New twist in case of coronavirus super-spreading cruise ship Ruby Princess as passengers are warned crew member has been diagnosed with tuberculosis

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Ruby Princess passengers have been issued with another health warning after a crew member was diagnosed with tuberculosis. 

NSW Health sent out an alert to all Ruby Princess passengers who were on board the cruise ship between March 8 - 19. 

The crew member was diagnosed with tuberculosis weeks after passengers were on the cruise.  

The member of staff is currently being treated in Sydney's Royal Prince Alfred Hospital.  

Cruise ship passengers disembark from the Princess Cruises owned Ruby Princess at Circular Quay in Sydney, Thursday, March 19, 2020

However, passengers have been told they are at low risk of contracting tuberculosis. 

'Most importantly, there is no reason to believe you are at increased risk of contracting tuberculosis from being on the cruise ship,' the NSW Health update read. 

'You do not need to take any action as a result of this information, and you do not need to be screened at this time.' 

Tuberculosis is an infectious disease that damages people's lungs or other parts of the body and can cause serious illness and death. 

The disease is spread by water particles from an infected person's mouth.

The news comes as NSW continues to recover from the ill-fated Ruby Princess debacle which saw coronavirus spread in March.

With the ship docked in Sydney, 2,700 passengers were allowed to freely disembark the ship, leading to more than 600 cases of COVID-19 and 22 deaths.  

A criminal investigation into the matter is ongoing. 

The Ruby Princess cruise ship is seen docked at at the Overseas Passenger Terminal on March 19

Cruise ship passengers disembark from the Princess Cruises owned Ruby Princess at Circular Quay in Sydney, Thursday, March 19

A Carnival Australia port agent has told the Ruby Princess special inquiry the ship was supposed to arrive in Sydney at 6am on March 19 but instead arrived at 2.30am.

Dobrila Tokovic told the commission it was her responsibility to collect 13 swabs from the ship's medical centre and take them to a nearby driver.

Three of the tests were positive, but NSW Health officials, who did not board the ship, had already allowed the 2700 passengers to disembark, return to their homes around Australia and self-isolate for 14 days.

The ship has since been linked with 22 deaths and almost 700 positive cases, including an outbreak in Tasmania.

Ms Tokovic said earlier conversations had suggested NSW Health would board the ship as they had done when its previous cruise disembarked in Sydney on March 8.

She was told in the hours before the ship's arrival they would not board, but said she wasn't overly surprised by this decision.

'Having 100 people unwell for the duration of a cruise would not stand out as a significant number where I would go 'oh wow they've got an outbreak',' Ms Tokovic said.

Ms Tokovic also said it was her responsibility to organise an ambulance for two unwell passengers as instructed by the ship's administration officer and onboard doctor.

She said she received a call the previous evening from the doctor, Ilse von Watzdorf, who recommended ambulance personnel take special precautions when treating the patients, who had been swabbed for COVID-19.

The commission also heard from NSW Ambulance's Simeon Pridmore, who was escorted onto the ship by Ms Tokovic to collect one of the two passengers needing an ambulance.

Mr Pridmore said at the commission he'd been warned before boarding of COVID-19 concerns and was told 11 other people had been swabbed and were in isolation.

The Ruby Princess cruise ship is seen docked at Port Kembla on April 23, 2020 in Wollongong

HOW CRUISE SHIPS HAVE BECOME HOTBEDS FOR THE CORONAVIRUS

The Diamond Princess cruise ship was at the centre of the early beginnings of the coronavirus outbreak in February. 

Japan forced the Diamond Princess cruise ship into quarantine at the port of Yokohama after hundreds contracted coronavirus. 

At least seven people who were on board the vessel died. 

Diamond Princess cruise ship seen above at Yokohama Port near Tokyo on February 26

From 15 March, all international cruise ships were banned by the Australian government from sailing into or out of Australian ports for 30 days.

On March 19, the Ruby Princess arrived in Sydney Harbour and more than 2,700 guests are allowed to disembark without adequate health checks. 

About 700 of its passengers have since tested positive for COVID-19, with many more put at risk - accounting for around 10 per cent of all Australia's cases.

So far, at least 22 COVID-19 deaths have been linked to the cruise liner. 

A criminal investigation was launched on April 5 into how passengers were able to disembark without checks.

Cruise ships around the world have struggled to find somewhere to dock during the coronavirus pandemic as countries close their ports to the vessels.

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NSW Port Authority senior manager Robert Rybanic also told the hearing Carnival's senior director of port operations Paul Mifsud said 'it was business as usual.'

'He said that NSW Health had deemed the ship a low risk ship and also that it wasn't a COVID ship and the ambulances weren't related to COVID,' Mr Rybanic said.

Commissioner Bret Walker SC questioned how anyone could confirm the Ruby Princess wasn't a 'COVID ship' before the swab tests results had come back.

'I just took that as the best information that he had ... I didn't pursue that any further,' Mr Rybanic said in response.

Duty harbourmaster that day Cameron Butchart, told the commission he had health and safety concerns in regards to sending a pilot to help the ship dock and offered to 'turn it around.'

Prime Minister Scott Morrison, meanwhile, said Mr Walker's earlier aggressive questioning of a NSW Health epidemiologist was 'out of line'.

NSW Health senior epidemiologist Kelly-Anne Ressler was reduced to tears when it was suggested there had been a 'reprehensible shortcoming' by the department when passengers were allowed to disembark in Sydney.

'I found that very distressing ... our nurses and doctors and first responders, they're all doing a great job, but also spare a thought for our public health officials,' Mr Morrison told 2GB Radio.

'We've got to get to the truth of this stuff but my first blush on that one, and that's not to call into question the independence of the commission, but I found that a bit out of line.'

The special commission will continue to hear evidence on Friday and is expected to deliver its final report by mid-August.