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Item No.:
01
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Site:
Medical-4-Hour Report
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Violation:
The number of sick passengers reported on the 4-hour report and submitted to MIDRS on December 5, 2012 at 1:59 AM was incorrect. The same 4-hour report was submitted to MIDRS on December 4, 2012 at 9:00 PM.
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Recommendation:
If the number of cases changes after submission of the initial report, submit an updated report no less than 4 hours before the vessel's arrival at the U.S. port. Ensure that the 4-hour update report contains a cumulative total count of the reported crew and passengers during the entire cruise, including the additional cases.
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Item No.:
02
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Site:
Medical-Shipping Container
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Violation:
There was no shipping container available to properly pack and ship samples that may need to be collected during an outbreak. The last container was used recently during an outbreak and a new container had been ordered.
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Recommendation:
Ensure the medical staff maintains a supply of at least 10 clinical specimen collection containers for both viral and bacterial agents (10 for each), as well as a shipping container that meets the latest shipping requirements of the International Air Transport Association (IATA) and U.S. Department of Transportation for Biological Substances, Category B designated shipments (or higher). Ensure the vessel maintains the appropriate labels and markings required for shipping Biological Substances, Category B shipments. Ensure the vessel maintains appropriate refrigerant materials to keep clinical specimens cool. (see Annex 13.4 of the VSP 2011 Operations Manual.)
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Definition
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Violation:
During voyage #331 and voyage #330F, there was one crew member that had 2 episodes of diarrhea and no other symptoms, but specimens were requested for these individuals and antidiarrheal medication was distributed to both of them. According to the medical staff, these symptoms were above normal for both crew members, but they were recorded on the AGE log as non-reportable.
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Recommendation:
Ensure a reportable case of AGE is a case reported to the master of the vessel, the medical staff, or other designated staff by a passenger or a crew member and meets the case definition based on the following symptoms: (1) Diarrhea (three or more episodes of loose stools in a 24 hour period or what is above normal for the individual. See section 4.1.2.1.3, illness symptoms); or (2) vomiting and one additional symptom including one or more episodes of loose stools in a 24-hour period, or abdominal cramps, or headache, or muscle aches, or fever (temperature of greater than or equal to 38C [100.4F]).
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Item No.:
05
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Site:
Potable Water-Far Point Calibration
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Violation:
The free residual halogen measured by the halogen analyzer at the far point was 1.13 ppm. The inspector measured the free residual halogen at 1.49 ppm during the first reading and 1.51 ppm during the second reading. The ship's staff measured the free residual halogen at 1.51 ppm. The analyzer was calibrated immediately.
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Recommendation:
Ensure the free residual halogen measured by the halogen analyzer is within 0.2 mg/L (ppm) of the free residual halogen measured by the manual test.
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Item No.:
06
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Site:
Potable Water-Microbiological Testing
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Violation:
The comparator bottle used to test the potable water samples using the Colitag method was expired.
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Recommendation:
If water samples are collected and analyzed by the vessel for the presence of E. coli, analyze the samples using a method accepted in Standard Methods for the Examination of Water and Wastewater. Ensure test kits, incubators, and associated equipment are operated and maintained in accordance with the manufacturers' specifications.
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Item No.:
08
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Site:
Potable Water-Spa Deck 8
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Violation:
Both of the backflow prevention devices on the left pedicure chair for the hot and cold water lines appeared to be leaking.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
08
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Site:
Potable Water-Photo Lab Deck 4
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Violation:
The cross-connection control list indicated there were three backflow prevention devices installed in the photo lab, but upon inspection there were only two backflow prevention devices installed on the hot and cold water lines.
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Recommendation:
Update or correct the cross-connection control list.
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Item No.:
16
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Site:
Galley-Breakfast Pantry
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Violation:
There were six half pints of milk and one liter of soy milk between 52F and 55F as measured by the inspector in reach-in refrigerator 4.10. The internal temperature of the refrigerator was 37F. The half pints of milk and liter of soy milk were immediately discarded by the crew.
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Recommendation:
Maintain potentially hazardous foods at 5C (41F) or less.
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Item No.:
20
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Site:
Galley-Breakfast Pantry
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Violation:
There was condensate pooling in the bottom of reach-in refrigerator 4.5.
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Recommendation:
Food contact equipment must be maintained in good repair and proper adjustment: (1) Equipment must be maintained in a state of repair and condition that meets the materials, design, construction, and operating specifications of these guidelines.
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Item No.:
22
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Site:
Galley-Dishwashing
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Violation:
The far right final rinse spray nozzle from the clean end of the glasswash machine was partially blocked, creating an ineffective spray pattern.
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Recommendation:
Ensure a warewashing machine and its auxiliary components are operated in accordance with the machine's data plate and other manufacturer's instructions. Ensure a warewashing machine's conveyor speed or automatic cycle times is maintained accurately timed in accordance with manufacturer's specifications.
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Item No.:
26
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Site:
Galley-Garde Manger
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Violation:
There was dried food residue on the bottom of the back plate of the previously cleaned slicer near the exit point of the sliced food.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Dining Room-Rotterdam
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Violation:
There was food residue on three previously cleaned small coffee cups in the lower cabinet of waiter station #37.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Housekeeping-Deck Pantries
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Violation:
There was a dried black residue in the corners of the clear plastic bins in the clean utensil storage area in Deck Pantries SP 16 and SP 25.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
33
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Site:
Provisions-Dry Stores
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Violation:
An accumulation of food debris and dust was on the deck against the bulkhead and in the corners under the shelves and pallets.
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Recommendation:
Ensure decks in food storage areas are cleaned as often as necessary.
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Item No.:
42
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Site:
Children Area-Toilet Room
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Violation:
There was greater than 22 inches between the step stool and the handwashing sink in the toilet room for 3-7 year olds.
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Recommendation:
Ensure handwashing sinks have a maximum height of 560 millimeters (22 inches) above the deck or a step stool.
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