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Guidance for Cruise Ships: How to Report Onboard Death or Illness to CDC

According to federal regulations, CDC requires the master of a ship destined for a U.S. port to report immediately any death or certain illnesses among the ship’s passengers or crew. CDC has outlined below how cruise ships should report deaths and illnesses (non-gastrointestinal) to the Division of Global Migration and Quarantine (DGMQ). Effective March 21, 2017, the definition of ill person under CDC regulations changed. This change, found in 42 Code of Federal Regulations part 71.1, clarifies the list of signs and symptoms that may indicate a person is ill with a communicable disease of public health concern.

There is no change to the methods for reporting these illnesses or deaths. The following instructions still apply:

Download, complete, and submit these fillable forms to DGMQ:

Exceptions to Reporting Illnesses on These Forms

Instructions for Reporting Deaths and Illnesses

Please DON’T submit any forms through e-mail that include personally identifiable information (PII). PII is any information that can be used alone or in combination to identify an individual. This includes names, addresses, phone numbers, dates (birth, hospital admission, travel), identifying numbers (passport, social security, driver’s license, alien), medical records, photographs, and for rare diseases, geographic locations.

  • Please download both forms and save them for future access. Use a separate Maritime Conveyance Illness or Death Investigation Form for each ill or deceased person.
  • Complete sections as instructed in the table below on the Maritime Conveyance Illness or Death Investigation Form [PDF - 4 pages] and all sections of the Maritime Conveyance Cumulative Influenza/Influenza-Like Illness (ILI) Form [PDF - 1 page]. You may type directly into the forms, or print them out and fill out by hand.
  • To submit the forms to the CDC Quarantine Station with jurisdiction over the next U.S. seaport of arrival, you have three options: email, fax or telephone.
    • By email: Click on the gray “Send Via E-mail” button in the upper left-hand corner of the form. (Note: In order to use this option, your e-mail account must be set up to automatically generate an e-mail message from a PDF), or save the form, then attach it to your e-mail and send it to MaritimeAdmin@cdc.gov. If you choose this option, your e-mailed report will automatically be sent to the CDC Quarantine Station, and you should receive an immediate confirmation e-mail.
    • By fax or by telephone: Look up the contact information for the CDC Quarantine Station with jurisdiction over the next U.S. seaport of arrival to obtain information and send by fax, or
      If you choose option fax or phone, a confirmation e-mail will be sent within 1 business day to the email address provided with the report. The quarantine station will contact you if follow-up information is needed.
  • If you don’t receive confirmation of your report or if you have any questions, please contact the CDC Quarantine Station with jurisdiction over the next U.S. port of arrival, the CDC Emergency Operations Center at 770-488-7100, or the Maritime Activity Administrator.
  • Please DON’T submit Section 5 (General Information about Ill or Deceased Person) on the Maritime Conveyance Illness or Death Investigation Form unless the quarantine station asks you to do so.
    Note: Because this section contains PII, you won’t be able to type any information directly into the fillable PDF form. You will need to print out this section of the form and fill it out by hand. Then submit Section 5 only by fax or by telephone.

Instructions for Cumulative Influenza/Influenza-Like Illness Report

CDC requests that cruise ships submit a cumulative ILI report (even if no deaths or ILI cases have occurred) preferably during the final 24 hours of the voyage or as soon as an outbreak is suspected, as described below. These reports should be made once a voyage by completing the one-page Maritime Conveyance Cumulative Influenza/Influenza-like Illness (ILI) Form [PDF - 1 page] and clicking on the grey “Send Via Email” box in the top left corner.

CDC requests that cruise lines immediately report any of the following events to the CDC Quarantine Station having jurisdiction over the next U.S. port of entry:

  • Outbreaks of influenza or ILI (exceeding 1.380 cases per 1,000 traveler days) among passengers or crew members (instructions for calculating ILI threshold can be found here).
  • Hospitalization (ashore or at sea) caused by, or suspected to be associated with, influenza or ILI onboard the vessel.

In addition, CDC is taking this opportunity to emphasize that any death, including those caused by or suspected to be associated with influenza or ILI, that occurs aboard a cruise ship destined for a U.S. port must be reported to CDC immediately. Report ILI hospitalizations or deaths by submitting an individual Maritime Conveyance Illness or Death Investigation Form [PDF - 4 pages] for each hospitalization or death, or report by phone.

Illness Type and Signs and Symptoms to Report by Federal Regulations

Required: Death/Disease/Symptoms to Report

Complete Sections 1–4 of the Maritime Conveyance Illness or Death Investigation Form [PDF - 4 pages]

  • Death
  • Quarantinable Diseases (both suspected or confirmed) listed in the President’s Executive Order: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and novel influenza viruses.
  • Signs and symptoms of public health interest included in the Federal Regulations:
    • (A) Fever (has a measured temperature of 100.4 °F [38 °C] or greater; or feels warm to the touch; or gives a history of feeling feverish) accompanied by one or more of the following:
      • Skin rash,
      • difficulty breathing or suspected or confirmed pneumonia,
      • persistent cough or cough with bloody sputum,
      • decreased consciousness or confusion of recent onset,
      • new unexplained bruising or bleeding (without previous injury),
      • persistent vomiting (other than sea sickness), headache with stiff neck;
      OR
    • (B) Fever that has persisted for more than 48 hours;
      OR
    • (C) Acute gastroenteritis, which means either diarrhea, defined as three or more episodes of loose stools in a 24-hour period or what is above normal for the individual, or vomiting accompanied by one or more of the following: One or more episodes of loose stools in a 24-hour period, abdominal cramps, headache, muscle aches, or fever (temperature of 100.4 °F [38 °C] or greater);
      OR
    • (D) Signs and symptoms of serious communicable diseases of public health interest included in the Federal Regulations

Note: Cruise ships carrying 13 or more passengers should continue to report acute gastroenteritis or diarrheal illness cases to the CDC-Vessel Sanitation Program (VSP)

* Medical staff should consider someone to have a fever if the ill person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100.4 °F [38 °C] or greater.

Note: Cruise ships carrying 13 or more passengers should continue to report cases of acute gastroenteritis or diarrrhea cases to CDC-VSP

Note: Complete Sections 1-3 only for varicella (chickenpox)

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