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OBJECTIVES
The impact on maritime transport of health threats due to biological,
chemical and radiological agents, including communicable diseases
Carmen Varela, Miguel Dávila, Francisco Nogareda, Rocío Palmera, Jesús Perez, Nick Bitsolas, Elina Kostara, Martin Dirksen-Fischer, Thomas von Münster, Barbara Mouchtouri, for the SHIPSAN ACT partnership
Work Package Leader: Instituto de Salud Carlos III, Spain and Universitätsklinikum Hamburg-Eppendorf
Joint Action financed: EU Public Health Programme 2008-2013 Years: 2013-2016 (45 months) Total cost: 2.571.346€ Subsidy from EC: 1.799.942€ Leader Organisation: University of Thessaly (UTH), Greece
To describe:
A. Evidence for chemical, biological and radiological events on ships or at ports.
B. Characteristics of authorities responsible for responding to radiological and
chemical events.
B. Practices & legal framework related to radiological and chemical events.
C. Hygiene standards & inspection practices related to fishing vessels.
D. Training needs related to core capacities under IHR* 2005 at ports.
E. Practices & responsibilities of port health authorities along inland waterways.
* International Health Regulations. World Health Organization 2005
METHODOLOGY
Part A
• Literature review on infectious diseases on all types of ships.
Part B
• Literature review and survey on chemical and radiological incidents in maritime transport.
Part C
• Survey on hygiene inspection practices on fishing vessels in EU.
Part D
• Survey on training needs related to core capacities at points of entry-ports in EU.
Part E
• Survey on practices & responsibilities of port health authorities along inland waterways in EU.
Communicable diseases outbreaks
0
5000
10000
15000
20000
25000
0
20
40
60
80
100
120
140
Food-Waterborne Respiratory Vaccinepreventable
Emerging Other
No
. of
case
s
No
. of
ou
tbre
aks
Communicable diseases
Outbreaks
Cases
Food and Waterborne diseases outbreaks
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
0
5
10
15
20
25
30
35
40
Norovirus Legionella ET E. Coli Ciguatera Salmonella Shigella
No
. of
case
s
No
. of
ou
tbre
aks
Food and Waterborne diseases
Outbreaks
Cases
Respiratory diseases outbreaks
0
500
1000
1500
2000
2500
3000
3500
0
5
10
15
20
25
Influenza Tuberculosis Other
No
. of
case
s
No
. of
ou
tbre
aks
Respiratory diseases
Outbreaks
Cases
0
50
100
150
200
250
300
0
5
10
15
20
25
30
Varicella Rubella Measles Mumps N. meningitidis Measl+Rube+Varic
No
. of
case
s
No
. of
ou
tbre
aks
Vaccine preventable diseases
Outbreaks
Cases
Vaccine preventable diseases outbreaks
State of the Art report
Results of surveys and literature review for:
A. infectious diseases
B. chemical and radiological events C. fishing vessels
D. core capacities training needs E. inland navigation
RESULTS
Part A. Infectious diseases
Chemical events according to the type of ship. N=94
Cargo ships66%
Fishing vessels
12%
Others4%
No data18%
Russian coastline and
nearby54%
Atlantic Ocean15%
Mediterranean Sea8%
USA coastline8%
No data15%
Radiological events according to the place of occurrence. N=13
0
2
4
6
196
0 -
19
69
197
0 -
19
79
198
0 -
19
89
199
0 -
19
99
200
0 -
20
12
No
. o
f e
ve
nts
Years
Radiological events. N=13
Nuclear ships85%
Cargo ship15%
Radiological events according to the type of ship. N=13
Part B. Radiological and chemical events
Acknowledgments: To the EU Commission for co-financing the Joint Action and to all participants from the EU and International institutions, the EU MS and the shipping industry.
Partners: 32 partners from 24 EUMS, European and international Institutions, shipping Industry. Advisory Board: DG SANTE, CHAFEA, ECDC, WHO, CDC-VSP. Associated partners: Regional Health Inspection-Varna, Bulgaria/Regional Health Inspection-Burgas, Bulgaria/Hamburg Port Health Center, Germany/Robert Koch-Institute, Germany/National School of Public Health, Greece/Directorate of Health, Centre for Health Security and Communication Diseases, Iceland/Health Service Executive, Ireland/Ministry of Health, Italy/Klaipeda Public Health Center, Lithuania/National Institute of Public Health, Slovenia/Instituto De Salud Carlos III, Spain/Public Health England, Centre for Radiation Chemical and Environmental Hazards, United Kingdom/Association of Port Health Authorities, United Kingdom. Collaborating partners: Ministry of Health, Austria/Federal Public Service of Health, Belgium/Ministry of Health and Social Welfare, Croatia/Ministry of Health, Cyprus/Centre of Maritime Health and Society, University of Southern Denmark/Health Board, Estonia/Ministry of Labour, Employment and Health, France/Minister for Health, the Elderly and Community Care, Malta/Municipal Health Services Rotterdam, Netherlands/National Institute for Health and the Environment, Netherlands/Norwegian Directorate of Health, Norway/Ministry of Health, Portugal/Medical University of Gdansk, Poland/Ministry of Health, Romania/Ministry of Health, social services and equality, Spain/Ministry of Transport, Construction and Regional Development of the Slovak Republic
This poster arises from the EU SHIPSAN ACT Joint Action. Sole responsibility lies with the author and the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) is not responsible for any use that may be made of the information contained therein.
0
5
10
15
20
25
30
35
40
Legislation Planning Detection and Recording
Impactassessment
Response Communication Training
Nu
mb
er o
f au
tho
riti
es
Health authorities Radiological Authorities Other authorities*
Authorities for radiological events on ships or at ports
The impact on maritime transport of health threats due to biological,
chemical and radiological agents, including communicable diseases
Carmen Varela, Miguel Dávila, Francisco Nogareda, Rocío Palmera, Jesús Perez, Nick Bitsolas, Elina Kostara, Martin Dirksen-Fischer, Thomas von Münster, Barbara Mouchtouri, for the SHIPSAN ACT partnership
Work Package Leader: Instituto de Salud Carlos III, Spain and Universitätsklinikum Hamburg-Eppendorf
Joint Action financed: EU Public Health Programme 2008-2013 Years: 2013-2016 (45 months) Total cost: 2.571.346€ Subsidy from EC: 1.799.942€ Leader Organisation: University of Thessaly (UTH), Greece
State of the Art report
Results of surveys and literature review for:
A. infectious diseases
B. chemical and radiological events C. fishing vessels
D. core capacities training needs E. inland navigation
RESULTS
Part B. Management of radiological and chemical events
Part C. Fishing vessels
0
5
10
15
20
25
30
35
40
Legislation Planning Detection and Recording
Risk assessment Response Communication Training
Nu
mb
er
of
auth
ori
ties
Health authorities Chemical Centers Other authorities*
Authorities for chemical events on ships or at ports
02468
101214161820
Respondents Legislation Detectionsystem
Lab capacity Contingencyplan
Specificpersonnel
No
. of
Co
un
trie
s
Events management
Radiological Events Chemical Events
Management of radiological or chemical events on ships or at ports
0
2
4
6
8
10
12
14
16
Legislation Planning Detection and Recording
Impactassessment
Response Communication Training
Nu
mb
er
of
EU c
ou
ntr
ies
Chemical events management
1 Authority 2 - 3 Authorities ≥ 4 Authorities
Number of authorities for management of chemical events on ships or at ports
0
2
4
6
8
10
12
14
16
Legislation Planning Detection and Recording
Impactassessment
Response Communication Training
Nu
mb
er o
f EU
co
un
trie
s
1 Authority 2 - 3 Authorities ≥ 4 Authorities
Number of authorities for management of radiological events on ships or at ports
Part D. Core capacities
Respondent countries = 16
Training needs at all times Training needs for public health emergencies of international concern
Part E. Inland waterways
Response rates: 13 of 27 countries, 21 authorities.
90% (n=19) reported that core capacities are fully or partially
established.
The provision of Maritime Declaration of Health and issuing of
Ship Sanitation Certificates was heterogeneous.
Port to port communication is not well established.
Part A. Infectious diseases
Most frequently published outbreaks on
ships were due to food and waterborne
diseases, mainly norovirus transmitted
from person to person.
Highest lethality was due to Legionella.
Norovirus and Legionnaires’ disease
reported more often on cruise ships
than in other type of ships.
Tuberculosis was not reported on
cruise ships or ferries.
Vaccine preventable diseases mainly
on crew from cruise ships.
Part B. Radiological and chemical events on
ships or at ports.
No published radiological public health events
affecting people on ships or at ports in recent
years.
Chemical events published occurred in cargo and
fishing vessels.
Part B. Authorities for radiological or
chemical events on ships or at ports at the
EU.
Radiological authorities were easier to
identify than chemical.
Competent authorities are usually not
health authorities.
Legislation and contingency plans are not
specific for ships or ports.
There is lack of training.
Part C. Fishing vessels
Most of the countries do not perform
regular inspections.
Almost 60% of the respondents report
any health event to the competent
authority.
Part D. Core capacities
Personnel working at ports mentioned specific
training needs. Mainly training needs on:
Public health risks on microbiological, radiological
and chemical agents.
Proceedings to report to competent authority at
port.
Proceedings to communicate with other
authorities.
Quarantine of suspected travellers.
Part E. Inland waterways
Development of international hygiene and
sanitation guidelines for inland navigation
vessels.
Need for standardized training of
European port health inspectors.
Need for an improved exchange of
information between port health
authorities.
Acknowledgments: To the EU Commission for co-financing the Joint Action and to all participants from the EU and International institutions, the EU MS and the shipping industry.
Partners: 32 partners from 24 EUMS, European and international Institutions, shipping Industry. Advisory Board: DG SANTE, CHAFEA, ECDC, WHO, CDC-VSP. Associated partners: Regional Health Inspection-Varna, Bulgaria/Regional Health Inspection-Burgas, Bulgaria/Hamburg Port Health Center, Germany/Robert Koch-Institute, Germany/National School of Public Health, Greece/Directorate of Health, Centre for Health Security and Communication Diseases, Iceland/Health Service Executive, Ireland/Ministry of Health, Italy/Klaipeda Public Health Center, Lithuania/National Institute of Public Health, Slovenia/Instituto De Salud Carlos III, Spain/Public Health England, Centre for Radiation Chemical and Environmental Hazards, United Kingdom/Association of Port Health Authorities, United Kingdom. Collaborating partners: Ministry of Health, Austria/Federal Public Service of Health, Belgium/Ministry of Health and Social Welfare, Croatia/Ministry of Health, Cyprus/Centre of Maritime Health and Society, University of Southern Denmark/Health Board, Estonia/Ministry of Labour, Employment and Health, France/Minister for Health, the Elderly and Community Care, Malta/Municipal Health Services Rotterdam, Netherlands/National Institute for Health and the Environment, Netherlands/Norwegian Directorate of Health, Norway/Ministry of Health, Portugal/Medical University of Gdansk, Poland/Ministry of Health, Romania/Ministry of Health, social services and equality, Spain/Ministry of Transport, Construction and Regional Development of the Slovak Republic
This poster arises from the EU SHIPSAN ACT Joint Action. Sole responsibility lies with the author and the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) is not responsible for any use that may be made of the information contained therein.
SUMMARY
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