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European Commission Directorate General for Health and Consumers EU SHIP SANITATION TRAINING NETWORK - SHIPSAN TRAINET PROJECT (2007206) European Manual for Hygiene Standards and Communicable Diseases Surveillance on Passenger Ships European Commission Directorate General for Health and Consumers Work package: 5 Deliverable: 9 LARISSA OCTOBER 2011 OCTOBER 2011 European Manual for Hygiene Standards and Communicable Diseases Surveillance on Passenger Ships EU SHIPSAN TRAINET project work package 5 Deliverable 8 Larissa, October 2011 Lead partners University of Thessaly, Greece National School of Public Health, Greece Associated partners Centro Nacional de Epidemiologia, Spain CMT Prooptiki Ltd, Greece Hamburg Port Health Center, Germany Health Protection Agency, United Kingdom Health Protection Inspectorate, Estonia Health Protection Surveillance Centre, Ireland Institute of Public Health, Slovenia Klaipeda Public Health Center, Lithuania Medical University of Gdansk, Poland Ministry of Health, Section of Communicable Diseases Surveillance, Bulgaria National Board of Health and Welfare, Sweden This Manual arises from the EU SHIPSAN TRAINET project which has received funding from the European Union, in the framework of the Public Health Programme. European Manual for Hygiene Standards on Passenger Ships 2 European Manual for Hygiene Standards on Passenger Ships 3 This Manual was produced under work package 5 of the SHIPSAN TRAINET project and was coordinated by the Department of Hygiene and Epidemiology of the University of Thessaly in Greece. Members of the coordination team were: Prof. C. Hadjichristodoulou, V.A. Mouchtouri, PhD, E. Kostara, MSc, P. Tserkezou, MSc, and Prof. J. Kremastinou. The following working group members were responsible for procuding this manual: I. Arvanitoyannis, University of Thessaly, Greece C.L.R. Bartlett, University College London, United Kingdom N. Black, LaRS, Health Protection Agency, United Kingdom T. Chavoshi, National Board of Health and Welfare, Sweden M. Gennata, University of Thessaly, Department of Medicine, Greece B. Jaremin, Interfaculty Institute of Maritime and Tropical Medicine in Gdynia, Poland M. Koureas, University of Thessaly, Department of Medicine, Greece M. Lamshoeft, Hamburg Port Health Center, Germany N. Launders, Health Protection Agency, United Kingdom J. Lee, European Working Group for Legionella Infections, United Kingdom T. Mastroyiannakis, CMT Prooptiki, Greece N. McGrath, Health Protection Surveillance Centre, Ireland M. Mollergren, National Board of Health and Welfare, Sweden G. Nichols, Health Protection Agency, Centre for Infections, United Kingdom T. Paux, Ministry of Health, France N. Pirnat, Institute of Public Health, Slovenia R. Pinaka, University of Thessaly, Department of Medicine, Greece M. Plemp, National Institute for public health and the Environment, the Netherlands G. Rachiotis, University of Thessaly, Department of Medicine, Greece T. Riemer, Hamburg Port Health Center, Germany J. Rjabinina, Health Protection Inspectorate, Estonia C. Schlaich, Hamburg Port Health Center, Germany M. Skipp, Carnival Cruises, United Kingdom M. Socan, Institute of Public Health, Slovenia O. Sokolova, Klaipeda Public Health Centre, Lithuania C. Varela Martinez, Centro Nacional de Epidemiologia, Spain S. Westacott, Association of Port Health Authorities, Southampton Port Health Authority, United Kingdom The Editorial Board of this manual constisted of the following members: C.L.R. Bartlett, University College London, United Kingdom C. Hadjichristodoulou, University of Thessaly, Department of Medicine, Greece J. Kremastinou, National School of Public Health, Greece J. Kutil, Carnival Cruises, USA D.L. Menucci, World Health Organization, France G. Nichols, Health Protection Agency, Centre for Infections, United Kingdom S. Rehmet, European Centre for Disease Prevention and Control, Sweden T. Skinner, MSC Cruises M. Skipp, Carnival Cruises, United Kingdom C. Varela Santos, European Centre for Disease Prevention and Control, Sweden European Manual for Hygiene Standards on Passenger Ships 4 The Working Group is grateful for all comments and contributions to this manual that have been received by the following members of the SHIPSAN TRAINET partnership: P. Aarsen, Paris Memorandum of Understanding, the Netherlands J. Ames, Centres for Diseases Control and Prevention, Vessel Sanitation Program, United States of America R. Andragetti, World Health Organization, France R. Begel, MSC Cruise Line P. Best, PB Environmental Health, United Kingdom N. Bitsolas, University of Thessaly, Department of Medicine, Greece S. Brown, P&O Ferries W. Bunia-Corbetta, ADS Insight, Brussels, Belgium K. Bunyan, Carnival Cruises, United Kingdom G. Cartledge, United Kingdom Ferry Industry/PSA R. Catt, P&O Cruises, United Kingdom T. Chodnik, Interfaculty Institute of Maritime and Tropical Medicine in Gdynia, Poland S. Collins, Cruise Lines International Association, Florida, USA D. Coulombier, European Centre for Disease Prevention and Control, Sweden V. Croskey, Holland America Line M. Dávila Cornejo, Ministry of Health, Spain E. Depoortere, European Centre for Disease Prevention and Control, Sweden M. Dietl, AIDA Cruise line, Germany J.M. Di Guardia, Direction Générale de la Santé, France D. Di Marco, Costa Crociere, Italy A. Diskin, Royal Caribbean Royal Caribbean International, Azamara Cruise Club, Celebrity Cruises M. Do Ceu Madeira, Ministry of Health, Portugal R. Evenhand, Silversea Cruises D. Gavrilis, Ionian University – Athena Research Centre, Greece G. Georgalas, Department of Health, Cyprus C. Gonzalez, Oceania Cruises/Regent Seven Seas Cruises C. Hadjipetris, Louis cruises, Cyprus M. Hagger, Pullmantur Cruises Ship Management Ltd. I. Hay, Anchor Hygiene Services Limited, Cohesive Public Health Support, London, United Kingdom P. Henry, Health Protection Surveillance Centre, Ireland M. Hrsak, Carnival Cruise Lines F. Jourdain, Direction Générale de la Santé, France A. Kantonis, Ministry of Health, Cyprus M. Kivi, World Health Organization, France A. Kotłowski, Interfaculty Institute of Maritime and Tropical Medicine in Gdynia, Poland C. Koutis, Technological Educational Institute of Athens, Greece A. Kunchev, Ministry of Health, Bulgaria J. Kutil, Carnival Corporation & plc T. Lammerding, AIDA cruise line, Germany A. Lavruvianec, Klaipeda Public Health Center, Lithuania E. Malissiova, University of Thessaly, Greece H. Maltezou, Hellenic Centre for Infectious Diseases Control and Prevention, Greece T. Marking, European Cruise Council, Belgium R. Marshall, Royal Caribbean International & Celebrity Cruises J.B McGruer, Royal Caribbean Cruises, United Kingdom LTD R. Meilicke, Health and Consumer Protection Directorate C/Unit C1 Programme Management, Luxembourg D.L. Menucci, World Health Organization, France N. Mikelis, International Maritime Organization, United Kingdom L. Nodarse, Apollo Ships C. Papatheodorou, Ionion University, Greece A. Pavli, Hellenic Centre for Infectious Diseases Control and Prevention, Greece C. Penny, Fred Olsen Cruise Lines M. Quintana –Gomez, SAGA Shipping Company Ltd. S. Rehmet, European Centre for Disease Prevention and Control, Sweden M. Recinos, Pullmantur Ship Management M. Rivas, Royal Caribbean Royal Caribbean International, Azamara Cruise Club, Celebrity Cruises F. Russo, MSC Cruises M. Saeme, Silversea/Seabourn/SeaDream/Windstar Cruises A. Shatalova, Latvian State Public Health Agency, Riga branch, Latvia T. Skinner, MSC Cruises A. Slepetiene, Klaipeda Public Health Centre Department of Public Health Safety Control, Lithuania European Manual for Hygiene Standards on Passenger Ships 5 I. Smith, Carnival Cruise Lines I. Snijders, Paris Memorandum of Understanding, the Netherlands G. Spala, Hellenic Centre for Infectious Diseases, Control and Prevention, Greece S. Stannard, Carnival United Kingdom N. Stewart, Carnival Cruises, United Kingdom T. Strang, Carnival Cruises, United Kingdom C. Swaan, RIVM – National Institute for PH and the Environment, the Netherlands J. Takkinen, European Centre for Disease Prevention and Control, Sweden G. Tarling, Princess Cruises S. Tomaszunas, Interfaculty Institute of Maritime and Tropical Medicine in Gdynia, Poland C. Varela Santos, European Centre for Disease Prevention and Control, Sweden L. Verhoef, DIVINE-NET, the Netherlands N. Vozelevskaja, Health Protection Service of Tallinn, Estonia N. Wang, World Health Organization, France D. Wagner, International & Strategic Coordination, Primary Health Care & Crisis Management, Belgium S. Williams, Royal Caribbean International, Miami, Florida, USA D. Zamfir, Louis cruises, Cyprus M. Zisiopoulou, University of Thessaly, Department of Medicine, Greece European Manual for Hygiene Standards on Passenger Ships 6 Abbreviations ARI Acute Respiratory Illness CCP Critical Control Point CFU Colony Forming Unit CL Critical Limit CLIA Cruise Line International Association CXR Chest X-Rays EAHC Executive Agency for Health and Consumers EC European Commission ECC European Cruise Council ECDC European Centre for Disease Prevention and Control ELDSNet European Legionnaires’ Disease Surveillance Network EPIET European Programme for Intervention Epidemiology Training EU European Union EUMS European Union Member States EWGLI European Working Group on Legionella Infections EWRS Early Warning and Response System FAO Food and Agriculture Organization FCV Feline Calicivirus FIFO First in – First out GI Gastrointestinal Illness HACCP Hazard Analysis Critical Control Point IHR International Health Regulations 2005 ILI Influenza-Like Illness ILO International Labor
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