A 77-year-old woman has died from COVID-19 after testing positive while sailing on a Carnival cruise to Belize, marking the first reported death since cruises restarted in the Caribbean and United States in June.
The Carnival Vista cruise ship sailing out of Galveston, Texas, reported 27 people testing positive over two weeks in late July and early August, the highest number of cases since cruises started sailing again.
NBC News was working to confirm the identity of the woman, who died on Aug. 14. The New York Times reported she was a great-grandmother from Oklahoma.
The woman departed on the Carnival Vista with her family on July 31 and tested positive for COVID-19 after experiencing respiratory complications, the Times reported. She was admitted to a hospital in Belize and put on a ventilator before being evacuated to Tulsa, Oklahoma, and receiving treatment.
The outbreak of 27 cases aboard the ship was discovered on the fourth day of an eight-day cruise, shortly before the ship docked in Belize. Twenty-six of those who tested positive were crew members and the other was a passenger.
Texas Gov. Greg Abbott signed a law banning businesses from requiring proof of vaccination, but more than 96% of passengers and all but one crew member aboard the Carnival Vista were fully vaccinated, according to the Belize tourism board. It wasn't clear if the woman who died was vaccinated or not.
"We are very sorry to hear about the death of a guest who sailed on Carnival Vista," Carnival said in a statement. "Regrettably, there is a fair amount of disinformation about the circumstances of this matter.
"The guest almost certainly did not contract COVID on our ship, and she was assisted with expert medical care on board and was ultimately evacuated from Belize after we provided a resource to her family. We have continued to provide support to her family and are not going to add to their sadness by commenting further."
Carnival has updated its vaccination policy so that starting on Saturday, most guests will be required to be vaccinated and must also present negative results of a COVID-19 test taken within three days before boarding a ship. Carnival also implemented a mask mandate on Aug. 7 for all passengers in indoor areas.
"We have always required vaccinations. From our restart in July, 95+% guests have been vaccinated. We meet the definition of a vaccinated cruise," a Carnival spokesperson told NBC News' Kerry Sanders on Tuesday. "And we added the testing requirement on July 28. (August) 28 is when new guidelines for the Bahamas go into effect."
As the more contagious Delta variant of the virus continues to spread, the Centers for Disease Control and Prevention issued updated guidance on Aug. 20 advising that travelers at increased risk for severe illness avoid going on cruises regardless of vaccination status.