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Communicable Disease Issues with Foreign Vessel Boarding

Communicable Disease Issues with Foreign Vessel Boarding. 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. Coast Guard Assessment.

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Communicable Disease Issues with Foreign Vessel Boarding

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  1. Communicable DiseaseIssues with Foreign VesselBoarding

  2. 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.

  3. 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...

  4. Hepatitis A,B,C,D Typhus Malaria Rabies Tuberculosis Cholera Yellow fever Schistosomias Pertussis Diphtheria HIV/AIDS Dengue fever Anthrax Typhoid fever Leishmaniasis Measles Intestinal parasites Polio Ambiasis Hemorrhagic fevers Major Communicable DiseasesEndemic to Third World Countries

  5. Characterization of Communicable Diseases • Disease agent, vector and reservoir • Primary body system affected • Mode of transmission • Portal of entry • Prevention and control measures

  6. EPI HOST Agent Environment

  7. 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 Examples:

  8. HIV & Hepatitis B in AMIO • HIV 7% • TB 5%

  9. Haitian AMIO Active Disease (15% Sick) Malaria 35% URI 10% TB - Active 9% Measles 6% Pneumonia 4% Filariasis 4%

  10. Chinese AMIO • Hepatitis B (44%) • TB • Cholera • Dermatitis • Hepatitis A & E

  11. 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 Important Communicable Disease Threats

  12. Blood-borne Diseases Hepatitis B,C HIV/AID Hemorahagic fever Ebola-Marburg Viral Plague (Septicemia) Vector-borne Diseases Plague (Bubonic) Rabies Malaria Dengue Fever Yellow Fever Encephalitis Lyme Disease Important Communicable Disease Threats con’t

  13. 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 Prevention & Control Elements

  14. 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

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

  16. Bloodborne Pathogens PPEs • Gloves • Eye protection (goggles) • Face shields • Respirator protection • Protective clothing • gowns, coveralls, aprons • Hand washing!!!!

  17. 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.

  18. 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 0157:H7 Hepatitis C HIV/AIDS

  19. 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

  20. 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

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