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H1N1 2009 virus – port public health concerns

H1N1 2009 virus – port public health concerns

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.

This is inappropriate and not in line with the scope of the International Health Regulations 2005 that seafarers are denied timely medical care and assistance by port authorities in cases where H1N1 2009 is identified onboard vessels within their jurisdiction. The need to grant seafarers access to vaccinations against H1N1 2009 virus while calling in a port, wherever this is compatible with the national vaccination strategy is also recognised.

Prevention and Control of H1N1 2009 is a joint responsibility of shipowners, masters, port agents, port medical services, pharmacies and port health authorities. The Conventions of the International Labour Organisation (ILO) stipulate that seafarers are to be provided with “health protection and medical care as comparable as possible to that which is generally available to workers ashore”. H1N1 ought not to be an exception to this humanitarian principle.