Dear readers,
It is a great pleasure to welcome you to a new issue of the EU HEALTHY GATEWAYS joint action Newsletter. Though 2019 is no longer brand-new, let me take the opportunity and wish you all a happy, healthy and prosperous New Year!
In this issue, the coordinator of the joint action, Prof. Hadjichristodoulou, gives a comprehensive overview of the latest activities of the joint action and lines out challenges and tasks to be achieved in 2019.
Our partners from Public Health England in the thematic section Chemical Threats introduce us to the supporting work provided to the European Commission by the Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) on questions concerning a wide variety of issues including health, environment and emerging risks.
In the events section, do not miss out on the very interesting information about past events and especially the SHIPSAN training courses for Spanish Port Health Inspectors held in the port of Alicante (Spain) in October 15-18, 2018. With respect to upcoming events, please save the following dates: the first training event to be organised within the EU HEALTHY GATEWAYS joint action is now scheduled for 12-14 March 2019 in Piraeus, Greece and will focus on event management at ports.
Personally, it is a great pleasure to already invite you on behalf of the coordination team and of our local Healthy Gateways team to the 1st General Assembly of the EU HEALTHY GATEWAYS joint action to be held in Hamburg, Germany, 13-14 June 2019.
Finally, in this issue we are very pleased to introduce to you the dedicated Varna team from the Regional Health Inspection, Bulgaria, and the lively and busy port of Varna.
Enjoy reading!
All the best from Hamburg,
Jan Heidrich
Prof. Christos Hadjichristodoulou
EU HEALTHY GATEWAYS Joint Action Coordinator, Professor of Hygiene and Epidemiology,
Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Greece
Happy New Year to all our readers!
We wish you all health and prosperity in the New Year!
For the EU HEALTHY GATEWAS consortium, 2019 will be a busy year! Our annual plan includes many activities and an outline presenting the key tasks per work package is included below.
Within 2019, save the dates for the forthcoming meetings and training courses. The first train the trainers’ training course for preparedness and response to public health events at ports will be organised in 12-14 March 2018 in Greece. The Preparedness and response to public health events at airports will also be organised within 2019. In June 2019 the 1st General Assembly/collaborative group meeting will be organised in Hamburg, Germany.
The network of professionals for ports, airports and ground crossings will be established.
The state of the art report including the following parts is planned to be finalised by September 2019.
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- Part A: Ground crossings statistics
- Part B: Legal framework of implementing health measures at border crossings
- Part C: Literature review: lessons learned from the previous public health events related to ground crossings and previous projects
- Part D: Training needs survey: Determine the needs of EU countries related to ground crossings core capacities
- Part E: Lliterature review on the role of ground crossings in invasive mosquito species dispersal
- Part F: Survey to identify best practices on core capacities implementation at ground crossings
The identification of best practices in maritime and air transport will be finalised within early 2019.
Beneficiaries and collaborating stakeholders will have to develop national sustainability plans following the templates that are currently finalised by the leader of Work Package 4: Sustainability.
Training materials will be developed to be used to the European Level and national level training courses (for more information on the training events please visit the website).
The following tasks will start and/or be completed within 2019:
- Catalogues of best practices on core capacities implementation for event detection, surveillance, management, contingency planning will be developed during the first half of year.
- Tool for contingency plan development and assessment
- Options for improving of detection and surveillance of public health events
- Guidelines for intercountry communication and information flow in outbreak investigations and management of public health events on ships
- SOPs for vector surveillance and control activities at PoE and for inspections for vectors of conveyances
- Auditing guidelines for hygiene inspections on ships
Download the joint action leaflet from here
Visit the web portal by clicking on the link below: www.healthygateways.eu
The private area of the website was developed and beneficiaries and collaborating stakeholders received access.
Information on management processes and work progress is posted in this area. Specifically, the private area hosts:
- Joint Action timetables and Mind-map
- Deliverables, milestones, documents/outputs produced under each work package (e.g. Management Plan, Dissemination plan)
- Joint Action meeting reports and templates
- Joint Action webinars
- EU POENET “network of professionals” (to be developed)
- Depositories for training resources and table-top/simulation exercises (to be developed)
Follow us on Social Media of the joint action
Thematic Sections
Scientific Committee on Health, Environmental and Emerging Risks (SCHEER)
Tom Gaulton, Charlotte Hague, Eirian Thomas and Raquel Duarte-Davidson.
Chemical and Environmental Effects Department, Public Health England
The use of chemicals in human society is ever-increasing and as such, so is the potential for adverse incidents involving chemicals. The majority of the chemical incidents which occur are manageable and dealt with in-country, however when this isn’t the case (e.g. in large-scale chemical incidents which may spread across borders) there are arrangements in place in the EU to provide assistance to countries.
Decision 1082/2013/EU on serious cross border threats to health1 sets provisions on the notification, ad-hoc monitoring, risk assessment and coordination of public health measures following serious cross border threats to health from biological, chemical, environmental events as well as events that have an unknown origin. These threats may spread or entail a significant risk of spreading, across national borders of Member States, requiring co-ordination at EU-level to ensure adequate protection of human health. Following an alert notification of a cross-border health threat, a risk assessment of the potential severity of the threat to public health shall be carried out. When this does not fall under the mandate of a relevant EU Agency (e.g. European Centre for Diseases Prevention and Control or European Food Safety Authority), the Commission would (upon request of Health Security Committee or on its own initiative) provide an ad hoc risk assessment.2
The Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) can be called upon to provide the European Commission with expert and independent scientific advice upon request, on questions concerning a wide variety of issues including health, environment and emerging risks.
In the event of a cross-border chemical health threat, the SCHEER Rapid Risk Assessment Working Group (RRA WG) coordinates the rapid risk assessment (RRA) and provides scientific advice, including advice on the health and environmental effects of chemicals. The SCHEER has a pool of experts, who can be called on to provide specialist advice, depending on the nature of the incident. For example, they can undertake a RRA that takes into account, if available, information such as the release of a chemical plume which may travel over borders, a chemical slick that affects the coastline of multiple countries or chemical pollution e.g. of a transboundary river.
Outputs from the RRA can include:
- a summary of the RRA produced for the commission, specifying the major risks to public health arising from the incident;
- a brief summary of the symptoms displayed by individuals exposed to the chemicals (i.e. a case definition), to aid in the identification of those exposed;
- and/or a hazard statement describing the hazards posed by the particular chemicals, their effects on human health and recommendations on the public health measures to take.
References
1. Decision 1082/2013/EU -
http://ec.europa.eu/health/preparedness_response/docs/decision_serious_crossborder_threats_22102013_en.pdf
2. SCHEER Mandate for an Opinion on Ad-hoc rapid risk assessment -
https://ec.europa.eu/health/sites/health/files/scientific_committees/environmental_risks/docs/scher_q_110.pdf
Recent Publications
Development of a public health emergency preparedness competency model for European Union countries.
Stoto Michael A., Savoia Elena, Nelson Christopher, Piltch-Loeb Rachael, Guicciardi Stefano, Takacs Judit, Varela Santos Carmen, Ciotti Massimo. Euro Surveill. 2018;23(49):pii=1700631. https://doi.org/10.2807/1560-7917.ES.2018.23.48.1700631
Abstract
In 2017, the European Centre for Disease Prevention and Control (ECDC) developed a competency model for individuals who work in public health emergency preparedness (PHEP) in European Union (EU) countries. The model serves as the basis for developing competency-based training programmes to support professionals in PHEP efforts at the country level. The competency model describes the knowledge and skills professionals need when working in national-level PHEP, such as preparedness committee members or their equivalents. In order to develop the model, existing competency statements were reviewed, as well as case studies and reports. Fifty-three professionals from the EU and other countries provided feedback to the model by participating in a three-stage consultation process. The model includes 102 competency, 100 knowledge and 158 skill statements. In addition to specifying the appropriate content for training programmes, the proposed common competency model can help to standardise terminology and approaches to PHEP training.
Aeromedical Transfer of Patients with Viral Hemorrhagic Fever.
Nicol ED, Mepham S, Naylor J, Mollan I, Adam M, d'Arcy J, Gillen P, Vincent E, Mollan B, Mulvaney D, Green A, Jacobs M.
Emerg Infect Dis. 2019 Jan;25(1):5-14. doi: 10.3201/eid2501.180662. Epub 2019 Jan 17.
Abstract
For >40 years, the British Royal Air Force has maintained an aeromedical evacuation facility, the Deployable Air Isolator Team (DAIT), to transport patients with possible or confirmed highly infectious diseases to the United Kingdom. Since 2012, the DAIT, a joint Department of Health and Ministry of Defence asset, has successfully transferred 1 case-patient with Crimean-Congo hemorrhagic fever, 5 case-patients with Ebola virus disease, and 5 case-patients with high-risk Ebola virus exposure. Currently, no UK-published guidelines exist on how to transfer such patients. Here we describe the DAIT procedures from collection at point of illness or exposure to delivery into a dedicated specialist center. We provide illustrations of the challenges faced and, where appropriate, the enhancements made to the process over time.
Events
Webinar Series of Preparedness at Points of Entry
A webinar was organised on Tuesday, 11th of December 2018 on Border health measures to reduce the potential for the introduction or exportation, and spread of public health diseases of international concern.
The webinar was recorded and is available for play back viewing. Contact us if you are interested to receive access to the recorded webinar.
Presenters:
- Clive Brown, Chief Quarantine and Border Health Services Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention
- Kathleen Moser, MD, Medical Officer, US-Mexico Unit – San Diego Office, Division of Global Migration and Quarantine, National Center for Emerging & Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention
- Rebecca Merrill, Epidemiologist, Global Border Health Team, US Centers for Disease Control and Prevention
SHIPSAN training courses for Spanish Port Health Inspectors
When: September - October 2018
Two SHIPSAN training courses for Spanish Port Health Inspectors were organized in Spain in the past few months. Both of them were included into the National Training Plan for Spanish Inspectors and were accredited by the Spanish National Accreditation System.
First, a 4-day face to face training course was held in the port of Alicante (Spain) in October 15-18. A total number of 20 trainees participated in the course with a high level of satisfaction. The course followed the structure and methodology proposed by SHIPSAN, including a passengers ship inspection.
On the other hand, 30 trainees completed the National SHIPSAN ACT e-learning course. It included not only completing the e-learning course developed by SHIPSAN in a specific period of time (one month), but also some other activities that provided the course added value. In this regard, the course was composed of three components: first, trainees had to pass the SHIPSAN e-learning. Second, they had to answer to 3 quiz questions related to SHIPSAN proposed by the supervisors of the course in a weekly basis. And finally, they had to participate in two videoconferences where they discussed their answers and interacted with the other trainees to agree on final solutions to all proposed scenarios.
Training of the trainers’ face-to-face training course on Preparedness and Response to public health events at ports
When: 12-14 March 2019 Where: Piraeus, Greece
The 3-day face-to-face training of the trainers training course titled “Preparedness and response to public health events at ports’’ will take place on the 12-14 March 2019 on board the cruise ship Celestyal Olympia docked at the port of Piraeus, Greece.
The training programme is being organised within the framework of the EU HEALTHY GATEWAYS joint action by the University of Thessaly (UTH), Greece in collaboration with the National Institute of Public Health and the Environment (RIMV), Netherlands.
The purpose of the training of the trainers’ programme is to increase competence and capacity for managing public health events at ports and on ships including risk assessment, decision-making and crisis communication. The training course will address issues of decision making for implementing evidence based health measures proportionate to the health risks.
After completing this course, participants will act as trainers to the face-to-face training course at national level to be organised within the framework of the EU HEALTHY GATEWAYS Joint Action at their country.
The EU Health Gateways joint action consortium will be asked within the next month to nominate participants to this training event according to their countries needs and priorities.
1st General Assembly meeting, 13-14 June 2019, Hamburg, Germany
When: 13-14 June 2019 Where: Hamburg, Germany
SAVE THE DATE!
The 1st General Assembly/collaborative group meeting for EU HEALTHY GATEWAYS joint action will take place on 13-14 June 2019 in Hamburg, Germany.
The EU HEALTHY GATEWAYS 1st General Assembly meeting will run in parallel to the 15th International Symposium on Maritime Health at HafenCity University.
http://ismh15.com/en/information/
EASA Aerodromes Technical Advisory Body meeting
When: 27-28 November 2018 Where: Cologne, Germany
EU HEALTHY GATEWAYS representatives were invited to attend and present the Joint Action and Work Package 6 (WP 6) during the 5th technical board (TeB) meeting for EU Member State Aerodrome representatives. The meeting was organized by EASA’s Aerodromes Regulations section and was held on 27-28 November 2018 at EASA (NDK) in Cologne, Germany. Ms. Lemonia Anagnostopoulou from the University of Thessaly, Greece attended the meeting on 28 November 2018. During the session allotted, Ms. Anagnostopoulou presented the Joint Action EU HEALTHY GATEWAYS with emphasis on the activities and deliverables of Work Package 6. Audience members for the session included EASA staff and EU Member State aerodrome representatives. After presenting, a brief question period followed regarding the competent authorities that would be involved in WP 6 activities. The meeting also provided an opportunity to briefly discuss with Dr. Panait (Medical Expert, EASA) the Joint Action and EASA’s future involvement and input for the advisory board.
Final Conference of the Joint Action EMERGE - Efficient response to highly dangerous and emerging pathogens at EU level
When: 27 – 28 November 2018 Where: Brussels, Belgium
REPORT written by Boris Kopilović, National Insitute of Public Health, Slovenia
Dr Kolilovic was invited to deliver a presentation about EU HEALTHY GATEWAYS Joint action at 4th meeting of General Assembly on 27. And 28. November 2018 in Brussels.
Emerge Joint Action deals mainly with emerging and re-emerging infectious pathogens with the potential to cause serious cross-border outbreaks. A recent example is the Ebola outbreak requiring strong diagnostic, clinical, and public health measures in Europe and abroad in order to get this incident under control.
The Joint Action EMERGE comprises a European network with about 40 diagnostic laboratories focused on risk group 3 bacteria and risk groups 3 and 4 viruses. EMERGE aims to provide a common, coordinated and effective response to infectious disease outbreaks at EU level and abroad.
State of the art and new diagnostic methods for high threat pathogens are evaluated. External quality assurance exercises and training schemes are performed to ensure best approaches for laboratory responsiveness in outbreak situations.
Dr Kolilovic’s presentation was held on the second day of the project. He presented Joint Action Overview. Presentation was well received and some questions were answered after report.
Participants were interested if we will write guidelines with questions and answers section for most important emerging diseases as it was done in the past for port health authorities in the case of Ebola virus disease (SHIPSAN ACT). They were also interested if these guidelines with question and answers will be written not only to port health authorities, but also for authorities on ground and air crossings. Participants were also interested if we have microbiological part of EU Healthy Gateways joint action.
‘’Evidence-based best practices on entry/exit screening for infectious diseases in humans’’ training programme
When: 30-31 January 2019 Where: Luxembourg
The 2-day training programme ‘’Evidence-based best practices on entry/exit screening for infectious diseases in humans’’ took place on the 30 -31 January 2019 in Luxembourg. The training programme was organised within the framework contract Chafea/2015/Health/05-LOT3 with support from a consortium including the University of Thessaly (Greece), the National Institute for Public Health and the Environment (Netherlands), and the Robert Koch Institute (Germany).
The purpose of the training programme was to improve knowledge and capacity on entry/exit screening for infectious diseases in humans at borders (ports, airports, ground crossings) in the countries participating in the Third Health Programme (2014-2020). This training aimed to build capacities and to foster cooperation between the public health/medical border authorities from EU Member States, EU border control agencies and international organisations.
Participants to the Third Health Programme were asked to nominate participants to this training course. A total of 85 participants (53 trainees from 25 countries participating in the Third Health Programme, representatives from ECDC, FRONTEX, EASA, EMSA, DG MOVE, CHAFEA and DG SANTE, representatives from the transport industry and expert speakers) participated in this training programme.
Training courses organised in 2019 by the European Scientific Association for Health and Hygiene in Maritime Transport
When: 12-14 March 2019 Where: Piraeus, Greece
The “European Scientific Association for Health and Hygiene in Maritime Transport”, under the distinctive title of “EU SHIPSAN ASSOCIATION” is a legal entity in the form of a civil association of non-profit purpose. It was established after as per the decision of the 2nd General Assembly meeting of EU SHIPSAN ACT joint action. The Association will work in the public health area by effectively participating in public consultations at European Union level.
Two courses will be organised on Health and Hygiene on the 12-14 March 2019 in Piraeus, Greece; one for the shipping industry and one for port health offices. The two training courses will be organised in parallel with the EU HEALTHY GATEWAYS joint action training event on preparedness and response to public health events at ports.
- Health and hygiene training course for the shipping industry
Target Audience:
- Managers with duties related to health and hygiene
- Ship officers working at a supervisory level
- In-house or contracted trainers responsible to deliver health and hygiene training to crew members
For further information and to apply click here
- Health and hygiene training course for port health officers
EUMS were asked to nominate participants to this training course.
Target Audience:
Technical/scientific expert representing a port health authority working at a competent authority fulfilling the following criteria:
- The competent authority has agreed to participate in the inspections of passenger ships scheduled at a European level and conducted according to the European Manual
- The inspectors’ works in a competent authority of an EUMS that is mandated by this EUMS to conduct hygiene inspections on passenger ships.
- The inspector has undertaken training (e-learning, face-to-face and on the job) for the European Manual based on the training material of SHIPSAN and fulfills the criteria included in the competency framework.
Visit the Associations website for further information: https://shipsanassociation.shipsan.eu/
The Regional Health Inspection – Varna team
Bulgarian port Varna has a long history as a point of entry of vessels from all over the world. In 1878, the medical management of Bulgaria started the organization and equipment of the quarantine service in Port of Varna. According to the “Rules of quarantine doctors and health services in Bulgarian Black Sea ports” from 1886, each arriving ship was visited first by the quarantine doctor to clarify the quarantine state.
Now the successor of this service is the team “Medical-sanitary border control” in Directorate “Surveillance of communicable diseases” in Regional Health Inspection – Varna. The team consists of 1 head inspector and Medical Dr Galina Kokosharova and 4 health inspectors – Yuliyan Varimezov and Krum Krumov have been trained within the framework of SHIPSAN ACT Joint action.
RHI Varna and the team of border health control participated in all SHIPSAN projects. In 2016 RHI Varna organized The National Training Course and in 2018, the Kick-off meeting of the new project HEALTHY GATEWAYS. The events were organized by financial and administrative officers Tzetza Yankova and Borislava Dimitrova, under the supervision of the Director of RHI Dr. Dochka Mihaylova and with the participation of the Chief Health Inspector of Republic of Bulgaria Dr.Angel Kunchev.
Points of Entry in Focus
Bulgarian Points of Entry are located in Varna, Burgas and Sofia.
The Port of Varna is the largest seaport in Bulgaria. It is located on the Black Sea's west coast on Varna Bay. Each year approximately 2000 ships arrived at Varna sea port and received the free practice. The Team of Border Health control in Regional Health Inspection Varna has issued about 130 certificates of sanitation control exemption per year. Bulgaria is one of the first contries that implemented The Information System of Maritime Single Window.
Varna Port Complex includes the port facilities of Varna East, Varna West, Power Station Terminal, Balchik. The port facilities are open for operations all year round. Now Port of Varna operates Bulgaria’s two largest port terminals: Varna East and Varna West. Varna East port is situated at only 1 km distance from the city center. Two inland canals connect the sea and Varna East port with lakes and Varna West port. The canals form an island, on which an oil terminal is located. Varna West port is located at 30 km west of Varna city, on the shore of Beloslav Lake. It is close to the chemical factories of Devnya which enables effective “factory-to-ship” direct handling of goods.
Varna Port offers full service: loading, discharging, stevedoring, freight forwarding, storage and various intermodal services. The port has open-air storage area and the warehouses.
The existing port facilities allow the handling of practically all kinds of solid bulk, break-bulk, containerized and some liquid-bulk cargoes. Exports are urea, soda ash, cement, clinker, silica, fertilisers, grain, containers. Imports are coal, metals, ores and ore concentrates, oil, phosphates, timber, molasses, containers,etc. The port successfully handles windmill components, transformer equipment, specific project cargo, etc.
The port serves passenger and cruise ships, scientific vessels and yahts.
The Port of Varna is also the national leader for container and grain traffic
Other port terminals are the Cruise Terminal, Petrol, Lesport, Varna Thermal Power Plant, Railroad Ferry Terminal. In the territory of Varna ports there are also ship repair and shipbuilding yards - SRY, Dolphin, Terem.
The Port of Varna, as a commercial port for more than 100 years and now as a port at the outer border of the EU, has always been and will be a port of national and international importance.
References:
www.port-varna.bg
Port of Varna
http://en.wikipedia.org/wiki/Port_of_Varna
