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