In late April 2009 the World Health Organisation (WHO) announced the emergence of a novel influenza virus. By December 2009 more than 208 countries and overseas territories or communities had reported laboratory confirmed cases of H1N1 2009, including more than 10,000 deaths.
Risk of transmission may be enhanced in crowded and semi-closed environments, due to proximity and prolonged opportunity to acquire H1N1 2009 virus infection from fellow travelers who may be ill. Therefore seafarers are recognised as a population at particular risk from the infection. WHO has currently published an interim technical advice for case management of H1N1 2009 on ships acknowledging the particularities of the ships’ environment as compared to general population.
While it is recognised that public health interventions at borders may play a role to delay or at least mitigate the international spread of emerging or re-emerging infectious disease, the focus with H1N1 2009 is now on the appropriate management of sick persons. From personal communication and newspaper reports the authors are aware that it is up to now reality in some countries that Free Practique is denied or delayed for ships where respiratory disease on board is declared.