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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Logs
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Violation:
During the voyage number 5277, there was one reported case which did not have anything written in the underlying illness column.
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Recommendation:
Ensure the AGE surveillance log includes a header containing the following information about the voyage: (1) Vessel name; (2) Voyage number; (3) Date from; (4) Date to; (5) Total number of passengers; (6) Reportable total number of passengers ill; (7) Total number of crew; (8) Reportable total number of crew ill. Total number of passengers and total number of crew must be the totals at the beginning of the voyage (i.e., totals on ?date from?). Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Patient ID; (2) Date of the first medical visit or report to staff of illness; (3) time of the first medical visit or report to staff of illness; (4) person's last name; (5) person's first name; (6) person's age; (7) person's sex; (8) designation as passenger or crew member; (9) cabin number; (10) crew member position or job on the vessel, if applicable; (11) date of illness onset; (12) time of illness onset; (13) illness symptoms, including the presence or absence of the following selected signs and symptoms, with a separate column for each of the following: (a) number of episodes of diarrhea in a 24 hour period; (b) bloody stools (yes/no); (c) number of episodes of vomiting in a 24 hour period; (d) fever (yes/no); (e) abdominal cramps (yes/no); (f) headaches (yes/no); (g) myalgia (yes/no); (14) date of last symptom; (15) time of last symptom; (16) entry (yes/no) for whether a specimen was requested; (17) entry (yes/no) for whether a specimen was received; (18) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (19) entry (yes/no) for whether this was a reportable case; (20) presence of underlying medical conditions that may affect interpretation of AGE. If none, write ?none,? ?not applicable,? ?N/A,? r similar wording. Comments may also be added to the log in this column after the information about underlying illness. Ensure the AGE surveillance log contains the above information in the exact order and is entered in the template in Annex 13.2.2. Ensure that the log data is exported in the exact order as in the example template in Annex 13.2.2 with analyzable formats such as Excel or Access. Ensure that any additional data fields are entered only outside of the form margins when exported to VSP.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Logs
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Violation:
During voyage numbered 5826, the follow up for the cabin mate of an ill employee took place too early. The illness onset was 2100, the first follow up was 2130 and the second follow up was 1800. Medical staff stated that the employee was difficult to contact for the 48 hour follow up so it was conducted before their work shift.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions for the asymptomatic cabin mates or immediate contacts of symptomatic crew: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members? symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews.
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Item No.:
08
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Site:
Potable Water-Potable Water System Maintenance/Repair Logs
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Violation:
There were three instances where there was no recorded free halogen chlorine value prior to the pipes being placed back into service. These instances were on 3 October 2018, 4 October 2018, and 27 September 2018.
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Recommendation:
Flush the disinfected parts of the system with potable water or otherwise dechlorinate until the free residual halogen is less than or equal to 5.00 mg/L (ppm). Document the free halogen test result.
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Item No.:
08
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Site:
Potable Water-Cross Connection Control Log
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Violation:
The two backflow prevention devices installed on the two showers in the medical ward were not listed on the cross connection control log. Staff updated this immediately.
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Recommendation:
Ensure the cross-connection control program includes at a minimum: a complete listing of cross-connections and the backflow prevention method or device for each, so there is a match to the plumbing system component and location. Include air gaps on the listing. Ensure a schedule for inspection frequency is set. Maintain a log documenting the inspection and maintenance in written or electronic form, and ensure it is available for review during inspections.
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Logs
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Violation:
During the voyage number 5826, a food handler did not report to medical upon onset of AGE but self-isolated in their cabin and called medical 4 hours later. The crew member did not leave the cabin, work or visit the mess during this time.
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Recommendation:
When food employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 48 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document date and time of last symptom and clearance to return to work. When nonfood employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 24 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document the date and time of last symptom and clearance to return to work.
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Item No.:
16
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Site:
Galley-Cold Room 26
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Violation:
A tray of lobster tails in this cooler with ice measured 51F when measured with a tip sensitive thermometer. The thermostat on the bulkhead for the cooler measured 50F. No other potentially hazardous items were stored in this area.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
21
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Site:
Bar-Pool
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Violation:
Cords behind the cappuccino machine were draped on the counter and covered with white shipping tape where they had become unattached from the bar counter. This tape and the cords were difficult to clean.
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Recommendation:
Ensure nonfood-contact surfaces are free of unnecessary ledges, projections, and crevices, and designed and constructed to allow easy cleaning and to facilitate maintenance.
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Item No.:
22
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Site:
Buffet-La Terrazza
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Violation:
At the end of lunch a sanitizing bucket contained soiled dirty water behind the desert station.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Buffet-La Terrazza
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Violation:
A sanitizing bucket beside the handwash contained soiled cloudy water.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Galley-La Terrazza
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Violation:
Water was leaking from a curtain at the dirty entrance for the rack type plate washer and dripping dirty soiled water onto the deck.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines; (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
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Item No.:
22
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Site:
Galley-La Terrazza
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Violation:
A sanitizing bucket by the grill contained soiled cloudy water.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Galley-Dishwash
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Violation:
The initial water pressure at the dirty end of this rack type plate washer in this area appeared to be out of adjustment causing the crew member to step back after every rack he placed in the machine. Shortly after the rack was placed a large amount of hot water would spray directly out of the machine back onto the dirty area and onto the deck.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines; (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
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Item No.:
22
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Site:
Galley-Potwash
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Violation:
A sanitizing bucket in this are contained cloudy water.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
30
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Site:
Buffet-Handwash Station
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Violation:
The handwash station behind the service counter was not stocked with paper towels.
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Recommendation:
Ensure each handwashing facility has a supply of hand-cleansing soap or detergent and a supply of single-service paper towels available.
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Item No.:
33
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Site:
Food Service General-Deck
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Violation:
Some of the decks in the galleys were observed stained and some in minor disrepair. The decking in other parts of the galleys was very clean and recently replaced indicating the ongoing deck replacement projects.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, bars, and food and equipment storage areas are constructed and maintained for easy cleaning. Do not use carpet in these areas.
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Item No.:
33
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Site:
Galley-Bakery
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Violation:
Water was flowing from a seam in the deckhead into the scupper to the right of the rotation oven in this area. There was no apparent source for the water leaking.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
33
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Site:
Galley-Dishwash
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Violation:
The initial water pressure at the dirty end of this rack type plate washer in this area appeared to be out of adjustment as a result the deck remained soiled and wet.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
33
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Site:
Galley-La Terrazza
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Violation:
The water leaking from the curtain at the dirty end of the rack type machine was accumulating on the deck and contained an additional buildup of food debris.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
36
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Site:
Galley-Bakery
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Violation:
The light intensity measured 70 lux behind the 3 ovens JC1040019 and JC1040018 and JC1040017.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
36
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Site:
Galley-Bakery
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Violation:
The light intensity at the preparation counter to the left of the previously identified oven JC1040019 and JC1040018 and JC1040017 measured 167 lux.
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Recommendation:
Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas.
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Item No.:
39
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Site:
Galley-High Fog Panel #3
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Violation:
Soiled water had accumulated inside this technical space behind the bulkhead.
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Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
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