Guidance for Cruise Ships: How to Report Onboard Death or Illness to CDC

According to federal regulations, CDC requires the master of a ship destined for a U.S. port to report immediately any death or certain illnesses among the ship’s passengers or crew. CDC has outlined below how cruise ships should report deaths and illnesses (non-gastrointestinal) to the Division of Global Migration and Quarantine (DGMQ). Effective March 21, 2017, the definition of ill person under CDC regulations changed. This change, found in 42 Code of Federal Regulations part 71.1, clarifies the list of signs and symptoms that may indicate a person is ill with a communicable disease of public health concern.

There is no change to the methods for reporting these illnesses or deaths. The following instructions still apply:

Download, complete, and submit these fillable forms to DGMQ:

• For reporting illness (non-gastrointestinal) or death:
  • Maritime Conveyance Illness or Death Investigation Form [PDF – 4 pages]
• For reporting influenza-like illness (ILI), defined as fever (temperature of 100.4 °F [38 °C] or greater) and a cough and/or a sore throat without a KNOWN cause other than influenza:
  • Maritime Conveyance Cumulative Influenza/Influenza-Like Illness (ILI) Form [PDF – 1 page]

Exceptions to Reporting Illnesses on These Forms

• Acute Gastroenteritis or diarrhea: Cruise ships carrying 13 or more passengers need to report to CDC’s Vessel Sanitation Program (VSP) any cases of acute gastroenteritis or diarrhea cases (such as Shigella, Salmonella, norovirus, hepatitis A) via the Maritime Illness and Death Reporting System (MIDRS). For more information, visit CDC Vessel Sanitation Program (VSP).
• Legionnaires’ Disease: To report a case of Legionnaires’ disease, please e-mail travellegionella@cdc.gov. For more information about Legionnaires’ disease, visit CDC’s Respiratory Diseases Branch (RDB).

Instructions for Reporting Deaths and Illnesses

Please DON’T submit any forms through e-mail that include personally identifiable information (PII). PII is any information that can be used alone or in combination to identify an individual. This includes names, addresses, phone numbers, dates (birth, hospital admission, travel), identifying numbers (passport, social security, driver’s license, alien), medical records, photographs, and for rare diseases, geographic locations.

• Please download both forms and save them for future access. Use a separate Maritime Conveyance Illness or Death Investigation Form for each ill or deceased person.
• Complete sections as instructed in the table below on the Maritime Conveyance Illness or Death Investigation Form [PDF – 4 pages] and all sections of the Maritime Conveyance Cumulative Influenza/Influenza-Like Illness (ILI) Form [PDF – 1 page]. You may type directly into the forms, or print them out and fill out by hand.
• To submit the forms to the CDC Quarantine Station with jurisdiction over the next U.S. seaport of arrival, you have three options: email, fax or telephone.
  • By email: Click on the gray “Send Via E-mail” button in the upper left-hand corner of the form. (Note: In order to use this option, your e-mail account must be set up to automatically generate an e-mail message from a PDF), or save the form, then attach it to your e-mail and send it to MaritimeAdmin@cdc.gov. If you choose this option, your e-mailed report will automatically be sent to the CDC Quarantine Station, and you should receive an immediate confirmation e-mail.
  • By fax or by telephone: Look up the contact information for the CDC Quarantine Station with jurisdiction over the next U.S. seaport of arrival to obtain information and send by fax, or
    If you choose option fax or phone, a confirmation e-mail will be sent within 1 business day to the email address provided with the report. The quarantine station will contact you if follow-up information is needed.
• If you don’t receive confirmation of your report or if you have any questions, please contact the CDC Quarantine Station with jurisdiction over the next U.S. port of arrival, the CDC Emergency Operations Center at 770-488-7100, or the Maritime Activity Administrator.
• Please DON’T submit Section 5 (General Information about Ill or Deceased Person) on the Maritime Conveyance Illness or Death Investigation Form unless the quarantine station asks you to do so.
  Note: Because this section contains PII, you won’t be able to type any information directly into the fillable PDF form. You will need to print out this section of the form and fill it out by hand. Then submit Section 5 only by fax or by telephone.

Instructions for Cumulative Influenza/Influenza-Like Illness Report

CDC requests that cruise ships submit a cumulative ILI report (even if no deaths or ILI cases have occurred) preferably during the final 24 hours of the voyage or as soon as an outbreak is suspected, as described below. These reports should be made once a voyage by completing the one-page Maritime Conveyance Cumulative Influenza/Influenza-like Illness (ILI) Form [PDF – 1 page] and clicking on the grey “Send Via Email” box in the top left corner.

CDC requests that cruise lines immediately report any of the following events to the CDC Quarantine Station having jurisdiction over the next U.S. port of entry:

• Outbreaks of influenza or ILI (exceeding 1.380 cases per 1,000 traveler days) among passengers or crew members (instructions for calculating ILI threshold can be found here).
• Hospitalization (ashore or at sea) caused by, or suspected to be associated with, influenza or ILI onboard the vessel.

In addition, CDC is taking this opportunity to emphasize that any death, including those caused by or suspected to be associated with influenza or ILI, that occurs aboard a cruise ship destined for a U.S. port must be reported to CDC immediately. Report ILI hospitalizations or deaths by submitting an individual Maritime Conveyance Illness or Death Investigation Form [PDF – 4 pages] for each hospitalization or death, or report by phone.

Illness Type and Signs and Symptoms to Report by Federal Regulations