this year so far scored 89 or less, including one that received 62 points.</li></ul> On most exams, a "B" is considered a passing grade. For cruise ships, scoring an 85 out of 100 on the Centers for Disease Control and Prevention's <a href="https://www.businessinsider.com/cruise-ships-best-worst-sanitation-scores-list-cdc-norovirus-2023-7" target="_blank">Vessel Sanitation Program</a> review is considered a failure. The CDC has reported <a href="https://www.cdc.gov/vessel-sanitation/cruise-ship-outbreaks/index.html" target="_blank">10 bacterial and viral outbreaks</a> on cruise ships since the start of 2024. Most cases have been norovirus, as these often-packed floating hotels can quickly propagate the highly contagious bug through contaminated water, food, surfaces, and people. If you're one of its unlucky victims, it could quickly ruin your vacation — the four predominant <a href="https://www.businessinsider.com/celebrity-cruises-constellation-cruise-ship-norovirus-stomach-flu-outbreak-2024-1" target="_blank">symptoms of norovirus</a>, also known as the stomach flu, are vomiting, diarrhea, nausea, and stomach pain. <div type="image" title="Radiance of the Seas, sailing near the South Franklin dock, Juneau, Alaska, in 2016. There are mountains with a blue-gray hue behind the ship." height="3680" width="7360" msid="114171501" hostid="261"></div> To mitigate these outbreaks, the CDC randomly conducts sanitary inspections on cruises without prior notice to the vessel. The public health agency then scores the ship from zero to 100, with outcomes of 85 or lower considered inadequate. The review includes checking common spaces such as kitchens, hot tubs, and children's activity centers. Obvious issues, such as vermin and improperly stored foods, will dock points. So will less-apparent issues, such as buffet handwashing stations with light sources less than 110 lux and the swimming pool's hair and lint strainer not being disinfected frequently enough. <div type="image" title="pool on Carnival Firenze cruise ship with people around the deck" height="1725" width="2300" msid="114171500" hostid="261"></div> The CDC has performed 119 inspections so far in 2024, including repeat inspections on five ships. The average score is about 95.7 — 20 vessels achieved perfect marks. But 10 vessels didn't break into the 90s range, including one that failed to pass, and Ritz-Carlton Yacht Collection's ultra-luxury <a href="https://www.businessinsider.com/photos-ritz-carltons-new-luxury-cruise-ship-sail-this-week-2022-10" target="_blank">Evrima</a>: <ol><li><keyword id="23631205" type="General" weightage="20" keywordseo="Crystal-Serenity" source="keywords">Crystal Serenity</keyword> — Crystal Cruises, scored 89 (inspected February 3)</li><li>Carnival Elation — Carnival Cruise Line, scored 89 (inspected March 14)</li><li>Adventure of the Seas — Royal Caribbean International, scored 89 (inspected January 23)</li><li>National Geographic Sea Bird — Lindblad Expeditions, scored 88 (inspected July 25)</li><li>Carnival Miracle — Carnival Cruise Line, scored 88 (inspected April 21)</li><li>MSC Magnifica — MSC Cruises, scored 86 (inspected May 17)</li><li>Evrima — Ritz-Carlton Yacht Collection, scored 86 (inspected February 9)</li><li>Carnival Breeze — Carnival Cruise Line, scored 86 (inspected March 21)</li><li>Caribbean Princess — Princess Cruises, scored 86 (inspected March 20)</li><li>Hanseatic Inspiration — Hapag-Lloyd Cruises, scored 62 (inspected September 29)</li></ol>An 11th vessel, <a href="https://www.businessinsider.com/photos-i-sailed-margairatvilles-new-cruise-ship-wont-again-2022-5" target="_blank">Margaritaville at Sea Paradise</a>, received a failing score of 83 on May 1 but passed a subsequent inspection with a 92 on July 2. The CDC performed 181 cruise inspections in 2023. Only one, MSC Seaside, hit below 85, scoring 67 when it was inspected in April 2023. However, it was reinspected three months later and received a 92. According to the public health agency's <a href="https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx" target="_blank">cruise review database</a>, since 1991, 50 ships have received scores below 85, with 75 total failed inspections. Hanseatic Inspiration is tied with Rederij Clipper Stad Amsterdam's Stad Amsterdam for the sixth-lowest score ever, though the latter most recently received 91 in 2019. The CDC's review of <a href="https://wwwn.cdc.gov/InspectionQueryTool/InspectionDetailReport.aspx?ColI=MjM2ODAxNzM%3d-CadqKFLR8PA%3d" target="_blank">Hapag-Lloyd's vessel</a> noted violations such as a maggot-infested decomposing bird under the outdoor grill and dead insects in areas with food. <h2>What the cruise lines have said</h2> <div type="image" title="Hanseatic Inspiration on water" height="2936" width="4674" msid="114171504" hostid="261"></div> A spokesperson for Hapag-Lloyd told Business Insider the score didn't reflect the company's standards. Following the inspection, the cruise line conducted an internal investigation and "intensive training sessions with external and internal trainers," it said. It plans to submit its corrective report to the CDC on time (the Vessel Sanitation Program manual states companies must submit their "corrective-action statements" within two weeks of receiving the CDC's final report). A Crystal Cruises spokesperson told BI most of <a href="https://www.businessinsider.com/crystal-2026-world-cruise-27-countries-on-luxury-ship-2024-3" target="_blank">Crystal Serenity's</a> violations were "operational items" that had since been addressed and corrected "through harmonization of procedures and additional training with our crew." <div type="image" title="The Crystal Serenity in Stockholm sailing near land." height="1725" width="2300" msid="114171508" hostid="261"></div> Similarly, a spokesperson for MSC Cruises told BI it had implemented an "improvement plan" on <a href="https://www.businessinsider.com/msc-four-month-world-cruise-photos-2023-12" target="_blank">MSC Magnifica</a> according to the CDC inspector's suggestions. Many of the changes were immediate and only needed "minor" efforts, it said. The cruise line said that it believes Magnifica's score "is not a true reflection of the ship as it is today" and that it would "welcome any future inspection." MSC noted that many of its ships frequently achieve above 90, including the MSC Meraviglia and MSC Seashore, which both received perfect marks in 2024. Carnival, Royal Caribbean, Lindblad Expeditions, <a href="https://www.businessinsider.com/ritz-carlton-second-luxury-cruise-ship-ilma-yacht-2023-3" target="_blank">the Ritz-Carlton Yacht Collection</a>, and Princess Cruises didn't respond to a request for comment. Correction: October 17, 2024 — An earlier version of this story misstated how many cruise ships had failed CDC inspections so far in 2024. Two ships failed, though one later received a passing score. The story was updated to clarify that the ship's second score was not low enough to be included on the list of lowest scores. The story also misrepresented some CDC figures. The numbers 119 in 2024 and 181 in 2023 referred to the number of CDC inspections, not the number of individual ships inspected. Similarly, 50 different ships, not 75, have received failing scores since 1991, with some doing so more than once. The story also misstated how many ships have achieved perfect scores in 2024. Twenty have done so, not 19. The story was updated to clarify that most ships in 2024 have scored at least 95, not 95 exactly.

These are the 10 dirtiest cruise ships, according to the CDC — including an ultra-luxury vessel

On January 27, the world's largest cruise ship is set to glide out of the Port of Miami. For the several thousand passengers who have reserved a berth on its maiden voyage through the Caribbean, the <a target="_blank" href="https://www.businessinsider.com/things-about-royal-caribbean-icon-of-the-seas-2024-1">Icon of the Seas</a> might seem like the dream holiday. Weighing as much as five Titanics, the ship is a floating ziggurat of fun and indulgence.The "first-of-its-kind combination of the best of every vacation," as Royal Caribbean describes it, boasts seven pools across the ship's 20 floors, an aquapark with six waterslides, a 55-foot water curtain, and a surfing simulator. There's a climbing wall, an ice-skating rink, a minigolf course, a karaoke bar, a casino, an escape room, an obstacle course, and "The Pearl," a multimedia sphere billed as "the world's largest kinetic sculpture." Passengers have 40 ways to dine across eight distinct "neighborhoods," and 28 ways to sleep, including the $80,000-a-week "Ultimate Family Townhouse," each with its own white picket fence, mailbox, and indoor slide. The opening of reservations for the Icon, in October 2022, saw Royal Caribbean's "single largest booking day in its 53-year history," the company said.The <a target="_blank" href="https://www.businessinsider.com/small-cruises-surprising-advantages-over-mega-ships-2023-10">megaship</a> embodies a rapid redemption for the cruise industry. In the early months of the pandemic, as the global cruising fleet moldered at port, some wondered whether the hiatus might prove terminal. Instead, <a target="_blank" href="https://www.businessinsider.com/cruise-vacation-carnival-disney-royal-caribbean-booking-popular-ships-2023-12">cruising has come roaring back</a>, setting passenger records and attracting a new cohort of younger travelers.But the Icon is also debuting at a moment of reckoning. As it pulls away from the American mainland, it will be pursued by a storm of animosity from port communities, environmental activists, and bystanders who feel that, in a period of <a target="_blank" href="https://www.businessinsider.com/overtourism-measures-limit-tourism-going-to-increase-venice-amsterdam-rome-2023-10">overtourism</a> and <a target="_blank" href="https://www.businessinsider.com/cruise-ship-air-pollution-carnival-cars-europe-study-2023-6">climate crisis</a>, it all seems a bit much.When a rendering of the <a target="_blank" href="https://www.businessinsider.com/9-reasons-royal-caribbean-icon-of-the-seas-shake-industry-2023-7">Icon's flamboyant stern</a> went viral in July, for every person presenting it as the ultimate vacation, someone else was calling it a monstrosity, an avatar of grotesque overconsumption. Few could deny that the lurid leviathan was indelible. But what is it an icon of, exactly?Love them or loathe them, giant cruise ships are among the most remarkable success stories of the mass tourism age. In the mid-20th century, as commercial airplanes supplanted boats as the main mode of long-distance transportation, passenger shipping lines fell into steep decline. Cruising was initially a small-scale and ponderous pastime: Ships would dock at ports of call for several days and cater to a clientele that had both time and money. Then Ted Arison, the scion of an Israeli shipping family, flipped the industry on its head by asking: What if the boat itself was the destination?In January 1972, Arison bought an old passenger liner and commissioned a hasty refit to provide space for onboard entertainment. Rechristened the Mardi Gras, the first <a target="_blank" href="https://www.businessinsider.com/reasons-carnival-cruises-best-for-first-time-cruisers-2023-5">Carnival cruise ship</a> sailed out of Miami that March. The modern cruising industry was born.Today, cruising includes river cruises, luxury special-interest journeys, and monthslong expeditions to some of the most remote maritime environments in the world. But what most people think of are the massive ships that followed in the Mardi Gras' wake: a vacation on the water. A boat like the Icon will spend the vast majority of its seven-day itinerary at sea, docking at only two or three ports along the way.In the decades after the Mardi Gras' inaugural journey, the annual cruise-passenger load grew exponentially — from 500,000 in 1970 to nearly 30 million in 2019. The Port of Miami, "Cruise Capital of the World," went from processing 61,000 passengers in 1950 to nearly 68,000 passengers in a single day in 2023.This expansion has pushed through some formidable bow waves. In 2012, the Costa Concordia made worldwide headlines when it foundered off the coast of Tuscany, Italy, killing 32 people. Eight years later, cruise ships such as the <a target="_blank" href="https://www.businessinsider.com/how-diamond-princess-cruise-ship-coronavirus-quarantine-went-wrong-2020-2">Diamond Princess</a> became early incubators for COVID-19. By summer 2020, <a target="_blank" href="https://www.businessinsider.com/carnival-corp-cruise-loses-billions-delta-variant-covid-19-2021-9">Carnival was hemorrhaging $1 billion a month</a>. As the borders reopened, the speed of the industry's recovery has been startling. Passenger numbers surged past 2019 levels last year."This week, in January, would typically be very quiet," Aaron Saunders, a senior editor at the cruising-review site Cruise Critic, told me earlier this month. He was calling from the Golden Jubilee lounge of the Carnival Celebration, the largest vessel in Carnival's fleet (it has a roller coaster on deck). "But this ship is entirely sold out," he said. "We've never seen ships this consistently full."More than anyone, repeat cruisers have fueled the bounce back. In a December 2022 survey by the <a target="_blank" href="https://cruising.org/-/media/clia-media/research/2023/2023-clia-state-of-the-cruise-industry-report_low-res.ashx">Cruise Lines International Association</a>, 85% of passengers said that they would cruise again. The appeal was clear: In CLIA surveys, people said cruises were easier to arrange, more relaxing, and more "pampering" than other holidays. People also coveted the variety of destinations and activities."Twenty years ago, the entertainment was extremely limited compared to what you have now," Sue Bryant, a veteran cruise journalist and editor, told me. "When the first ship introduced a climbing wall, it was considered outrageously revolutionary. Now you've got zip lines, water slides, and musical shows from Broadway and the West End. The product is always improving." But perhaps the most surprising feature of this surging popularity is how much of it is also being driven by younger travelers. Data recently compiled by researchers at CivicScience showed that 69% of 18- to 24-year-olds were at least "somewhat interested" in going on a cruise, the highest level of any age group. At the time of writing, videos of life aboard another Royal Caribbean ship, the Serenade of the Seas, six weeks into a nine-month <a target="_blank" href="https://www.businessinsider.com/why-royal-caribbeans-9-month-ultimate-world-cruise-unusual-2024-1">Ultimate World Cruise</a>, had become a viral sensation. Posts with the hashtag #ultimateworldcruise, most of them created by millennial and Gen Z influencers, had accrued over 350 million views on TikTok alone.As the industry casts off outdated clichés of retirees, shuffleboard, and black-tie dining, some companies have gone all out for the young-adult market. <a target="_blank" href="https://www.businessinsider.com/virgin-voyages-sea-terrace-room-balcony-photo-cruise-cabin-tour-2023-8">Virgin Voyages</a>, which debuted in 2021 with the promise to "sail our ships with sass," has a no-kids policy and boasts onboard amenities — such as brunch bars, Peloton classes, and resident drag performers — tailored to a young customer base."Some people think that cruises are all about partying. Others have an idea that cruises are formal, all about ballroom dancing," Emma Le Teace, a cruise writer and YouTuber, said. "Both these options do exist. But young customers are realizing that there are hundreds of options in between."Crucially, in a period of high inflation, all these perceived upsides are available for controlled costs. The standard cruise package is all-inclusive. Though alcohol and <a target="_blank" href="https://www.businessinsider.com/best-ways-save-money-on-cruise-from-frequent-traveler-2023-8">off-ship excursions tend to cost extra</a>, a person can, in theory, spend a week on board without spending another dollar.All this is why, for millions of repeat customers, cruising is the best and only way to travel.A week on a giant floating resort will never be for everyone. For the writer David Foster Wallace, in his famous 1991 essay for Harper's, there was "something about a mass-market Luxury Cruise that's unbearably sad." Three decades later, many of the characteristics that ensure cruising's popularity and profitability are the same ones that burden it with ethical ballast.The modern cruise industry is dominated by the company Arison founded, Carnival, which owns almost half the entire global market, and Royal Caribbean, of which the Icon of the Seas is the latest flagship. Both companies are headquartered in Miami, but their vessels sail under what's known in maritime parlance as "flags of convenience." To bypass strict American regulations and high taxes, companies register their ships to a foreign country. Carnival, for instance, is flagged to Panama, Royal Caribbean to the Bahamas. Originally pioneered by passenger-ship companies seeking to sell booze during Prohibition, today this tactic has enabled cruise lines to sidestep stringent labor laws. Low-ranking employees on large cruise ships, often from low-income countries, have reported working long hours for below minimum wage, while enjoying few, if any, employment benefits. (One <a target="_blank" href="https://www.businessinsider.com/cruise-ship-job-long-hours-low-pay-no-days-off-2023-2">former cruise worker</a> recently told Business Insider that he knew of colleagues working for as little as $2 an hour.)But a perhaps greater contention is the industry's immense <a target="_blank" href="https://www.businessinsider.com/carnivals-history-of-environmental-violations-cruise-industry-2020-3">environmental impact</a>. In common with most large oceangoing vessels, cruise ships have traditionally been powered by heavy fuel oil, a viscous diesel that tends to be the cheapest — read: dirtiest — fuel available. When burned, it emits prodigious quantities of CO2, as well as toxic particulates that contaminate the air and water. A 2019 study by Transport &amp; Environment, a Brussels nongovernmental organization, found that Carnival's European fleet emitted 10 times as much sulfur oxide, a pollutant that has been proved to harm the human respiratory system, as all the continent's 260 million passenger vehicles combined. <div type="image" title="The Carnival Jubilee is transported by tugboat while a crowd watches from the grassy shore." height="3712" width="5568" msid="107147778" hostid="261"></div>Cruise lines insist that a greener future is viable. Carnival has committed to halve its carbon emissions by 2030 and reach net zero by 2050. Royal Caribbean promises a net-zero ship by 2035. But many climate experts say that the "transitional" mitigations are nowhere near adequate. Liquefied natural gas, which powers most new cruise ships, including the 90,000-horsepower engines on the Icon, emits about 25% less CO2 than conventional marine fuels, but it <a target="_blank" href="https://theicct.org/publication/the-climate-implications-of-using-lng-as-a-marine-fuel/">generates methane</a>, a particularly potent greenhouse gas.Friends of the Earth's latest Cruise Ship Report Card, which scores major lines on metrics including air-pollution reduction, water-quality compliance, and transparency, gave both Carnival and Royal Caribbean yet another F."Cruise-ship greenhouse-gas emissions grew more than 20% between 2012 and 2018," Bryan Comer, the director of the International Council on Clean Transportation's marine program, told me. The only way to bring that down, he said, is through "mandatory, enforceable regulations."For anti-cruise activists, the wider climate crisis has become a rallying point. In October, when the World Traveller, a luxury cruise ship often assigned to the polar regions, arrived in the French port of Douarnenez, it was booed by a crowd of protesters, some dressed as walruses and polar bears. Anti-cruise sentiment has begun to carry over into restrictive legislation. Several <a target="_blank" href="https://www.businessinsider.com/list-us-port-towns-want-to-limit-ban-cruise-ships-2023-4">major cruise ports</a>, including Venice, Italy; Dubrovnik, Croatia; and Amsterdam, have introduced prohibitions and levied new taxes on passengers. But many campaigners remain unsatisfied. "The big cruise companies are playing three-dimensional chess, while the local governments play checkers," Karla Hart, the founder of the Global Cruise Activist Network, told me.Hart, whose hometown of Juneau, Alaska, is a summer cruise hub, said the industry had an ignominious history of <a target="_blank" href="https://foe.org/cruise-history-violations/">environmental violations</a> and of leveraging flags of convenience, clever marketing, and political clout to get its way. "They're very good at spinning the story to make themselves look better. But greenwashing and obfuscation are ingrained in the corporate culture," she added.Despite their notoriety, boats such as the Icon are few in number. Cruise Market Watch forecasts there will be 360 cruise ships in service at the end of this year, comprising less than 1% of the global commercial fleet. But they're a conspicuous target. "It's easy to point a finger at the ship in the harbor and say there's our problem. It's a lot harder to get angry about the 37 flights a day that are arriving from all over the world," Saunders, the cruise critic, said.While many port residents decry the ships' disruptive impact, others vaunt them as economically indispensable. In April, when ships returned to Skagway, Alaska, after a long COVID-19 hiatus, <a target="_blank" href="https://www.cbc.ca/news/canada/north/skagway-alaska-tourists-season-1.6818337">reports</a> described store owners weeping with relief.Meanwhile, ongoing calls for ships to be proscribed risk precipitating a vicious cycle in which cruise companies, ostracized at traditional ports, merely reroute to their coastal concessions. Both of the routes traveled by the Icon of the Seas include a stop off at Royal Caribbean's private island, <a target="_blank" href="https://www.businessinsider.com/perfect-day-cococay-private-bahamian-island-tour-photos-2022-5">Perfect Day at CocoCay</a>, in the Bahamas.A lot of the discourse boils down to cruise ships' arresting optics. The industry's tendency toward gigantism is partly about economies of scale — it's more cost-effective to squeeze as many passengers as possible onto one large ship than many small ships — but it's also an arms race designed to polarize and provoke. "That stern is such a departure from anything that has ever been created on a ship before," Saunders said, referring to the Icon's eye-catching rear end. "It was always going to stir the pot."<div type="image" title="Rendering of the Icon of the Seas" height="6000" width="6000" msid="107147985" hostid="261"></div>To detractors, the fact that each new incarnation of megaship seems to aspire to more, adding entrées to an already stuffed menu, can seem symbolic of an impatient, gluttonous, and superficial age — the perfect holiday for a society that demands constant diversion. "Cruise passengers learn to be suspicious of anything outside of their cruise bubble. They don't want to see anything that's ugly. They don't want to see anything that's real," Hart said. Her house often shakes from helicopter excursions carrying cruise passengers to Juneau's shrinking ice fields. "These trips are sold as 'once in a lifetime' opportunities," she added, "but it's basically a theme-park experience offered by companies that are trying to empty your wallet."But the same resort-style product that repels some people proves irresistible to others, for whom a boat like the Icon is a kind of fantasy. While overseas travel has become freighted with anxiety post-pandemic, a cruise ship, by contrast, is the ultimate contained environment — convenient, predictable, and hassle-free. From the moment of boarding, a passenger is insulated from the variables and complexities of traveling in a foreign place. The food and drink are always flowing. Your luggage is never far away. The entertainment runs 24/7. Adrift on a parallel world of rest and recreation, the ships take you away from terrestrial concerns and, by extension, away from moral scruples.If cruising is an industry that has long benefited from loopholes in maritime law, then today it also benefits from something else: a loophole in consumer conscience.<a target="_blank" href="https://www.businessinsider.com/author/henry-wismayer">Henry Wismayer</a> is a writer based in London. He writes essays, features and commentary for a range of publications including The New York Times, National Geographic, Financial Times, and Noema.

The truth behind America's cruise obsession: 'They don't want to see anything that's real'

<ul class="summary-list"><li>Doctors have warned that London Underground's subway network could increase exposure to the coronavirus after it emerged that the British capital's first case of the disease has been hospitalized, according to <a href="https://news.sky.com/story/coronavirus-doctors-fear-tube-could-spread-covid-19-as-london-gets-first-case-11932794">Sky News</a>.</li><li>It it not known what transport the infected woman - believed to be a Chinese national - used after landing in the UK's capital. She is currently being treated in a London hospital.</li><li>London Underground, known to locals as "the Tube," is used by 1.3 billion passengers per year and was found in 2017 to be the "dirtiest" branch of the UK capital's transport network.</li><li>The London case is the UK's ninth case of the coronavirus - now officially named COVID-19 - and the UK government has raised its estimate of risk to the public from "low" to "moderate."</li><li><a href="https://www.businessinsider.com/?hprecirc-bullet">Visit Business Insider's homepage for more stories</a>.</li></ul>One of the UK's busiest transport networks could be an ideal place to spread the coronavirus, an Oxford University academic <a href="https://news.sky.com/story/coronavirus-doctors-fear-tube-could-spread-covid-19-as-london-gets-first-case-11932794" target="_blank" rel="noopener">told Sky News</a> today.The comments come after the UK's ninth coronavirus patient was confirmed in London - the capital's first case - who is believed to be a female Chinese national, <a href="https://news.sky.com/story/coronavirus-first-case-in-london-as-virus-spreads-to-capital-11932540" target="_blank" rel="noopener">according to Sky News</a>. The woman picked up the virus in China before arriving in London, the UK's chief medical officer Professor Chris Whitty has confirmed <a href="https://www.gov.uk/government/news/cmo-for-england-announces-ninth-case-of-novel-coronavirus" target="_blank" rel="noopener">in a statement</a>. He added that she is currently being treated at London's Guy's and St Thomas' hospital. It is unclear whether or not she used the capital's subway - known in Britain as "the Tube" - after leaving the airport.England's public health authority, Public Health England, <a href="https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public" target="_blank" rel="noopener">has advised</a> people travelling from Hubei, and anyone with symptoms who has recently travelled to China and affected neighboring countries, to avoid public transport and taxis. But Dr Robin Thompson, a junior research fellow at Oxford University, said the case presents an "increased risk" to Londoners because of the city's dense population and wealth of transport connections, reported Sky News.Dr Thompson, <a href="https://www.chch.ox.ac.uk/staff/dr-robin-thompson" target="_blank" rel="noopener">whose specialisms include the spread of epidemics</a>, told the outlet: "In general, if an initial case is in a densely populated area, then the risk of sustained person-to-person transmission following is higher."This is exacerbated by the fact that London is a transport hub, and the Underground could provide a network to spread the virus quickly.""As a result, given this case was in London, it might be expected that there is an increased risk posed by this case compared to the others we have seen."Epidemiologist Dr Michael Head, <a href="https://www.southampton.ac.uk/medicine/about/staff/mh1d14.page" target="_blank" rel="noopener">senior research fellow at the University of Southampton</a>, told Sky News that the risk to Londoners depends on her interactions after landing."If this is low, then the risk of sustained human-to-human transmission is also low," he said.The 250-mile Tube network, which serves <a href="https://madeby.tfl.gov.uk/2019/07/29/tube-trivia-and-facts/" target="_blank" rel="noopener">1.3 billion passengers</a> per year, was described in a 2017 study as the "dirtiest form of transport in the capital."<a href="https://www.staveleyhead.co.uk/blog/nine-superbugs-found-on-london-public-transport/" target="_blank" rel="noopener">"London: Under the Microscope"</a> - a collaboration between insurers Staveley Head and London Metropolitan University - found nine so-called "superbugs" - bacteria that are resistant to antibacterial treatment - on the city's transport. <a href="https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public?gclid=CjwKCAiAhJTyBRAvEiwAln2qBw2gDQXgMRbF3nrnBdMcu9oPUB7sxpHIOe7_dneuQUX75ZPRujBdORoC810QAvD_BwE" target="_blank" rel="noopener">In a statement</a> updated on Wednesday, the UK's executive agency for health, Public Health England, said that more COVID-19 cases are "highly likely" in the UK. The risk to the public has been raised from "low" to "moderate."The Health Secretary Matt Hancock <a href="https://www.gov.uk/government/news/health-secretary-announces-strengthened-legal-powers-to-bolster-public-health-protections-against-coronavirus" target="_blank" rel="noopener">announced on Monday</a> new powers for health workers to forcibly quarantine people who are at risk of spreading the infection, saying he is taking a "belt and braces approach" to the issue - British slang for making doubly sure. <ul class="read-more-links"><li>Read more:</li><li><a href="https://www.businessinsider.com/china-virus-everything-we-know-deadly-2019-ncov-wuhan-spread-2020-1?r=US&amp;IR=T">Here's everything we know about the coronavirus outbreak. </a></li><li><a href="https://www.businessinsider.com/coronavirus-hmp-bullingdon-prison-sanitation-overcrowding-danger-2020-2?r=US&amp;IR=T">2 inmates at a UK jail were tested for the Wuhan coronavirus after a prisoner collapsed in his cell. Here's why prisons are among the worst places to handle outbreaks.</a></li><li><a href="https://www.businessinsider.com/us-quarantine-evacuees-released-tested-negative-coronavirus-2020-2?r=US&amp;IR=T">The US just completed its first successful quarantine in almost 60 years. </a></li><li><a href="https://www.businessinsider.com/diamond-princess-cruise-ship-crew-greater-risk-of-coronavirus-exposure-2020-2?r=US&amp;IR=T" target="_blank" rel="noopener">11 crew on the quarantined coronavirus cruise ship have contracted the disease - and the rest are afraid they'll be next</a></li></ul>

Thousands of people could be exposed to the coronavirus on the London Underground, doctors warn after the city finds its first case

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