Page 229 - Vessel Sanitation Program 2018 Operations Manual

VSP 2018 Operations Manual

include a high incidence of illness in successive cruises, unusual severity
of illnesses or complications, or a large number of persons reporting the
illness over a brief period of time.

13.4.1.7 Rapid Response
Conducting an OUTBREAK investigation aboard a vessel demands a
rapid, organized, and comprehensive response. Because of the
TURNOVER of passengers, and sometimes crew members, the
investigation must be rapid in order to collect data needed to identify the
cause.

13.4.1.8 Collaboration
The investigation is a collaborative effort of the cruise line, passengers and
crew members aboard the vessel, and VSP. Therefore, an organized plan
drafted between the organizations and individuals involved is crucial in
conducting a successful investigation—a comprehensive effort that
includes epidemiologic, environmental, and laboratory studies.
Recommendations based on the success of the investigation can then be
implemented to prevent a recurrence on the following cruise.

13.4.2 Objectives

The objectives of an investigation are to
• Determine the extent of the AGE among passengers and crew.
• Identify the agent causing the illness.
• Identify risk factors associated with the illness.
• Formulate control measures to prevent the spread of the illness.

13.4.3 Outbreak Investigation Procedures

13.4.3.1 Contingency Plan
The early stages of an investigation are usually coordinated aboard the
vessel by the vessel’s medical staff in cooperation with engineering and
hotel staff. It is important to have a coordinated contingency plan in place
on board the vessel before implementation is needed. All staff with a
potential for involvement in an investigation should be familiar with the
contingency plan.

13.4.3.2 Periodic Review
This preliminary preparation will assist the vessel with the necessary rapid
implementation of investigation and response measures before the arrival
of the VSP team. The OUTBREAK contingency plan should be
periodically reviewed to ensure it will still meet the vessel’s needs in
dealing with an OUTBREAK.

Annex 13.4: Acute Gastroenteritis Outbreak Investigation; 176