Dear readers,
The international community of experts in international prophylaxis, as you know, is grappling with the issue related to the epidemic from the novel coronavirus (2019-nCov) in the Wuhan region of China.
The new 2019-nCoV was first detected by the Chinese authorities in the city of Wuhan, China and to date we do not know the origin of the virus.
Cases have been detected as of 29 January in Asia, but also in Australia, Europe and North America (read more here and here). According to the latest situation report from WHO on 29/01/20, 6,065 confirmed 2019-nCoV cases have been reported globally from which the 5,997 cases were from China. As of 29th of January, a total of 132 deaths have been reported inside China.
The issue is closely followed by public health authorities globally and measures have been implemented by European Members States at Points of Entry.
It should be noted that WHO travel advice regarding international traffic is that measures to limit the risk of exportation or importation of the disease should be implemented, without unnecessary restrictions of international traffic.
In this regard "HEALTHY GATEWAYS" has set up an ad hoc working group and, at the request of DG SANTE from the European Commission, it is drafting guidelines for public health measures at the points of entry focusing on advice about the decision making to implement entry screening and advice for aircraft and ship operators for preparedness and response to the outbreak of novel Coronavirus 2019-nCoV infection. This circumstance confirms the need to provide and update contingency plans to deal with health emergencies of international concern.
Coming to the content of this newsletter I would like to underline, in particular, the contribution of Prof. Hadjichristodoulou, who updates us on the state of the art of the HEALTHY GATEWAYS joint action, the voice of the industry on the prevention of measles on cruise ships and also the results of the large-scale emergency exercise organized at Vilnius airport, Lithuania.
Enjoy the reading!
Dr. Mauro Dionisio, MD, M.P.H.
Ministry of Health
Directorate General for Health Prevention
Chief, Office 3 –Coordination of Port, Airport and Border Health Offices
IHR Contact Point.
Sailors and air crew health care services – Coordination office.
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
In December the Interim Periodic report was submitted to CHAFEA outlining the main achievements of the joint action. A small summary of the work completed from the core and technical work packages from May 2018 until October 2019 is presented in the Thematic Section of this newsletter.
In addition to the Interim periodic report, an interim evaluation was conducted. The results of the interim evaluation were encouraging since the evaluation of activities showed a high degree of satisfaction of participants. Details are presented in Figure 1. In the upcoming months the external evaluation will be conducted by a subject matter expert and key stakeholders of the joint action will have the opportunity to share their views with regards to the joint action progress, added value and impact.
In parallel to the above activities a dissemination analysis was conducted that showed a good level of diffusion of the joint action activities to the stakeholders. In particular, partners reported via the bimonthly dissemination monitoring reports they have participated in >150 external dissemination events (conferences, workshops, meetings with key stakeholders, training events etc.) at international, European and national level and presented the work of the joint action. A total of seven scientific publications have been made. Partners have reported that they have made about 30 non-scientific non-peer reviewed publications (electronic and paper publications) at national and European level most of which were articles featuring the joint action activities. Moreover, the leaflet of the joint action has been translated into three languages (Italian, Lithuanian and Spanish) and has in total >600 downloads. Finally the web portal has recorded a total of 7785 page views from 1168 users from 31 October 2018-31 October 2019.
The steering committee of the EU Healthy Gateways kick-started the new year with an annual review meeting where the work remaining and the timetable for completion of milestones and deliverables for the 2020 were reviewed. A lot of work has been done and for a lot of the activities this was preparatory work for which the outcomes will be evident during this year.
The main activities to be completed within this year include:
- European Points of Entry Network - EU POENET
- State of the art report for ground crossing
- Web-based catalogues of best practices on core capacities implementation at points of entry
- Standard Operating Procedures for vector surveillance at points of entry
- National Sustainability plans
Events that are expected to be organised within 2020 are the following:
- Multisectorial Table-top exercise at European level for ports
- Multi sectorial table top exercise at national level for all points of entries
- Table-top exercises at local level for ports, airports and ground-crossings
- Training course on vector surveillance at points of entry
- Training course on preparedness and response at ground-crossings
National training courses on preparedness and response at airports and ports organised by the consortium members
Visit the web portal by clicking on the link below: www.healthygateways.eu
Novel Coronavirus (2019-nCoV)
Published guidance and reports for Novel Coronavirus (2019-nCoV) and advice on preparedness and response for Points of Entry and transport operators are available here:
https://www.healthygateways.eu/Novel-coronavirus
Deliverables available for download
Deliverables of the EU HEALTHY GATEWAYS joint action are listed in the web-portal in the following area
https://www.healthygateways.eu/Deliverables
All deliverables that are characterised as public will be available for download from the web-portal.
The newest addition is the Interim Evaluation Report that is available for download here: https://www.healthygateways.eu/Portals/0/D3%201_IER_Final_5Dec19_V2.pdf?ver=2019-12-19-123701-083
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The measles outbreak in Pacific Islands and the potential effects on cruise ships
Fulvio Kette, MD, FERC, Head of Medical Services, Carnival Maritime, Hamburg
Alfredo Andreis, MD, Director of Medical Services, Carnival Maritime, Hamburg
Introduction
In recent years an increasing campaign against vaccinations has emerged. Through the web thousands of people have begun to question the benefits of the vaccination stating that vaccines may be the cause of severe diseases such as the autism and serve solely to enrich the producing Companies.
This has led to a critical decrease in vaccination coverage and in the last few years to an increased incidence of diseases in many industrialized countries, particularly among infants and children who were not vaccinated because of the belief of their parents.
Scientists all over the world have attempted to demonstrate the falsity of the beliefs of the no-vax, however produced only minor results due to the lack of convincing the most reluctant people.
The fake news
Among the most common fake news discussions on vaccines, some are worthy to be mentioned (1)
Vaccines cause autism: false. There is no evidence at all. The proportion of autism in vaccinated and non-vaccinated children is the same;
Too many vaccines are administered simultaneously: false. Altogether the vaccines contain slightly more than 200 antigens whereas a simple scratch releases some millions of antigens;
Vaccines are administered too early: false. By leaving infants and children without coverage it raises tremendously the risk of contracting the infective diseases;
Vaccines weaken the immune defenses: false. On the contrary the vaccines raise the immune defenses of the body in the most natural and safer way;
Vaccines are a business for the industrial pharmaceutical Companies: although the producing Companies get economic benefits, the amount is substantially lower as compared to other more common drugs such as for antiulcer products;
Non-vaccinated children are healthier than the vaccinated ones: false. It is indeed true just the opposite. Non vaccinated children can spread dangerous diseases.
The origin of the fake news about vaccination
It was the study of the English doctor Andrew Wakefield that linked autism and vaccines, published in The Lancet on February 28, 1998 (2). This study was withdrawn a few years later but despite having been denied by dozens of searches, it is still the most cited by anti vax organizations.
The research was conducted on 12 children. "The theory was that for some mysterious reason the trivalent vaccine could create an alteration of intestinal permeability allowing external agents to more easily pass the intestinal barrier causing autism".
Following the publication, there was immediately a drop in coverage in Great Britain and in some countries of northern Europe, with an increase in cases and deaths, especially those due to measles. In the following years, several other studies showed that this study had no scientific basis, and an investigation found that Wakefield had agreements with some lawyers specialized in compensation cases, as well as holding a patent for its own vaccine. The article was officially withdrawn in 2010, and in the same year the doctor was expelled, although he continued his activity in the US and in the rest of the world.
The situation in the Pacific Islands
In recent weeks, an outbreak of measles has been occurring in the Pacific Islands (Samoa, Fiji, Tonga). The Ministry of Health in Tonga on December 4 reports (3):
“The outbreak of measles in Tonga began in early October 2019, following the return of a squad of Tongan rugby players from New Zealand. The first rugby player developed measles in New Zealand. Subsequently, a further 12 players developed laboratory-confirmed measles after returning to Tonga. The early outbreak involved mainly teenagers from schools on Tongatapu, as well as students from Vava’u High School. … Cases have been seen in all 70 villages on the main island of Tongatapu. .... An inter-disciplinary Ministry of Health Epidemic Task Force meets weekly to advice on management of the outbreak. In addition to routine outbreak response activities, a time-limited vaccination program targeting secondary school students has almost been completed and vaccination efforts are now being directed at other target groups.”
Samoa Island
Description of the outbreak
“The Ministry of Health (MoH) held a news conference in Apia on 9 October 2019 to announce a suspected measles case that may be transmitted from the Auckland outbreak. The MoH further reported that if laboratory results sent to Australia were positive, an outbreak would be declared. … WHO warns against unnecessary air travel to Samoa and additional passenger surveillance had been implemented at the main international airport. … On 15 November, Government of Samoa declared a state of emergency for the measles outbreak for 30 days.
As of 28 November, there were 250 cases recorded in the last 24 hours and 39 measles related deaths. Approximately 98 per cent of the measles cases are from Upolu and notably concentrated in the Vaimauga West and Faleata West districts with about 92 per cent admission rates, of which highest are among children below the age of 5 years.
On December 5, 4357 measles cases have been reported since the outbreak with 140 recorded in the last 24 hours and on December 7 4460 measles cases were documented, of which 68 died. Of these, 57 were children under 4 years old.” (4).
The cause
The causes of such outbreaks are related to the dramatic, sharp decrease in the vaccination rate in Samoa Island that was 90% in 2013, and dropped down to 31% in 2018. This occurred following an incident in 2018 when two infants died shortly after receiving measles vaccinations, which led the country to suspend its measles vaccination program. However, the reason for the two infants' deaths was an incorrect preparation of the vaccine by two nurses who mixed vaccine powder with expired anaesthetic.
The perspective
The World Health Organisation said this week that measles infected nearly 10 million people in 2018 and killed 140,000, mostly children.
The picture for 2019 is even worse with provisional data up to November showing a three-fold increase in case numbers compared with the same period in 2018.
The benefits of vaccination
Vaccination does not offer only protection to the individual person against the disease; it also provides the so called “Herd immunity” which is the resistance to the spread of a contagious disease within a population resulting from a sufficiently high proportion of individuals who are immune to the disease, especially through vaccination.
Take home Messages
Measles is an extremely infective disease with severe and potentially fatal complications particularly among children under 4 years old.
The outbreak that occurred in Pacific Islands may have real impacts on our activities as those Islands are on the route of our ships. Bringing even a single case of measles on board because of the lack of vaccination of someone might lead to an on board outbreak with devastating effects.
Vaccination is essential in as many crew members as possible to impede the diffusion of the disease. According to the SHIPSAN guidance on vaccine preventable disease, the pre-embarkation preventive measures define the strategies to guarantee that the crew members are adequately protected against vaccine-preventable diseases (5).
The second doses of measles vaccination is being administered to raise the protection up to 97% as the first dose provides already 93% of immunity (6)
MMR (Measles, Mumps, Rubella) vaccine can be safely and effectively administered after exposure to measles provided the vaccine is given within 72 hours from the exposure.
References
- Burioni R. Il vaccino non e’ un’opinione. Oscar Saggi, Mondadori, 2016.
- RETRACTED: Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive disorders in children. The Lancet 1998, 351 (9103): 637-641.
- Ministry of Health, Government of Tonga. Tonga measles outbreak 2019. December 4, 2019.
- Emergency Plan of Action (EPoA), Samoa measles outbreak. EP-2019-000139-WSM, December 2, 2019.
- Guideline IV Prevention and control of vaccine-preventable diseases on passenger ships; focusing on measles, rubella and varicella. European Manual for Hygiene Standards on Passenger Ships, Second Edition 2016, page 193-209.
- Measles, Mumps, and Rubella (MMR) vaccination: what everyone should know. CDC Center for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/index.html.
Summary of major results and key findings of the first 18 months of operation, their uptake and future potential use
During the first 18 months of operation, the need for an updated list of European points of entry (including contact details from competent health authorities in each point of entry) became evident. Furthermore, at the 1st General Assembly meeting the consortium identified the need for a web-based, searchable catalogue where best practices on core capacities implementation at points of entry could be shared and continuously updated by Member States. An additional issue discussed during the 1st General Assembly meeting was the insufficient guidance existing to address the challenge of contact tracing and exchange of personal passenger data between conveyance operators and public health authorities. Evaluation of the two European level training activities implemented by EU HEALTHY GATEWAYS during the first reporting period, as well as the training needs assessment demonstrated that a need exists in Europe for training courses related to preparedness and response at points of entry. Under the framework of the European scheme for inspections of passenger ships, audits are conducted to identify areas for improving the inspection programme and measure progress made in achieving standardization of inspections. Further details on these key findings and their future potential use are described in the section below.
List of European designated points of entry according to IHR (2005)
The Joint Action has developed a list of designated points of entry in Europe, as reported by the EU HEALTHY GATEWAYS partners. The list identifies the competent authority for designated points of entry as well as the contact persons for each competent authority. To date, the list includes a total of 62 designated ports in 11 countries (and three countries that are in the process of designation) and 35 designated airports in 13 countries (with four countries in the process of designation). No ground crossings have been designated but 5 countries are in the designation process. Contact persons identified through the list will be invited to join the network of professionals that has been established by EU HEALTHY GATEWAYS. As per the decision of the Joint Action consortium during the 1st General Assembly meeting, the list of European designated points of entry is being further developed into a searchable database, and expanded to include all points of entry, not only designated. This searchable database will be hosted in European Points of Entry Network EU POENET currently under development and will be a unified source of information on points of entry in Europe that can be continuously updated.
Web-based catalogues of best practices on core capacities implementation at points of entry
Best practices on core capacities implementation at ports and airports have been identified by EU HEALTHY GATEWAYS, while best practices for ground crossings are being collected. The practices identified cover all types of health threats, contingency planning, risk communication and advice for event management at points of entry. An online catalogue template has been developed to integrate best practices identified into a web-based format. The web-based catalogues are searchable by keyword, with practices categorized based on the area they relate to under International Health Regulations. While practices included in the catalogues are not meant to be considered a gold standard, many of them are evidence-based and fulfil certain evaluation criteria developed to determine what is considered “best practice”. The grade/level of evidence behind each practice is included within the web-based catalogue. The catalogue’s structure allows countries to describe their practices in a way that is useful to other Member States. In addition, since they will be hosted on the Joint Action’s web portal the catalogues can be updated by Member States allowing for continuous collection of practices.
Short-term solutions proposed to address the issue of contact tracing and exchange of passenger personal data between conveyance operators and public health authorities
It was noted during the 1st General Assembly meeting that effective contact tracing is challenged by delays in the timely exchange of data between conveyance operators and public health authorities. General Assembly members agreed on a proposed short-term solution that EU HEALTHY GATEWAYS could develop to address this challenge reported by Member States. The solution proposed is the development of a Memorandum of Understanding (MoU), which could be signed between public health authorities responsible for contact tracing in a given country and conveyance operators from this country. In addition, a letter to national conveyance operators involved in contact tracing could be developed, addressing their duties, obligations and stating clearly that the General Data Protection Regulation (GDPR) is not a limitation to exchange of data and is embedded in Decision No. 1082/2013/EU. Further exploration and development of these solutions will be carried out by EU HEALTHY GATEWAYS in the remaining time of the Joint Action. The proposed solutions should facilitate the exchange of information, not only resolving the issue related to fear around GDPR, but also positively affecting the timeliness of data exchange. Such advantages would be indispensable for increasing the level of public health security.
Tools for contingency plan development/assessment
Outlines for the online step-based tools are being developed for ports, airports and ground-crossings. The purpose of the tools will be to either:
- Support EU MS to create a contingency plan using existing guidance, if contingency plans are not already in place;
- Support EU MS to evaluate their current contingency plans against criteria based on existing guidance, if contingency plans are in place
Standard Operating Procedures for vector surveillance at points of entry
SOPs are being prepared for vector surveillance and control activities at points of entry (focusing on ports and airports) and a working group is being established to support this activity.
Chemicals threats at points of entry
A repository of chemical events detected which occur at, near, or affect points of entry is being developed via Public Health England’s regular chemical surveillance activities. A half-day Workshop for Chemical Threats at Points of Entry (20 September 2019 in Belgrade, Serbia) was conducted to identify gaps, opportunities and raise awareness of best practice for chemicals at all points of entry and improve understanding of existing arrangements in MS.
Training activities under the framework of EU HEALTHY GATEWAYS
A training needs assessment was conducted with the purpose of identifying the specific training needs of ports, airports and ground crossings and the preferred training methodology of the different types of designated points of entry. The results reflect the needs and preferences of the target groups for the training courses, specifically professionals responsible for event management at points of entry. The results were therefore used during the design and development of the two European level training of trainers’ courses carried out so far. These courses provided training on public health event management at ports/airports and included sessions on how to organize a national training course (participants were supported to identify training objectives, methodology and practical issues for when they planning a training in their own country), in order to support countries to fulfil the training needs in European points of entry. As a result of these European level courses, participants will act as trainers in national level courses to be organized under the framework of the Joint Action, to promote a multiplier effect for the transfer of knowledge. EU HEALTHY GATEWAYS also developed SOPs to facilitate Member States with implementing training courses in their own countries.
A total of 87 professionals have been trained between the two European level training courses. At the interim point of the Joint Action, uptake of the training is already evident. At national level three European countries participating in the consortium and the Taiwan CDC have reported organizing training courses. Spain has included in their annual plans training on the European Manual for Hygiene Inspections and Communicable Diseases Surveillance on passenger ships, while Malta, Lithuania and Taiwan CDC have organized national level training courses based on the materials produced by EU HEALTHY GATEWAYS on preparedness and response to public health events at points of entry.
Audits conducted under the European scheme for inspections of passenger ships
Considering the particular conditions on passenger ships, EU HEALTHY GATEWAYS implements a programme for passenger ship inspections and audits in European countries applying the EU legal framework. The objectives of these audits are to:
- Identify areas for improving the inspection programme
- Measure the progress made in achieving standardization of inspections
- Identify any training needs on the inspection procedures, the techniques, the technical knowledge on areas of the European manual and the use of EU SHIPSAN Information System (SIS)
- Any training needs based on the inspector competencies detailed in the European Manual, Part B – Annex 1 and 2
- Provide training as part of the audit process, as appropriate
- Support the inspection team to apply the inspection grading system
In 2018, 12 audits by one expert were conducted in the ports of EU MS while in 2019, 20 audits by three experts were conducted in EU MS ports.
Interim advice for preparedness and response to cases of the novel Coronavirus (2019-nCoV) infection at points of entry in the European Union (EU)/EEA Member States (MS)
This interim advice was prepared after a request from the European Commission's Directorate-General for Health and Food Safety (DG SANTE).
An ad-hoc working group was established with members from the EU HEALTHY GATEWAYS joint action consortium.
The scope of the advice provided in this document is to assist public health authorities in developing their short-term and long-term national and local preparedness plans. It further contains useful advice for the air and the maritime transport sectors.
This first version of advice addresses issues of air and maritime transportation. There are also rail connections between China and Europe. The working group will address issues for ground crossings in the next version of the advice.
Download here:
EASA Safety Information Bulletin - Coronavirus ‘2019-nCoV’ Infections – Operational Recommendations
A Safety Information Bulletin (SIB) was published by EASA in regard to the 2019-nCoV outbreak.
The SIB is available from the EASA website at the following link: https://ad.easa.europa.eu/ad/2020-02
https://ad.easa.europa.eu/ad/2020-02
Two cases of airport-associated falciparum malaria in Frankfurt am Main, Germany, October 2019
Wieters Imke, Eisermann Philip, 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
Abstract: 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.
The use and reporting of airline passenger data for infectious disease modelling: a systematic review.
Meslé Margaux Marie Isabelle, Hall Ian Melvyn, Christley Robert Matthew, Leach Steve, Read Jonathan Michael. Euro Surveill. 2019;24(31):pii=1800216. https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800216
Abstract:
Background: A variety of airline passenger data sources are used for modelling the international spread of infectious diseases. Questions exist regarding the suitability and validity of these sources.
Aim: We conducted a systematic review to identify the sources of airline passenger data used for these purposes and to assess validation of the data and reproducibility of the methodology.
Methods: Articles matching our search criteria and describing a model of the international spread of human infectious disease, parameterised with airline passenger data, were identified. Information regarding type and source of airline passenger data used was collated and the studies’ reproducibility assessed.
Results: We identified 136 articles. The majority (n = 96) sourced data primarily used by the airline industry. Governmental data sources were used in 30 studies and data published by individual airports in four studies. Validation of passenger data was conducted in only seven studies. No study was found to be fully reproducible, although eight were partially reproducible.
Limitations: By limiting the articles to international spread, articles focussed on within-country transmission even if they used relevant data sources were excluded. Authors were not contacted to clarify their methods. Searches were limited to articles in PubMed, Web of Science and Scopus.
Conclusion: We recommend greater efforts to assess validity and biases of airline passenger data used for modelling studies, particularly when model outputs are to inform national and international public health policies. We also recommend improving reporting standards and more detailed studies on biases in commercial and open-access data to assess their reproducibility.
Past events of the joint action
A full-scale emergency response exercise at Vilnius airport, Lithuania
Brigita Kairiene1, Ginreta Megelinskiene1, Martin Dirksen-Fischer2, Rolanda Lingiene1, Robertas Petraitis1
1 National Public Health Centre under the Ministry of Health, Lithuania
2 Hamburg Port Health Authority, Germany
On the 10th of December, 2019 the representatives from 14 institutions joined forces to strengthen their skills in managing the most challenging situations at the points of entry. In this case Vilnius airport is the only one designated airport in Lithuania in which aircrafts with suspected potentially contagious infectious diseases must land due to the IHR regulations.
A full-scale emergency response exercise was organized in the framework of EU HEALTGY Gateways Joint Action by National Public Health Centre under the Ministry of Health Vilnius Department and Lithuanian Airports Vilnius Airport. The exercise was very high evaluated by stakeholders, participating in it, Minister of health and also by experts from abroad, including one of the authors who is Co-leader in the field of work package 6.
In the exercise which lasted more than 5 hours there was simulated a situation that an aircraft is landed at the Vilnius airport carrying a person with potentially contagious infectious disease, in this exercise – Ebola haemorrhagic fever.
Actions of all involved institutions were performed according to contingency plan and showed that National Public Health Centre under the Ministry of Health and other stakeholders are ready to detect, respond, asses risk, make the right decisions and risk communication activities in case of suspected communicable disease, outbreak, contamination or other biological event on aircraft or airport territory.
In total, the exercise involved about 250 specialists from different sectors: health, transport, custom, state border control, police, air company, volunteers and etc.
This exercise was the first big exercise in the Baltic countries. It showed again, that a full-scale exercise which costs a lot of human resources and time to prepare and evaluate, cannot be substituted easily. It could be added that also the aspect of psycho-social support with the help of the Lithuanian Red Cross and “Order of Malta” was trained. This aspect of the exercise should be included in all full-scale exercises.
Future Events of the joint action
MULTISECTORIAL TABLE-TOP EXERSICE FOR PORTS AT EUROPEAN LEVEL
This 1-day small scale discussion-based tabletop exercise (TTE) will be conducted through the web under the framework of EU HEALTHY GATEWAYS (Milestone 4.4) on the 3rd of June 2020. This TTE will be developed to test the guidelines being produced for inter-country communication and information flow in outbreak investigations and management of public health events. Further information will be reported in future issues of the newsletter.
OTHER Events
Training courses for the shipping industry in 2020
The European Scientific Association for Health and Hygiene in Maritime Transport - EU SHIPSAN is announcing the upcoming on-line live streaming training course for the shipping industry.
Title: Health and hygiene management training course for the shipping industry
Dates: 11-15 May 2020
Purpose: This course is designed to assist you in developing and implementing health and hygiene management plans in accordance with the European standards and will provide examples of up-to-date, good practices.
Who should attend?
- 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
Course methodology: The course will run over a 5-day period (total duration: 20 hours) during which you will complete three sessions including:
- pre-recorded lectures and assignments to be completed at your own pace (asynchronous sessions) and
- 3 live online Q&A sessions (duration: 90 minutes each) that will be scheduled on Tuesday, Thursday and Friday to review the assignment results, answer questions and discuss with the course instructors.
Registration: To register click here - Registration deadline: 1st May 2020
For further information see the attached syllabus or visit the EU SHIPSAN Association website (click here)
Professor Rafał Gierczyński is head of Department of Bacteriology and Bio-contamination Control in the National Institute of Public Health - National Institute of Hygiene NIPH-NIH, Warsaw, Poland. Rafał Gierczyński is also deputy director for Epidemiological and Environmental Safety in the NIPH-NIH. He obtained his M.Sc in Environmental Microbiology in 1995 at the University of Warsaw. In 2000 he become Ph.D. on molecular genetics of Yersinia enterocolitica in NIH.
Rafał Gierczyński joined NIH in September 1995. In July 2000 he was qualified as a researcher. In December 2010 completed his habilitation theses (D.Sc.) on molecular epidemiology of Yersinia enterocolitica and was offered a position of associate professor in NIPH-NIH. He has practical experience in research on antimicrobial resistance, virulence markers and genetic diversity of Gram‑negative bacteria. Rafał Gierczyński conducted research on genetic diversity of Bacillus anthracis in Poland that revealed a high diversity of the bacterium in the country.
His professional experience includes three-month FEMS Fellowship in Max von Pettenkofer‑Institut für Hygiene und Medizinische Mikrobiologie, Munich, Germany (2004) and one-month short term mission (Med. Vet. Net.) in University of Madrid, Spain (2008)..
Rafał Gierczyński was a team member of project “Prevention of the Hepatitis C Virus (HCV) infections in Poland” cofounded by Switzerland and Ministry of Health in Poland. Since 2008 when he completed his specialisation on public health, Rafal Gierczynski is active in Public health related projects – mostly on epidemiology and prophylactics of infectious diseases.
Professor Gierczyński has supported participation of NIPH - NIH in EU Healthy GateWays Joint Action from the very start. His personal involvement helped in strengthening the collaboration with FRONTEX, which is very crucial for the future development of the Joint Action which aims to support all kinds of Points of Entry in EU Member States for better detection and response to public health threats.
Specificities at Ground-crossings – the Poland-Ukraine border example
By Dr. Janusz Janiec: IHR NFP Coordinator, Co-leader of Work Package 5:Ground Crossings, National Institute of Public Health, Poland.
The EU HEALTHY GATEWAYS joint action focus on three types of Points of Entry. Despite many similarities, as all of them are the gateways to countries for passengers and cargo, Ground Crossings differ from ports and airports a lot. One of the main element that makes ground crossings different is the diminished possibility to plan ahead. At ground crossings source information only becomes available as a vehicle approaches, and most of a time is not available beforehand. And this knowledge of the source of an arriving vehicle could be crucial for prioritization of measures if needed. This difference can be better understand through the numbers of passengers and vehicle passing the border e.g. between Poland and Ukraine, Border between these two countries is part part of outer EU Schengen border. On the distance of 535 km of the border (total length of outer EU Schengen border in Poland is about 1185km) there are 12 land crossings between Poland and Ukraine, of which 6 are railway crossings, 8 road crossings, 1 pedestrian crossing. Of all these crossings 9 of them are of the passenger type and 10 of the cargo type. 10 border crossings operate 24/7. Of the 12 land crossings operating between Poland and Ukraine, six of them may introduce foodstuffs and materials or products intended to come into contact with food, and as such are subject to border sanitary control on the territory of the European Community.
For the last four years the number of passengers that crossed between Poland and Ukraine is constantly above 21 000 000 and the number of road transports (passenger cars, buses, trucks and other means of road transport) varies between 6 and 7 000 000. Great amount of volume of passengers appears at ground crossing not according to the schedule like in airports and without prior knowledge like in ports. This is situation is always going to be a challenge for appropriate resource allocation and for prioritization and implementing measures if needed, in case of any public health threats related to land transport.
Probably, there are many strategies how to address this challenge for ground crossings operations but one of them is a promising project developing by Custom Service. On the web portal of dedicated to Points of Entry (https://granica.gov.pl) there is a project described called eBooking: Electronic notification of the arrival of organized tourism groups at road borders of the Poland. The idea of introducing the this project is to revive tourist and business contacts between the inhabitants of Poland and Russia, Belarus and Ukraine by removing barriers and creating maximum facilities for people crossing the border for tourist purposes. This project is at the same time a modern tool that facilitates effective and efficient control of buses and buses transporting organized groups. The goal of the system is to maximally shorten the stay of buses at the border crossing while maintaining effective customs control.
The eBooking is based on prior electronic notification of the Customs Service of the Republic of Poland about the planned arrival of a bus transporting organized tourist groups together with passenger lists to adapt personnel border crossings of both the Customs Service and the Border Guard and to assess the risk of travel before its actual appearance on the border. These activities, carried out by separate Customs Service units located outside border crossings, help officers from border crossings and significantly reduce the time the bus stays on the border.
The project is dedicated to tour operators based in the European Union and third countries conducting business and economic activities, the purpose of which is to transport organized tourist groups (The Customs Service of the Republic of Poland guarantees that personal data of persons reported in the system will be protected in accordance with the provisions on the protection of personal data).
At present the new service called eBooking Truck is already in operation. It gives the option of electronic reservation of the border crossing within 30-day.To use it in a current phase, the conveyance operator has to register through the website www.e-booking.gov.pl, which allows access to booking the crossing and check dates. It is also planned to provide a simplified booking method without logging in.
Currently, the system allows making reservations at two border crossings:
- with the Russian Federation in Grzechotki,
- with Belarus at the car terminal in Koroszczyn.
According to the Customs Service, the system was created based on research carried out in transport environments by the Institute of Logistics and Warehousing.
The system assumes that border checks will be facilitated by shortening the waiting time at border crossing points and will enable entrepreneurs and drivers themselves can easily plan a convenient time for customs clearance in road transport. (Source: Newsletter of the Customs Chamber No. Z / 63/2015).
By Antonello Campagna, Ministry of Health, Italy
According to IMO International Code of Signals, 2005 What is the meaning of these nautical flags?
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