Best practices for core capacities at ports
C Hadjichristodoulou, B Mouchtouri
European Journal of Public Health, Volume 29, Issue Supplement_4, November 2019, ckz185.135, https://doi.org/10.1093/eurpub/ckz185.135
Published: 13 November 2019
Abstract
Introduction
A survey was conducted in the frame of the EU HEALTHY GATEWAYS joint action with the purpose to identify best practices implemented at designated points of entry-ports of EU Member States for: core capacities implementation; detection, surveillance and management of public health events; vector surveillance and control practices at ports; contingency planning; risk communication; and inspection of ships for vectors.
Methodology
A questionnaire was disseminated to the EU Member States designated partners of the joint action. “Best practices” were considered those which fulfilled the following four criteria: a) practices are implemented according to the International Health Regulations (2005) requirements for core capacities; b) practices are documented and legislated/formalised; c) staff have been trained in implementing the documented practices; d) practices have been tested with exercises or have been applied in real life events.
Results
Data were collected from 15 ports of 13 countries including eight designated ports and one that that designation has not been completed. Best practices were described for medical services including diagnostic facilities, training programmes, exercise for testing contingency plans, staff competency frameworks, equipment and health measures implementation. Standard Operating Procedures and national legal frameworks were collected.
Conclusions
Despite the progress that has been made in the IHR core capacities implementation, it seems that best practices exist based on the countries priorities and needs. There are not many examples of PoE implementing best practices in all areas of the survey. Achievement of core capacities is a continuing effort and exchange of best practices among EU MS can be beneficial.
Public health events in the maritime transport sector
C Varela Martinez, C Hadjichristodoulou, B Mouchtouri
European Journal of Public Health, Volume 29, Issue Supplement_4, November 2019, ckz185.134, https://doi.org/10.1093/eurpub/ckz185.134
Published: 13 November 2019
Abstract
Introduction
A literature review to describe evidence on communicable diseases affecting people on ships or at ports, from 1990 to 2013 was carried out. Also, a literature review on radiological and chemical events of public health relevance associated with ships or at ports, from 1940 to 2013 was performed.
Methodology
Databases reviewed were: Medline, Scopus, Web of Science, Spanish Society of Maritime Medicine, and WebPages of WHO, The International Radio Medical Advice Centre, International Atomic Energy Agency, European Maritime Safety Agency, Marine Accident Investigation Branch, Spanish Nuclear Safety Council and the Major Accident Reporting System.
Results
From 1990 to 2013, 196 outbreaks relating to ships or ports with more than 24,000 cases and 19 deaths were published. 59% of outbreaks (n = 116) were food- and waterborne, causing 82% (n = 19741) of cases and 12 deaths (11 deaths due to Legionella, case fatality ratio of 7%); almost a third was caused by norovirus. Respiratory diseases, mainly Influenza, caused 18% of outbreaks and 2 deaths. Thirteen radiological events were published that affected 500 persons and caused 47 deaths, 24 due to exposure to elevated levels of radiation. During the study period 94 chemical events were published, of which 69 events affected people and in the remaining events only a public health risk was present. These 69 chemical events generated almost 12,000 cases and more than 2,000 deaths. Thirty countries, including all EU Member States, Norway and Iceland, were requested to complete the questionnaires regarding identification of authorities and practices for management of radiological and chemical events.
Conclusions
Food- and waterborne diseases are most reported; followed by respiratory diseases. Legionellosis accounted for the highest case fatality ratio. Tuberculosis was reported only on seafarers from cargo or fishing vessels and vaccine preventable diseases was mainly reported on crew members from cruise ships.
Effective training in cross-border infection prevention and response
D de Rooij, E Belfroid, C M Swaan, J Raab, A Timen
European Journal of Public Health, Volume 29, Issue Supplement_4, November 2019, ckz185.133, https://doi.org/10.1093/eurpub/ckz185.133
Published: 13 November 2019
Abstract
Introduction
Competent personnel at points of entry is important to prevent international spreading of disease. Education, training and exercises (ETE) are commonly used to secure this competency. We studied what effective training looks like, by conducting a literature review on effective ETE, conducting a training needs assessment.
Methodology
A systematic search in Embase, Medline, Web of Science, ERIC, Cinahl, and PsycInfo, to identify effective ETE on infectious disease control was performed. We integratively analysed effectiveness of ETE methods on different outcome levels: satisfaction, learning, behavior and organizational performance. Also, we assessed training needs and -preferences among professionals involved in infectious disease control at points of entry in Europe. They completed a digital questionnaire about previously received ETE, importance of topics, highest training needs, and their preferred ETE methodologies.
Results
We identified a range of effective ETEs in 62 studies. However, details on specific ETE methodologies are scarce, thwarting to link effectiveness to methodology. Also, long term and high level outcomes like behavioral change or public health system performance are reported less frequently than mere satisfaction or knowledge change, while these former often have higher relevance in real practice. Respondents (n = 59) had highest training needs concerning handling ill or exposed persons, and design and use of the contingency plan. Training needs correlated with importance of topics. Highest preferred training methods were presentations and e-modules.
Conclusions
We call for more extensive evaluations of education, training and exercises in infectious disease control, with measurement of high level outcomes and long term effects. Results from the current review and training needs from the field could be combined to design most effective ETE at points of entry.
Best practices and training for preparedness and response at airports
J Heidrich, J Angrén, D Schwarz, A Klahr, M Dirksen-Fischer
European Journal of Public Health, Volume 29, Issue Supplement_4, November 2019, ckz185.136, https://doi.org/10.1093/eurpub/ckz185.136
Published: 13 November 2019
Abstract
Introduction
Airports are important points of entry (PoE). More than 2.5 billion passengers pass through Europe’s airports every year. The nature of airports provides manifold opportunities for interactions among persons from all over the world and their environment with the potential for exposure, transmission and spread of infectious disease. Therefore, training, preparedness and response (P&R) to public health risks and events at airports are of utmost importance. The EU Joint Action Healthy Gateways airports branch (HGair) aims to strengthen P&R at airports in a multidisciplinary way.
Methods
Based on the international health regulations (IHR) and on previous research, HGair investigates P&R using a multi-method approach and offers a variety of training activities. A survey to identify best practices on IHR core capacities, event detection, surveillance, management and contingency planning at airports is being carried out. Training methods include face-to-face trainings on European, national and local level, table-top and simulation exercises as well as web-based training.
Results
Main results of HGair are best practice catalogues, a tool for contingency plan development and assessment at airports, a depository of P&R training materials and table top/simulation exercises, standardized operation procedures for vector control at airports and for inspection of aircrafts for vectors, a web-based platform and network of experts to communicate and notify rapidly in case of cross-border risks to health at airports and in air travel. So far, completed questionnaires (n = 14) on best practices in P&R were received from designated airports in 13 European countries, showing variations in reported practices.
Conclusions
European airports report different P&R practices. Deliverables and results of HGair provide the opportunity to strengthen IHR core capacities at airports and to harmonize surveillance and management of cross-border health threats in the air travel sector.
Mouchtouri VA, Christoforidou EP, An der Heiden M, Menel Lemos C, Fanos M, Rexroth U, Grote U, Belfroid E, Swaan C, Hadjichristodoulou C.
Int. J. Environ. Res. Public Health 2019, 16(23), 4638; https://doi.org/10.3390/ijerph16234638
Abstract
A scoping search and a systematic literature review were conducted to give an insight on entry and exit screening referring to travelers at points of entry, by analyzing published evidence on practices, guidelines, and experiences in the past 15 years worldwide. Grey literature, PubMed. and Scopus were searched using specific terms. Most of the available data identified through the systematic literature review concerned entry screening measures at airports. Little evidence is available about entry and exit screening measure implementation and effectiveness at ports and ground crossings. Exit screening was part of the World Health Organisation's (WHO) temporary recommendations for implementation in certain points of entry, for specific time periods. Exit screening measures for Ebola Virus Disease (EVD) in the three most affected West African countries did not identify any cases and showed zero sensitivity and very low specificity. The percentages of confirmed cases identified out of the total numbers of travelers that passed through entry screening measures in various countries worldwide for Influenza Pandemic (H1N1) and EVD in West Africa were zero or extremely low. Entry screening measures for Severe Acute Respiratory Syndrome (SARS) did not detect any confirmed SARS cases in Australia, Canada, and Singapore. Despite the ineffectiveness of entry and exit screening measures, authors reported several important concomitant positive effects that their impact is difficult to assess, including discouraging travel of ill persons, raising awareness, and educating the traveling public and maintaining operation of flights from/to the affected areas. Exit screening measures in affected areas are important and should be applied jointly with other measures including information strategies, epidemiological investigation, contact tracing, vaccination, and quarantine to achieve a comprehensive outbreak management response. Based on review results, an algorithm about decision-making for entry/exit screening was developed.
A selection of actions funded under the third EU health programme : special edition for the EU health programme conference, 30 September 2019
These success stories are just a selection of the hundreds of projects and actions that were made possible through the third EU health programme, which has been working since 2014 to improve public health in Europe. The health programme gives the European Commission the opportunity to substantiate its strong commitment to invest available funds in ways that get real results and ensures that each euro invested from the EU budget adds value and has a positive impact on people's health and daily lives.
Available here: https://op.europa.eu/en/publication-detail/-/publication/98986869-e049-11e9-9c4e-01aa75ed71a1/language-en?WT.mc_id=Selectedpublications&WT.ria_c=null&WT.ria_f=null&WT.ria_ev=search
Wieters Imke, Eisermann Philipp, Borgans Frauke, Giesbrecht Katharina, Goetsch Udo, Just-Nübling Gudrun, Kessel Johanna, Lieberknecht Simone, Muntau Birgit, Tappe Dennis, Schork Joscha, Wolf Timo.
Euro Surveill. 2019;24(49):pii=1900691. https://doi.org/10.2807/1560-7917.ES.2019.24.49.1900691
Two cases of presumably airport-acquired falciparum malaria were diagnosed in Frankfurt in October 2019. They were associated with occupation at the airport, and Plasmodium falciparum parasites from their blood showed genetically identical microsatellite and allele patterns. Both had severe malaria. It took more than a week before the diagnosis was made. If symptoms are indicative and there is a plausible exposure, malaria should be considered even if patients have not travelled to an endemic area.
Events
Sustainability Site Visit and High-Level Policy Officers Meeting
When: Tuesday, 26th November 2019 Where: Rome, Italy
A sustainability site visit and high-level policy officers meeting was organised on Tuesday 26th November 2019 in Rome, Italy. This meeting was held back-to-back with a national Italian dissemination day conference “Cross-border health safety: the Joint Action HEALTHY GATEWAYS” organized by the Istituto Superiore di Sanita and Minstero della Salute on 25th November 2019.
The purpose of the meeting was to discuss the national level uptake and integration of maritime transport activities and deliverables of the EU HEALTHY GATEWAYS Joint Action. In this respect, participants discussed about the new Regulation (EU) 2019/1239 of 20 June 2019 establishing a European Maritime Single Window environment, decided on certain recommendations and the sustainability of SHIPSAN Information System and committed to political support. Conclusions from the meeting will be sent to DG SANTE to be considered for the implementing act under Article 17 of the abovementioned Regulation.
In this meeting 10 high-level policy officers and 9 consortium members from 5 EU Member States participated. The meeting was organised by the University of Thessaly, Greece (EU HEALTHY GATEWAYS Coordination), Ministry of Health, Italy (Local organisers) and the University Medical Center Hamburg-Eppendorf (UKE), Germany (Leaders of Work Package 4: Integration in National Policies and Sustainability).
A full-scale emergency response exercise at Vilnius airport, Lithuania
When: 10th December 2019 Where: Vilnius, Lithuania
On the 10th of December 2019, a full-scale emergency response exercise at Vilnius airport was performed, imitating a scenario where an aircraft arrives carrying a passenger suspected to have an infectious disease. These full-scale emergency response exercise was organized in the framework in the EU HEALTHY Joint Action. More information about it will be in next Newsletter.
Other Past Events
Workshop: Sharing best practices and building effective training at European points of entry - 12th European Public Health Conference
When: 20 – 23 NOVEMBER 2019 Where:, MARSEILLE, FRANCE
An 1-hour workshop titled “Sharing best practices and building effective training at European points of entry” was planned by RIVM, the University of Thessaly and UKE-Germany. For further details on the workshop visit the link here
For further details please visit the conference website here
