NEHA March 2024 Journal of Environmental Health


Open Access


Resources for Healthy Cruising

CAPT Luis Rodriguez, MS, REHS/RS, CP- FS, CPO, DAAS

Keisha Jenkins, MPH, DrPH

Michtta Jean- Louis, MPH, PharmD, CPH

fact sheet on our website includes important handwashing information translated into eight languages including Japanese, Portu- guese, German, and Tagalog. If a person gets sick on their cruise and experiences diarrhea or vomiting, they should promptly report their illness to the ship medical center for proper assessment, treatment, and moni- toring (Figure 1). Infographics and posters from VSP encourage this reporting and other healthy behaviors for passengers to help them stay well on vacation. Another helpful resource from VSP is the Cruise Ship Inspection Search. VSP conducts routine inspections to determine how well ships are maintaining sanitation standards in accordance with the current VSP Opera- tions Manual. Passengers can search for a specific ship to find the most recent inspec- tion report for that ship, including violations of VSP standards and what the ship did to fix the problem. They can also look at ships that scored 100 on their inspection report. VSP also posts information about outbreaks of gastrointestinal illness on the website. VSP requires cruise ships to report the number of passengers and crew who have symptoms of gastrointestinal illness. When the number of illnesses reaches 3% of the total number of passenger or crew population, it is consid- ered an outbreak and is posted on the VSP Outbreak webpage. Assisting the Cruise Ship Industry to Protect Traveler Health VSP assists the cruise ship industry with protecting the health of the traveling public. CDC (2023) established VSP in 1975 to foster cooperation between the cruise ship industry

Editor’s Note: The National Environmental Health Association strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature this column on environmental health services from the Centers for Disease Control and Prevention (CDC) in every issue of the Journal . In these columns, authors from CDC’s Water, Food, and Environmental Health Services Branch, as well as guest authors, will share tools, resources, and guidance for environmental health practitioners. The conclusions in these columns are those of the author(s) and do not necessarily represent the o„cial position of CDC. CAPT Rodriguez is an environmental health specialist and Dr. Jenkins and Dr. Jean-Louis are epidemiologists who work in the Vessel Sanitation Program of the National Center for Environmental Health within CDC.

P eople often associate cruise ships with acute gastroenteritis illnesses, but this illness is relatively infrequent on cruise ships. Millions of passengers sail on cruise ships every year. From 2006 through 2019, Jenkins et al. (2021) reported that 252 cruise ships sailed on voyages under the ju- risdiction of the Vessel Sanitation Program (VSP) within the Centers for Disease Con- trol and Prevention (CDC). Furthermore, the rate of acute gastroenteritis illness on cruise ships decreased for passengers and crew from 2006–2019 (Jenkins et al., 2021). Health of- ficials track illnesses on cruise ships, so out- breaks are reported quickly. Norovirus is the most common cause of acute gastroenteritis globally, and it is the most common causative agent of cruise ship outbreaks. Norovirus is a very contagious virus that causes vomiting and diarrhea, and

it spreads through contaminated food or water or by touching contaminated surfaces. Close living quarters might increase the opportunity to spread illness. Resources to Educate Cruise Ship Passengers VSP provides resources to educate cruise ship passengers on how to stay healthy while on vacation. Some of our most popular resources for travelers include prevention fact sheets, infographics, and information about individ- ual cruise ship inspection reports and acute gastroenteritis outbreaks. All these resources can be found on our website at nceh/vsp/public/public.htm. One of the most important ways to reduce the risk of getting ill on cruise ships is good hand hygiene, especially after using the toilet and before touching your face or eating. One


Volume 86 • Number 7

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