Interim Guidelines for Maritime Vessels Arriving From Foreign Points of
Entry (PoE) (Ports) with persons with influenza-like illness on board.
(i)
The Ministry of Health, Barbados in pursuit of its obligations to protect Barbados from
Communicable Diseases, has developed this interim protocol to be used when dealing with ships
carrying passengers with influenza - like illness. This protocol should be used in conjunction with
other Ministry of Health guidelines pertaining to Port Health and may be updated as the
International, Regional or Local environment warrants.
(ii)
The International Health Regulations (2005), the Health Services Act (1969), and the
Quarantine Act (1947) were used to inform the development of these guidelines along with
guidance from the World Health Organization and the Centers for Disease Control. In short
Barbados will seek to take actions to prevent the introduction or spread of an infectious disease
while being mindful of the impacts of any such actions on travel and trade.
(iii)
Barbados being a small developing country has limited capacity in its provision of
emergency health care and has to continually prioritize and rationalize much needed resources.
Where possible, in keeping with International protocol, Barbados will seek to provide care or
access to care for any person who is gravely ill.
(iv)
Definitions:
a. Influenza-Like Illness (ILI) is defined as recent onset of sore throat or cough with
or without fever.
b. Acute Respiratory Illness (ARI) is defined as a measured temperature of ≥38oC
and recent onset of at least one of sore throat or cough.
(v)
Pandemic H1N1 2009 is a novel virus that, though generally mild, has the potential to
cause a significant burden of illness and hence associated socioeconomic effects. Even though the
vast majority of persons with H1N1 will have mild illness there is the potential for more severe
illness particularly in persons with certain risk factors. Measures to reduce the spread of this
disease include hygiene, social distancing, as well as isolation.
1.
The Master or Captain of vessels arriving from foreign points of entry shall, at a point of
entry (ports) in Barbados shall:
1
1.1
Ascertain the state of health of all persons on board and prepare a Maritime Declaration of
Health in the form set out in Schedule A below. If a ship’s doctor is on board he shall
countersign the declaration.
Forward such Maritime Declarations of Health electronically through the ship’s agent to
1.2
the Medical Officer of Health (Ports) and the Environmental Health Specialist (Port) at
least twenty-four (24) hours before the vessel arrives at a point of entry in Barbados.
In addition, submit through its agent, acting on the Vessel’s behalf, the Notice of
1.3
Expected Arrivals Form (Form A – Barbados Port Inc.), at least 24 hours prior to vessel
arrival. This form has been amended to include notification to the Port of “Case(s) of
illness or communicable disease on board.”
2.
If there are cases of Influenza-like illness on board the vessel the Master or Captain shall:
2.1.
Provide updated reports in addition to Section 1.2, if any cases require hospitalization or
if more than five additional cases present following the 24 hour report. An update must
be given one (1) hour before arriving at a point of entry in Barbados.
2.2.
Communicate answers to relevant questions as set out in Schedule B below, to Port
Health Authorities in Barbados.
3.
Declare the number of passengers and crew disembarking in Barbados, their nationalities,
intended address in Barbados, international home addresses and telephone numbers. Other
information needed includes:
3.1.
The ship’s plans for persons (passengers and crew) with ILI disembarking the vessel.
3.2.
The ship’s plans for persons with ILI joining the vessel.
3.3.
The contingency plans in place to handle Pandemic H1N1 2009.
3.4.
Evidence that the ship provided health information to passengers and crew regarding
Pandemic H1N1 2009.
4. The Chief Medical Officer shall notify the Minister of Health of the pending arrival of a
vessel with possible case(s) of H1N1 on board clearly outlining the pertinent details obtained
2
from the ship’s doctor. Thereafter the Minister of Health shall report to the National Security
Council for consideration.
5. In the unlikely event that the vessel needs to be quarantined, the berthing will be allocated
and managed by Barbados Port Inc, in consultation with the Chief Medical Officer and the
National Security Council. Otherwise, all other “normal” berthing arrangements shall be
assigned and managed by Barbados Port Inc.
6. On arrival at a point of entry in Barbados, a vessel with suspected cases of Pandemic H1N1
2009 shall be boarded at sea by the Pilot. Permission will be given to the ship to dock in the
harbour and then the Medical Officer of Health – Port and the Environmental Health
Specialist – Ports will board the ship and carry out the duties outlined in Bullet Nos. 8-12.
7.
The Pilot shall proceed to the bridge to carry out his normal duties of ensuring the safe
docking of the vessel. At this time, the signed Notice of Expected Arrival of a ship (Form A)
will be presented to the Pilot for Barbados Port Inc. records.
8.
The Environmental Health Specialist (Ports) and the Medical Officer of Health (Ports)
shall proceed to the ship’s medical facility to interview the Master/Captain and the ship’s doctor
and examine the Maritime Declaration of Health and the ship’s medical records, including
electronic logs and any other available data.
9.
The isolation measures for the suspect case(s) and contacts shall also be reviewed by the
Environmental Health Specialist (Ports) and the Medical Officer of Health (Ports).
10.
The Environmental Health Specialist (Ports) shall enter additional information to the Ship
Sanitation Certificate for the vessel outlining the health measures taken to address the health
events found.
11.
The Medical Officer of Health (Ports) shall inform the Chief Medical Officer of the
actual health status of the vessel and advise accordingly.
12.
Provisional free pratique will be granted for the Boarding Team consisting of the
Environmental Health Officer, Customs Officer and Immigration Officer and two ship agents to
board the vessel.
3
13.
A person on board a ship who knowingly or has reason to suspect that they are suffering
from infectious disease shall not disembark the vessel without the permission of the Medical
Officer of Health (Ports).
13.1.
14.
Any person who contravenes this provision shall be found guilty of an offence.
Provisional free pratique will NOT be granted by the Medical Officer of Health (Ports)
for the Boarding Team to embark the vessel if FALSE DECLARATIONS or WILFUL
OMISSIONS were made by the ship Master/Captain or the ship’s doctor.
15.
Provisional free pratique will be decided by the Chief Medical Officer in an incidence of
false declarations and wilful omissions.
16.
The Chief Medical Officer shall update the Security Council of the health status of the
vessel on arrival.
17.
Where the Security Council REFUSES to grant free pratique, the vessel will be allowed
to dock and take on food and water.
18.
The Security Council will decide on the withdrawal of free pratique if the health status
of a vessel changes while that vessel is in port
19.
The Chief Medical Officer shall advise Port Personnel on any specific safety or
precautionary measures that need to be taken in the process of providing shore-based or shipbased services to the vessel.
20.
The Chief Medical Officer/ International Health Regulations Focal Point shall inform the
International Health Regulations Focal Point at the next port of call about the suspected or
confirmed case/s and the health measures applied.
21.
All existing security protocols shall be observed with respect to the movement of vehicles
and attendants for the transfer of sick persons to and from the vessel.
22.
All persons in isolation with ILI who do not need to disembark shall remain in isolation
onboard the vessel.
4
23.
Persons with ILI who need to disembark due to Barbados being their final destination
should be managed as follows:
23.1.
If they have been a febrile for at least 24 hours, they may be allowed to disembark
and continue their onward journey with no restrictions.
23.2.
If they are febrile, they should be transported in a separate transport while wearing
a surgical mask to a designated facility. Ship agents must liaise with the Medical Officer
of Health – Port and the designated facility manager before transfer of passengers.
5
Schedule A
MARITIME DECLARATION OF HEALTH
To be completed and submitted to the competent authorities by the masters of ships arriving from
foreign ports.
Submitted at the port of ………………………………………….
Date …………….…
Name of ship ……........……....………… Registration/IMO No..................................
Arriving from ……..……………………..…sailing to ...................................................
(Nationality)(Flag of vessel) …………………………………………………………….
Master’s name ..................................................................................................................
Gross tonnage (ship) ……………………....
Net Tonnage …….……………..……
Valid Sanitation Control Exemption/Control Certificate carried on board? Yes ............
No ….................... Issued at ….....………………………… Date ……........................
Re-inspection required?
Yes ……... No ……..
Has ship/vessel visited an affected area identified by the World Health Organization?
Yes ....... No ……...
Port and date of visit …………………….……………………………...........................
List ports of call from commencement of voyage with dates of departure, or within past thirty
days, whichever is shorter:
............................................................................................................................................................
............................................................................................................................................................
........................................................................................................................
Upon request of the competent authority at the port of arrival, list crew members, passengers or
other persons who have joined ship/vessel since international voyage began or within past thirty
days, whichever is shorter, including all ports/countries visited in this period (add additional
names to the attached schedule):
(1) Name …………………………………joined from: (i) …………..……....…..
(ii) …....…..……………....(iii) .........................................
(2) Name …………………………………joined from: (i) …………………........
(ii) ……………….........….(iii) .........................................
(3) Name ………………………………….joined from: (i) ……………….....…...
(ii) ……..….....…...………(iii) ........................................
Number of crew members on board …………
Number of passengers on board ……….…….
Health questions
(1) Has any person died on board during the voyage otherwise than as a result of accident?
Yes ..... No …...
If yes, state particulars in attached schedule. Total no. of deaths ……………..........
6
(2) Is there on board or has there been during the international voyage any case of disease which
you suspect to be of an infectious nature?
Yes........ No….....
If yes, state particulars in attached schedule.
(3) Has the total number of ill passengers during the voyage been greater than normal/expected?
Yes ...... No ..…....
How many ill persons? ..........
(4) Is there any ill person on board now?
If yes, state particulars in attached schedule.
Yes ........ No ….....
(5) Was a medical practitioner consulted?
Yes ....... No ….....
If yes, state particulars of medical treatment or advice provided in attached schedule.
(6) Are you aware of any condition on board which may lead to infection or spread of disease?
Yes ....... No ….....
If yes, state particulars in attached schedule.
(7) Has any sanitary measure (e.g. quarantine, isolation, disinfection or decontamination) been
applied on board?
Yes ....... No …...
If yes, specify type, place and date.
.......................................................................................................................................
(8) Have any stowaways been found on board?
If yes, where did they join the ship (if known)?
..................................................................................................
Yes ....... No …...
(9) Is there a sick animal or pet on board?
Yes ......... No ........
Note: In the absence of a surgeon, the master should regard the following symptoms as grounds
for suspecting the existence of a disease of an infectious nature:
a) fever, persisting for several days or accompanied by (i) prostration; (ii) decreased
consciousness; (iii) glandular swelling; (iv) jaundice; (v) cough or shortness of breath;
(vi) unusual bleeding; or (vii) paralysis.
b) with or without fever: (i) any acute skin rash or eruption; (ii) severe vomiting (other than
sea sickness); (iii) severe diarrhoea; or (iv) recurrent convulsions.
I hereby declare that the particulars and answers to the questions given in this Declaration of
Health (including the schedule) are true and correct to the best of my knowledge and belief.
Signed ……………………………………………….
Master
Countersigned ……………………………………….
Ship’s Surgeon (if carried)
Date ………………………………
7