The Cruise Industry's Commitment to Public Health and Medical Capabilities

Cruise Lines International Association (CLIA) member cruise lines have consistently demonstrated industry’s strong commitment to providing clean and sanitary environments aboard our vessels, and appropriate medical facilities and care for our guests.

Commitment to Providing a Healthy Ship Environment

• Ships undergo regular inspections, conduct crew training and maintain frequent communication with the United States Department of Health and Human Services Centers for Disease Control and Prevention (CDC) Vessel Sanitation Probram (VAP) to provide a safe, healthy environment for all at sea.
• The cruise industry works with the Centers for Disease Control and Prevention (CDC) Vessel Sanitation VSP to help ensure cruise ships are in compliance with strict international and federal sanitation standards that are effective in mitigating illness aboard cruise ships.
• Each CLIA member cruise line must have a plan for the prevention and containment of gastrointestinal illnesses (GI), which include norovirus. In the uncommon event of an outbreak, CLIA member cruise lines are to follow the Outbreak Prevention and Response Plan (OPRP).
• Norovirus, the most prevalent illness behind the common cold, is uncommon in cruise ships due to extensive sanitation procedures. Approximately 9 million passengers embarked on a CLIA cruise ship from a U.S. port in 2008. There were 15 outbreaks reported that year to the CDC, involving a total of 1,737 ill passengers (according to CDC website), which represents approximately one one-hundredth of one percent of passengers (0.0193%). If you add in cases which did not rise to the two percent threshold of an outbreak, say another 5,000 illnesses, this still represents far less than 1% of passengers.
• CLIA ships regularly exceed the CDC's minimum sanitation inspection score of 85. In fact, most CLIA cruise lines score about 95. Scores are available to the public through the CDC website at www.cdc.gov/nceh/vsp.

Commitment to Providing Medical Care

CLIA adopted a policy that its members adhere to the American College of Emergency Physicians (ACEP) guidelines on appropriate emergency care and health care maintenance for passengers and crew on board ships. ACEP is the world’s largest association of emergency medicine professionals. ACEP specifies that:

• All ocean-going cruise ships have medical facilities on board and are staffed by trained and licensed medical professionals with at least three years of clinical experience, including minor surgery and emergency care. All doctors and nurses are to be fluent in English.
• The CLIA Medical Working Group, comprised of licensed and experienced shipboard physicians, member medical professionals and consultants, meets regularly to discuss cruise ship medical response and consider new developments.

Regulations and Compliance

• International: World Health Organization INTl Health Regulations
• United States: CDC Vessel Sanitation Program and Quarantine programs