Public health reference tool for cruise ship operators 

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This public health reference tool compiles references to Canadian public health resources on communicable disease prevention. This information is being provided to cruise ship operators for general awareness purposes only. Resources shared as part of this tool are not industry-specific and guidance may need to be adapted to suit the context of a cruise ship.

The information in this tool is valid at the time of publication. The Public Health Agency of Canada (PHAC) will periodically review this webpage and make updates, as needed. It is good practice for cruise ship operators to regularly monitor current Canadian public health news, recommendations and regulatory requirements. This tool does not provide medical or legal advice.

For more information:

Cruise travel and public health

Cruise travel can pose various risks for the transmission of communicable diseases:

Cruise ship operators can mitigate risks of communicable disease transmission by:

An effective public health framework can help protect the health of passengers and crew and minimize the risk of onward disease transmission during port visits.

Communicable disease resources

The Government of Canada publishes disease-specific guidance and information that can help operators identify preventive strategies and mitigate risks. Links to resources on the prevention of communicable diseases in the context of cruise travel are shared below, including information on respiratory infectious diseases and gastrointestinal illness.

This section also includes links to infection control guidelines for communicable diseases that are less common. It is not intended to be a comprehensive representation of public health risks on board cruise ships.

For vaccine-preventable diseases, industry health professionals can also refer to the Canadian Immunization Guide for more information on recommendations for the immunization of travellers.

For further information:

Common communicable diseases

Respiratory infectious diseases

Outbreaks of respiratory infectious diseases can occur at any time of the year on cruise ships. It is common for some respiratory infectious diseases to co-circulate on a seasonal cycle, including:

Some respiratory infectious diseases of concern do not follow a seasonal cycle, such as:

Gastrointestinal illness

The sharing of a common food and water supply in the semi-enclosed setting of a cruise ship can lead to disease outbreaks. Cruise ship crew or passengers may present symptoms of acute gastrointestinal (GI) illness prior to and during a voyage, often diagnosed as a norovirus infection. Noroviruses are very contagious viruses that cause diarrhea and vomiting.

To learn more:

Other communicable diseases

Mpox (monkeypox)

Clusters of mpox (monkeypox) cases have been reported in non-endemic countries. The majority of the cases reported outside of endemic areas have been in those who have had close or intimate contact with a person who has mpox. This disease is caused by a viral infection, and the most commonly presenting symptom is a rash.

To learn more:

Vector-borne diseases

Diseases can also be spread from one animal to another (e.g., humans) through an intermediary or vector – typically, a biting insect or tick. Mosquitos are a common disease vector, and can spread diseases such as:

Resources for preventing the spread of communicable diseases

This section provides references to Government of Canada resources on public health measures and other best practices that can be applied in cruise ship settings – e.g., against respiratory infectious diseases and gastrointestinal illnesses. The information on public health measures shared below is not intended to be exhaustive.

Public health measures

Hand hygiene and respiratory etiquette measures

Making health promotion materials (e.g., videos, audio, factsheets, and infographics) available throughout the ship can provide those onboard with instructions and reminders for hand hygiene and respiratory etiquette (i.e., covering coughs and sneezes and wearing a respirator or mask when symptomatic or in settings that are small, crowded, or poorly ventilated).

The Government of Canada has published guidance and health promotion material on hand hygiene:

For information on masking:

Cleaning and disinfecting high-touch surfaces and objects

Environmental sanitation practices are important to reduce the risk of communicable diseases on board cruise ships. The routine cleaning and disinfection of surfaces and objects that are frequently touched can remove or kill infectious particles that cause disease, reducing the risk of illness transmission through contact with contaminated materials.

The Government of Canada has published guidance on cleaning and disinfection, including information specific to passenger conveyances and to COVID-19.

To learn more:

Safe food handling

Following general food safety practices can also help prevent the spread of enteric and food-borne diseases. The Government of Canada provides information on general food safety practices.
To learn more:

Indoor ventilation

Taking steps to maintain and improve indoor ventilation can help prevent the airborne transmission of communicable disease in specific locations. Routine maintenance of HVAC systems will contribute to the reduction in levels of infectious particles.

The Government of Canada has published a COVID-19-specific factsheet and guidance on indoor ventilation.

To learn more:

Other risk mitigation resources

Outbreak management plans

An effective outbreak management plan includes specific activation triggers, and corresponding public health measures that can help contain the spread of communicable disease. Establishing programs for drills and exercises can help with preparedness for some outbreak situations. Including protocols for identifying and informing passengers of possible exposure to illness can facilitate case management.

For communicable disease outbreak management plans, PHAC recommends referencing the following resources:

The Government of Canada has also published information on personal protective measures to help reduce the spread of respiratory infectious diseases, which can assist operators with the development of public health messaging as part of actions included in an outbreak management plan:

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