Cruise Ship Health, USPH and Vessel Sanitation Program


Understanding cruise ship health is critical not only for crew members, but also for those seeking to work on a cruise ship. From personal hygiene and frequent hand-washing to sanitization and proper food handling, there are plenty of policies, procedures and regulations to keep a cruise ship healthy.


Cruise Ship Health:  Overview

In discussing cruise ship health, we often use the following acronyms:  USPH is United States Public Health, sometime referred to as “Port Health.”  This relates to the port authorities that go on board a cruise ship to conduct inspections. These inspections are carried out by a sector of the Center for Disease Control (CDC) called the VSP or Vessel Sanitization Program.

Cruise ships must comply with international and port state controls regarding public health which means inspection scores are also public. Although most cruise ships in the Cruise Lines International Association (CLIA) report scores of close to 100%, there are the occasional ships that encounter an outbreak. Therefore cruise ship health is reported by the news when it occurs.


Cruise Ship Health in the News

Typically the media only covers the negative stories that relate to cruise ship health, sensationalizing Norovirus outbreaks on specific ships. The reason that you hear about the incidents through the news is because cruise ships are required by law to report any gastrointestinal illness to the CDC. Hotels, resorts, and airlines do not need to report this type of information which is why they are rarely covered by the media.

Acording to an online maritime magazine, Marine Link, “…an average of 17 cruises are cancelled every year due to Norovirus outbreaks, costing the cruise ship industry millions of dollars.”  In fact, “…by the end of August 2012, there had been 11 cruises that had Norovirus outbreaks” according to the CDC.

Considering the number of ships and how many cruises offered each year, that’s a reasonable percentage.


Cruise Ship Illnesses

A cruise ship is a closed environment where viruses can breed quickly, similar to schools, daycares, nursing homes and hospitals. The cruise ship does a lot to prevent viruses from coming on board as well as takes measures to prevent viruses from spreading.

To start, prior to a passenger boarding a cruise, they must complete a health questionnaire and attests to the fact that they are not and have not been sick recently. If they report that they have been ill, they can be denied boarding. This can lead to passengers lying on their questionnaire.

Once on board, not all passengers follow proper and frequent hand-washing practices, which may lead to the spread of viruses. Viruses can be spread by using the tongs in the buffet, holding stairway and corridor handrails, pushing elevator buttons, opening doors, touching surfaces in the public restrooms, and using the same toys in the children’s center.

When someone is ill on the ship and it is reported to the medical department, a sanitation procedure is conducted along with a reporting procedure. Cabin stewards, waiters, youth counsellors and other cruise ship employees must also report to their supervisor (who will report to the medical department) if they know of an individual that has diahrrea or has been vomiting. These are signs of influenza or a gastrointestinal disease such as Norovirus.

The cruise ship cabin of an infected passenger or crew member must be sanitized and individual must be quarantined to their cabin. Children that have been sick must have a doctor’s note to prove that they are well enough to participate in the onboard youth programming.

The medical team must keep track of all reportable cases for both passengers and crew. The ship will operate under “red”, “orange” or “yellow” conditions, depending on how many of the ship’s passengers and crew are infected by a virus. The color-coded system is not only a guideline for specific sanitization procedures but also to alert officers to stay away from passenger areas such as the gym and buffet.

Additionally, cruise ships must report the total number of gastrointestinal (GI) illness cases evaluated by the medical staff before the ship arrives at the next port. When there are 2% of the passengers and crew with symptoms of diarhea during the voyage, the ship must also report the number to the CDC. When the percentage is at least 3% the CDC will conduct an investigation.


CDC Vessel Sanitation Program

Besides conducting investigations into disease outbreaks, the CDC is also responsible for the Vessel Sanitation Program (VSP), which assists the cruise industry to prevent and control GI illnesses on cruise ships. This branch of the CDC conducts periodic and unannounced cruise ship inspections. The majority of cruise ships average about 97%.

The Vessel Sanitation Program inspections take five to eight hours to complete. They inspect the following areas:

  • Potable water supply
  • Food storage and preparation
  • Food service
  • Employee’s personal hygiene practices
  • Cleanliness of the ship
  • Outbreak response procedures
  • Ventilation hygiene
  • Children’s center hygiene and sanitization procedures
  • Pest control
  • Crew training


Stay Healthy Working on a Cruise Ship

It’s in the interest of both the cruise ship and the crewmember to stay healthy while working on board. Not only does the management not want their crew or passengers to be sick, no one likes to be sick either. The cruise ship officers and crew do their best to keep the ship healthy by following the guidelines set out by the Vessel Sanitization Program. Unfortunately, some passengers embark on their cruise sick and then the contamination begins.

Both passengers and crew can protect themselves by practicing frequent and proper hand-washing. Using sanitizer before entering food service areas is another way to control the spread of viruses. In addition, crew are administered mandatory flu shots as well are not allowed to join a ship without a medical certificate that attests to their health.


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