Unfortunately, on a confined cruise ship where everyone is eating the same thing, a bout of food poisoning can often effect a large number of passengers. In June 2000 there was an outbreak on the Disney Magic that caused over 260 people to develop gastroenteritis. The U.S. Centers for Disease Control and Prevention (CDC) is the government agency responsible for investigating outbreaks of diarrhea on cruise ships. The CDC traced the illness to shrimp that was served on the embarkation lunch buffet. The CDC found "a variety of bacterial and parasitic pathogens" in stool samples of passengers who ate the shrimp.
Outbreaks such as the one on Disney Magic are relatively rare, given the large numbers of people who are cruising. Many of us who travel extensively develop a fatalistic attitude about dining out in general, and feel that the pleasures of traveling far outweigh the risks of "catching something" or getting diarrhea. Fortunately for us, the CDC works with the cruise line industry to prevent gastrointestinal pathogenic outbreaks, and there are steps you can take to help prevent or lessen your chances of getting food poisoning.
The CDC began its Vessel Sanitation Program (VSP) in the early 1970s. This program is a cooperative activity between the CDC and the cruise ship industry to help minimize the risk of gastrointestinal diseases. The VSP seems to be working. In the 1970s and early 1980s, 12 to 15 outbreaks of diarrheal illness occurred each year on cruise ships. By 1999, the number of outbreaks had decreased to three.
Twice each year, VSP staff inspect over 140 participating cruises ships while they are in a U.S. port. The inspections are financed by the vessel owners, and the fee is based on the ship's tonnage. The ships are judged against the "Vessel Sanitation Program Operations Manual", and each ships is given a score between 1 and 100. Only scores 86 and above are considered passing. If a ship fails an inspection, it will be inspected again during the next four to six weeks.
The inspectors check food, water, spas and pools, employee hygiene, and the general cleanliness of the ships. One advantage for cruise travelers is that the scores are published on the VSP website. In addition, CDC publishes the "Summary of Sanitation Inspections of International Cruise Ships", commonly referred to as the "green sheet." Over 6,000 travel-related services around the world receive the green sheet. Although the VSP encourages cleanliness aboard ships, the system is not foolproof. The Disney Magic received a 94 on December 3, 1999, just 6 months before its food poisoning outbreak.
There are steps you can take to help prevent food-borne disease. Sometimes I think we leave common sense at home when we travel, but it is easy to take some steps to lower your risk of getting sick. First, all meat should be properly cooked. This will kill many types of bacteria. The same applies to seafood. Next, food on buffets that sits out for long periods is particularly susceptible. Eggs can also be a problem. Very few eggs carry salmonella, but if the ship's chef mixes one bad egg with hundreds of good ones and then serves them only partially cooked. . . well, you can guess what can happen. Finally, eating "local" food is really tempting, but remember that foreign restaurants' kitchens are not necessarily subject to food inspections. Raw fruits and vegetables washed with tap water that is unfit for drinking cause many cases of travelers' diarrhea.
In summary, you can't control the cleanliness of the ship's kitchen, but you can check out their score from the VSP. You can control your intake and limit your risk by watching what you eat and drink ashore, and by not eating uncooked meats, eggs, and seafood on the ship. Don't let your fears of food-borne illness scare you from having a great cruise vacation. Just remember that common sense goes a long way to helping you make the right food choices when away from home.