Surface sanitation is used to mitigate the transmission of infectious agents and is the collective process of washing a surface then rinsing it with potable water to remove debris and residual cleaning agent. If necessary and depending on surface type, contamination event, or regulatory requirement, an antimicrobial agent (chemical sanitizer or disinfectant) registered with the Environmental Protection Agency or heat (steam or hot water) can be applied to the surface to reduce or inactivate pathogenic microorganisms. The absence of universally defined terms and regulations pertaining to the various stages of surface sanitation has resulted in confusion, potentially leading to inadequate sanitation practices and persistent surface contamination. We addressed this issue by raising awareness of the significance of surface cleaning and elucidating the fundamental principles, key considerations, and potential areas for improvement concerning surface cleaning. Specific topics covered include a comprehensive description of surface cleaning, barriers hindering effective surface cleaning, correlation between contamination and foodborne disease outbreaks, and variations among cleaning agents. To maintain conciseness and relevance, the exclusive focus is on hard, nonporous surfaces, which have been identified as potential sources for the transmission of pathogenic microorganisms associated with foodborne illnesses.

A suspected outbreak of influenza A and SARS-CoV-2 at a long-term care facility in Los Angeles County was months later, determined to not involve influenza. To prevent inadvertent transmission of infections, facilities should use highly specific influenza diagnostics and follow CDC guidelines that specifically address infection control challenges.

An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* (1). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness (2). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well (3). Passengers on certain cruise ship voyages might be aged >/=65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection (4). During February-March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.