Swine Influenza - Guidance Note

April 2009

The World Health Organization* (WHO) has recently advised that the risk of a swine influenza pandemic has increased. Swine influenza or "flu", a virus that normally infects pigs, has been detected in people in Mexico, the U.S., New Zealand, Canada, and the U.K. Health officials around the world are checking to see whether infections have occurred in their countries and preparing measures to prevent its spread.

Flu is generally transmitted through the respiratory tract. Droplets of infected body fluids can carry flu when people cough or sneeze. Studies indicate that masks called N95 respirators, when properly used, filter germs from the breath and can hamper the spread of flu. Neither contact with pigs nor eating pork has been linked to the spread of the flu. Nonetheless, health researchers are working to establish that mode of transmission of the virus is by personal contact.

The symptoms of swine flu are as follows: about 1 to 4 days usually elapse between the time a person is infected and the onset of symptoms. Influenza normally causes symptoms such as coughing, sneezing, headaches and body aches, fever, chills, and sometimes vomiting and diarrhoea. Swine flu causes the same symptoms and may be difficult to distinguish from other strains of flu and respiratory illnesses; those affected may experience difficulty breathing, dizziness, confusion, or severe vomiting and diarrhoea.

Enhanced personal hygiene, including more frequent hand-washing, and avoiding people who are coughing or sneezing, may reduce the risk of individuals contracting swine flu. Those who are not health professionals should avoid contact with sick people or those who are coughing or sneezing. If any of the above mentioned symptoms appear it is prudent to assume that swine flu is involved and be treated accordingly.

Since episodes of swine flu have already emerged in various locations worldwide it is strongly recommended to Members that the following preventive actions are taken:

1. Maintaining at all times a very high degree of hygiene among crew

2. Avoid shaking hands where possible, but where contact has occurred ensure that hands are washed thoroughly and frequently, particularly before eating.

3. Avoid enclosed spaces with large concentrations of people.

4. Avoid sharing cutlery, dishes and clothing.

5. Do not smoke in enclosed spaces.

6. Increase the amount of ventilation and sunlight entering accommodations as much as possible.

7. Persons should avoid exposing themselves to sudden temperature changes.

8. Drink plenty of fluids.

9. Eat foods with an elevated amount of vitamins A and C such as
papaya, orange, lemon, carrot, etc.

10. Avoid contact with persons who present symptoms of flu.

In the event that anyone on board a vessel presents symptoms of sudden high fever, headache, cough and muscular/joint pain, the appropriate local health authorities must be advised immediately if the vessel is in port in order to commence medical evaluation as soon as possible. In the event that any crewmember exhibits these symptoms prior to arrival in port, a notice must be given to the port authorities in advance of the vessel's arrival.

In addition for ships calling at ports in the areas where disease has been detected the following preventive actions must be implemented:

1. Prohibit shore leave to all crewmembers.

2. Restrict access to the ship allowing only officials, ship’s agents, surveyors, terminal workers and stevedores onboard.

3. Access to the vessel should be denied to anyone showing symptoms of illness. Anyone who exhibits such symptoms after having boarded must be removed from the vessel.

4. Avoid receiving provisions or fresh water.

5. Watchmen must use additional personal protective equipment such as respirators masks and gloves.

WHO advise that the risk of an influenza pandemic has increased, however, it does not mean that this is inevitable.

*The latest information on the status of the swine influenza outbreak, together with further guidance, can be found on the WHO website at: www.who.int/csr/disease/swineflu/en/index.html