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Port health call for tighter ebola controls

Stuat Spear20/08/2014 - 12.00

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Pilots radio ahead in case of sickness aboard Credit: Komar
Pilots radio ahead in case of sickness aboard Credit: Komar

Port health officers are warning that a lack of co-ordinated health controls at ports and airports is posing an increased risk of ebola entering the UK.  

The warning comes as the ebola outbreak in West Africa, the world’s deadliest to date, is spreading from Guinea to Liberia, Sierra Leone and Nigeria with 2,127 reported cases resulting in 1,145 deaths.

Earlier this month the World Health Organization upgraded the outbreak to a public health emergency of ‘international concern’ under the International Health Regulations (2005). The upgrade requires all states to ‘manage travellers originating from known Ebola-infected areas who arrive at international airports’. 

However the Association of Port Health Authorities (APHA) is warning that in the absence of any central guidance from Public Health England (PHE) port health officers, responsible for enforcing International Health Regulations and for maintaining the bio-security of UK borders, are being forced to produce their own health controls to protect ports and airports.

APHA executive board member Gary Cooper said: ‘I have spoken to port health colleagues around the country and we are concerned that we are having to do things on an ad-hoc basis and are having to pick up on guidance that has been prepared for the Border Agency and guidance for air crews, it means what we are doing throughout the UK is just not consistent.

‘We are calling for more information on preventing the disease getting into the UK. We need to adopt a consistent proportionate response for all our ports and airports and we also need controls in place to protect the health of our staff as we will be the first people to come into contact with a potential case.’

Under the International Health Regulations the commander of a vessel or aircraft who suspects there may be a sick individual aboard must alert port health before arrival. Port health officers are then required to implement their port health plan to deal with any potential health risk.

In the absence of any specific national guidance Sandra Westacott, team leader for port health at the Port of Southampton, has put together a health plan for dealing with a potential ebola incident after she contacted a PHE public health expert for advice. Southampton is one of the UKs major passenger and cargo ports.

‘We need to be able to provide information to a ship’s master who could be several days out having to cope with a possible situation without medical confirmation about the disease and also provide some practical guidance for personnel visiting ships, ’ said Ms Westacott.

‘I have advice now from PHE after I contacted them myself because of my concerns that our advice was not sufficient enough to cope with that eventuality. I have been given information and a link to the WHO website but from a UK point of view we would prefer advice to be stamped up by Public Health England.’

At Heathrow pilots are being instructed to contact the airports medical officer of health if they suspect an infected passenger, medical officers are authorised by the local authority but are employed by PHE. At Stansted Airport port health officers have been using guidance issued to UK Border Agency staff and guidance provided to airline crews from the International Air Transport Association to deal with a potential Ebola incident.

But according to Mr Cooper it is not just major airports and ports that are at risk. According to the Civil Aviation Authority there are over 45 UK airports that receive international flights.

Responsible for overseas passengers arriving at ports around Cornwall as well as Newquay Airport Mr Cooper has warned that port health is particularly vulnerable where a port medical officer is not required to be on-site.

‘These are weak points and we are not unique by any means. We have lots of private aircraft coming from all over the world into Newquay and we need to know how to handle things if Ebola lands on our doorstep. We might have a designated port medical officer but there is no one on-site,’ said Mr Cooper.

Port Health Officers are calling for the sort of support being given to front line medical staff who have been provided guidance that help them establish the potential risk posed by any individual who presents themselves.

A PHE spokesperson said: ‘PHE has informed medical practitioners about the situation in West Africa and requested they remain vigilant for unexplained illness in those who have visited the affected area, and actions to take in the event of a possible case.

‘Advice has already been issued to Immigration Removal Centres on carrying out health assessments for people who may have previously been in Ebola outbreak areas within the preceding 21 days.

‘In light of the ongoing outbreak, PHE will continue to liaise with Border Force and Port Health, to update guidance for staff working in airports and port, however Port Health would primarily receive briefing from local authorities.’

Local authorities with ports are reminded that ships require a Maritime Declaration of Health when infectious disease is suspected of being aboard and to ensure their contact with PHE is up-to-date in case an incident requires escalation.




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