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EU SHIPSAN ACT JA - Newsletter: Issue 19

21 April 2016/Categories: News, Newsletters

Download the EU SHIPSAN ACT JA - Newsletter: Issue 19 in .pdf format


Editorial



Dr. Martin Dirksen-Fischer, Head of Hamburg Port Health Authority, Germany








Dear Readers, 


In the last editions of the SHIPSAN ACT Newsletter you found the Editorial from our dear colleague Dr. Rimantas Pilipavicius from Klaipeda, Lithuania. Now it will be my honour to greet you with some ideas and hints to the articles appearing in the new issue.

As Rimantas wrote: “The beginning of each year gives us the chance to sort our priorities, looking out for the most urgent issues most likely to be on the agenda in the next couple of months
”. This approach might be expanded by simply looking back as well.

What were the most important issues in the past months and years? Did we expect them to happen? So, let us start with Ebola and the ever-evolving issue of the Zika virus. For sure: I never thought that an Ebola outbreak with more than 11.000 dead people would ever occur in my lifetime. This outbreak brought very demanding challenges to the world of maritime medicine as well. I do think that we as the SHIPSAN community reacted fairly well; we formulated statements and advises that people might have found useful. Still: this outbreak reminds us of the fact that even the unexpected can happen, especially when the Public Health system in the outbreak countries is nearly non-existent. And we never should give up answering the one important question: What else could happen? Where are the dangers of tomorrow? How could we react in the right way?

Right at the moment we are dealing with the evolving Zika crisis. For many reasons a quite different crisis than the Ebola crisis but still a challenge for the maritime health community as well. While this newsletter is distributed to its readers, the European Union is formulating its policies, again accompanied by the SHIPSAN ACT Joint Action community with advice. Zika is an example once again showing how our knowledge about a “harmless” virus can change over time, producing new illnesses unknown before.

When looking into this new issue, it is my pleasure to remind you to read the articles presented to us. Be it Alison Jones (Radiological incidents) or Martin Walker (Environmental health). These authors help us with their work to be ever ready to answer that one question: What else could happen?

But please also find the news from our leadership (Concerning the new edition of the Manual) and reports from different national trainings. Feel free to find out how many of the colleagues and trainers on the pictures you know personally. It is fun. And we all need that as well. What could be more fun than being remembered of a nice port, in this case, Thessaloniki, Greece. Have a look at the article and its pictures, presented to us by Christina Kapoula and Sofoklis Kourtidis, both Public Health inspectors.



News from the leadership 

 
Prof Christos Hadjichristodoulou, SHIPSAN ACT Joint Action Coordinator
Dr Barbara Mouchtouri, SHIPSAN ACT Joint Action Manager

The EU SHIPSAN ACT Joint Action is already counting three years of implementation. The EU SHIPSAN ACT Joint Action was initially funded for 36 months and should have been concluding its activities by April 2016. However, a six month no-cost extension has been submitted to the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA), which is the European Agency overlooking the implementation of the Joint Action, extending the consortium activities up to October 2016. This will provide the partnership with the opportunity to continue the implementation of the activities such as the short notice (48hr) inspections, the use of the SHIPSAN ACT Information System (SIS), e-learning courses and webinars and to complete sustainability activities. This six month no-cost extension will assist the partnership to plan further the transition from the joint action to the take-up level from all EUMS.

The revised European Manual for Hygiene Standards and Communicable Diseases Surveillance on passenger ships (February 2016 edition) is available for download from the SHIPSAN website (http://www.shipsan.eu/Home/EuropeanManual.aspx). A new e-learning course has been developed for port health officers titled “Inspections of passenger ships in accordance with the European Manual for Hygiene Standards and Communicable Diseases Surveillance”. The e-learning course is a prerequisite for all inspectors/public health officers that conduct inspections in accordance with the pre-agreed European Schedule for Routine Inspections on passenger ships.

An ad hoc working group was established to respond to questions about whether health measures need to be taken in maritime transport in response to Zika virus disease. The interim guidance produced is available in the website of SHIPSAN ACT.



Thematic Sections 

Chemical and radiological issues on ships: International, European and national emergency arrangements for radiation incidents

Authors: Alison Jones, Senior Radiation Protection Scientist, Planned Exposures Group, Radiation Assessments Department, Public Health England

International, European and national emergency arrangements exist to enable countries to prepare for and respond to radiation incidents. The figure shows the flow of information that should be followed once an incident has been declared on a ship either at sea or in a port. The ship’s master would notify the competent authority, this may be the Port Health Authority or the emergency services. Once it was established that the incident involved radioactive material, the appropriate public health authority should be notified who will provide radiation experts to assess the situation. International, European and national legislation and regulations regarding emergency arrangements for radiation incidents will then apply, and some of these have been described below.

The International Health Regulations, 2005 (IHR) apply to incidents involving radiological materials and obliges countries to notify the World Health Organization (WHO) of potential public health effects if certain criteria are met. It is the responsibility of the national focal point in each member state to notify the WHO IHR contact point of all events that may constitute of public health emergency of international concern. If these criteria are met, then the event is classified as a Public Health Emergency of International Concern (PHEIC) by the WHO Director General in consultation with the member state and the IHR emergency committee. In addition, the regulations state that at designated points of entry public health emergency contingency plans should be developed. Competent Authorities, defined under the IHR as “an authority responsible for the implementation and application of health measures under these Regulations” would notify relevant national Public Health Authorities who will provide radiation experts to investigate and manage any risks posed by the incident reported (WHO, 2008).

At the European level the current EC Basic Safety Standards Directive supports radiation protection through national legislation and states that Member States should be prepared in the event of a radiological emergency in their own or/ and other countries (European Commission, 1996). A new revised Directive (European Commission, 2013) which was adopted by the Council and Member States, will bring into force this new Directive by 2018. At national level, each country should therefore establish emergency preparedness and planning to protect the population, property and the environment. National services and experts in radiation protection should be identified and roles and responsibilities assigned.

In the event of a radiological incident in which a Member State intends to take countermeasures to protect their population against the effects of any release of radioactivity, that Member State must notify the European Commission (EC) and member states that are, or are likely to be, affected by the measures to be taken and the reasons for taking them. The information provided must include information relevant to minimising the foreseen radiological consequences, if any, in those States. The EC will forward this notification to all its member states, which are then required to inform the EC at appropriate intervals of measures taken and radioactivity levels measured in their country.

In addition, the International Atomic Energy Agency (IAEA) facilitates systems of notification, warnings and assistance (IAEA, 1986a) (IAEA, 1986b). The IAEA can be called upon to provide assistance if the country does not have the infrastructure to deal with the emergency. In order to provide support to a country to deal with an emergency a number of networks that can assist in a radiation emergency situation have been set up; these would deal with emergencies on land or sea.

A number of initiatives have been set up at EU and international level to facilitate the exchange of information or to provide support to countries affected by a radiological event. The most important are described below.

The European Radiological Data Exchange Platform (EURDEP) (EC, 2016) (https://eurdep.jrc.ec.europa.eu/Basic/Pages/Public/Home/Default.aspx) makes radiological monitoring data from most European countries promptly available in close to real-time in emergencies. To achieve this, EU Member States, and other European countries which are members of EURDEP, send their data to EURDEP from their territorial radiation-monitoring networks. Participation of EU member states is regulated by the Council Decision 87/600 (CEC, 1987) and the Recommendation 2000/473/Euratom (CEC, 2000).

The ECURIE system is the European Communities Urgent Radiological Information Exchange network, created following the Chernobyl accident in 1986 (CEC, 1987) (https://rem.jrc.ec.europa.eu/RemWeb/activities/Ecurie.aspx). Member States that have signed the ECURIE Agreement form a network of contact points and competent authorities officially nominated by each Member State. The main responsibility of the contact points is to make all notifications through the ECURIE network.

The IAEA’s Response and Assistance Network (RANET) provides international assistance and advice in the event of a nuclear or radiological emergency (IAEA, 1986b; IAEA, 1986a; IAEA, 2013) (http://www-ns.iaea.org/tech-areas/emergency/ranet.asp?s=1&l=65#). Countries that are willing to provide assistance in the event of an emergency, register their capabilities with RANET. As of February 2016 RANET has 28 member countries who have registered their capabilities under 8 categories: source search and recovery; radiation survey; environmental sampling and analysis; radiological assessment and advice; medical support; dose assessment; decontamination; and nuclear installation assessment and advice.

The Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) (http://www.who.int/ionizing_radiation/a_e/rempan/en/) was established in 1987 in order to fulfil WHO's responsibility under the two international conventions on Early Notification and Assistance (IAEA, 1986a) (IAEA, 1986b). Currently there are forty medical and research institutions signed up. The network is designated to provide medical and public health assistance in an emergency to people exposed to radiation. It also facilitates a long-term care and follow-up of radiation accident victims and conducts research in radiation emergency medicine, radiotherapeutics, bio-dosimetry and radiation epidemiology.


References

CEC (1987). 87/600/Euratom: Council Decision of 14 December 1987 on Community arrangements for the early exchange of information in the event of a radiological emergency. Off J Eur Commun.
CEC (2000). Euratom: Commission recommendation of 8 June 2000 on the application of Article 36 of the Euratom Treaty concerning the monitoring of the levels of radioactivity in the environment for the purposes of assessing the exposure of the population as a whole. . Off J Eur Commun 43(L 191), 34-46.
EC (2016). EURDEP: European Radiological Data Exchange Platform. [Online] Available at https://eurdep.jrc.ec.europa.eu/Basic/Pages/Public/Home/Default.aspx [accessed February 2016]
European Commission (1996). Council Directive 96/29/Euratom of 13 May 1996 laying down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionizing radiation. Off J Eur Commun L159(29), 1.
European Commission (2013). Council Directive 2013/59/Euratom of 5 December 2013 Laying Down Basic Safety Standards for Protection Aginst the Dangers Arising from Exposure to Ionising Radiation, and Relealing Directives 89/619/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom. Official Journal of the European Union L13(1).
IAEA (1986a). Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency. IAEA, Vienna, Austria
IAEA (1986b). Convention on Early Notification of a Nuclear Accident. Vienna, Austria
IAEA (2013). IAEA Response and Assistance Network. IAEA, Vienna, EPR-RANET 2013.
WHO (2008). International Health Regulations. W. H. Organization, Geneva, Second Edition.




Environmental health and hygiene on ships: Inspection techniques for assessing the risks posed by standing water on vessels

Martin Walker, Port Health Officer, Suffolk Coastal Port Health Authority, Felixstowe, England


Key Message: Risk assessment processes for inspectors when looking at the risks posed to human health as a result of standing water on vessels becoming mosquito habitats.

Introduction
I chose to write this article due to the prominence of the Zika Virus outbreak. Elsewhere in this issue, you will find details of the Zika Virus Maritime guidance1, but I wanted to look a little more into some of the issues faced on board vessels that inspectors may find. As readers are no doubt aware, the World Health Organization (WHO) declared Zika Virus as the 4th Public Health Emergency of International Concern (PHEIC)2 (after H1N1, Wild Polio and Ebola). The vector for the virus is the Yellow Fever Mosquito (Aedes aegyptii) and it breeds where stationary water collects. As such, ships can become a habitat and means of transport for this and other mosquito species. However, standing water is a more generic issue as other invasive mosquito species may also be harboured in such sites.


Inspection Processes
Inspectors will be aware that the model Ship Sanitation Certificate specifically lists standing water as a key area of inspection. However the WHO Technical Handbook3 does not list it as a specific area. Requirements and recommendations for vector control are found within all areas as a general issue to be dealt with, but standing water is specifically mentioned in Area 13, sections 13.2.1 and 13.2.2.

In terms of ship inspection, this is yet another factor that inspectors need to consider but apply a risk based approach. Whilst it is useful to consider issues that are current or en-vogue (such as Zika Virus), inspection time is always precious and invariably limited. We should always remember that an inspection to issue a new Ship Sanitation Certificate (SSC) needs to encompass all areas of the vessel. Other inspections (routine or unannounced) could focus upon specific risk areas.

At training courses, WHO have always promoted a “risk based” approach to inspection. Whilst the consequences of mosquito borne illnesses can present a serious hazard (e.g. Malaria, Dengue, West Nile Virus), the risks of spread of diseases will vary considerably according to a variety of vessel characteristics. The process of risk assessment can be seen in these infographics below from the SHIPSAN ACT Joint Action. Whilst they are focussed upon inspection findings, the concept can equally be applied to deciding upon risk ranking prior to inspection.

When time is limited, concentrating more resource towards Urgent Action and High Priority (Risk Rankings 1 & 2) is appropriate. Higher availability of resources can open up action towards Risk Rankings 3-5 in that order. The likelihood of harm from Mosquitos may be high, but the actual level of risk can vary substantially. Here, we need to consider particular risk factors to give an appropriate risk ranking.

Risk Factors for Standing Water
Inspectors could consider the following factors when carrying out risk assessments, either for determining which vessels to inspect for routine/unannounced inspections or for determining priorities/time allocation when on board for SSC Renewal. This is not an exhaustive list but could be used as an initial basis.

1 Vessel voyage and characteristics Where has the vessel visited and when? Have any affected areas been visited? Duration of the voyage.

2 Cargo carried Are high risk cargoes carried? What containers/holds are used?

3 Construction of the vessel Is the design of the vessel known (past inspections/knowledge, photographs, plans)? Are significant habitat sites likely?

4 Health of the crew/passengers Any illness on-board? Any symptoms attributable to serious mosquito borne illnesses?

5 Confidence in the management Are you confident that the ship is well managed? Can you see evidence of this (e.g. Effective Integrated Pest Management Plans)? Is there evidence from past inspections?

6 Assessment of guidance available For example, the ZIKA Virus Maritime Guidance and WHO Fact Sheets

In addition to the interim guidance from SHIPSAN ACT, other useful resources are available. For a more detailed account of habitats on board, I would particularly like to direct inspectors to join PAGNet4 where there is currently a very interesting discussion about standing water on ships (including some detailed observations from Dr. S. Senthil Nathan of Kandla Port, India). PAGNet is an informal network hosted by WHO to, (amongst other aims), share experience and expertise about a range of topics relevant to those working in public health control at Points of Entry. As facilitator for the Ports and Shipping Group, I am particularly keen for more inspectors to join, to ask technical questions in a friendly environment and to share their experiences. The discussions often highlight significant differences that may be found in vessel practices around the world. For example, inspection findings from Kandla Port included the use of drums to store water on board as a result of rationing of water by the ship and the damaged drainage area around compressor points of refrigerated (“Reefer”) containers.

Conclusions
The hazards posed by standing water on board vessels are significant within a global health framework. However, the measures needed to mitigate that risk should be relatively straightforward. Vigilance and timely action in dealing with hazards found will help to protect all. There is also plenty of practical guidance and support for inspectors. Finally, I am reminded of discussions about the deadliest animals in the world. Bill Gates5 notes that despite it’s miniscule size, the mosquito tops the list for the number of deaths that it causes each year.


References:
1 “Interim Guidance on maritime transport and Zika Virus Disease”, SHIPSAN ACT Joint Action, http://www.shipsan.eu/Home/Zikavirus.aspx
2 http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika-microcephaly/en/
3 “Handbook for Inspection of Ships and Issuance of Ship Sanitation Certificates”, World Health Organization, http://www.who.int/ihr/publications/handbook_ships_inspection/en/
4 “PAGNet”, https://extranet.who.int/pagnet/home
5 “The Deadliest Animal in the World”, gatesnotes, The blog of Bill Gates https://www.gatesnotes.com/Health/Most-Lethal-Animal-Mosquito-Week



News and events

Interim guidance on maritime transport and Zika virus disease

An interim guidance was prepared by the EU SHIPSAN ACT Joint Action after a request from the European Commission (EC) and queries received by partners of the European Union joint action “The impact on maritime transport of health threats due to biological, chemical and radiological agents, including communicable diseases” (EU SHIPSAN ACT) in regards to maritime transport and Zika virus disease. An ad-hoc working group was established to produce this interim guidance.
The document was produced based on the currently available information published by World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) in regards to epidemiology and knowledge for Zika virus disease, as well as previous risk assessments and work about mosquitoes conducted by ECDC.

A summary of the interim guidance is presented below. The complete document is available on the EU SHIPSAN ACT website (http://www.shipsan.eu/).

Summary
The role of maritime transport in Zika virus disease spread
The introduction of human cases of Zika virus disease (crew or passengers, symptomatic or asymptomatic) through ship travel is considered very low since most travelers in the affected countries return to European Union Member States (EUMS) through air travel. Moreover, it is unlikely that ships can introduce Zika virus disease to the population in the EU through Zika virus infected mosquitoes from affected areas. However, it is certainly known that specific types of imported goods including used tyres and ornamental plants (e.g. Dracaena sanderiana - lucky bamboo) introduce invasive mosquito species (IMS) to EU, usually at the egg life stage that is able to survive transportation. These two categories of imported goods can be infested with mosquitoes including Aedes aegypti and Aedes albopictus. Since imported symptomatic and asymptomatic human cases are continually arriving in EUMS through air transport, and Aedes albopictus mosquito, which is competent to transmit Zika virus has been established in a number of areas in EUMS, the possibility for local transmission of the disease in the future, especially in the summer months cannot be excluded. Further information for risk assessment can be found in the updated risk assessment published by ECDC. Imported used tyres, and ornamental plants (mainly plant cuttings requiring water during transportation) can: a) re-introduce Aedes aegypti in Europe, which is the main vector of Zika virus disease and other diseases such as yellow fever and dengue fever; b) introduce Aedes albopictus and other IMS in areas not currently present or established; c) import additional Aedes albopictus mosquito populations and other mosquito species in areas where are currently established and influence the mosquito population dynamics and density.

Recommendations for health measures
Integrated Pest Management Plans should be implemented at ports by the competent authorities and on board ships by ship operators routinely and efforts should focus in this direction. Disinsection of all sea freight and ships from affected countries is not recommended. Special treatment and rules for transporting and handling specific imported goods including used tyres and ornamental plants requiring water during transportation (e.g. Dracaena sanderiana - lucky bamboo) is recommended as follows.

Used tyres

Regulations for treatment of imported used tyres before shipment and requirement to be kept dry during transportation and additionally special storage condition thereafter could be implemented in EU, provided that all EUMS enforce the same regulations effectively.
The measure of treatment of imported used tyres should be combined with measures and regulations within EU concerning all the means of transportation between EUMS to prevent dispersal from the areas that Aedes albopictus is present to areas in EU that has not been introduced. This requires the capacity of the points of entry – ports in the EUMS to inspect representative samples of used tyres and to implement control measures to the imported goods at the port facilities, in case of deficiencies. Moreover, it requires regulation enforcement and inspections at the storage facilities of tyres at destination. Limitations in the enforcement of such regulation are the challenging and time consuming inspection process of containers and the practical difficulties in implementing disinsection in a potentially large number of wet or infested tyres, as well as the low effectiveness of methods for the suppression of mosquito eggs.

Ornamental plants requiring water during transportation

Regulations for the transportation of imported ornamental plants that require the presence of water containerised or in a sealable hold space and disinsection of the container or the sealable hold space at least ten days after shipment and before opening, could be implemented in EU, provided that all EUMS enforce the same regulations effectively for all imported ornamental plants that require water during transport. This requires the capacity of the points of entry – ports in the EUMS to disinsect the imported goods at the port facilities. Limitations in the enforcement of such regulation are the challenging and time consuming inspection process of containers and the practical difficulties in implementing disinsection.

Measures would be also needed to be applied within EU to prevent dispersal from the areas that Aedes albopictus is present to areas in EU that has not been introduced.

Enforcement of special regulations for disinsection before shipment of used tyres and ornamental plants and for standards about the transportation of used tyres dry has not been effective in preventing IMS dispersal in the US and other countries, but has been effective in New Zealand (an islands country) to prevent their introduction.

EU SHIPSAN ACT past events:

National training course, Piraeus, Greece, 7-9 March 2016


The Hellenic Ministry of Health in collaboration with the EU SHIPSAN ACT Joint Action organized a national training course titled “Inspections according to the European Manual for hygiene standards and communicable diseases surveillance on passenger ship and Issuance of Ship Sanitation Certificates” from 7th to 9th of March 2016 on board the cruise ship Olympia of Celestyal Cruises which was docked at the port of Piraeus.

A total of 43 trainees from 17 ports (Kavala, Korinthos, Lesvos, Patra, Katakolo, Piraeus, Rhodes, Thessaloniki, Chania, Elefsina, Heraklion, Igoumenitsa, Preveza, Kalamata, Lavrio, Chios, Limassol) participated in the training course conducted.
The course which combined theoretical and practical training was targeted to public health officers and public health doctors working at the competent authorities of the country and authorised to conduct hygiene inspections on ships on an international voyage sailing in the European Union. Trainees had the opportunity to visit all areas of the ship (galley, bars, stores, medical facilities, housekeeping, garbage room, chemical mixing room, ventilation, recreational water facilities, etc) conducting a simulated hygiene inspection. The evaluation results showed that trainees were fully satisfied by the theoretical and practical activities of the course.

Participants were welcomed by the Project Officer from the Consumers, Health, Agriculture and Food Executive Agency – CHAFEA, the General Secretary of Public Health from the Ministry of Health, the Director of the Public Health Department of the Ministry of Health, the Branch Director of Maritime Coastguard of the Hellenic Ministry of Mercantile Marine and Island Policy, the president of the PanHellenic union of public health inspectors and by representatives of the Celestyal Cruises.

National training course, Varna, Bulgaria, 17-18 March 2016
A national training course was organized in Varna, Bulgaria by the Director of Regional Health Inspection of Varna in collaboration with the EU SHIPSAN ACT Joint Action.

The 2-day training course titled “Inspections according to the European Manual for hygiene standards and communicable diseases surveillance on passenger ship” took place from the 17th to 18th of Μarch 2016 and was targeted to the port health inspectors. A total of 21 participants from two inland ports (Ruse and Silistra) and two seaports (Burgas and Varna) attended the training course.
Trainers were from Bulgaria, Ireland, Estonia and and Greece.


The course included theoretical training and a simulation case study of a ship inspection.
The evaluation results showed that the training course objectives were fully achieved and that trainees were fully satisfied with both theoretical and group work. 



People from the project

Martin Dirksen-Fischer

Martin Dirksen-Fischer was born in Hamburg, Germany 1960. He also studied in Hamburg and married here in 1990 his wife. They have twins, now 25 years old as well. Surprisingly, they were also born in Hamburg.

He is a great friend of Greece. Of course. And also: A great friend of Taiwan. He just recently returned from there after an invitation by the Taiwan government to give lectures and to inspect harbors and airports. The question was: Do these ports and airports fulfill the IHR-standards? (Yes, they do-very much!). This task was fulfilled with Mathias Kalkowski, well known to many in the project.

His Hobbies: Hanging around with family and friends, he loves Mini golf, a very specific German form of Golf, asking for less place and effort.

Since 2012 he serves his city and its citizens as the head of Hamburg Port Health Authority, which is part of the Institute for Hygiene and Environment. This Institution belongs to the Hamburg Public Health Department (Behörde für Gesundheit und Verbraucherschutz). He is working for the Public Health institutions of his town since 1996.

Medical Specialisation:
Mr. Dirksen-Fischer specialized in Public Health 1998 and in Psychiatry in 1996.
He is the head of the Arbeitskreis der Küstenländer für Schifffahrtshygiene, (Ship Sanitation Committee of German Federal States).
He also serves as a member of the Coordination Committee of the EU SHIPSAN ACT Joint Action, and he is a member of the Sustainability Working Group of the EU SHIPSAN ACT Joint Action.


Recent Publications

Efficacy of oxidizing disinfectants at inactivating murine norovirus on ready-to-eat foods.
Girard M, Mattison K, Fliss I, Jean J.
Int J Food Microbiol. 2016 Feb 16;219:7-11.

Abstract

Noroviruses are the leading cause of foodborne illness, and ready-to-eat foods are frequent vehicles of their transmission. Studies of the disinfection of fruits and vegetables are becoming numerous. It has been shown that strong oxidizing agents are more effective than other chemical disinfectants for inactivating enteric viruses. The aim of this study was to evaluate the efficacy of oxidizing disinfectants (sodium hypochlorite, chloride dioxide and peracetic acid) at inactivating noroviruses on fruits and vegetables, using a norovirus surrogate, namely murine norovirus 3, which replicates in cell culture. Based on plaque assay, solutions of peracetic acid (85ppm) and chlorine dioxide (20ppm) reduced the infectivity of the virus in suspension by at least 3 log10 units after 1min, while sodium hypochlorite at 50ppm produced a 2-log reduction. On the surface of blueberries, strawberries and lettuce, chlorine dioxide was less effective than peracetic acid and sodium hypochlorite, which reduced viral titers by approximately 4 logs. A surprising increase in the efficacy of sodium hypochlorite on surfaces fouled with artificial feces was noted. 


Comparative Virucidal Efficacy of Seven Disinfectants Against Murine Norovirus and Feline Calicivirus, Surrogates of Human Norovirus.

Zonta W, Mauroy A, Farnir F, Thiry E.
Food Environ Virol. 2016 Mar;8(1):1-12. doi: 10.1007/s12560-015-9216-2. Epub 2015 Oct 7.

Abstract

Human noroviruses (HuNoV) are the leading cause of acute non-bacterial gastroenteritis in humans and can be transmitted either by person-to-person contact or by consumption of contaminated food. A knowledge of an efficient disinfection for both hands and food-contact surfaces is helpful for the food sector and provides precious information for public health. The aim of this study was to evaluate the effect of seven disinfectants belonging to different groups of biocides (alcohol, halogen, oxidizing agents, quaternary ammonium compounds, aldehyde and biguanide) on infectious viral titre and on genomic copy number. Due to the absence of a cell culture system for HuNoV, two HuNoV surrogates, such as murine norovirus and feline calicivirus, were used and the tests were performed in suspension, on gloves and on stainless steel discs. When, as criteria of efficacy, a log reduction >3 of the infectious viral titre on both surrogates and in the three tests is used, the most efficacious disinfectants in this study appear to be biocidal products B, C and D, representing the halogens, the oxidizing agents group and a mix of QAC, alcohol and aldehyde, respectively. In addition, these three disinfectants also elicited a significant effect on genomic copy number for both surrogate viruses and in all three tests. The results of this study demonstrate that a halogen compound, oxidizing agents and a mix of QAC, alcohol and aldehyde are advisable for HuNoV disinfection of either potentially contaminated surfaces or materials in contact with foodstuffs.

Persistence of Influenza A (H1N1) Virus on Stainless Steel Surfaces.
Perry KA, Coulliette AD, Rose LJ, Shams AM, Edwards JR, Noble-Wang JA.
Appl Environ Microbiol. 2016 Mar 18. pii: AEM.04046-15. [Epub ahead of print]

Abstract
As annual influenza epidemics continue to cause significant morbidity and economic burden, an understanding of viral persistence and transmission is critical for public health officials and healthcare workers to better protect patients and their family members from infection. The infectivity and persistence of two influenza A (H1N1) strains (A/New Caledonia/20/1999 and A/Brisbane/59/2007) were evaluated on stainless steel (SS) surfaces using three different surfaces matrices (2% fetal bovine serum, 5 mg/mL mucin, and viral medium) at varying absolute humidity conditions (4.1 x 105 mPa, 6.5 x 105 mPa, 7.1 x 105 mPa, 11.4 x 105 mPa, 11.2 x 105 mPa, and 17.9 x 105 mPa) for up to seven days. Influenza virus was deposited onto SS coupons (7.07 cm2) and recovered by agitation and sonicating in viral medium. Viral persistence was quantified using a tissue culture based enzyme-linked immunosorbent assay (ELISA) to determine the median tissue culture infective dose (TCID50) of infectious virus per coupon. Overall, both strains of influenza A virus remained infectious on SS coupons with an approximate 2 log10 loss over seven days. Factors that influenced viral persistence included absolute humidity, strain/absolute humidity interaction, and time (P ≤ 0.01). Further studies into hand transfer of influenza A virus from fomites and the impact of inanimate surface contamination in transmission should be investigated as this study demonstrates prolonged persistence on non-porous surfaces.
IMPORTANCE: The study tested the ability of two influenza A H1N1 strains to persist and remain infectious on stainless steel surfaces in varying environmental conditions. It is demonstrated that influenza A H1N1 virus can persist and remain infectious on stainless steel surfaces for 7 days. This raises the question of what role contaminated surfaces play in the transmission of influenza A virus and that additional studies should be conducted to assess this.



What’s new on the website




Quiz

Author: Editor

When did the great and last big cholera outbreak occur in Hamburg, causing thousands of dead people to which the famous Robert Koch referred to with the sentence: “Dear gentlemen, I forget that I am in Europe? “


Answer to the previous issue quiz:
Quarantine was first time introduced in 1377 in Dubrovnik on Croatia’s Dalmatian Coast and this was used to prevent the spread of deadly contagious disease widely known as Black Death. The term quarantine originates from Italian word quaranta giorni which means forty days. Ships arriving in coastal cities from infected ports were required to sit at anchor for 40 days before landing.

Congratulations to the following for providing the correct answer:

• Fernando del Hierro Vega, Director, Ministerio de Hacienda y Administraciones, Spain

• John Ambrose CFCIEH DMS, Port Health Officer, Quality Manager, Markets and Consumer Protection, London Port Health Authority, United Kingdom



Port in focus

Port of Thessaloniki

Authors:
  • Sofoklis Kourtidis, Public Health Inspector, Director in Department of Environmental Hygiene and Hygiene Control, Region of Central Macedonia
  • Christina Kapoula, Public Health Inspector, Department of Environmental Hygiene and Hygiene Control, Region of Central Macedonia

The Port of Thessaloniki is situated in the north of Greece, in the Aegean Sea basin and constitutes the second largest port in Greece, after the Port of Piraeus.

Thessaloniki belongs to the Central Macedonia Region and is an ancient port city, established in the year 315-6 BC, by King Cassander of Macedon, prominent general of Philip II and Alexander the Great, and it bears the name of his wife Thessalonike of Macedon, paternal sister of Alexander the Great. Thessaloniki and its port had played an important role during the Roman, Byzantine and Ottoman period but also at the contemporary history.

Today, the city is a modern metropolis and university city, an important economic, industrial, commercial and political centre, and a major transportation hub for the rest of southeastern Europe. The city is renowned for its festivals, events and vibrant cultural life in general and is considered to be Greece's cultural capital. Thessaloniki also is a popular tourist destination for cruise ships.

Thessaloniki port is located on the inner part of the Bay of Thermaicos, at a distance of 1km from the Passenger Railway Station and 16km from the city's International Airport. The port enjoys a privileged position, linked to a dense, traffic network that is directly linked to the national and international road network, bypassing thus city entrance. All the port quays have double/triple rail-lines and are linked to the national and international railroad network. It is the largest transit-trade port in the country and it services the needs of approximately 15 million inhabitants of its international mainland.


Aerial view of the port (www.thpa.gr)

The port facilitates all kinds of cargo as well as passenger traffic, but mainly it facilitates dry bulk and general cargoes. It has six piers with a total quay length of 6,200 metres and a sea depth ranging from eight to 12 metres. The storage area consists of open and indoor areas with a total surface of 600,000 square metres. The port also has installations suitable for liquid fuel storage and it is located in proximity to the international, natural-gas pipeline.

Due to the temperate climate, the well protected from weather conditions approach, the existence of a 1000m-long wave breaker which protects the port from the southern winds, the almost null tide, (maximum height of 0.7m) and the port's secure installations, the loading and unloading of cargoes as well as the embarkment/disembarkment of passengers on the ships are taking place unhindered, throughout the year.

The port is divided into three terminals: the passenger terminal, the container terminal and the dry and general cargo terminal.


Passengers Terminal (www.pkm.gov.gr)



Passengers Terminal (www.elime.gr)


   

Cargo Terminal (www.elime.gr)



Container Terminal (www.elime.gr)

The port is also an authorised port from WHO for SSCC, SSCEC and Extension of a certificate. It has been characterised as a Port of National Interest in the Country's Coastguard System, (National Gazette, 16.2.07) and one of the five Greek ports, which belongs to the Core Network of Trans-European Transport Networks.


Pier A (www.thpa.gr)

In recent years, an increase in cruise ships arrivals has been witnessed at the Port of Thessaloniki. During 2015, 34 cruise ships approached the port of Thessaloniki carrying about 14,000 tourists, versus 30 cruise ships during 2014 and 18 cruise ships during 2013 (growth rate of 72,22%).


Passengers Terminal (www.elime.gr)


Source:

https://www.thpa.gr
https://en.wikipedia.org/wiki/Port_of_Thessaloniki
https://en.wikipedia.org/wiki/Thessaloniki
http://www.pkm.gov.gr/
http://www.elime.gr/


Michael Gogas, Konstantinos Papoutsis, Eftihia Nathanail, Giannis Adamos and Paraskevi Kapetanopoulou, “A comparison study on urban–interurban interfaces on ports: Constantza and Thessaloniki ports case studies”, 2nd INTERNATIONAL CONFERENCE ON SUPPLY CHAINS

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