M/T or M/V “xx” IMO No: PLANS AND PROCEDURES FOR RECOVERY OF PERSONS FROM THE WATER
THETA MARINE CONSULTING LTD. theta@thetamarine.net www.thetamarine.net
VECTOR MANAGEMENT PLAN
M/T - M/V “ IMO No:
”
VECTOR MANAGEMENT PLAN (Water and Food Safety Included)
Note: This document was developed based on "information supplied by the ship owner and / or the ship
manager, and / or the ship operator".
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ACKNOWLEDGEMENT LIST All crew members are to review the plan and confirm by signing the attached list:
NAME
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RECORD OF CHANGES
No.
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Revision Detail / Description
Approved By : Name / Signature
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Table of Contents GLOSSARY........................................................................................................................................ 7 Section 1. INTRODUCTION ........................................................................................................... 11 1.1 GENERAL ................................................................................................................................ 11 1.2 PURPOSE AND OBJECTIVE ................................................................................................... 11 1.3 APPLICABILITY AND SCOPE ................................................................................................... 11 1.4 REQUIREMENTS REGULATIONS AND GUIDELINES .............................................................. 11 Section 2. HEALTH RISKS ASSOCIATED WITH VECTORS ON SHIPS ....................................... 12 Section 3. VECTOR AND RESERVOIR CONTROL ........................................................................ 13 3.1 Guidelines ................................................................................................................................ 13 3.2 Countries who are adopting integrated Vector Control Strategy........................................... 14 3.3 Application on Board Vessels ................................................................................................. 15 3.4 Best Practice on Board for Food and Water safety ................................................................ 15 3.5 PREVENTIVE MEASURES........................................................................................................ 19 3.5.1 Screens ................................................................................................................................... 20 3.5.2 Insecticides ............................................................................................................................ 21 3.5.3 Rodent Vector Control ........................................................................................................... 22 3.5.4 Vessel Equipment for Vector Management .......................................................................... 25 Section 4. HUMANS AFFECTS FROM VECTORS......................................................................... 30 4.1 Malaria ...................................................................................................................................... 30 4.2 Chikungunya ............................................................................................................................ 31 4.3 Schistosomiasis ........................................................................................................................ 32 4.4 Dengue fever ............................................................................................................................. 32 4.5 Filariasis ................................................................................................................................... 34 4.6 Leishmaniasis .......................................................................................................................... 35 4.7 Onchocerciasis ........................................................................................................................ 36 4.8 Japanese Encephalitis ............................................................................................................. 36 4.9 Table of Vector Bourne Diseases ............................................................................................ 37 4.10 The global distribution and burden of major vector-borne diseases.................................... 38 Section 5. ROLES AND RESPONSIBILITIES ................................................................................ 39 5.1. Allocation of responsibility and safety committee ................................................................. 39 5.2. SSC certificate.......................................................................................................................... 40 5.3 MLC certificate ......................................................................................................................... 40 5.4. PSC inspections ....................................................................................................................... 40 Section 6. COMPETENCE AND FAMILIARIZATION ..................................................................... 42 ANNEX 1 - RISK ASSESSMENT WITH ANTICIPATED CONDITIONS ............................................ 44
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APPENDIX - 1
SHIP-SPECIFIC INFORMATION............................................................................ 47
APPENDIX - 2 VULNERABLE LOCATIONS ON BOARD .............................................................. 51 APPENDIX - 3
VULNERABLE AREAS & EQUIPMENT ON BOARD............................................. 54
APPENDIX - 4
VECTOR MANAGEMENT INSPECTION FORM "VMF- 01"................................... 56
APPENDIX - 5
VECTOR (Pest & Rodent) MANAGEMENT LOG "VMF- 02"................................. 60
APPENDIX - 6 VECTOR MANAGEMENT EQUIPMENT INVENTORY "VMF- 03" .......................... 61 APPENDIX - 7 KANDLA, INDIA - COMPLIANCE INSTRUCTIONS FOR PORT ENTRY AND OPERATIONS (As per M.I Marine Safety Advisory 54-2014) ........................................................ 62 APPENDIX - 8 GUIDANCE "ON POLICY" - MAKING FOR INTEGRATED VECTOR MANAGEMENT (By World Health Organization) ........................................................................... 68
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GLOSSARY • Acceptable non-rat-proof material A material with a surface that is treated (“flashed”) to be resistant to rat gnawing when the edges are exposed to gnawing (the “gnawing-edges”), but that is subject to penetration by rats if the gnawing-edges are not treated. • Accessible Capable of being exposed for cleaning and inspection with the use of simple tools, such as a screwdriver, pliers or an open-ended wrench. • Affected Persons, baggage, cargo, containers, conveyances, goods, postal parcels or human remains that are infected or contaminated, or carry sources of infection or contamination, so as to constitute a public health risk. • Affected area A geographical location specifically for which health measures have been recommended by WHO under International Health Regulations (2005) • Backflow The flow of water or other liquids, mixtures or substances into the distribution pipes of a potable supply of water from any source or sources other than the potable water supply. Back-siphonage is one form of backflow • Back-siphonage The backward flow of used, contaminated or polluted water from a plumbing fixture or vessel or other source into a water-supply pipe as a result of negative pressure in the pipe. • Black water Waste from toilets, urinals or medical facilities. • Cleaning Removal of visible dirt or particles through mechanical action, reducing the microbial environment population through the application of chemical, mechanical or thermal processes for a certain period of time. • Communicable disease Diseases caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi. The diseases can be spread, directly or indirectly, from one person to another. Zoonotic diseases are communicable diseases of animals that can cause disease when transmitted to humans. • Competent authority Authority responsible for implementing and applying health measures under the International Health Regulations (2005).
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Section 1. INTRODUCTION 1.1 GENERAL Vector-borne diseases are infectious diseases which are transmitted by various organisms such as include insects, snails and rodents. These diseases present threats to people and their communities in developing countries. Some of the most debilitating of these diseases are malaria, dengue, lymphatic filariasis,Japanese encephalitis, leishmaniasis, onchocerciasis, and schistosomiasis. The Global Strategic Framework for Integrated Vector Management (IVM), issued by the WHO stipulates that Integrated Vector Management provides a basis for strengthening vector control in a manner that is compatible with national health systems.
1.2 PURPOSE AND OBJECTIVE The primary aim of this Plan is to provide guidance for the Master and other crew members onboard the ship regarding procedures of Vector Management and to highlight the importance of applying appropriate control measures. This Plan is to be kept onboard and in order to achieve its purpose, crews onboard should be familiar with this document.
1.3 APPLICABILITY AND SCOPE This document is intended to provide examples of accepted good practices. However, it is acknowledged that there may be equally effective alternative solutions that should be deployed to achieve the desired objectives. This Plan is to be available for viewing on request by a Port State Authority and is written in the English language which is the working language of the crew.
1.4 REQUIREMENTS REGULATIONS AND GUIDELINES The International Health Regulation (2005) state that: “Conveyance operators should permanently keep conveyances for which they are responsible free of sources of infection or contamination, including vectors and reservoirs. Every conveyance leaving an area where vector control is recommended by WHO should be disinfected and kept free of vectors�. When there are methods and materials advised by WHO, these should be employed. States should accept disinfection applied by other States if methods and materials advised by WHO have been applied. The presence of vectors on board conveyances and the control methods used to eradicate them shall be included on the Ship Sanitation Control Certificate.
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Section 2. HEALTH RISKS ASSOCIATED WITH VECTORS ON SHIPS The control of disease vectors such as insects and rodents is necessary for the maintenance of health on board ships. Mosquitoes, rats, mice, cockroaches, flies, lice and rat fleas are all capable of transmitting disease. Rodents are well established at port areas and are considered vectors for many diseases. Plague, murine typhus, salmonellosis, trichinosis, leptospirosis and rat bite fever are known to be spread by rodents. Malaria is transmitted to humans by mosquito vectors. If not properly controlled, such vectors could breed and be carried by ships. Infection with malaria during a voyage represents a serious risk to health and life of crew and passengers. On board, the chances for early diagnosis and proper treatment are limited. Persons and vectors on board can in turn spread disease to ports
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Section 3. VECTOR AND RESERVOIR CONTROL 3.1 Guidelines This section provides user-targeted information and guidance, identifying responsibilities and providing examples of practices that can control risks. Two specific Guidelines (situations to aim for and maintain) are presented, each of which is accompanied by a set of Indicators (measures for whether the guidelines are met) and Guidance notes (advice on applying the guidelines and indicators in practice, highlighting the most important aspects that need to be considered when setting priorities for action). Ports receive and manage goods and people from all over the world. Therefore, ports are exposed to the risk of vectors from any part of their country or any other port in the world. In addition, the activities undertaken at ports, such as handling foodstuffs, attracts many species of vermin. Once on board ship, being relatively isolated from medical facilities makes diagnosis and treatment of disease more difficult and potentially increases the risk of serious harm. The relatively crowded nature of ships facilitates the spread of disease and ensures a concentration of foodstuffs and hosts for vectors. Outbreaks associated with the presence of vectors on board are usually linked to both inadequate control and sanitation on board and to insufficient attention to preventing contamination in the first place. The failure of initial prevention leads to contamination which is then exacerbated by failed ongoing control. A preventive approach using good design that minimizes opportunity for vector penetration, hiding and proliferation is the foundation of any good vector control strategy. Multiple barriers should be actively maintained including:
screening out vectors using all reasonable means, controlling vectors on board, eliminating habitats suitable for vector survival and breeding, where practicable, and reducing the opportunity for exposure of passengers and crew to vector-related infectious agents.
One or more of the following control measures may be employed:
Regular inspection of ship spaces, particularly where infestation is most likely to occur, such as food storage, food handling and refuse disposal spaces. Elimination of pest hiding places and point of accumulation in which trash, food particles, or dirt may accumulate. Frequent cleaning of living quarters and spaces where food is stored, prepared, or served or in which dishes and utensils are washed and stored. Proper storage and disposal of food refuse and rubbish. Elimination of habitat for insect larvae ideally through design or, if unavoidable, though maintenance, such as preventing the formation of standing water in lifeboats. Use of screens on all structural openings to the outer air during seasons when insects are prevalent. The application of suitable insecticides. Issue No.01 / Date: 01.10.2014
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As vectors such as rodents, vermin and flying insects may have access to ships when in port, control measures for the suppression of vermin and insect infestation are necessary. These control measures must be carried out under the direction of a ship’s officer, charged with this responsibility and frequently inspected.
3.2 Countries who are adopting integrated Vector Control Strategy When the vessel is calling ports where an Integrated Vector Management Plan is implemented by the country, the seafarers should ensure that all the necessary procedures described in this plan are effectively followed and relevant records are kept. Moreover, it is advisable before arrival, the local agent or Authorities to be contacted for any particular local regulations with which the vessel should comply with during her whole stay.
ďƒ˜ India India is one of the many countries who are adopting integrated vector control strategy and monitoring the results on Integrated Vector Management strategies. India's population suffers from these diseases, in the form of morbidity and mortality from diseases such as malaria and dengue. To address these issues the National Health Policy set goals for reducing malaria, dengue and Japanese encephalitis mortality, eliminating kala-azar, and eliminating lymphatic filariasis. After the successful implementation of Enhanced Malaria Control Program in many districts in India, National Vector Borne Disease Control Program, (the central agency responsible for guidelines, policy and implementation of vector borne disease in India) envisages to launch Vector borne disease control project in the country with assistance from the World Bank. India is one of the countries also committed to the WHO Pesticide Evaluation Scheme (WHOPES), whose primary objective is to facilitate the search for alternative pesticides and application methods that are less harmful to humans and the environment as well as being cost-effective. For compliance at port of India, it is recommended the vessel to ensure that the mooring ropes are stored in such a way, preferably stowed on 15-20 cm height pallets, allowing for vessel crew to carry out self-inspection, enabling thorough inspection underneath and preventing the harborage of vectors. Considering the vessel's garbage storage capacity, effective planning should be made for Garbage disposal at port. Particularly food and wet wastes generated by the vessel should be stored at cool temperatures preferably inside freezer boxes in case the vessel is equipped with same. Drums placed in open air should be avoided as they are considered a sanitary hazard for vector infestation and attraction during stay at port. Alternatively, if no freezer box is available on board, the vessel should follow the international regulations permitting discharge of food waste at sea prior to arrival at port and ensure that food wastes generated at port are either delivered ashore or are properly sealed in appropriate bags. It is advisable that these sealed bags to be maintained in freezer rooms in bin(s) until departure.
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In order to prevent their dislocation and rat harborage, rat guards should be equipped with a locking system. For preventive purposes, an indicative list and quantity of the relevant equipment is considered the following: Rat Traps of Cage type - 12 pieces Rat Guards with lock system - 24 pieces Rat Baits - 24 packets In case any rats are trapped on board during port stay, the Port Health Authority should be informed through the vessel's agents. If the vessel requires screening for rodents, lightering can be carried out at anchorage points under the following conditions: Record all the names of the tugs/barges as they come in contact with the vessel as well as the timings of alongside and departure All the tugs/barges during their casting with the vessel, must have rat guards with lock systems on the mooring line from the vessel side and the tugs/barge side The vessel agent is to declare the tugs and barges that are going for operations to the vessel to the Port authorities for their inspection. The Responsible Officer of the vessel should ensure the tugs/barges strictly follow the placement of the rat guards with lock systems on the barge side and the vessel side of all the mooring ropes and the pilot ladder must be heaved up immediately after the boarding of Authorities, stevedores or other operations personnel. The Responsible Officer of the vessel should provide bright lighting focused on the barges and the mooring lines during the entire period of port operations from sunset to sunrise.
3.3 Application on Board Vessels Ports handle on a daily basis all types of traffic, provide support and storage facilities for all types of vessels managing goods and people from all around the world. Ports therefore are exposed to the risk of vectors from any part of their country or any other port in the world. The activities undertaken at ports, such as handling of provisions, furthermore attract many vectors. On board vessels, the relative isolation of seafarers and passengers from medical facilities makes a diagnosis and treatment of any disease difficult and potentially increases the risk of serious harm when the vessel is at sea. Due to the nature of the vessel operation, the spread of diseases may be facilitated. Outbreaks associated with the presence of vectors on board are usually linked both to inadequate control and sanitation on board. The failure of initial prevention leads to contamination, which is then exacerbated by failed ongoing control.
3.4 Best Practice on Board for Food and Water safety By implementing best practices on board the vessel crew members can be sheltered from vector infestation. One of the methods of implementing best practices on board is through the correct inspection of food provisions and food storage. Improper storage of provisions on board seagoing ships is a hazard, as provisions are frequently carried for many weeks or even months, and the ship can be subject to extreme climatic influences. Issue No.01 / Date: 01.10.2014
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Inspection of provisions that could become infested before being loaded on board the vessel is critical in preventing infestations of vectors on board the vessel. All dry food products should be inspected upon receipt and rejected if evidence of infestation is found. The quality of such food and potable water on board shall be suitable and the food shall be within the expiry dates. Potable water is regularly monitored through applicable hygiene procedures on board. In addition, on board inspection of all replenishments should be conducted, preferably within 48 hours of receipt, including newly-acquired stored products transferred from supply ships at sea. General inspection and surveillance procedures are as follows: • Perform the receipt inspection with the aid of a flashlight. • Examine packaging (e.g., individual boxes, plastic bags, or cardboard boxes) • Invert items in plastic bags and look for insect excrement (a fine powdery substance) which may have fallen to the bottom of the package. • Examine seams and folds in packaging and the inside corners of cardboard boxes. • Pay special attention to any items at or near the expiry date. These items have a higher risk of infestation. • Items most susceptible to infestation should receive priority during receipt. Cereals and other products containing raisins should be carefully checked. Storage, especially for cold stores, in an unpacked condition might have an adverse effect on provisions. Therefore, the following should be ensured: • • • •
Spaces are readily cleaned and disinfected and do not harbour hazards. Temperatures used in food storage do not support microbial pathogen growth. Ready-to-eat food is separated from the raw food. All food is separated and protected from sources of contamination.
Storing food in the food storage rooms must be performed in such way to allow: • adequate maintenance and cleaning • avoid vector access and harborage • enable food to be effectively protected from contamination during storage
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Apart from food storage rooms, the following locations on board are considered vulnerable to vectors and thus attention should be paid and adequate measures should be taken or maintained on board in order to prevent or control the undesired invasion of vectors: Galley Toilets Cabins Lockers Garbage bins/barrels Lifeboats ER skylight Accommodation Ventilation Forecastle area Storage location of mooring ropes Dining rooms Uncovered barrels
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Ensure cleanliness Ensure cleanliness Ensure cleanliness Ensure cleanliness and tidiness Ensure lids in place Ensure no accumulated waters Ensure no invasion Ensure no invasion Cleanliness and tidiness Cleanliness and tidiness Ensure cleanliness No accumulated waters
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The Galley and Food preparation/storage areas should be maintained clean at all times and disinfection should be carried out when deemed necessary. Galley and food areas and equipment need to be kept in good condition in order to: • facilitate all cleaning and disinfection procedures • function as intended • prevent contamination of food (e.g. from debris and chemicals).
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Adequate facilities for the storage of food, ingredients and non-food chemicals (e.g. cleaning materials, lubricants and fuels) must be provided. Cleaning can remove food residues and dirt, which may be a source of habitats suitable for vector survival and breeding. Disinfection may be necessary after cleaning. Cleaning chemicals should be handled and used carefully and in accordance with manufacturers' instructions. Cleaning chemicals should be stored, separately from food, in clearly identified containers to avoid the risk of contamination.
Maintenance, cleaning and disinfection ensure that all locations which may be affected on board are appropriately cleaned and maintained. This includes the cleaning of the cleaning equipment themselves. Cleaning and disinfection must be continually and effectively monitored for it to be suitable and effective.
3.5 PREVENTIVE MEASURES By following preventive approaches and measures and through the implementation of good planning, the opportunity for vector penetration, hiding and proliferation can be minimized, which is the foundation of a good vector control strategy on board the vessel.
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A number of measures may be followed on board the vessel such as:
screening out vectors using all reasonable means use of screens if possible on structural openings to the outer air in areas affected by insects - seal holes in walls, panels, dead space-entry exit points eliminating habitats which are suitable for vector survival and breeding, where practicable reducing the opportunity for exposure of seafarers to vector-related infectious agents. elimination of vector hiding places and point of accumulation in which trash, food particles or dirt may accumulate
In the galley, pantry, mess rooms and provision rooms, the following practices should apply:
wash basins, drainage lines and panels should be free of any leakages rusted walls, floorings, cabinets, store and cupboards should be maintained panels and cupboards should be maintained- especially wooden ones garbage bins should be kept covered at all times removal of scuppers of all drainage lines and drainage holes for cleaning purposes to be plausible inspect drainage line, tiles for food leftovers/residues separate colour coded garbage collection in the galley and pantry for food wastes, plastics and other wastes warm water should be used for cleaning free flow of all drains should be ensured food garbage after each meal to be thrown in the deck storage drums and to be kept covered at all times at the end of each day scuppers to be removed and cleaned on both sides - this is one of the active breeding points and food source for cockroaches keep cabins free from leftover foods dining should take place at allocated places - if a seafarer should dine at other time rather than the allocated time, the plates to be left inside the sinks or as per sanitary guidelines of the vessel. Left-over food not to be left out in the open avoid food spills and cover garbage bins after disposal of food
3.5.1 Screens Sleeping quarters, mess rooms and dining-rooms, indoor recreational areas and all food spaces must be effectively screened when ships are in areas where flies and mosquitoes are prevalent. Screening of sufficient hole tightness, no more than 1.6 mm spacing, is recommended, with screens on all outside openings. Screen doors should open outwards and be self-closing, and the screening must be protected from damage by heavy wire netting or other means, which may include the use of metal kick plates.
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Section 4. HUMANS AFFECTS FROM VECTORS Vectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another, causing serious diseases in human populations. These diseases are commonly found in tropical and sub-tropical regions and places where access to safe drinking-water and sanitation systems is problematic.
4.1 Malaria Malaria is a mosquito-borne infectious disease of humans and other animals caused by parasitic protozoans of the Plasmodium type. Malaria causes symptoms that typically include fever, fatigue, vomiting and headaches. In severe cases it can cause yellow skin, seizures, coma or death. These symptoms usually begin ten to fifteen days after being bitten. In those who have not been appropriately treated disease may recur months later. In those who have recently survived an infection, re-infection typically causes milder symptoms. This partial resistance disappears over months to years if there is no ongoing exposure to malaria. Commonly, the disease is transmitted by the bite of an infected female Anopheles mosquito. This bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites then travel to the liver where they mature and reproduce. The risk of disease can be reduced by preventing mosquito bites by using mosquito nets and insect repellents, or with mosquito-control measures such as spraying insecticides and draining standing water. Several medications are available to prevent malariain travellers to areas where the disease is common.
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The signs and symptoms of malaria typically begin 8–25 days following infection; however, symptoms may occur later in those who have taken antimalarial medications as prevention. Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms, and can resemble other conditions such as septicemia, gastroenteritis, and viral diseases. The presentation may include headache, fever, shivering, vomiting, hemolytic anemia, jaundice, hemoglobin in the urine, retinal damage, and convulsions. The classic symptom of malaria is paroxysm—a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO). It is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated. Decreased consciousness Significant weakness such that the person is unable to walk Inability to feed Two or more convulsions Low blood pressure (less than 70 mmHg in adults and 50 mmHg in children) Breathing problems Circulatory shock Kidney failure or hemoglobin in the urine Bleeding problems, or hemoglobin less than 50 g/L (5 g/dL) Pulmonary oedema Blood glucose less than 2.2 mmol/L (40 mg/dL) Acidosis or lactate levels of greater than 5 mmol/L If any of the above symptoms are experienced by a crew member after a vessels' visit to a malaria infested country, symptoms should be reported and medical advice should be sought.
4.2 Chikungunya Chikungunya is a viral disease that is also spread by mosquitoes. Two important vectors are Aedes aegypti and Aedes albopictus, which also transmit dengue virus. These species bite during daylight hours with peak activity in the early morning and late afternoon. Both are found biting outdoors but Aedes aegypti will also readily bite indoors. There is no direct person-to-person transmission. Chikungunya is an acute febrile illness with sudden fever and joint pains, particularly affecting the hands, wrists, ankles and feet. Recovery takes place usually after a few days but in some cases the joint pains may persist for weeks, months or even longer. Other common signs and symptoms include muscle pain, headache, rash and leukopenia. Occasional cases of gastrointestinal complaints, eye, neurological and heart complications have been reported. Symptoms in infected individuals are often mild and the infection may go unrecognized or be misdiagnosed in areas where dengue occurs. Chikungunya occurs in sub-Saharan Africa, south-east Asia and tropical areas of the Indian subcontinent, as well as islands in the south-western Indian Ocean. Seafarers travelling to such areas should take precautions to avoid mosquito bites during both day
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and night. There are no specific antiviral drugs and no commercial vaccine. Treatment is directed primarily at relieving the symptoms, particularly the joint pain. The best means of prevention is overall mosquito control and the avoidance of bites by any infected mosquitoes. No specific treatment is known, but medications can be used to reduce symptoms. Rest and fluids may also be useful. When the vessel is visiting ports where the existence of this vectors is possible, crew members should try and minimize the amount of exposed skin and apply insect repellent. Another form of protection is to spray living and sleeping areas with an insecticide to kill insects. If the above mentioned symptoms are experienced by a crew member, symptoms should be reported and medical advice should be sought.
4.3 Schistosomiasis Schistosomiasis (also known as bilharzia, snail fever, and Katayama fever) is a parasitic disease caused by trematode flatworms of the genus Schistosoma. Larval forms of the parasites, which are released by freshwater snails, penetrate the skin of people in the water. In the body, the larvae develop into adult schistosomes, which live in the blood vessels. The females release eggs, some of which are passed out of the body in the urine or faeces. Others are trapped in body tissues, causing an immune reaction. In urinary schistosomiasis, there is progressive damage to the bladder, ureters and kidneys. In intestinal schistosomiasis, there is progressive enlargement of the liver and spleen and intestinal damage is caused. Manifestations of the disease include abdominal pain, cough, diarrhea, high white blood cell count, fever, fatique and at sometimes genital sores. Methods to prevent the disease include improving access to clean water and reducing the number of snails. In areas where the disease is common entire groups may be treated all at once and yearly with the medication praziquantel. This is done to decrease the number of people infected and therefore decrease the spread of the disease. Praziquantel is also the treatment recommended by the World Health Organization for those who are known to be infected. Control of schistosomiasis is based on drug treatment, snail control, improved sanitation and health education on board the vessels. Crew members should protect themselves by drinking water that is safe and implementing sanitation procedures on board. Upon detection of the above symptoms, medical advice should be sought.
4.4 Dengue fever Dengue fever , also known as breakbone fever, is a mosquito-borne tropical disease caused by thedengue virus. Symptoms nclude fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressureoccurs.
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Dengue is transmitted by several species of mosquito within the genus Aedes. The virus has five different types; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. As there is no commercially available vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites. Treatment of acute dengue is supportive, using either oral or intravenous rehydration for mild or moderate disease, andintravenous fluids and blood transfusion for more severe cases. The number of cases of dengue fever has increased dramatically since the 1960s, with between 50 and 528 million people infected yearly. Apart from eliminating the mosquitoes, work is ongoing on a vaccine, as well as medication targeted directly at the virus.
Typically, people infected with dengue virus are asymptomatic (80%) or only have mild symptoms such as an uncomplicated fever. Others have more severe illness (5%), and in a small proportion it is life-threatening. The incubation period (time between exposure and onset of symptoms) ranges from 3 to 14 days, but most often it is 4 to 7 days. Therefore, travelers returning from endemic areas are unlikely to have dengue if fever or other symptoms start more than 14 days after arriving home. Children often experience symptoms similar to those of the common cold and gastroenteritis (vomiting and diarrhea) and have a greater risk of severe complications, though initial symptoms are generally mild but include high fever. The febrile phase involves high fever, potentially over 40 °C (104 °F), and is associated with generalized pain and a headache; this usually lasts two to seven days. Nausea and vomiting may also occur. A rash occurs in 50–80% of those with symptoms in the first or second day of symptoms as flushed skin, or later in the course of illness (days 4–7), as a measles-like rash. A rash described as "islands of white in a sea of red" has also been described. Some petechiae (small red spots that do not disappear when the skin is pressed, which are caused by brokencapillaries) can appear at this point, as may some mild bleeding from the mucous membranes of the mouth and nose. The fever itself is classically biphasic or saddleback in nature, breaking and then returning for one or two days. Issue No.01 / Date: 01.10.2014
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Section 6. COMPETENCE AND FAMILIARIZATION It is important to ensure that all crewmembers are being fully briefed on Vector Management procedures and that they are able to properly use and follow the relevant procedures and items that are available on board. This example provides a checklist called the “Food Hygiene Supervision and Instruction and/or Training” on the Essentials of Food Hygiene which forms the basis of the following training outline. All crew should be properly supervised and instructed to ensure they work hygienically. A greater degree of supervision may be needed for:
new crew awaiting formal training; crew handling high risk foods; less experienced crew; and crew whose first language is not the same as that spoken by others on the ship and/or crew with learning or literacy difficulties.
When a ship’s operation or part of the operation employs only one or two people, supervision may not be practical. In such cases, training and levels of competence must be sufficient to allow work to be unsupervised. All food handlers should, before starting work for the first time, receive written or verbal instruction in the essentials of food hygiene, viz :
keep yourself clean and wear clean clothing; keep hair and beards trimmed and covered; always wash your hands thoroughly: before handling food or starting work, after using the toilet, handling raw foods or waste, after every break, after blowing your nose, eating, drinking or smoking. tell your supervisor, before commencing work, of any skin, nose, throat, stomach or bowel trouble, fever or infected wound; ensure cuts and sores are covered with a waterproof, high visibility dressing; avoid unnecessary handling of food; do not smoke, eat or drink in a food room, and never cough or sneeze over food; if you see something wrong, tell your supervisor; do not prepare food too far in advance of service; keep perishable food either refrigerated or piping hot; keep the preparation of raw and cooked food strictly separate; when reheating food ensure it gets sufficiently hot throughout; clean as you go. Keep all equipment and surfaces clean. Follow the cleaning programs; and follow all food safety instructions in any of the ship’s operational manuals or on food packaging or from your supervisor.
As some of the above points may not be relevant to all ships and operations, they should be amended accordingly to suit the operation. All relevant crew should have Hygiene Awareness Instruction. The topics covered should be appropriate to the job of the individual and may include:
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the ship operator’s policy with priority given to food hygiene and safety; harmful bacteria; personal health and hygiene stressing the need for high personal standards, reporting illness, etc; cross-contamination causes and prevention; food storage protection, temperature control; waste disposal, cleaning, sanitation and disinfection materials, methods and storage; ‘foreign body’ hazards and potential contamination; and awareness of pests liable to be encountered on board and relevant action to be taken.
In addition, crew must be told how to do their particularly job hygienically. In particular, they should be instructed on any control or monitoring points of the HACCP plan. The depth, breadth and duration of training will be dependent upon the particular job role and the degree of risk involved in the activity. The first level of training aims to give a level of understanding on the basic principles of food hygiene and the course may be of about 6 hours duration. The following topics should be covered:
food poisoning micro-organisms types and sources; simple microbiology, toxins, spores, growth and destruction; food operation areas and equipment; common food hazards: physical, chemical and microbiological; personal hygiene: basic rules and responsibilities; preventing food contamination and spoilage; food poisoning, symptoms and causes; cleaning and disinfection/sterilization; awareness of relevant regulations and requirements]; pest awareness; and effective temperature control of food, e.g. chilled or frozen storage, thawing, cooking, cooling, reheating and holding.
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ANNEX 1 - RISK ASSESSMENT WITH ANTICIPATED CONDITIONS AND SHIP CHARACTERISTICS A self-assessment program can be preceded by a risk assessment. A risk assessment is a systematic review, with a critical look at work processes and issues in the galley. For inspiration, look up the risk assessment module in the program Health and Safety at Sea. There are three risk factors that can have an impact on food safety : Microbiological Bacteria, mould and mildew, viruses and parasites. Viruses cause vomiting and diarrhoea. Dangerous bacteria give the same symptoms and can cause even severe life-long effects and mould can develop toxins in food. Chemical Detergents that contaminate food, oxidized metal, chemicals (phthalates) to soften plastics and chemical sprays that come in contact with food can transfer substances that are damaging to health, pesticide residues from surface treatments, chemical substances formed during production, naturally arising toxins, for example in dried fruit – there are risks in all of these. Physical Shards from chipped china (bowls and glasses), plastic from packaging, bits of metal or plastic from worn equipment, dirty condensate from the cooker hood, mouldy wood in the galley – all these can be hidden reasons for broken teeth, bad stomachs or unhygienic cookery. A risk analysis has seven stages: i. Identify the risks What can go wrong when receiving goods, loading stores, keep them in stock, prepare food and cleaning in the galley? ii. Identify the CCP’s How can I manage behavior or take measurements to reduce the risks so that things do not go wrong? iii. Define the critical limits What is the limit between not being acceptable and not going wrong? iv. Monitoring How and how often should I write things down? v. Corrective action What should I do if something goes wrong? vi. Documentation How can I make my monitoring manageable in writing and what did I do when something went wrong? vii. Revision How should I match the self-assessment program to daily routines in the galley? Issue No.01 / Date: 01.10.2014
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APPENDIX - 2 VULNERABLE LOCATIONS ON BOARD Areas marked with red are considered vulnerable locations
A - DECK
B - DECK
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APPENDIX - 3
VULNERABLE AREAS & EQUIPMENT ON BOARD
A) FORWARD AREA (FORECASTLE)
B) AFT AREA (POOP DECK)
C) MOORING ROPES
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D) GARBAGE STATION
E) RAT GUARDS
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APPENDIX - 4
VECTOR MANAGEMENT INSPECTION FORM "VMF- 01"
Note - 1: This form should be completed either by ticking the boxes or upon completion of the inspection an entry to be made in the Bridge Log Book referring to Form's Number and time of completion. Frequency : Inspection to coincide with Company's SMS Health and Hygiene procedures.
DATE : ............................. PLACE : AT SEA / PORT .......................... ITEMS TO BE INSPECTED
CONTROL MEASURES - CORRECTIVE & PREVENTIVE ACTIONS
1. CONSTRUCTION Galley surfaces
Clean galley surfaces
Windows available or ventilation system adequacy
Adequate ventilation system
Toilet facilities
To be clean
Cabins and Deck
1.Tidy, cozy and well ventilated. 2.There is no evidence of rodent infestation and insect infestation and it is under control.
Bathrooms and shower rooms
To be clean
External doors and windows
To be vector protected
Screen mesh
Whenever screen mesh is installed to be gauge 1.6 mm or less (and as per Flag state requirements)
Mooring ropes storage areas
Ensure proper storage
Lifeboat(s) and Rescue Boat
Ensure no water accumulation
2. CREW AND PASSENGERS Crew and Passengers
Crew and Passengers certificates
Hygiene Conditions
Maintain toilets free of leaks
Toilet flushing system
Keep toilet flushing system proper maintained
Linens and cloths
Provide laundry facilities in good and safe working condition.
4. VENTILATION
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√
RESULTS
√
RESULTS
√
RESULTS
Adequate cleaning and maintenance for accommodation spaces to be implemented Cleaning and disinfection whenever required to be implemented
Toilet leaks
Cooling system
RESULTS
All crew and passengers / visitors / technicians etc, are in good health. No infected cases, suspects or foodborne diseases are reported. ▲ All crew posses valid health certificates. Crew and passengers from yellow fever infected area possess valid yellow fever vaccination certificates.
3. CLEANING & MAINTENANCE Cleaning and maintenance
√
To be working properly and ensure air quality
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APPENDIX - 5
VECTOR (Pest & Rodent) MANAGEMENT LOG "VMF- 02"
Identify location and measures taken to prevent / control invasion of Vectors during vessel's stay at port.
DATE
LOCATION
VECTORS DETECTED ? (Yes / No)
MEASURES TAKEN (e.g
RESULTS
Traps, sticky traps, baits,redonticide medicines, etc)
RESPONSIBLE OFFICER (SIGNATURE)
Note: All vessels must keep the Traps during a port stay and for Five (5) days continuously after leaving a port to prevent any harborage of rodents from ports of departure. It must be weekly thereafter if the voyage is longer . If any rats are trapped during a port stay the Port Health Authority must be informed through the vessels agent immediately.
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APPENDIX - 6 VECTOR MANAGEMENT EQUIPMENT INVENTORY "VMF- 03" Note: Equipment inventory for items such as insecticides, rat guards, rat traps, rat baits, pesticides, procedure masks) DATE
EQUIPMENT
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LOCATION
QUANTITY
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CONDITION
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