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Item No.:
02
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Site:
Medical-Case Definition
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Violation:
A crew member experiencing gastrointestinal symptoms on the 7/3-7/7 voyage was classified as a non-reportable case, and medical staff wrote in the comments this was not normal for the patient. A crew member experiencing gastrointestinal symptoms on the 6/23-6/28 voyage was classified a non-reportable case, and medical staff wrote in the comments the symptoms were above normal for the patient. Both crew members were treated as a reportable case and isolated according to the protocol. Medical staff were unclear that a patient with diarrhea symptoms can be a reportable case if the symptoms are above normal for the individual. A similar finding was documented in the last inspection.
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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.:
44
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Site:
Medical-Case Definition
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Violation:
Medical staff were unclear that a patient with diarrhea symptoms can be a reportable case if the symptoms are above normal for the individual. This was noted in the last inspection.
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Recommendation:
Ensure the supervisor or person in charge of medical operations related to AGE on the vessel demonstrates to VSP?during inspections and on request?knowledge of medical operations related to AGE, is able to demonstrate this knowledge by compliance with Section 4 of the VSP 2011 Operations Manual or by responding correctly to the inspector?s questions as they relate to the specific operation, and properly trains employees to comply with Section 4 of the VSP 2011 Operations Manual as it relates to their assigned duties.
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Item No.:
01
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Site:
Medical-Reporting
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Violation:
The Maritime Illness and Death Reporting System (MIDRS) 4-hour report was incorrect for the 7/7-7/12 voyage. The report noted zero reportable crew gastrointestinal cases, but the acute gastroenteritis (AGE) log documented one reportable crew case. Staff reported this is an error with the medical reporting system, which generates the emails with the MIDRS reports automatically.
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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-Late Reporting
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Violation:
A crew member experiencing gastrointestinal illness symptoms on the 6/19-6/23 voyage had an illness onset at 1000 on 6/9, and did not report to medical until 1640 that day. The crew member ate in the staff mess. Documentation verified this crew member was disciplined.
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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.:
08
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Site:
Recreational Water Facilities-Aft Pump Room- Kid's Pool
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Violation:
The air gap between the potable water filling and the compensation tank of the kid's pool was not twice the diameter of the supply line.
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Recommendation:
Ensure air gaps are at least twice the diameter of the delivery fixture opening and a minimum of 25 millimeters (1 inch).
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Item No.:
08
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Site:
Recreational Water Facilities-Pump Room- Aft Lido Whirlpool
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Violation:
The air gap between the potable water filling and the compensation tank of the aft whirlpool was not twice the diameter of the supply line.
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Recommendation:
Ensure air gaps are at least twice the diameter of the delivery fixture opening and a minimum of 25 millimeters (1 inch).
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Item No.:
16
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Site:
Buffet-Deli Station
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Violation:
Two in-use containers of pasteurized eggs, being used for omelets, were on the preparation counter without a 4-hour discard label. This was corrected.
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Recommendation:
Containers of POTENTIALLY HAZARDOUS FOOD under time control and placed on preparation counters must be labeled with the discard time, even if the outlet is open less than 4 hours.
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Item No.:
19
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Site:
Buffet-Lido Pantry Station #1
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Violation:
Tongs for waffles, out for passenger self-service, were placed on a plate outside of the sneeze shield. This was corrected.
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Recommendation:
During service, ensure the food contact portion of each self-service food dispensing utensil is covered or located beneath shielding. Ensure that dishware, glassware, and utensils out for service are inverted or covered.
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Item No.:
37
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Site:
Buffet-Lido Pantry Station #1
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Violation:
Heavy condensate was observed on the deckhead above the syrup warming station. Condensate was not dripping.
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Recommendation:
Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads.
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Item No.:
33
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Site:
Galley-Lido Center
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Violation:
Deck tile grouting was missing or recessed throughout much of this area.
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Recommendation:
Ensure decks in food preparation areas are maintained in good repair.
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Item No.:
36
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Site:
Galley-Ice Machines
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Violation:
The light intensity behind the ice machines was less than the required 110 lux of light.
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Recommendation:
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.:
26
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Site:
Galley-Aft Beverage Station Ice Machines
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Violation:
The ice contact side of the plastic deflector panel was soiled with a dark mold-like residue inside ice machine #822 and #833. A heavy accumulation of granular sediment was observed in the water return bath to ice machine #833. Nearly identical findings were observed during the previous inspection.
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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:
Galley-Fwd & Aft Service Lines
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Violation:
Several deck tiles were cracked and chipped, as well as missing and recessed deck tile grouting, throughout much of this area. A plan was reviewed to repair the deck tiles and grouting.
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Recommendation:
Ensure decks in food preparation areas are maintained in good repair.
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Item No.:
33
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Site:
Galley-Soup/Sauce Station
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Violation:
Several deck tiles were cracked and chipped, as well as missing and recessed deck tile grouting, throughout much of this area. A plan was reviewed to repair the deck tiles and grouting.
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Recommendation:
Ensure decks in food preparation areas are maintained in good repair.
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Item No.:
28
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Site:
Galley-Room Service
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Violation:
Small condiment containers were stored on a serving tray which was soiled with a liquid residue. The tray and containers were sent to be cleaned.
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Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (2) in a location where they are not exposed to splash, dust, or other contamination; (3) at least 150 millimeters (6 inches) above the deck.
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Item No.:
20
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Site:
Preparation Room-Potato Peeler
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Violation:
The exit chutes to the potato peelers were in poor repair and exposed large gaps and seams, which were difficult to clean. Heavy sealant was used to try and close the gaps and seams, but was observed peeling and flaking off.
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Recommendation:
Materials used in the construction of multiuse utensils and food contact surfaces of equipment must be: (1) durable, corrosion resistant, and nonabsorbent; (2) sufficient in weight and thickness to withstand repeated warewashing; (3) finished to have a smooth, easily cleanable surface; and (4) resistant to pitting, chipping, crazing, scratching, scoring, distortion and decomposition.
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Item No.:
19
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Site:
Bar-Pool Bar
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Violation:
A dead ant and bee were observed inside a bottle of flavored liquor. A second bottle had a dead ant.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination.
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Item No.:
39
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Site:
Bar-Pool Bar
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Violation:
Ants and a bee were observed inside liquor bottles at this bar.
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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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