Introduction:
Infectious disease risks related to passenger ship travel are documented among cruise, ferry, river cruise and expedition ships^1-5. Studies examining risk factors and success of control measures inform evidence-based guidelines and practices. However, emerging infections generate new evidence. COVID-19 emphasized the need for updated guidelines and practices. This scoping review maps literature currently informing passenger ship infection prevention and control strategies.

Methods:
The scoping review was conducted in accordance with PRISMA-ScR. PubMed, Scopus and grey literature were searched for scientific articles, legislation, guidelines and policies on infection prevention and control related to passenger ships (cruise, ferry, river cruise, expedition) and seaports between 1990-2023. Publications were categorised by: infectious disease, maritime setting, population, geographic region and measures.

Results:
The review identified 620 publications, primarily scientific articles (58%) and guidelines (28%). The majority of technical guidelines (68%) were at regional or national level, with fewer guidance documents available at international level. Technical guidance documents originated from various sources, including 48 publications from the World Health Organization, followed by 33 documents from previous European joint actions (HEALTHY GATEWAYS, SHIPSAN ACT). Infectious disease prevention and control in cruise ships was addressed approximately four times more than any other passenger ship type. From all eligible publications, seaports were addressed by approximately 30% of publications, while seaport communities were only referenced by approximately 5% of publications.

Conclusions:
Most literature focused on cruise ships, indicating a more robust evidence-base in this setting. Comparatively less scientific literature focused on other ship types or seaports. A generic approach is needed for preparedness planning in the maritime sector, addressing both known and unknown infectious disease events. Further research should create context-specific guidelines for all types of infection prevention and control in ferries, river cruise, expedition ships and seaports.