Dear readers, 

It is with great pleasure that I will be continuing the post of the Editor of the

EU HEALTHY GATEWAYS e-Newsletters and I’d like to express my gratitude to the  

HG coordinating team for trusting me.

 

 

The General Assembly of the joint action decided the continuation of the e-newsletter publication. We therefore aim to publish about 3 e-Newsletters per year. The e-Newsletter will be the means to communicate to you all activities towards the implementation of the roadmap for the short and long term sustainability as decided by the General Assembly (read more about in previous issue here). In addition, the e-Newsletter will present European and national events as well as scientific publications related to preparedness and response at Points of Entry. If you have an event, research results or relevant initiatives you wish to include in the e-Newsletter, you are welcome to email us.

Once the EU HEALTHY GATEWAYS has come to an end, it’s really positive to maintain certain activities such as the inspections conducted in the scope of the Inspection Plan for Passenger Ships or training activities. The EU SHIPSAN SCIENTIFIC ASSOCIATION supports those interesting activities that allow inspectors to be permanently trained and updated.

And now it’s time to talk about the future. The HEALTHY SAILING project sets sail under the umbrella of the EU funding program Horizon Europe, with the objective of making the passenger shipping sector safer and more competitive. During the following 36 months, the 24 partners will work together to produce evidence for reducing public health incidents on passenger ships. Their work will definitely complement and give continuity to the previous activities. An important plan is the expansion and implementation of the successful schemes of HEALTHY GATEWAYS to the wider MED area, including non-EU countries. Go for it!

Another example of the commitment to training is the presentation of the first edition of the MSc in Public Health and Maritime Transport that will provide students with the skills needed for a career in this field. We encourage all the maritime sector professionals to join the MSc that will start in 2023.

And last but not least, the 1st SHIPSAN congress was hosted in Athens this past October. If you did not have the chance to participate, read all about here.

 

Dr. Miguel Dávila Cornejo

Head of the Health Coordination and Management Unit,

Deputy Directorate of Foreign Health,

Directorate General of Public Health, Ministry of Health, Spain

 

 

Future activities

 

 

RESEARCH & INNOVATION

 

 

HEALTHY SAILING

Prevention, mitigation and management of infectious diseases on cruise ships and passenger ferries

Project Nr. 101069764 (Horizon Europe)

 

 

GENERAL OBJECTIVE

 

 

The project’s general objective is to improve the quality of passenger shipping services brought to society,

facilitating recovery from the COVID-19 pandemic and making the passenger shipping sector safer,

more resilient, competitive and efficient. This will be achieved by producing evidence for infection control,

validated prevention, mitigation and management (PMM) measures and training,

intended for use in policymaking and ship operations,

and whose implementation will reduce public health incidents on-board large passenger ships.

 

 

 

APPROACH AND METHODOLOGY

 

HEALTHY SAILING provides a comprehensive approach introducing innovative, multi-layered, risk and evidence- based, cost-effective tested PMM measures for infectious disease, differentiated for large ferries, cruise ships and expedition vessels.

 

 

HEALTHY SAILING OUTPUTS

 

Through the activities of seven Work Packages, the project will:

Establish a comprehensive scientific evidence- base concerning mechanisms facilitating on- board spread of infection and effectiveness of different mitigation measures:

Epidemiological studies, systematic literature reviews, risk assessment analysis, mathematical modelling to predict the spread of COVID-19 and Norovirus, setting disease thresholds/ alert levels and computational modelling for prediction of respiratory droplet and aerosol dispersion within passenger ship ventilated environments. Interventional studies to assess the impact of introduced PMM measures.

 

Produce evidence-informed guidelines for:

•  Prevention, mitigation and management of COVID-19 in routine ship operations

• Vaccination of passengers and crew in large passenger ships

•  Specificities and needs of medical operations in expedition vessels

• Updating existing guidelines for passenger ship ventilation systems, considering droplet and aerosol transmission risks

  Recommendations will also be produced for incorporating environmental health and hygiene standards into existing guidelines/manuals in accordance with evidence produced.

 

 

Develop, test and validate measures for healthy environments and early health threat detection on-board:

• Toolkit for systematic monitoring of surface cleaning and disinfection and intervention study evaluating the toolkit

• AI Water Safety Plan decision support tool to simplify plan development, improve water quality and prevent waterborne diseases

•  Syndromic surveillance system of infection diseases for passenger ships

•  Integrated health e-surveillance IT system (E- SS) for infectious diseases, covering all datamanagement needs for efficiently performing real-time syndromic, laboratory and environmental health surveillance

• Artificial Intelligence (AI) Intelligence Immune System (IIS), receiving input data to produce a voyage profile and health threat alerts, characterise threat levels and recommend/monitor health measures

• Inventory of fast diagnostic laboratory methods including safe and reliable self- specimen collection protocols for crew and passengers

• Facilitated access to ship medical facilitiesencouraging reporting among travellers

 

Address port operations and community needs through:

• Testing and demonstrating an integrated e-pass based on one-ID concept for optimized embarkation, effective and continuous tracking of travellers, and extended use of a wearable RFID

• Development of a toolkit predicting port response capacities required for numbers of travellers and interoperability of port/ship contingency plans

•  A scientific international panel will be established for exchange of best practices and to promote a harmonised global approach.

 

Further knowledge, awareness and compliance via:

• A blended learning toolkit enriched with hands- on training for crew, passengers and stakeholders incorporating augmented reality and gaming

• A toolkit for technology induced behavioural change in hand hygiene - interventional study to improve hand hygiene practices and assess differences between ship areas regarding contamination rates and hand hygiene practice

• Guidelines with communication approaches (including risk communication) as part of PMM measures

 

 

 

 

 

Future activities

 

                                                                  

 

                                  

                             

 

 

MSc in Public Health and Maritime Transport

Start date: September 2023

ECTS: 120

                                             

 

The MSc in Public Health and Maritime Transport aims to provide students with the skills needed for a career in public health, epidemiology, occupational health and environmental health, while also focusing on the practical application of these skills in the context of maritime transport. This MSc is ideal for those who choose to pursue a career in the health and related sectors, as well as those who currently work or plan to work in the maritime sector. The course is suited to students with both medical and non-medical backgrounds who intend to develop their research and technical professional skills.

The teaching staff providing course lectures are recognized leaders in academic fields of applied epidemiology, public health, environmental health and hygiene, chronic and infectious diseases, maritime health, health economics, occupational health including seafarers, human resources management and shipping economics. Guest lecturers include public health professionals with practical experience in maritime public health aspects.

 

Teaching staff from seven universities in Greece, Cyprus, Germany, Norway and Sweden will form the core base of tutors for this course.

Apply here until 31 May 2023

Visit our website https://mscpublichealthmaritime.med.uth.gr/ or contact us via email mscphm-admin@uth.gr

 

 

 

 

 

 

 

 

 

  Public Health Congress 2022 on Maritime Transport and Ports: sailing to the post-COVID-19 era                         

 

             

 

21 -22 October 2022, Athens, Greece

The European Scientific Association for Health and Hygiene in Maritime Transport (EU SHIPSAN ASSOCIATION) organized in collaboration with Cruise Lines International Association (CLIA) and the Association of Mediterranean Cruise Ports (MedCruise) the inaugural international Public Health Congress 2022 on Maritime Transport and Ports: sailing to the post-COVID-19 era on 21-22 October 2022 at Eugenides Foundation in Athens.

The Congress brought together about 400 expert scientists, government officials, maritime industry representatives, port administrators and other organisations. More than 80 expert speakers and chairs from national, European and international organisations (WHO, European Commission DG MOVE, EMSA, US CDC, CLIA, MedCruise, ECSA) discussed the latest, evidence- based, scientific data in the field of public health in maritime transport. In addition to invited speakers, 41 abstracts were submitted out of which 39 were accepted: 29 for oral and 10 for poster presentation. The Congress was organised in hybrid mode giving the opportunity for both in person or virtual participation.

 The Congress took place under the auspice of theHellenic Ministries of Health, Tourism, and Maritime Affairs & Insular Policy, and the University of Thessaly in Greece. Greece was one of the first countries worldwide that allowed safe and fast cruise resumption.

 

The aim of the event was to present best practices and current research and innovation activities and results in the field of public health in maritime transport. Issues related to evidence-based prevention and response strategies for global health diseases such as COVID-19, Monkeypox, influenza, Norovirus gastroenteritis, as well as environmental health and hygiene, crew health, cross -border health threats related to the maritime transport sector were discussed. Cruise line protocols represented some of the strongest actions taken by any industry to address and mitigate COVID-19. Ports in the Med also have worked intensively to create the conditions for safe cruise ships and passengers and crew visits. The responsible return of cruise tourism has been underpinned by collaboration with governments and public health experts, and the industry’s efforts were proven effective.

During the Congress, scientific evidence were presented about effective measures to safely restart cruise ship operations, as well as research results demonstrating that cruise ships implementing certain protocols have been a safe holiday setting during the pandemic when comparing the risk of COVID-19 transmission in the community and land-based holiday premises. As we move into the post-COVID-19 era, it is important to use the knowledge gained to improve preparedness and move to potential future public health risks in ports and ships. After the pandemic-related drop, the cruise industry is steadily recovering, and the forecast is to surpass pre-pandemic levels in 2023. Globally, the cruise industry generates more $150 billion in economic activity every year, supporting 1.17 million jobs.

For more information visit the congress webiste here.

 

 

 

 

 

RECENT PUBLICATIONS

 

Re-Starting the Cruise Sector during the COVID-19 Pandemic in Greece: Assessing Effectiveness of Port Contingency Planning

Anagnostopoulos L, Kourentis L, Papadakis A, Mouchtouri VA.

Int J Environ Res Public Health. 2022 Oct 14;19(20):13262. doi: 10.3390/ijerph192013262. PMID: 36293840; PMCID: PMC9603745.

Abstract

Coronavirus disease (COVID-19) outbreaks on board cruise ships early in the pandemic highlighted gaps worldwide in public health emergency contingency plans (PHECPs) for responding to unknown threats. To restart cruise operations in 2021 and respond to potential COVID-19 outbreaks, a major tourist-based Greek island port (Port A) developed a COVID-19 PHECP. We assessed plan effectiveness by reviewing epidemiological data and monitoring outcomes, followed by an intra-action review (IAR) analyzing three event responses. From May to December 2021, 118 calls from 23 cruise ships with 119,930 passengers were recorded, with 29 COVID-19 cases in 11 cruises on board 7 ships. No outbreak was recorded during the study period. Strengths of the introduced PHECP included commitment of senior management; a core multi-disciplinary team of local authorities/ship agents involved in design and execution; interoperability agreements for port and ships' PHECPs; cruise industry commitment to compliance; and pre-existing scenarios considering capacity needs. Central government coordination for preparedness planning at local ports is essential for successful responses. Monitoring local and country level response capacities is critical to inform planning, risk assessment, and decision-making. Immediately recording ports' response actions provides the basis to capture lessons and improve contingency plans. To facilitate communication and common response protocols between European and non-European ports, IARs should be conducted between countries.

Read more here

 

Transmission of SARS-CoV-2 Associated with Cruise Ship Travel: A Systematic Review

Rosca EC, Heneghan C, Spencer EA, Brassey J, Plüddemann A, Onakpoya IJ, Evans D, Conly JM, Jefferson T. Transmission of SARS-CoV-2 Associated with Cruise Ship Travel: A Systematic Review. Trop Med Infect Dis. 2022 Oct 9;7(10):290. doi: 10.3390/tropicalmed7100290. PMID: 36288031; PMCID: PMC9610645.

Abstract

Background: Maritime and river travel may be associated with respiratory viral spread via infected passengers and/or crew and potentially through other transmission routes. The transmission models of SARS-CoV-2 associated with cruise ship travel are based on transmission dynamics of other respiratory viruses. We aimed to provide a summary and evaluation of relevant data on SARS-CoV-2 transmission aboard cruise ships, report policy implications, and highlight research gaps.

Methods: We searched four electronic databases (up to 26 May 2022) and included studies on SARS-CoV-2 transmission aboard cruise ships. The quality of the studies was assessed based on five criteria, and relevant findings were reported.

Results: We included 23 papers on onboard SARS-CoV-2 transmission (with 15 reports on different aspects of the outbreak on Diamond Princess and nine reports on other international cruises), 2 environmental studies, and 1 systematic review. Three articles presented data on both international cruises and the Diamond Princess. The quality of evidence from most studies was low to very low. Index case definitions were heterogeneous. The proportion of traced contacts ranged from 0.19 to 100%. Studies that followed up >80% of passengers and crew reported attack rates (AR) up to 59%. The presence of a distinct dose-response relationship was demonstrated by findings of increased ARs in multi-person cabins. Two studies performed viral cultures with eight positive results. Genomic sequencing and phylogenetic analyses were performed in individuals from three cruises. Two environmental studies reported PCR-positive samples (cycle threshold range 26.21- 39.00). In one study, no infectious virus was isolated from any of the 76 environmental samples.

Conclusion: Our review suggests that crowding and multiple persons per cabin were associated with an increased risk of transmission on cruise ships. Variations in design, methodology, and case ascertainment limit comparisons across studies and quantification of transmission risk. Standardized guidelines for conducting and reporting studies on cruise ships of acute respiratory infection transmission should be developed.

Read more here

 

 

 

 

 

UPCOMING EVENTS