1.5 Health Regulations Flashcards
Q. What are the International Health Regulations (IHR)?
The International Health Regulations (2005), or IHR (2005), represents a binding international legal agreement involving 196 countries across the globe, including all the member States of the WHO. Their aim is to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide.
The purpose and scope of the IHR (2005) is to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks and which avoid unnecessary interference with international traffic and trade.
Implemented through Commonwealth Quarantine Act 1908
Q. What is a Public Health Emergency of International Concern (PHEIC)?
A PHEIC is defined in the IHR (2005) as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”. This definition implies a situation that is:
Serious, sudden, unusual or unexpected.
Carries implications for public health beyond the affected State’s national border.
May require immediate international action.
What is meant by ‘deratting’?
Deratting means the procedure whereby health measures are taken to control or kill rodent vectors of human disease present in baggage, cargo, containers, conveyances, facilities, goods and postal parcels at the point of entry.
What is the difference between a pandemic and an epidemic?
Q. What is meant by ‘free pratique’?
Free pratique means permission for a ship to enter a port, embark or disembark, discharge or load cargo or stores; permission for an aircraft, after landing, to embark or disembark, discharge or load cargo or stores; and permission for a ground transport vehicle, upon arrival, to embark or disembark, discharge or load cargo or stores.
Whenever possible, States are encouraged to authorise granting of free pratique by radio instead of an official boarding the vessel.
Q. The port health authority disinfected the provision store after finding infected food in the storage. A hefty fine was charged to the carrier (ship’s owner). The owner is unhappy with the outcome and has asked the Master to ensure that there is no trouble at the next port. What can the Master do to prove that disinfection had taken place?
Under the International Health Regulations (IHR), the health authority should, if requested, issue, free of charge to the carrier, a certificate specifying the measures applied to a ship or container, the parts treated, the methods used and the reasons why they have been applied.
Q. Under the IHR, can the port health authority refuse free pratique to a vessel if one of its crew members has a minor non-communicable disease that is not subject to regulation?
No, The IHR states that except in an emergency constituting a grave danger to public health, a ship which is not infected or suspected of being infected with a disease subject to the regulations should not be refused free pratique on account of any other epidemic disease and should not be prevented from discharging or loading cargo or stores, or taking on fuel or water.
Q. One of your crew members have a regulated communicable disease. Your vessel has to transit through the territorial waters of Spain en route to Portugal. You are not calling any port in Spain, nor are you approaching its coast. Under the IHR, can the Spanish health authorities put your vessel on quarantine arrest?
No, The IHR states that no health measures should be applied by a State to any ship which passes through waters within its jurisdiction without calling at a port or on the coast.
Q. Are we allowed to discharge sewage in ports?
No, the health authority may take all practicable measures to control the discharge from any ship of sewage and refuse which might contaminate the waters of a port, river or canal.
Which flag is raised to indicate that the vessel is healthy and requires free pratique?
What are the documents to be presented by the Master to health authorities?
Ship Sanitation Certification (SSC) – valid for 6 months
International Sewage Pollution Prevention Certificate or exemption certificate– valid for 5 yrs
Crew medical and vaccination certificates.
Maritime declaration of health (normally submitted by the Master prior to arrival or by radio).
Narcotics list and medical chest certificate.
Q. What is meant by the incubation period of a disease? Give an example.
The incubation period of a disease is the time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear. For example, the incubation period of chickenpox is 14-16 days.
Q. Describe the three major regulated diseases from IHR 1969. What is the incubation period for each of them?
Plague
Was historically spread across the continents through merchant ships which harboured rats that carried fleas infected with the plague.
The incubation period of plague is six days.
Vaccination against plague should not be required as a condition of admission of any person to a territory.
During the stay of a ship in a port infected by the plague, special care should be taken to prevent the introduction of rodents on board. Rat guards are placed on mooring lines and the gangway is rigged with sufficient clearance from the ground.
Provision stores, galley, mess rooms and crew cabins etc., should be regularly inspected.
The vessel requires a Ship Sanitation Control Certificate.
Or a Ship Sanitation Control Exemption Certificate.
Cholera
Cholera is an infection of the small intestine by certain strains of bacteria.
It is spread mostly by unsafe water and unsafe food that has been contaminated with human faeces containing the bacteria. Undercooked seafood is a common source.
The incubation period of cholera is five days.
Yellow Fever
Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains, particularly in the back, and headaches.
The incubation period of yellow fever is six days.
Vaccination against yellow fever may be required of any person leaving an infected area on an international voyage.
Every member of the crew of a ship using a port in an infected area must be in possession of a valid certificate of vaccination against yellow fever.
