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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE Surveillance Log
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Violation:
The AGE log for voyage 9-17 August 2025, indicated a crew member was a reportable AGE case; however, information in the underlying illness column stated they were a non-reportable case due to medical assessment.
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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) Total number of reportable AGE cases among passengers; (7) Total number of crew; (8) Total number of reportable AGE cases among crew.
Ensure the total number of passengers and total number of crew are 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 contains the following information in separate columns: (1) Patient I.D.; (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; (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) Recorded temperature; (f) Abdominal cramps (yes/no); (g) Headaches (yes/no); (h) 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 AGE case; (20) Presence of underlying medical conditions that may affect interpretation of AGE; for example, diabetic diarrhea, inflammatory bowel disease, gastrectomy, antibiotic-induced diarrhea, vomiting from chemotherapy, ear infections in children or others. If none, write "none," "not applicable," "N/A," or similar wording.
Ensure the AGE surveillance log contains the above information in the exact order. Complete all fields of the AGE surveillance log, even if entry is zero or nonapplicable. If a field is not completed, document the reason in the notes column (for example, a virtual consultation).
Ensure the log data is exported in an analyzable form (such as Microsoft Excel or Microsoft Access) in the exact order noted above. Ensure any additional data fields in the surveillance log are entered only outside of the form margins when exported.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The Excel version of the AGE log did not include a 'Comments or Notes' column. (VSP 2025 Environmental Public Health Standards)
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Recommendation:
Ensure the AGE surveillance log contains the above information in the exact order. Complete all fields of the AGE surveillance log, even if entry is zero or nonapplicable. If a field is not completed, document the reason in the notes column (for example, a virtual consultation).
Ensure the log data is exported in an analyzable form (such as Microsoft Excel or Microsoft Access) in the exact order noted above. Ensure any additional data fields in the surveillance log are entered only outside of the form margins when exported.
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Item No.:
11
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Site:
Medical-Crew Member Isolation
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Violation:
A nonfood employee had an onset of AGE symptoms on 4 August 2025 at 1100, but did not report to the medical center until 1615 that day. Records indicated they were ashore during symptom onset and working ashore while symptomatic.
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Recommendation:
When nonfood employees are symptomatic and 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.:
11
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Site:
Medical-Crew Member Isolation
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Violation:
A food employee had an onset of AGE symptoms on 16 July at 1200, but did not report to the medical center until 1745 that day. The food assessment stated they were off duty during that time. The health questionnaire stated they went to laundry each evening, but this was unclear if it was their personal laundry or if they were actually working during that time.
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Recommendation:
When food employees are symptomatic and 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; (4) Review [when possible] any reportable AGE cases among passengers or crew reported after the food employee's illness onset for epidemiologic link/connection.
Ensure the food employee's supervisor or person in charge conducts an assessment of food prepared or served by the food employee while symptomatic and take appropriate corrective actions. Document corrective actions taken as a result of the assessment. Exclude food employees suspected of, diagnosed with, or exposed to any communicable disease caused by Salmonella typhi, Shigella spp., E. coli O157:H7, hepatitis A virus, norovirus, or other communicable diseases that can be transmitted by food, from working in any food or food-related areas or operations, including working with exposed food, warewashing, equipment, utensils, linens, single-service articles and single-use articles. Do not allow the excluded individual to return to the above duties until they are symptom free for a minimum of 48 hours. Ensure food employees who have conditions or symptoms of boils, open sores, infected wounds, diarrhea, jaundice, fever, vomiting, sore throat with fever, or discharges from the nose or mouth report these conditions or symptoms to the vessel's medical staff and are restricted from working with exposed food, warewashing, clean equipment, utensils, linens, and unwrapped single-service and single-use articles.
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Item No.:
11
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Site:
Medical-Crew Member Isolation
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Violation:
A food employee had an onset of acute gastroenteritis (AGE) symptoms on 26 August 2025 at 0700, but did not report to medical until 0930 that morning. The time card indicated the employee worked from 2128 on 25 August until they reported to medical the next morning.
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Recommendation:
When food employees are symptomatic and 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; (4) Review [when possible] any reportable AGE cases among passengers or crew reported after the food employee's illness onset for epidemiologic link/connection.
Ensure the food employee's supervisor or person in charge conducts an assessment of food prepared or served by the food employee while symptomatic and take appropriate corrective actions. Document corrective actions taken as a result of the assessment.
Exclude food employees suspected of, diagnosed with, or exposed to any communicable disease caused by Salmonella typhi, Shigella spp., E. coli O157:H7, hepatitis A virus, norovirus, or other communicable diseases that can be transmitted by food, from working in any food or food-related areas or operations, including working with exposed food, warewashing, equipment, utensils, linens, single-service articles and single-use articles. Do not allow the excluded individual to return to the above duties until they are symptom free for a minimum of 48 hours. Ensure food employees who have conditions or symptoms of boils, open sores, infected wounds, diarrhea, jaundice, fever, vomiting, sore throat with fever, or discharges from the nose or mouth report these conditions or symptoms to the vessel's medical staff and are restricted from working with exposed food, warewashing, clean equipment, utensils, linens, and unwrapped single-service and single-use articles.
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Item No.:
13
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Site:
Other-Chef's Table Variance
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Violation:
On 25 August 2025, a passenger failed to complete the health questionnaire to verify they did not have acute gastroenteritis symptoms. Medical verified this passenger was asymptomatic.
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Recommendation:
Ensure health questionnaires are completed for each participant, and each provision of the approved variance is followed.
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Item No.:
16
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Site:
Galley-Deck 10 - Market Place - Starboard Beverage Station
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Violation:
The left-side milk container inside the temperature-controlled bulk milk dispenser measured 44F with a thermometer from both crew and the inspector. The ambient air temperature gauge read 34F.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain TCS/PHF at 57C (135F) or above or 5C (41F) or less.
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Item No.:
19
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Site:
Buffet-Deck 10 - Market Place - Islands 1, 2, and 4
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Violation:
The light bulb's protective coating on the service line over-shelves was peeling or missing above food items out for passenger self-service.
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Recommendation:
Protect food from contamination by storing the food: Where it is not exposed to splash, dust, or other contamination.
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Item No.:
21
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Site:
Galley-Deck 10 - Market Place - Starboard Beverage Station
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Violation:
The ambient air temperature gauge of the bulk milk dispenser read 34F. The left-side milk container inside the dispenser measured 44F with a thermometer from both crew and the inspector.
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Recommendation:
Ensure ambient air temperature-measuring devices: (1) Scaled in Celsius or dually scaled in Celsius and Fahrenheit are designed to be easily readable and accurate to within 1.5C (within 3F) in the intended range of use; (2) Scaled only in Fahrenheit are accurate to within 3F in the intended range of use.
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Item No.:
21
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Site:
Preparation Room-Fish
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Violation:
The undercounter cabinet door near the freezer was in disrepair and was unable to close.
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Recommendation:
Design and construct nonfood-contact surfaces of equipment and utensils to be durable and to retain their characteristic qualities under normal use conditions. Ensure nonfood-contact surfaces are free of unnecessary ledges, projections, and crevices, and are designed and constructed to allow easy cleaning and to facilitate maintenance.
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Item No.:
26
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Site:
Galley-Deck 10 - Pizza Station
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Violation:
Three of the nine light bulbs above the front counter were soiled with old food residue. The area was not in operation and was previously cleaned. The area was cleaned immediately.
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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.:
27
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Site:
Galley-Deck 10 - Pizza Station
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Violation:
More than a day's accumulation of dust was on top of the cleaning locker. This was cleaned immediately.
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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.:
30
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Site:
Galley-Deck 3
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Violation:
The handwashing station's soap dispenser was clogged and was unable to dispense soap.
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Recommendation:
Ensure each handwashing station has a supply of hand-cleansing soap or detergent and a supply of single-service paper towels.
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Item No.:
30
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Site:
Galley-Deck 3 - Chefs Table
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Violation:
The paper towel dispenser for the crew handwashing sink was empty.
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Recommendation:
Ensure each handwashing station has a supply of hand-cleansing soap or detergent and a supply of single-service paper towels.
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Item No.:
33
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Site:
Buffet-Deck 3 Staff Mess
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Violation:
The deck tile grout around the hot buffet line was in disrepair.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
33
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Site:
Pantry-Deck 10 - Aft Bar
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Violation:
Condensate collected on the deckhead above the walk-in refrigerator's door frame.
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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-Deck 10 - Pizza Station
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Violation:
The deckhead light fixture conduit box was not flush with the deckhead, which created a gap.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
36
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Site:
Buffet-Deck 10 - Market Place - Islands 1, 2, and 4
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Violation:
The light bulb's protective coating on the service line over-shelves was peeling or missing above food items out for passenger self-service.
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Recommendation:
Ensure light bulbs are shielded, coated, or otherwise shatter resistant in areas with exposed food; clean equipment, utensils, and linens; or unwrapped single-service articles and single-use articles.
Protect an infrared or other heat lamp against breakage by a shield surrounding and extending beyond the bulb so only the face of the bulb is exposed.
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Item No.:
39
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Site:
Galley-Deck 10 - Overflow Dishwash
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Violation:
A small fly was in the area.
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Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in food areas.
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Item No.:
39
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Site:
Galley-Deck 10 - Cucina del Capitano
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Violation:
A small fly was in the show galley.
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Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in food areas.
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