In 1975, the U.S. Centers for Disease Control and Prevention (CDC) established the vessel sanitation program alongside the cruise ship industry. Traveling on cruise ships exposes people to new environments and high volumes of people, including other travelers.

This exposure can create the risk for illness from contaminated food or water or, more commonly, through person-to-person contact. In 2022, approximately 12.5 million passengers embarked from North American ports for their cruise vacation.

Sick people can spread gastrointestinal illnesses to others through food and water and by touching handrails, elevator buttons, shared utensils, and other people. Other public health issues on cruise ships can include controlling Legionella, managing pests and insects, and ensuring clean air and water.