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Item No.:
02
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Site:
Medical-Close Contact Follow-Up Interviews
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Violation:
Close contact interviews for more than one crew member AGE reportable case were not conducted or documented. For example; a Junior Waiter had AGE symptoms during the 6-16 February voyage, his questionnaire stated there were two people in the cabin, but no information was available in the electronic medical surveillance system for interviews with his cabin mate; a 1st Commis had AGE symptoms on 30 January, his questionnaire stated there were two people in the cabin, but no information was available in the electronic medical surveillance system for interviews with his cabin mate; a Gift Shop worker had AGE symptoms on 10 January, his questionnaire stated there were two people in the cabin, but no information was available in the electronic medical surveillance system for interviews with his cabin mate.
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Recommendation:
Maintain the following records on board for 12 months and make them available for review by VSP during inspections and outbreak investigations: (1) medical log/record; (2) AGE surveillance log; (3) 2-hour self-administered questionnaires; (4) interviews with cabin mates and immediate contacts of crew members with AGE [initial, 24-, and 48-hour]; (5) documentation of the 3-day assessment of crew members with AGE symptoms before joining the vessel; (6) documentation of the date and time of last symptom and clearance to return to work for food and nonfood employees; and (7) documentation of the date and time of verbal interviews with asymptomatic cabin mates and immediate contacts of symptomatic crew.
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Item No.:
02
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Site:
Medical-AGE Surveillance Logs
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Violation:
A review of the AGE surveillance logs for 7 January to 26 February indicated the underlying illness column was left blank unless a reportable AGE case had associated conditions.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Date of the first medical visit or report to staff of illness; (2) time of the first medical visit or report to staff of illness; (3) case identification number; (4) person?s name; (5) person?s age; (6) person?s sex; (7) designation as passenger or crew member; (8) crew member position or job on the vessel, if applicable; (9) cabin number; (10) meal seating information; (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) number of episodes of vomiting in a 24-hour period; (c) bloody stools; (d) recorded temperature; (e) abdominal cramps; (f) headaches; (g) muscle aches; (14) entry (yes/no) for whether this was a reportable case; (15) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (16) presence of underlying medical conditions that may affect interpretation of AGE. 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.:
08
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Site:
Potable Water-Evaporator #2
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Violation:
Water was continuously dripping from the reduced pressure assembly atmospheric relief vent, indicating a possible device failure.
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Recommendation:
Maintain backflow prevention devices in good repair. Inspect backflow prevention devices periodically and replace any failed units.
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Item No.:
11
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Site:
Medical-Crew Member Reporting
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Violation:
A 1st Commis had an onset of acute gastroenteritis (AGE) symptoms at 15:30 on 24 February. He reported to the medical center at 17:00. His time card indicated he worked from 15:30 - 19:00 and 19:30 - 22:00, however he was in medical isolation starting about 17:00.
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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.:
20
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Site:
Galley-Deck 6 Pastry Shop
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Violation:
The ice cream machine was labeled out of order since 6 February, 2017. Staff presented a work order.
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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; and (2) Cutting or piercing parts of can openers must be kept sharp to minimize the creation of metal fragments that can contaminate food when the container is opened.
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Item No.:
22
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Site:
Galley-Deck 5 Port Side Cold Kitchen (Garde Manger)
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Violation:
The undercounter dishwasher (DK06) adjacent to the preparation counter was out of order during the inspection. Staff presented the service order and noted that the dishwasher stopped working the morning of the inspection.
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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.:
27
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Site:
Buffet-Deck 14 Horizon Court Forward Port Side Italian Cafe
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Violation:
Two portable heating units used to keep desserts warm during operation, had excess debris accumulated on the heating bulbs and underside.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
28
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Site:
Galley-Deck 5 Starboard Service Line
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Violation:
The undercounter storage cabinets had at least 10 stacks of 30 or more plates. The bottom plates of each stack were resting in water on the storage shelf.
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Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying, and covered or inverted.
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Item No.:
33
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Site:
Galley-Deck 5 Port Side Cold Kitchen (Garde Manger)
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Violation:
The deck below the undercounter dishwasher (DK06) and cleaning cabinet was soiled with food debris and a serving spoon was removed. The area was not in operation during the inspection. Staff stated that the area was cleaned prior to the inspection.
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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.:
34
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Site:
Galley-Deck 5 Starboard and Port Side
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Violation:
Technical areas under bain marie #1 and bain marie #12 had braided flexible piping that steam travels through. In both areas multiple drips occurred where the flexible pipe screwed into the pressure connectors. Under bain marie #12, the leaking flexible pipe was positioned over a deck drain, so water did not accumulate on the deck under the service line area. Staff engineers and plumbers replaced the flexible piping with straight pipe during the inspection and the leaks stopped. The galley was not in service at the time of inspection.
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Recommendation:
Ensure a plumbing system in a food area is maintained in good repair.
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Item No.:
35
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Site:
Galley-Deck 5 Starboard and Port Side
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Violation:
Under bain marie #1, the flexible piping was not positioned over a deck drain, so excess water accumulated on the deck under the service line area. Staff engineers and plumbers replaced the flexible piping with straight pipe during the inspection and the leaks stopped. Galley staff cleaned and removed the excess water pooling on the deck during the inspection. The galley was not in use at the time of the inspection nor during the piping repairs.
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Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
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