Outbreaks of diarrhoeal illness on passenger cruise ships, 1975-85
Addiss DG, Yashuk JC, Clapp DE, Blake PA.
- Epidemiology & Infection 1989 Aug;103(1):63-72.
- We reviewed data from the Vessel Sanitation Program (VSP), established by
the US Public Health Service in 1975, to describe the epidemiology of
shipboard diarrhoeal outbreaks, determine the risk of outbreak-related
illness among cruise ship passengers, and evaluate changes in rates and
patterns of shipboard diarrhoeal illness since the VSP was implemented.
When the programme began, none of the cruise ships passed periodic VSP
sanitation inspections; since 1978, more than 50% of ships have met the
standard each year. On cruises lasting 3-15 days and having at least 100
passengers, diarrhoeal disease outbreaks investigated by the Centers for
Disease Control decreased from 8.1 to 3.0 per 10 million passenger days
between 1975-79 and 1980-85. The proportion of outbreaks due to bacterial
pathogens (36%) did not change. Seafood cocktail was implicated in 8 of 13
documented food-borne outbreaks. The risk of diarrhoeal disease outbreaks
on cruise ships appears to have decreased since implementation of the VSP
but has not been eliminated.