title: Actions for prevention and control of health threats related to maritime transport in European Union.
abstract: BACKGROUND
  Actions at European Union level for International Health Regulations (IHR) 2005 implementation and maritime transport were focused on two European projects implemented between 2006 and 2011.
  
  
  METHODS
  Situation analysis and needs assessment were conducted, a Manual including European standards and best practice and training material was developed and training courses were delivered. Ship-to-port and port-to-port communication web-based network and database for recording IHR Ship Sanitation Certificates (SSC) were established.
  
  
  RESULTS
  Fifty pilot inspections based on the Manual were conducted on passenger ships. A total of 393 corrective actions were implemented according to recommendations given to Captains during pilot inspections. The web-based communication network of competent authorities at ports in EU Member States was used to manage 13 events/outbreaks (dengue fever, Legionnaires' disease, gastroenteritis, meningitis, varicella and measles). The European information database system was used for producing and recording 1018 IHR SSC by 156 inspectors in 6 countries in accordance with the WHO Handbook for inspection of ships and issuance of SSC.
  
  
  CONCLUSIONS
  Implementation of corrective actions after pilot inspections increased the level of compliance with the hygiene standards in passenger ships sailing within the EU waters and improved hygiene conditions. The communication tool contributed to improvement of outbreak identification and better management through rapid sharing of public health information, allowing a more timely and coordinated response. After the implementation of actions on passenger ships, the European Commission co-funded a Joint action that will expand the activities to all types of ships and chemical, biological and radio-nuclear threats (deliberate acts/accidental).
authors.affiliation: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece. xhatzi@med.uth.gr
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
authors.forename: Varvara A
authors.initials: VA
authors.lastname: Mouchtouri
authors.forename: Paolo
authors.initials: P
authors.lastname: Guglielmetti
authors.forename: Cinthia Menel
authors.initials: CM
authors.lastname: Lemos
authors.forename: Gordon
authors.initials: G
authors.lastname: Nichols
authors.forename: Thierry
authors.initials: T
authors.lastname: Paux
authors.forename: Clara
authors.initials: C
authors.lastname: Schlaich
authors.forename: Miguel Davila
authors.initials: MD
authors.lastname: Cornejo
authors.forename: Carmen Varela
authors.initials: CV
authors.lastname: Martinez
authors.forename: Mauro
authors.initials: M
authors.lastname: Dionisio
authors.forename: Sybille
authors.initials: S
authors.lastname: Rehmet
authors.forename: Bogdan
authors.initials: B
authors.lastname: Jaremin
authors.forename: Jenny
authors.initials: J
authors.lastname: Kremastinou
mesh_terms: D003140:Communicable Disease Control / Q000379:methods / Q000458:organization & administration*; D003142:Communication; D004196:Disease Outbreaks / Q000517:prevention & control*; D005062:European Union; D014943:Global Health; D006801:Humans; D006920:Hygiene / Q000592:standards*; D007318:Inservice Training; D012499:Sanitation / Q000592:standards*; D012767:Ships / Q000592:standards*; D014195:Travel
keywords: Health; International Health Regulations; Maritime; Ship; Travel