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Case Report

First Case of COVID-19 in Badung Regency: a Lesson From Indonesian Cruise Ship Worker

Cokorda Agung Wahyu Purnamasidhi, Cokorde Istri Yuliandari Krisnawardani, Ni Putu Oktaviani Rinika Pranitasari, Putu Utami Dewi, Komang Ayu Witarini, Ni Made Susilawathi.


Introduction: Coronavirus Disease 2019 (COVID-19) is an outbreak of respiratory illness later proved caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) first notified in Wuhan. COVID-19 was then known to rapidly spread from China to other parts of the world. Travel-related transmissions especially via cruise ships were identified in many countries including Indonesia. Bali is a major Indonesian tourist destination that had its first case of COVID-19 who was a cruise ship worker and classified as an imported case.
Case report: A 23-year-old Balinese male cruise ship worker visited Europe 2 weeks prior to hospital admission. He came with shortness of breath, sore throat, dry cough, fatigue for 3 days and fever for 9 days. Physical examination revealed fever with normal blood pressure, pulse rate, and respiratory rate. Blood saturation (SpO2) of 98% with oxygen nasal cannula 2 L/min. The rapid screening test for COVID-19 was reactive and confirmed by nasopharyngeal swabs rRT-PCR. Chest X-ray revealed bilateral perihilar and pericardial haziness. He was subsequently given empirical antibiotics with azithromycin, chloroquine, oseltamivir, vitamin C and antitussive agents. He was discharged with good recovery on the 21st day after two consecutive negative swab examination results.
Conclusion: In our case, we highlighted cruise-ship workers as a vulnerable population in COVID-19 transmission. Travel history information is important for clinician to identified of suspected COVID-19 cases.

Key words: COVID-19, Cruise Ship Worker, First case, Transmission

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