The Centers for Disease Control and Prevention (CDC) established the Vessel Sanitation Program (VSP) in the 1970s as a cooperative activity with the cruise ship industry. The program assists the cruise ship industry in fulfilling its responsibility for developing and implementing comprehensive sanitation programs to minimize the risk for acute gastroenteritis. Every vessel that has a foreign itinerary and carries 13 or more passengers is subject to twice-yearly inspections and, when necessary, re-inspection.

The third edition of the Guide to Ship Sanitation presents the public health significance of ships in terms of disease and highlights the importance of applying appropriate control measures. It is intended to be a basis for the development of national approaches to controlling the hazards, providing a framework for policy-making and local decision-making. It may also be used as a reference for regulators, ship operators and ship builders as well as for assessing the potential health impact of projects involving the design of ships.

"The Centers for Disease Control and Prevention (CDC) established the Vessel Sanitation Program (VSP) in the 1970's as a cooperative activity with the cruise ship industry. The program assists the cruise ship industry in fulfilling its responsibility for developing and implementing comprehensive sanitation programs in order to minimize the risk of gastrointestinal diseases. Every vessel that has a foreign itinerary and carries 13 or more passengers is subject to twiceyearly inspections and, when necessary, reinspection. The VSP operated continuously at all major U.S. ports from the early 1970's through 1986, when CDC terminated portions of the program. Industry and public pressures resulted in Congress directing CDC through specific language included in CDC appropriations to resume the VSP. The National Center for Environmental Health (NCEH) at CDC became responsible for the VSP in 1986. The NCEH held a series of public meetings to determine the needs and desires of the public and cruise ship industry and on March 1, 1987, a restructured program began. In 1988, the program was further modified by introducing user fees to reimburse the U.S. government for costs. A fee based on the vessel's size is charged for inspections and reinspections. A VSP Operations Manual based on the FDA 1976 model code for food service and the World Health Organization's Guide to Ship Sanitation was published in 1989 to assist the cruise ship industry in educating shipboard personnel. In 1998, it became apparent that is was time to update the 1989 version of the VSP Operations Manual. Changes in the FDA Food Code, new science on food safety and protection, and newer technology in the cruise ship industry contributed to the need for a revised Operations Manual. During the 2 years following, the VSP solicited comments from and conducted public meetings with representatives of the cruise industry, general public, FDA and international public health community to ensure that the 2000 manual would appropriately address current public health issues related to cruise ship sanitation. Although the previous VSP Operations Manual was in use for 5 years, we have seen new technology, advanced food science, and emerging pathogens which require the manual to be updated. This document represents the comments and corrections submitted by all those cooperative partners in government, private industry, and the public. We would like to thank all those who submitted comments and participated throughout this process. As new information, technology, and input is received, we will continue to review and record that information and maintain a public process to keep the Manual current. The VSP Operations Manual 2005 continues the 30 year tradition of government and industry working together to achieve a successful a nd cooperative Vessel Sanitation Program that benefits millions of travelers each year."--Page ii.

The Centers for Disease Control and Prevention (CDC) established the Vessel Sanitation Program (VSP) in 1975, as a cooperative activity with the cruise ship industry. This program assists the cruise ship industry in fulfilling its responsibility for developing and implementing comprehensive performancebased systems to protect the health of the traveling public. The Operations Manual for the VSP has been modified as a result of emerging public health issues, industry recommendations, introduction of new technologies within the industry, new guidance from sources used in the previous edition, and CDC's experience. The program operations and inspections are based on this manual.