The International Council of Cruise Lines (ICCL) and its 16 members today announced formal adoption of aggressive new guidelines to prevent the occurrence of Severe Acute Respiratory Syndrome (SARS) – both before and after ships sail. Developed in close consultation with the U.S. Centers for Disease Control and Prevention (CDC) and Health Canada, the measures are designed to protect ships’ passengers, crew and ports of call alike.
Although no confirmed reports of SARS have been reported on any ICCL member vessel, the membership of the ICCL is acting with an abundance of caution. In the weeks following the initial outbreak of SARS, cruise lines individually began taking aggressive health precautions of their own and have collaborated as an industry in daily discussions with the ICCL and health officials. At the same time, cruise lines began working with federal health officials and their own medical experts to identify best practices and to adopt a uniform set of policies and procedures for all of the lines, which are even more comprehensive than those issued by the CDC. That collaboration resulted in today’s action, which reinforces the cruise industry’s commitment to its passengers, crew and communities.
ICCL’s guidelines reflect a dual focus – first on preventing a passenger or crew member who may have been exposed from boarding a ship, and secondly on strengthening sanitation protocols once the ship has set sail. Foremost is prevention before ships leave their port of embarkation, which includes screening and denial of boarding for individuals at high risk of having been exposed to the virus and rerouting ship itineraries to avoid ports included in current travel warnings. Second, ships have strengthened their already stringent disinfection and sanitation policies followed before, during and after each cruise.
“Working closely with the nation’s top health experts, we have made prevention our utmost priority and first line of defense against SARS – and this means careful screening of crew, passengers and visitors to prevent anyone from bringing the virus on board,” said ICCL President Michael Crye.
At a minimum, new ICCL-member SARS guidelines include:
DESIGNATION OF AREAS OF SPECIAL CONCERN AND AREAS FOR INCREASED SCREENING
· From time to time, ICCL shall designate “Areas of Special Concern” and “Areas for Increased Screening.”
These designations will be based on information distributed by the CDC, World Health Organization and other public health authorities and will take into account, among other factors, the effectiveness and extensiveness of the efforts being undertaken by local authorities in the area to limit the spread of SARS.
· The current Areas of Special Concern are China, Hong Kong, Vietnam and Singapore.
· The current Area for Increased Screening is Toronto (Canada).
· Member lines will make every attempt to contact all passengers who are from, will transfer or transit through, an Area of Special Concern in advance of their cruise. Passengers will be advised of the ICCL policies regarding travel itineraries or health conditions that could result in denial of boarding. These guests will be advised in advance of the cruise line’s policy regarding travel itineraries and other factors that may result in denial of boarding and details of compensation.
PASSENGER, VISITOR AND CREW SCREENING PRIOR TO BOARDING
· All passengers, visitors and crew will be required to complete and sign a written questionnaire prior to boarding. This questionnaire will be used to determine the following:
o Entry, transfer or transit through either an Area of Special Concern or an Area for Increased Screening
o Close contact* with a confirmed or suspect SARS patient, SARS care provider, SARS healthcare setting or a SARS household.
o SARS symptom screening for those who are from, or have transferred or transited through, an Area for Increased Screening.
· The answers to the questionnaire will be used to make the determinations required under the Denial of Boarding Policy.
DENIAL OF BOARDING POLICY
· All passengers, visitors and crew who have been in, or have transferred or transited through, an Area of Special Concern within the preceding 10 days will be denied boarding, along with their immediate traveling party.
· All passengers, visitors and crew who have had close contact with a confirmed or suspect SARS patient, SARS care provider, SARS healthcare setting or a SARS household, within the preceding 10 days will be denied boarding.
· All passengers, visitors and crew who have been in, or have transferred or transited through, an Area of Increased Screening within the preceding 10 days will receive enhanced screening for symptoms of SARS before being allowed to board.
· Individual lines may increase the 10-day period as to all or some of the determinations referred to above.
ROUTING AIR/SEA PASSENGERS AND CREW TO AVOID CONCERN AREAS
· All ICCL member lines will utilize air routes for arriving and departing passengers (those that have purchased air from the cruise line) and crew that will avoid Areas of Special Concern.
· For those passengers who have personally arranged their travel to and from ICCL member vessels, our member lines will make every attempt to advise in advance that passengers make arrangements to avoid Areas of Special Concern.
HIRING FREEZE OR QUARANTINE FOR CREW FROM AREAS OF SPECIAL CONCERN
· All ICCL member lines will, until further notice, place a hiring freeze or minimum ten day quarantine on all crew from Areas of Special Concern.
DISINFECTION PROCEDURES AND PROTOCOLS
· All ICCL member lines will maintain close coordination with the U.S. CDC and will utilize recommended disinfectants and sanitation protocols with the goal of reducing the possibility of viral transmission including SARS.
· All ICCL member lines will maintain adequate supply of N-95 masks, gowns, and appropriate diagnostic test kits.
MEDICAL REPORTING AND MANAGEMENT
· All ICCL member lines will continue to develop and maintain case management protocols for respiratory illness. These may include surveillance, examination, treatment, and where appropriate, isolation.
· All ICCL member lines will maintain appropriate respiratory support equipment and medications appropriate for the emergency care of respiratory illness.
· All ICCL member lines will report respiratory illness as appropriate to public health authorities and coordinate with diagnosis and case management including isolation and/or quarantine.
Should a suspected SARS case be identified on a cruise ship all members of the ICCL have trained medical staff on board with appropriate isolation protocols and medical treatment facilities to respond and report the incident to the CDC or Health Canada. In addition, ICCL member lines abide by guidelines for their medical facilities that go above and beyond both U.S. and international maritime requirements. Many cruise lines are being flexible with their cancellation policies for reimbursing and rebooking passengers denied boarding due to preventative screening for possible exposure to SARS. However, members cruise lines’ policies vary, so passengers should contact the lines directly or their travel agent for more information.
These practices, which have proven effective in reducing the transmission of infectious illnesses on board ships, include enhanced disinfection, cleaning and sanitary practices using disinfectants designed specifically to kill viruses such as SARS. “The standard by which they are held for sanitation is the highest in the world,” Dave Forney, chief of the Vessel Sanitation Program, said earlier this year.