Routine Inspections        

            Surveillance and Outbreak Investigation      

            Consultation Services    

            Training Seminars           

            Public Information           

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Mission

The Centers for Disease Control and Prevention (CDC) started the Vessel Sanitation Program (VSP) in the early 1970s because of several disease outbreaks on cruise ships.  VSP was established to protect the health of passengers and crew by minimizing the risk of gastrointestinal illness on cruise ships.  The program assists the cruise ship industry to develop and implement comprehensive sanitation programs. 

VSP accomplishes its mission through sanitation inspections, disease surveillance and investigations, review of construction plans for new ships, and onsite inspections of new ship construction and renovation. VSP also trains cruise ship employees in proper public health techniques including food handling and preparation, potable water system management, and pool and spa operation and maintenance.

ROUTINE INSPECTIONS

VSP staff inspect cruise ships with a foreign itinerary that call on U.S. ports and that carry 13 or more passengers.  Cruise ships are subject to inspections twice a year.  The inspections are conducted to ensure that vessels are maintaining adequate levels of sanitation and to provide guidance to vessel staff when needed. 

Inspections are based on the Vessel Sanitation Program Operations Manual 2000 (http://www.cdc.gov/nceh/vsp/manual/VSP%20Operations%20Manual%202000.pdf).  Some of the inspection criteria include the following:

Water supply—storage, distribution, protection, and disinfection

Spas and pools—filtration and disinfection

Food—protection during storage, preparation, and service

Employee hygiene practices

General cleanliness and physical condition of the ship—cleanliness and absence of insects and rodents

Training programs—environmental and public health practices

Inspections are scored on a point system of 100.  Cruise ships earn a score based on the criteria listed above.  Ships that score an 86 or higher have a satisfactory sanitation level; ships that score an 85 or lower have an unsatisfactory sanitation level and will be reinspected, usually within 30-45 days to determine if conditions have improved.  In general, the lower the score, the lower the level of sanitation; however, a low score does not necessarily imply an imminent risk for gastrointestinal illness. Since the program began, the number of disease outbreaks on ships has declined even though the number of ships sailing and the number of passengers carried has increased significantly.

Inspection scores and reports are published on the VSP Web site http://www2a.cdc.gov/nceh/VSPIRS/vspmain.asp.  In addition, a compiled list of ship inspection scores are published every month in the “green sheet” at http://www2a.cdc.gov/nceh/VSPIRS/VspRptGreenSheet.asp. This sheet is distributed to more than 3,000 travel-related services around the world.

SURVEILLANCE AND OUTBREAK INVESTIGATION

VSP provides assistance to cruise ships when the number of ill passengers or crew members has reached 2% or greater of the total number of passengers or crew members or when an unusual GI pattern or characteristic is found.

Cruise ships are required to log and report the number of passengers and crew members who have reported GI illness symptoms.  Additionally, vessels are required to keep a list of all passengers and crew members who have requested antidiarrheal medication.   VSP staff reviews this information to do the following:

1. Determine the magnitude and distribution of GI illnesses among passengers and crew

2. Assist in the assessment of sanitation practices, identify infectious agents, and determine prevention and control strategies

3. Evaluate the effectiveness of prevention and control strategies

4. Provide lab support to confirm the cause of the illness

By determining the cause of an outbreak, CDC officials can help devise effective intervention strategies to prevent a recurrence of the outbreak.

CONSULTATION ON NEW CONSTRUCTION AND RENOVATION

Cruise ship owners or shipyards that build or renovate cruise ships may request a plan review and an on-site construction inspection of new or remodeled vessels before their first or next operational inspection.  This consultation helps ship builders construct or renovate the ship according to public health guidelines. 

Plan reviews and construction inspections are based on VSP Construction Guidelines (http://www.cdc.gov/nceh/vsp/pub/Construction%20manual-August%202001.pdf).  Inspected items include food storage, preparation, and service and water bunkering, storage, disinfection, and distribution. 

Plan reviews and construction inspections result in increased handwashing, maintaining proper food temperatures, and protection of potable water.

 TRAINING AND SEMINARS

Since 1989, VSP has offered sanitation seminars to cruise ship employees.  Training sessions are offered six times per year in Florida.

The training sessions explain recommended standards, emphasize the reasons for the standards, and discuss how to comply with the standards.  Specifically, cruise ship employees examine water storage, distribution, protection and disinfection; food protection during storage, preparation, cooking, and service; employee practices and personal hygiene; to general cleanliness, facility repair, and vector control; and potential for contamination of food and water.

These seminars facilitate communication between government regulators and cruise ship employees.

PUBLIC INFORMATION

VSP responds to requests for information from state and local agencies, health professionals, international agencies and governments, and the general public.  VSP also maintains a Web site.

For more information, please contact: vsp@cdc.gov

Vessel Sanitation Program

National Center for Environmental Health

Centers for Disease Control and Prevention (CDC)

4770 Buford Highway, F-23

Atlanta, GA 30341

Telephone: (770) 488-7070, (954) 356-6650, 1 (800)-323-2132

FAX: (770) 488-4127

Air Pollution and Respiratory Health

Global Health Office    

Asthma           

Health Studies 

Division of Laboratory Sciences                      

Mold Emergency and Environmental Health Services               

Preventing Lead Poisoning in Young Children  

Environmental Hazards and Health Effects                   

Vessel Sanitation - Sanitary Inspection of International Cruise Ships