Communicable Disease Issues with Foreign Vessel Boarding

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Communicable DiseaseIssues with Foreign
VesselBoarding
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Background

• Post cold war geopolitical changes
• Mass human migrations
• Global markets international transportation
• Breakdown of public health system
• Resurgence of old, and emergence of new
  infectious diseases.

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Coast Guard Assessment

• Coast Guard experience is that effective foreign
  vessel boardings and other operations that put CG
  members in close contact with persons from
  regions endemic with important communicable
  diseases can take place without undo risks to
  health...

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Major Communicable DiseasesEndemic to Third
World Countries

• HIV/AIDS
• Dengue fever
• Anthrax
• Typhoid fever
• Leishmaniasis
• Measles
• Intestinal parasites
• Polio
• Ambiasis
• Hemorrhagic fevers

• Hepatitis A,B,C,D
• Typhus
• Malaria
• Rabies
• Tuberculosis
• Cholera
• Yellow fever
• Schistosomias
• Pertussis
• Diphtheria

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Characterization of Communicable Diseases

• Disease agent, vector and reservoir
• Primary body system affected
• Mode of transmission
• Portal of entry
• Prevention and control measures

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EPI
HOST
Agent
Environment
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Examples

• Disease Measles
• agent measles virus
• host man
• transmission airborne
• prevention immunization
• Disease Dengue Fever
• agent flaviviruses
• host man
• transmission mosquito
• prevention deet, net

• Disease Lyme Disease
• agent spirochete
• host rodents, deer
• transmission tick
• prevention avoidance
• Disease Hantavirus ARDS
• agent hantavirus
• host rodents
• transmission inhalation of rodent urine feces
• prevention avoidance

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HIV Hepatitis B in AMIO

• HIV 7
• TB 5

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Haitian AMIO

• Active Disease (15 Sick)
• Malaria 35
• URI 10
• TB - Active 9
• Measles 6
• Pneumonia 4
• Filariasis 4

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Chinese AMIO

• Hepatitis B (44)
• TB
• Cholera
• Dermatitis
• Hepatitis A E

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Important Communicable Disease Threats

• Air-borne Diseases
• Tuberculosis (TB)
• Measles
• Influenza
• Hantaviruses
• Chickenpox
• Legionella
• Various types of meningitis
• Plague (Pneumonic)

• Food/Water borne Diseases
• Hepatitis A, E
• Typhoid Fever
• Salmonellosis, Shigellosis
• Cholera
• Amebiasis, Giardiasis
• Polio
• other intestinal parasites
• acute gastroenteritis

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Important Communicable Disease Threats cont

• Vector-borne Diseases
• Plague (Bubonic)
• Rabies
• Malaria
• Dengue Fever
• Yellow Fever
• Encephalitis
• Lyme Disease

• Blood-borne Diseases
• Hepatitis B,C
• HIV/AID
• Hemorahagic fever
• Ebola-Marburg Viral
• Plague (Septicemia)

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Prevention Control Elements

• Secure maintain sources of clean water
• Proper sewage infectious waste disposal
• Adherence to safe food practices
• Education

• PPE Personal Protective Equipment (respirators,
  gloves, outer clothing)
• Conscientious Personal Hygiene
• Appropriate immunizations
• Universal Precautions

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Bloodborne Pathogens Sources

• Blood
• Body Fluids
• semen, vaginal secretions, spinal joint fluids,
  fluids contaminated with blood, human tissue
  other then intact skin.
• Tears
• Vomit
• Urine
• Feces

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Bloodborne Pathogens Exposures

• Blood or body fluid must be contaminated
• Skin breaks
• cuts, scraps, dermatitis, acne
• Splashes
• eye, mouth, nose
• Penetration (injection)
• needle stick

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Bloodborne Pathogens PPEs

• Gloves
• Eye protection (goggles)
• Face shields
• Respirator protection
• Protective clothing
• gowns, coveralls, aprons
• Hand washing!!!!

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Universal PrecautionsFor Bloodborne Pathogens

• All blood body fluids are considered
  potentially infectious.
• Use of Personal Protective Equipment (PPE)
• Disposal of sharps in approved containers.
• No eating, drinking, smoking, applying cosmetics,
  handling contact lens.
• Separate food and potentially infectious
  materials.

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Emerging Infectious Diseases

• Definition
• Diseases of infectious origin whose incidence in
  humans has either increased within the past two
  decades or threaten to increase in the near
  future.
• Reasons
• Population growth, environmental stress, mass
  migration, poverty, government decay
• Examples
• Tuberculosis Viral Hemorrhagic Fever
• Cholera Hantavirus
• Crytosporidiosis E-Coli 0157H7
• Hepatitis C HIV/AIDS

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Problem-Solving Guidelines

• Characterize work activities and circumstances.
• Ascertain exposures
• Determine at-risk personnel
• Develop prevention/control measures and plans
• Implement, surveillance, adapt

Evaluate
Integrate
Act
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Elements for Effective Health/Safety Policy
Making Practices

• Know resources and limitations
• Define expected outcomes
• Operationalize
• Integrate
• Promulgate guidance
• Provide necessary tools/training
• Awareness
• Adequate reporting system
• Solid science
• Keep current, revise and update
• Worker buy-in