Port health infection control and Legionella
E. Coli bacteria
Information about the reporting of infectious disease and Legionella treatment and control on board vessels.
The principal legislation that involves ships and aircraft arriving from outside the UK are The Public Health (Ships) Regulation's 1979 (as amended). These regulations reflect the provisions of The International Health Regulations 2005.
Ships Medical Supplies
Masters of ships arriving at Heysham Port, Glasson Dock or Lancaster Quay must notify the Heysham Port Health Authority of any suspected infectious disease or death on board the vessel other than by an accident. Masters must also report the presence of animals or captive birds and any illness or death in those animals or birds.
During boarding inspections a valid Declaration of Health must be presented to port staff (if vessel is from a port outside the EU) to show the health of the crew.
Making a report is simple, all a Master of a vessel need do is contact the Authority NOT more than 12 hours before arriving in port (outer port limit) and NOT less than 4 hours before arrival in port. This can be done in several ways, via radio message to the relevant Port Control, who in turn will contact the Port Health Officers, alternatively Masters may directly contact the Authority, details can be found below.
Hydrant at Heysham South Quay
The authority operates a 24-hour telephone standby system to enable messages to be received from the Masters of vessels arriving at Heysham Port or Glasson Dock who are required to notify the presence of illness thought to be of an infectious nature. Outside normal office hours masters should telephone +0044 1524 67099
Medical staff are on call to visit vessels and enable a diagnosis to be made of the illness and to recommend further action to prevent the spread of the disease. Certain diseases require notification to the World Health Organisation.
Masters of vessels and ship surgeons (where applicable) should complete a Maritime Declaration of Health, which should then be faxed to: +0044 1524 582709 or be handed to a visiting Officer from the Authority. Declarations must be fully completed whenever there is a suspected or confirmed case or cases of infectious disease on board a ship arriving in Port, or whenever there are animals or captive birds on board the vessel and if they have shown any mortality or signs of infectious disease. The forms below should be completed then forwarded to the Contact Details Below:
Mains water pipe coiled
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Legionella occurs when the bacterium legionella pneumophilia is inhaled by individuals in small droplets of water suspended in the air which contain the bacterium.
Certain conditions increase the risk from legionella
- A suitable temperature for growth - 20 to 45OC
- A source of nutrients for the organism e.g. sludge, scale, rust, algae etc.
- A way of creating and spreading breathable droplets, eg cooling towers, showers, using fire hoses and washing down the hold (if fresh water is used)
It should be noted that most people exposed to legionella do not become ill, legionnaires disease does not spread from person to person, symptoms appear 'flu-like' and include:
- High temperature, fever and chills.
- Muscle pain
- Pneumonia and occasionally diarrhoea and signs of mental confusion (in bad cases)
If the illness is identified early a full recovery is normally made with males being more susceptible than females, approximately 12 percent of cases prove fatal.
Instances of the disease are normally associated with water systems that have been poorly maintained, (by doing nothing, using improper chemicals or inadequate cleaning), dead legs in pipework.
Recent occurrences of Legionella found on board ships has highlighted the problem which in turn raises awareness, however, masters of merchant vessels must remain vigilant and be aware of this life threateningly disease.
What practical measures should be taken
- Study the hot and cold water storage systems and identify all water points, "dead legs" and "blind ends" or long pipe runs.
- Temperature check ALL hot and cold water points ie. taps, showers and hoses. Allow hot water to run for 1 minute and cold water for 2 minutes before taking a reading. The boiler output temperature must be greater than 60OC The hot water supply must be greater than 50OC. The cold supply must be less than 20OC.
- Check that the actual cleaning, maintenance and disinfection routines are in place on the vessel at present.
This should include:
- The hot water outlet temperature should be greater than 60OC and the cold water less than 20OC.
- Dismantle, inspect, clean, descale and soak the shower heads and pipework for a few hours, at least once every three months in a disinfectant / chlorine solution. Remove any calcified deposits found.
- Remove all "dead legs". Super chlorinate the fresh water tanks every six months (50PPM)
- Any crew or passenger cabin that has been out of use for two - four weeks must have the shower cleaned and soaked in a chlorine solution prior to the cabin being occupied.
- If the water temperatures are found to be outside those recommended have the water microbiologically tested.
Microbiological results take the form of three, five, seven and ten day results from readings made.
- Identify and assess ALL points where water could be made into an aerosol and be inhaled by crew, passengers and/or visitors
- Document the findings so that these can be included in the planned maintenance or ISM procedures.