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Investigation Update on the Regal Princess

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Investigation Update – September 2, 2003

Since October 2002, the Centers for Disease Control and Prevention’s Vessel Sanitation Program (VSP) has been following or investigating several instances of gastrointestinal illness aboard cruise ships. Outbreaks of gastrointestinal illness continue to be reported throughout the U.S. and subsequently, we continue to see an increase in the number of passengers with gastrointestinal illness on some cruises.

Cruise vessels sailing to U.S. Ports are required to notify the CDC of every case of gastrointestinal illness reported to the ships’ medical staff, for each cruise. This report must be filed 24 hours prior to arrival at a U.S. port, from a foreign port. If the number of passengers or crew ill reaches 2% during the cruise, the vessel is required to file a special report. The CDC continues to closely monitor these illness reports on a daily basis. An “outbreak” of gastrointestinal illness is defined as having 3% or more of either passengers or crew reported with a gastrointestinal illness.

Cruise vessels currently being closely monitored are:

Regal Princess (Princess Cruises) for the cruise of August 18 to September 2, 2003, reported 301 of 1,557 passengers (19.3%) and 45 of 687 crew (6.6%) with gastrointestinal illness. Stool samples collected from ill passengers and crew have been analyzed and norovirus has been confirmed by a public health laboratory in the U.K. Crew of the Regal Princess have conducted extensive cleaning and disinfection of the vessel during the duration of the cruise. However, to allow additional time for cleaning and disinfection without passengers present, Princess Cruises elected to bring the vessel into New York one day early. Additional cleaning teams will board the vessel and the vessel will embark passengers on Thursday, September 4, as scheduled.

General Information

Cruise ship travelers are reminded that simple hygienic practices, such as frequent and thorough hand washing with warm water and soap, and avoiding contact with other passengers when ill, are important measures to prevent the spread of disease.

Additional information about CDC’s Vessel Sanitation Program is available at

Information on Norwalk-like viruses is available at: and

Additional information on gastrointestinal diseases is available at

CDC protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

For more information, CDC’s Vessel Sanitation Program can be reached at