1. Vessel Sanitation Program Charting a Healthier Course National Center for Environmental Health Vessel Sanitation Program

2. 2 Mission  Prevent the introduction, transmission, or spread of communicable diseases into the United States  Assist cruise ship industry in developing and implementing comprehensive sanitation programs to minimize the risk for gastrointestinal illnesses

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4. 4 VSP Staff  Atlanta  4 Inspectors/EHOs  1 Epidemiologist  1 Admin Assistant  1 IT Specialist  Ft. Lauderdale  5 Inspectors/EHOs  1 Admin Assistant Total: 9 EHOs, 1 epi, and 3 support staff for entire U.S.

5. 5 VSP History 1987 In compliance with congressional directive, VSP reestablished with following components: Unannounced inspections Follow-up inspections Construction consultation Investigation of outbreaks Biweekly publication of inspection scores Inspection reports on request 1980 First overseas consul- tation on construction 1986 Inspections discontinued & industry “encouraged” to develop a program of self-inspection using Vessel Sanitation Inspection Manual 1975 Voluntary compliance to maintain minimum levels of sanitation and minimize threat of GI illness Inspection results available to the public 1970-1975 Routine sanitation inspections of all arriving vessels Significant risk associated with cruise ships WHO Guide to Ship Sanitation 1988 User fees charged to support 100% of VSP budget Cost for 2002 = $0.03/passenger/day

6. 6 Inspection Fees/ Fiscal Years 2006–Present Vessel SizeGross Registered TonsFee Extra Small<3,001$1,300 Small3,001–15,000$2,600 Medium15,001–30,000$5,200 Large30,001–60,000$7,800 Extra Large60,001–120,000$10,400 Mega>120,001$15,600

7. 7 Jurisdiction  Cruise vessels that  Carry 13 or more passengers  Have an international itinerary  Call on U.S. ports  2010  180+ vessels  14.3 million passengers * Estimate by Florida-Caribbean Cruise Association (FCCA)

8. 8 Allure of the Seas/ Oasis of the Seas Length360 m Size225,282 GRT Passengers 5,400 Crew2,165 Arabella Length50 m Size91 GRT Passengers40 Crew8

9. 9

10. 10 VSP Program Components  Operational Inspections  Surveillance & Outbreak Investigations  Construction  Training & Consultation

11. 11 Operational Inspections  Twice a year  Unannounced  Maximum score of 100  Minimum passing score is 86

12. 12 Based on  Previous VSP Ops Manual  Current FDA Model Food Code  WHO Guide to Ship Sanitation  Extensive References

13. 13 Operational Inspections

14. 14 Inspections in New York State  FY 2008 – 7  FY 2009 – 15  FY 2010 – 14  FY 2011 – 17  FY 2012 – 10  Ports included Brooklyn (Red Hook Cruise Terminal), New York (Manhattan Cruise Terminal), Kingston, Oswego, and Troy

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19. 19 VSP Program Components  Operational Inspections  Surveillance & Outbreak Investigations  Construction  Training & Consultation

20. 20 Surveillance  Report 24 hours before arrival at a U.S. port  Submit a 4-hour update  Submit a special report when gastrointestinal illness reaches 2% and again at 3%  Use electronic reporting system

21. 21 Outbreak Investigations  Laboratory assessment  Epidemiological assessment  Environmental assessment

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25. 25 VSP Program Components  Operational Inspections  Surveillance & Outbreak Investigations  Construction  Training & Consultation

26. 26 Construction  New builds  Renovations  Plan reviews  Yard Inspection  Final inspection  Equipment reviews

27. 27 2011 Construction Guidelines

28. 28 Plan Review/Construction Inspections

29. 29 Equipment Evaluations

30. 30 VSP Program Components  Inspections  Surveillance & Outbreak Investigation  Construction  Training & Consultation

31. 31 Training  Train-the-trainer course for cruise ship supervisors  Six times per year  Miami and Seattle  700 industry personnel per year

32. 32 International Consultation Egypt – Nile Cruises

33. 33  10-12 cruise vessels: floating hotels  ATHENS 2004 mandate for USPHS inspection before arrival in Piraeus  EU SHIPSAN: project to standardize Europe on ship sanitation inspections International Consultation

34. 34 www.cdc.gov/nceh/vsp

35. For more information please contact Centers for Disease Control and Prevention National Center for Environmental Health Vessel Sanitation Program 4770 Buford Highway NE – MS 59 Atlanta GA 30341-3724 USA Telephone: 770-488-3141 Fax:770-488-4127 1850 Eller Drive – Suite 101 Fort Lauderdale, FL 33316-4201 USA Telephone: 954-356-6650 Fax:954-356-6671 Toll Free: 800-323-2132 TTY:888-232-6348 Email: vsp@cdc.gov / Web: www.cdc.gov/nceh/vsp The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

36. Vessel Sanitation Program Charting a Healthier Course National Center for Environmental Health Vessel Sanitation Program