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SHIP SANITATION CERTIFICATE PROGRAM COURSEUnit 1: Introduction to International Health RegulationsCIN: B-322-1100SSEPTEMBER20121-1-01-1-0

Course Terminal Objectives1 0 - Describe the requirements of the International1.0Health Regulations2 0 - Explain the Ship Sanitation Certificate Program2.03.0 - Identify the elements of shipboard organization4.0 - Describe the procedures to CONDUCTShipboard Sanitation Certification and ISSUEappropriatei t certificatestifi t1-1-1

International Health Regulations (2005)Fl t FocusF& IImpactstFleetEnabling Objectives:1.1 State the purpose of the World Health Organization1 2 State1.2St t theth purpose andd scope off ththe IInternationaltti l HHealthlthRegulations (IHR)1 3 Define key IHR/SSCP terms1.31.4 List the IHR Articles of Fleet Focus1.5 Compare the two types of Ship Sanitation Certificatesg y of International Concern1.6 State the Public Health Emergency(PHEIC) decision criteria1-1-2

World Health OrganizationIHR (2005)WHO’s central and coreresponsibility has been themanagementt off theth globall b lregime for control of theinternational spread ofdisease.Image courtesy of World Health Organization (WHO)http://www.who.int/ihr/en/index.html1-1-3

IHR – Entry Into Force 194 WHO Member States : June 1515, 2007 U.S. entered: July 18, 2007 All countries comply : 2012U.S. Navy photo by Mass Communication Specialist 3rd Class Aaron Shelley1-1-4

International Health Regulations (2005)Article 2 Purpose and ScopeTo prevent, protect against, control and provide a publichealth response to the international spread of disease inways that are commensurate with and restricted to publichealth risks,, and which avoid unnecessaryy interferencewith international traffic and trade.1-1-5

IHR Core Principles1. Prevent, protect against, control and respond to theinternational spread of disease.2.2 Avoid unnecessary interference with international trafficand trade.3. Reduce the risk of disease spread at international airports,seaports and ground crossings.1-1-6

IHR Overview:Key Obligation for States Establish National IHR Focal Point (NFP) Strengthen the following core capacities for public health events:– Disease surveillance and reporting– AssessmentAt andd notificationtifi ti– Response Assess public health events using the decision instrument, and reportpotential PHEICs to WHO. Provide routine inspection and control activities to preventinternational disease spread at designated airports, ports and groundcrossings. Collaborate with other Member States and WHO concerning IHRimplementation.1-1-7

Comparison of Public HealthSt t i forf IHRStrategiesIHR(1969)IHR(2005)Control at bordersControl at BordersAndContainment at the sourceList of Notifiable DiseasesAll Public Health Threats(All Hazards)Preset MeasuresAdaptive Response1-1-8

IHR/SSCP Key DefinitionsFree Pratique - Permission for:– a ship to enter a port, embark or disembark, discharge orload cargo or stores;– an aircraft ((after landing)g) to embark or disembark,discharge or load cargo or stores;– a ground transport vehicle (upon arrival) to embark ordisembark, discharge or load cargo or stores.1-1-9

IHR/SSCP Keyy DefinitionsP blic Health Risk - Likelihood of an eeventPublicent that mamay: Adversely affect health of human populations Spreadpinternationallyy or Present a serious and direct danger.1-1-10

IHR/SSCP Key DefinitionsPHEICPublic Health Emergency of International Concern –an extraordinary event determined: To constitute a public health risk to other States throughthe international spread of diseaseand To potentially require a coordinated internationalresponse.1-1-11

IHR/SSCP Key DefinitionsShip : A seagoing or inland navigation vessel on aninternational voyage.1-1-12

Examples of CDC IHR Notifications to WHO Clostridium botilinum (2007) – Castleberry Chili. Salmonella typhimurium (2008 - 2009) – peanut outbreak. Measles (2007) – International Little League game. MDR-TB (2007 – 2008) – on international flights (3 events). Contaminated heparin products (2008).(2008) Salmonella serotype Saintpaul (2008) – linked to tomatoesand jalapeno peppers.1-1-13

IHR (2005)Articles of Fleet Focus Article 3636: Certificate of vaccinationaccination or other prophprophylaxisla is –provided by ship. Article 37: Maritime Declaration of Health – provided byship.ship Article 39 : Ship Sanitation Certificates.Certificates1-1-14

Certificate of Vaccination or Other ProphylaxisArticle 36: No health documentsrequired other than onesspecified in IHR. Annex 6Vaccination,, Prophylaxisp yand Related Certificates. Annex 7RequirementsConcerning Vaccinationsor Prophylaxis for specificdiseases.Photo Courtesy of James Gathany/Centers for Disease Control and Prevention (CDC)1-1-15

Article 37 Maritime Declaration of HealthPort Authority May dispense withsubmission of Declaration(Free Pratique) May require submissionsignedi d bby CaptainC t i orMaster and countersignedby the Ship MDR Located on BUMED FormWebpagep g1-1-16

Article 39 – Ship Sanitation CertificatesShip Sanitation ControlExemption CertificateShip Sanitation ControlCertificate Issued when no PHEICfound Valid for six months May be renewed once forone month Issued when PHEIC found Valid for six months May be renewed oncefor one month1-1-17

PHEICD ti tiDetermination(IHR Annex 2)* See handout for acomplete set of decisioninstrument/algorithmquestions.1-1-18

PHEIC Events Requiring NotificationAny event involving one or more cases of four specificdiseases:di Smallpox Poliomyelitis due to wild-type poliovirus Human influenza (new subtype) SARS1-1-19

PHEIC Events Requiring Notification(IHR Annex 2)All eeventsents that fulfillf lfill anany twot o of fourfo r situationalsit ational ppublicblic healthcriteria specified below: Is the public health impact of the event serious? Is the event unusual or unexpected? IsI thereth any significanti ifi t riski k off internationali tti l spread?d? Is there any significant risk of international travel or traderestrictions?1-1-20

IHR DecisionInstrumentIs the event serious?YNIs the event unexpected?Is the event unexpected?YYNNRisk of spreadinternationally?Risk of spreadinternationally?YYNRisk for internationalsanctions?YNNReassesswhen morei finformationtiavailableNotify the event under the International Health Regulations1-1-21

Summary and Review Purpose of the World Health Organization Purpose and scope of the International HealthRegulations (IHR) Key IHR/SSCP terms IHR Articles of Fleet Focus Types of Ship Sanitation Certificates PHEIC decision criteria1-1-22

International Health Regulations (2005) Fl t F & I tFleet Focus & Impacts Enabling Objectives: 1.1 State the purpose of the World Health Organization 12 1.2 St tState th d f th I t ti l H lththe purpose and scope of the International Health Regulations (IHR) 13 1.3 Define key IHR/SSCP terms 1.4 List the IHR Articles of Fleet Focus 1.5 Compare the two types of Ship Sanitation Certificates