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.