OMB Approved Control
No. 0920–1335 Exp.
01/31/2026
**Please submit to maritimeadmin@cdc.gov daily by 1200 ET**
Directions: Please enter all data for:
1) Case counts and traveler test results identified for the previous day
(i.e., report submitted by 1200 ET today will include information from yesterday [0000 hrs. to 2359 hrs. ET]), and
2) Traveler test results received since last submission for the following:
Symptomatic Case Counts with Viral testing
Asymptomatic Case Counts with Viral testing for
Identified close contacts
Embarkation day screening
During or end of quarantine screening of newly embarking crew
Routine screening
Disembarkation screening
Completion of this form is requested of cruise ships operating or intending to operate in U.S. waters under CDC’s reporting jurisdiction. For additional guidance, see Guidance for Maritime Vessels on the Mitigation and Management of COVID-19.
Ship: |
|||||||
Voyage number: |
Voyage start date (mm/dd/yyyy): |
Voyage end date (mm/dd/yyyy): |
|||||
Date Submitted (mm/dd/yyyy): |
|||||||
Closest seaport at time of submission (City and Country): |
|||||||
GPS coordinates of ship at time of submission (in decimal degrees): |
|
Crew [1] |
Passengers |
||||
Latitude: (in decimal degrees [DD], e.g., 45.34) |
Longitude: (in decimal degrees [DD], e.g., -78.0) |
Total # of travelers onboard: |
|
|
|||
|
|
|
|
|
|||
Important Reporting Reminders COVID-19 Reporting and Management
Influenza Reporting and Management
Reporting Cruise Ship Fatalities or Other Illnesses of Public Health Concern
|
|||||||
Do you have ANY new testing, results, or other information to report via EDC today?
|
|||||||
Today, are you entering new (not previously reported) results for the following test categories (check all that apply)?
|
|
||||||
Symptomatic Case Counts with Viral Testing (i.e., NAAT [4] or antigen test): (Please report daily final diagnostic test results only [e.g., if a symptomatic person is antigen-negative then viral test-positive on the same day, do not report the initial antigen-negative result to EDC] [3]) Ships that choose to use antigen tests should follow FDA antigen-testing guidance. |
Enter Numbers Below (Unless Otherwise Specified) |
||||||
Crew [1] |
Passengers |
||||||
Row |
What is your COVID-19-like Illness (CLI) case count for the previous day? CLI clinical criteria/definition:
or
or
|
|
|
||||
1 |
|||||||
2 |
Of those persons with CLI, how many were tested for COVID-19 using a viral test? |
|
|
||||
3 |
Of those persons with CLI tested for COVID-19 using a viral test, how many tested positive? |
|
|
||||
4 |
Of those persons with CLI that tested positive for COVID-19 using a viral test, how many were newly embarking crew members in quarantine? |
|
|
||||
5 |
Of those persons with CLI tested for COVID-19 using a viral test, how many tested negative? |
|
|
||||
6 |
Of those persons with CLI that tested negative for COVID-19 using a viral test, how many were newly embarking crew members in quarantine? |
|
|
||||
7 |
Of those persons with CLI that tested negative for COVID-19 using a viral test, how many tested positive for influenza? [6] |
|
|
||||
8 |
Of those persons with CLI that tested negative for COVID-19 using a viral test AND the ship performs RSV testing, how many tested positive for respiratory syncytial virus [RSV])? [6] |
|
|
||||
9 |
Of those persons with CLI that tested negative for COVID-19 using a viral test, how many tested positive for another respiratory pathogen (e.g., Legionella, Streptococcal pharyngitis, infectious mononucleosis)? [6] |
|
|
||||
10 |
Of those persons with CLI tested for COVID-19 using a viral test, how many never registered a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
11 |
Of those persons with CLI for this reporting day, how many were not tested for COVID-19 because they had already tested positive as an identified close contact (and asymptomatic) in the past 14 days (i.e., on a previous reporting day)? |
|
|
||||
12 |
Were there any additional CLI cases that were not accounted for by the questions above (e.g., symptomatic persons testing positive for both COVID-19 and another respiratory pathogen [e.g., influenza, RSV])? Please explain: |
|
|
||||
HOSPITALIZATIONS, VENTILATOR USE, AND MEDICAL EVACUATIONS
|
|
|
|||||
13 |
How many symptomatic persons needed hospitalization (onboard or ashore) due to CLI or COVID-19? |
|
|
||||
14 |
Of those hospitalized due to CLI or COVID-19, how many required mechanical ventilation? |
|
|
||||
15 |
Of those hospitalized due to CLI or COVID-19, how many were medically evacuated from the ship? |
|
|
||||
Asymptomatic Case Counts with Viral Testing (i.e., NAAT [4] or antigen test): Ships that choose to use antigen tests should follow FDA antigen-testing guidance. |
Enter Numbers Below (Unless Otherwise Specified) |
||||||
Crew [1] |
Passengers |
||||||
IDENTIFIED CLOSE CONTACT TESTING (please see Guidance for Maritime Vessels on the Mitigation and Management of COVID-19 for close contact testing recommendations). Ships that choose to use antigen tests should follow FDA antigen-testing guidance. |
|||||||
16 |
How many asymptomatic persons were tested for COVID-19 using a viral test after being identified as a close contact of a:
|
|
|
||||
17 |
Of the asymptomatic persons tested for COVID-19 using a viral test after being identified as a close contact, how many tested positive? |
|
|
||||
18 |
Of the asymptomatic persons tested for COVID-19 using a viral test after being identified as a close contact, how many tested negative? |
|
|
||||
19 |
Of the asymptomatic persons tested for COVID-19 using a viral test after being identified as a close contact, how many were never able to register a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
EMBARKATION DAY SCREENING TESTING [7] Ships that choose to use antigen tests should follow FDA antigen-testing guidance. |
|||||||
20 |
How many asymptomatic persons were tested for COVID-19 using a viral test on the day of embarkation? |
|
|
||||
21 |
Of the asymptomatic persons tested for COVID-19 using a viral test on the day of embarkation, how many tested positive? |
|
|
||||
22 |
Of the asymptomatic persons tested for COVID-19 using a viral test on the day of embarkation, how many tested negative? |
|
|
||||
23 |
Of the asymptomatic persons tested for COVID-19 using a viral test on the day of embarkation, how many were never able to register a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
DURING OR END OF QUARANTINE SCREENING TESTING OF NEWLY EMBARKING CREW Ships that choose to use antigen tests should follow FDA antigen-testing guidance. |
|||||||
24 |
How many asymptomatic newly embarking crew members were tested for COVID-19 using a viral test at the end of quarantine (i.e., prior to leaving quarantine)? |
|
|
||||
25 |
Of the asymptomatic newly embarking crew members tested for COVID-19 using a viral test at the end of quarantine, how many tested positive? |
|
|
||||
26 |
Of the asymptomatic newly embarking crew members tested for COVID-19 using a viral test at the end of quarantine, how many tested negative? |
|
|
||||
27 |
Of the asymptomatic newly embarking crew members tested for COVID-19 using a viral test at the end of quarantine, how many were never able to register a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
Ships that choose to use antigen tests should follow FDA antigen-test guidance. |
|||||||
28 |
How many asymptomatic persons were tested for COVID-19 using a viral test for routine crew screening or passenger voyage testing? |
|
|
||||
29 |
Of the asymptomatic persons tested for COVID-19 using a viral test for routine crew screening or passenger voyage testing, how many tested positive? |
|
|
||||
30 |
Of the asymptomatic persons tested for COVID-19 using a viral test for routine crew screening or passenger voyage testing, how many tested negative? |
|
|
||||
31 |
Of the asymptomatic persons tested for COVID-19 using a viral test for routine crew screening or passenger voyage testing, how many were never able to register a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
DISEMBARKATION SCREENING TESTING OF TRAVELERS Ships that choose to use antigen tests should follow FDA antigen-test guidance. |
|||||||
32 |
How many asymptomatic persons were tested for COVID-19 using a viral test collected within 24 hours before disembarkation? |
|
|
||||
33 |
Of the asymptomatic persons tested for COVID-19 using a viral test collected within 24 hours before disembarkation, how many tested positive? |
|
|
||||
34 |
Of the asymptomatic persons tested for COVID-19 using a viral test collected within 24 hours before disembarkation, how many tested negative? |
|
|
||||
35 |
Of the asymptomatic persons tested for COVID-19 using a viral test collected within 24 hours before disembarkation, how many were never able to register a positive or negative result (e.g., inconclusive or invalid result)? |
|
|
||||
36 |
Were there any additional asymptomatic cases testing positive that were not accounted for by the questions above? Please explain: |
|
|
[1] All overnight contractors/visitors/vendors should be identified as crew for all CDC reporting requirements (i.e., day contractor/visitors/vendors can be excluded)
[2] Confirmed COVID-19 means laboratory confirmation for SARS-CoV-2, the virus that causes COVID-19, by viral test.
[3] Please refer to FDA antigen-testing guidance.
[4] Examples of available NAATs for SARS-CoV-2 include but are not restricted to: reverse transcription polymerase chain reaction (RT-PCR), reverse transcription loop-mediated isothermal amplification (RT-LAMP), transcription-mediated amplification (TMA), nicking enzyme amplification reaction (NEAR), and helicase-dependent amplification (HDA).
[5] A febrile person in the presence of a more likely diagnosis (e.g., cellulitis, urinary tract infection, tooth abscess) does not represent CLI and should not be reported via EDC.
[6] If an alternate infectious etiology is identified through laboratory testing, routine infection control precautions recommended for the diagnosis should be followed.
[7] Embarkation day testing applies to all passengers on back-to-back sailings prior to the ship sailing on the next voyage, regardless of vaccination status.
Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-1335.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Maritime Unit |
File Modified | 0000-00-00 |
File Created | 2023-09-04 |