As with all other forms of risk, the control of infectious diseases depends on a range of engineered controls, safe working practices and monitoring and surveillance. All are supported by training and by effective supervision. The diversity of infectious agents and routes of exposure means that precautionary measures sometimes need to be tailored to the characteristics of certain infections.
Environmental controls include safe storage of food and quality assured water supply. An additional aspect, where vector organisms transmit infections such as malaria is preventing their access to those on board.
Work practices include safe food preparation, personal hygiene and sometimes separation of those suspected of being infected from others on board, or the use of personal protective equipment
Vaccination – see text at end of volume. This type of personal protection is sometimes effective enough to mean that other precautions need to be less stringent.
G.7.1 Practical aspects
To be effective, the control of infectious diseases needs clearly defined responsibilities. The responsible organisations and persons and their roles are included in Table 2.
Organisation/person | Action | Consequence | Additional information |
Seafarer | Accurate self declaration at PEME Report illness or close contacts promptly. Behaviours, eg use of insect repellent, use of condoms. Vaccination and chemoprophylaxis. Follow public health guidelines eg use of masks, distancing, hand hygiene | Reduce incidence of disease on board. Ensure own health is optimal and management plan in place. Reduce carriage and transmission of infectious disease amongst crew and from ship to shore, locally and to distant ports | National resources ISWAN ITF IMHA ILO IMO |
Shore based workers eg pilots, stevedores | Report illness or close contacts. Follow public health guidelines eg use of masks, distancing, hand hygiene | Reduce transmission of disease from shore to ship | |
Person responsible for medical care on board (Doctor, Officer etc). Master of the ship | Prompt and accurate assessment of seafarer Effective medical care in conjunction with TMAS Appropriate instigation of shipboard policies re isolation, cleaning etc in conjunction with Master Good communication with shore based authorities eg Port Health and the shipping company | Identify possible infectious disease Ensure prompt medical care to manage disease Identify those who may already have been infected and minimise further spread on board Required notification to local health authorities and shipping company for guidance on board and to ensure appropriate action in port | IHR |
TMAS | Support person responsible for medical care in care of seafarer Discuss need for isolation, assessment of close contacts or other sick seafarers. Advise on reporting to shore based organisations | Ensure appropriate care and monitoring to identify complications Support officers and seafarers and reduce transmission to others on board Ensure good communication and planning for ongoing care and management | |
Port Health Authorities | Enter early dialogue with ship to establish likely diagnosis and need for care on arrival in port Facilitate access to medical care as required Discuss and make necessary arrangements for assessment and management of others on board eg testing, quarantine, isolation | Ensure appropriate ongoing care for seafarer in appropriate facility upon arrival Ensure care can be accessed without delay Appropriate assessment and management of others on board to identify further cases and prevent further transmission to others on board or those ashore | IHR MLC |
National governments | Through appropriate legislation: Ensure access to medical care for sick seafarers Ensure objective assessment and care of others on board | Appropriate treatment of seafarer and identification of further cases. Reduce transmission from ship to shore | IHR MLC |
Table 2: Roles and responsibilities in managing infectious diseases in the maritime environment