Standard Operating Procedures

for

prevention, early warning and response to

Public Health events at Points of Entry

Surveillance1 Granting ''free pratique'' to Ships01 Surveillance1

Table of Contents

I

Messages vi

Introduction 01

Acknowledgement 03

Scope 04

Objectives 05

Guiding Principles 05

Definitions 06

ROUTINE PROCEDURE AT SEA PORTSPART A

1. Granting ‘free pratique’ to Ships 08

2. On arrival of an Aircraft with 'free pratique' to the Sea Port 11

3. Issuing Ship Sanitation Control Exemption Certificate/Ship Sanitation Control Certificate 12

4. Monitoring discharge by Ships 15

5. Supervising sanitary condition of facilities used by travellers and staff 15

6. Surveillance of notifiable diseases among travellers and staff at the Port 18

7. Vector control in the premises of the Port 20

8. Attending to Medical/Surgical emergencies of travellers 20

9. Vaccination for Yellow Fever 21

10. Screening and Prophylaxis for Malaria 21

11. Death on Board 21

12. Maritime interceptions at sea 22

13. Victims of human trafficking and Returning Labor Migrant workers 22

Surveillance1 Granting ''free pratique'' to Ships01 Surveillance1 PROCEDURES IN RESPONDING TO A PUBLIC HEALTH EMERGENCY OF

INTERNATIONAL CONCERN (PHEIC) AT SEA PORTSPART B

1. Surveillance 23

2. Prompt risk assessment 23

2.1 A Human case/suspected case of having an illness of PHEIC on board 23

2.2 An animal affected/suspected of having an illness of PHEIC on board 26

2.3 Cargo containing contaminated food or livestock on board 26

2.4 Cargo containing hazardous radioactive/nuclear material on board 27

2.5 Cargo containing hazardous chemical material on board 27

2.6 Ships affected/ suspect of having a PHEIC 27

Table of Contents

ii

3. Notification 28

4. Rapid Detection 30

5. Response 31

5.1 Disembarked travellers: affected, suspected or under surveillance 31

5.2 Death on board due to a suspected/confirmed illness of PHEIC 35

5.3 Affected or suspect animals or cargo with food items or radioactive/nuclear 35

material or chemical material coming to Sri Lanka

5.4 Additional sanitary measures for the travellers who continue the voyage, Ships and 36

premises of the Port

5.5 Disposal of any contaminated water or food, human or animal dejecta, 39

waste water and any other contaminated matter from the Ship

5.6 A case/suspected case of any PHEIC within the country or among staff at the Port 39

6. Preparedness 41

7. Risk Communication 41

1. Granting 'free pratique' to aircraft prior to arrival to the Air Port 42

2. On arrival of an Aircraft with 'free pratique' to the Air Port 44

3. Monitoring the discharge by Air Crafts 47

4. Supervising sanitary condition of facilities used by travellers and staff of the Air Port 47

5. Surveillance of infectious/notifiable diseases among travellers and staff at the Air Port 50

6. Vector control in the premises of the Air Port 52

7. Vaccination for Yellow Fever 52

8. Screening and Prophylaxis for Malaria 52

9. Death on Board or bringing human remains or ashes of cremated bodies 53

10.Victims of human trafficking and Returning Labour Migrant workers 55

01PART C ROUTINE PROCEDURE AT AIR PORTS

Table of Contents

iii

PROCEDURES IN RESPONDING TO A PUBLIC HEALTH EMERGENCY OF

INTERNATIONAL CONCERN (PHEIC) AT AIR PORTSPART D

1. Surveillance 56

2. Prompt risk assessment 56

2.1 A Human case/suspected case of having an illness of PHEIC on board 56

2.2 An animal affected/suspected of having an illness of PHEIC on board 59

2.3 Cargo containing contaminated food or livestock on board 59

2.4 Cargo containing hazardous radioactive/nuclear material on board 60

2.5 Cargo containing hazardous chemical material on board 60

2.6. Aircrafts affected/suspect of having a PHEIC 60

3. Notification 63

4. Rapid Detection 64

5. Response 65

5.1 Disembarked travellers: affected, suspected or under surveillance 65

5.2 Death on board or human remains brought due to a suspected/

confirmed illness of PHEIC 69

5.3 Affected or suspect animals or cargo with food items or radioactive/

nuclear material or chemical material 69

5.4 Additional sanitary measures for the travellers who continue the voyage,

Aircrafts and premises of the Air Port 70

5.5 Disposal of any contaminated water or food, human or animal dejecta, waste water and

any other contaminated matter from an Aircraft suspected/ confirmed as having a

PHEIC 73

5.6 Applying entry controls during PHEIC 73

5.7 A case/suspected case of any PHEIC within the country or among staff at the Air Port 74

6. Preparedness 75

7. Risk Communication 76

List of Annexures

iv

Annexure 1 Yellow Fever Endemic Countries 78

Annexure 2 Checklist for granting ‘free pratique' to Ships 79

Annexure 3 Certificate of vaccination against Yellow Fever 80

Annexure 4 Maritime Declaration of Health form 81

Annexure 5 Issuing Ship Sanitation Control Exemption Certificate/ Ship Sanitation

Control Certificate 84

Annexure 6 Sequenceof inspection areas 86

Annexure 7 Checklist for Inspection of Ships and Issuance of Ship Sanitation Control

Exemption Certificate/ Ship Sanitation Control Certificate 87

Annexure 8 Inspection of the kitchen/food outlets/catering services 89

Annexure 9 Guidelines for taking food samples from the kitchen/food outlets

catering services 91

Annexure 10 Guidelines for taking water samples 92

Annexure 11 Vectors-borne disease, related pathogens and vectors 94

Annexure 12 Health Declaration Form 95

Annexure 13 Personal protective equipment 96

Annexure 14 Checklist for assessment of a human case/suspected case of

PHEIC on board 97

Annexure 15 Checklist for secondary screening of travellers detected by thermal

scanners or Health Declaration Form by PHMO during a PHEIC 98

Annexure 16 Checklist for granting 'free pratique' to aircrafts 99

Annexure 17 Checklist for secondary screening of travellers detected by thermal

scanners or Health Declaration Form by APMO during a PHEIC 100

List of Figures

v

Figure 1 Process of granting ‘free Pratique’ to ships 09

Figure 2 Process of issuing Ship Sanitation Control Certificate (SSCC),

Ship Sanitation Control Exemption Certificate (SSCEC) or extension 13

Figure 3 Process of supervising sanitary condition of facilities used by travellers

and staff 17

Figure 4 Process of surveillance of notifiable diseases among travellers and staff 19

Figure 5 Procedure for prompt risk assessment of a ship suspected of having a public

health emergency of international concern (PHEIC) at Sea Ports 25

Figure 6 Procedure for ships affected/suspect of having a PHEIC 29

Figure 7 Procedure for Disembarked travellers, animals and cargo 33

Figure 8 Additional sanitary measures for the travellers who continue the voyage,

Ships and premises of the Port 38

Figure 9 Process of granting ‘free Pratique’ to ships 43

Figure 10 Process after granting ‘free pratique’ to Aircrafts 46

Figure 11 Process of supervising sanitary condition of facilities used by travellers and

staff 49

Figure 12 Process of surveillance of notifiable diseases among travellers and staff 51

Figure 13 Procedure for assessing a ship suspected of having a public health emergency

of international concern (PHEIC) at Air Port 57

Figure 14 Procedure for an Aircraft affected/suspect of having a PHEIC 62

Figure 15 Procedure for disembarked travellers, animals and cargo 66

Figure 16 Additional sanitary measures for the travellers who continue the voyage,

Aircrafts and premises of the Airport 71

Message from Honourable Minister of Health

vi

With the transition to peace and economic boom, our country has accelerated its progress

on becoming an aviation, naval, energy, knowledge and commercial hub in the Asian region.

The rapid development has accelerated Sri Lanka's global linkages and there is a now a

mass movement of people within the country and out of the country with ever increasing

cross-border travel. With this rapid increase of international travel also comes the

emergence and re-emergence of new diseases. It is therefore very important for Sri Lanka

to have a comprehensive National Border Health Strategy. I have given high priority to the

National Migration Health Programme, having launched the Migration Health Policy for our

country in 2013.

Indeed, I am very pleased that Sri Lanka is seen as a model for many other nations in the

enabling migration health, in global forums such as the World Health Assembly meetings.

The fact that we now have a dedicated border health strategy shows our commit for the

protection of migrants and the public health of our country at large.

Inter-Ministerial and Inter-Agency coordination also plays a significant role in

implementation of the National border health strategy, and I acknowledge the

participation and contribution of all stakeholders in this process. These Standard

Operating Procedures (SOPs) are like a 'compass' that our health officials working at

borders can hold with them to guide them in their daily work. These SOPs enable our health

staff to better prepare, respond, enhance surveillance activities and improve coordination

efforts at airports and seaports.

I am pleased that the Ministry of Health with the ongoing technical cooperation of IOM has

been able to advance Sri Lanka's progress on Migration health and establish these SOPs as

part of the larger Border Health strategy.

Hon. Maithripala Sirisena

Minister of Health, Sri Lanka

Message from Secretary Health

vii

Border health has become an important public health concern due to increased cross border

travel globally. During the last four decades Sri Lanka also experiences rapid increase in

population mobility due various reasons such as employment, education, commerce, trade or

tourism etc. Due to country's free trade policy, various products and items flow into the

country freely. Through our sea and air ports there is import of various biological, zoological,

chemical and radiological products from other countries which may not go through strict

standard control measures.

As the country is becoming an important hub on trade, commerce, education and knowledge

in par with global advancements, it is quite important to understand the complex nature of

the health and other related problems arising from such inter-country connectivity, mobility

and goods imported to the country. We know by our experience that some of these pose a big

threat to the health and wellbeing not only of the present population but that of the future

generation too. Therefore we need to look at our existing legal and policy framework,

strategies and practices to prevent such threats and face the challenges successfully. It is

important to identify the gaps and loopholes in our policies and legal framework and revise

them to suit today's context.

I am pleased to state that this timely need has been addressed by the technical team who

undertook the task of developing the Standard Operating Procedures (SOP). The lesson in

public health protection in boarders is the need to manage multiple events which occur at

these sites and understand the importance of inter-sectoral collaboration and collective

action rather than just dealing with routine events. These guidelines were developed through

'evidence-based' operational research and rigorous consultation involving multiple

stakeholders. The dynamics of field health resources were also taken into account in

developing the guidelines. These SOPs provide information for determining the appropriate

public health measures that should be adopted for prevention, early warning and quick

response to health and health related events occurring at seaports and airports. They

enhance the work practices, preparedness, responsiveness, quality and efficiency of our

airport and seaport health personnel.

I wish to thank the International Organization for Migration (IOM) for their expertise and

continued support to strengthen country's border health, and development of the Migration

Health Policy for Sri Lanka. The Ministry of Health in collaboration with IOM will use these

SOPS to improve the technical competency and the skills of human resources working in the

field of boarder health and to establish the Boarder Health Information system.

Dr Y D Nihal Jayathilaka

Secretary, Ministry of Health

Message from Director General of Health Services

viii

Introduction and re-introduction of vectors and new pathogens to Sri Lanka, which is also

rapidly eliminating diseases such as Malaria continues to be a major public health focus of

the Ministry of Health. The National Border Health Strategy led by the Ministry of Health

follows the reforms embedded within the National Migration Health Policy (MHP), a

process integrally supported with the technical assistance of IOM through a four-year

Inter-Ministerial coordination process. I have been closely involved in contributing to the

development of the policy process, where a key recommendation within the National

Action Plan was to 'strengthen capacity of the borders'.

The development of these SOPs represents an important milestone in this overall strategy,

and I would acknowledge the hard work and leadership of the Directorate of Quarantine

and the ongoing technical support of IOM to make this a reality. The SOPs also address the

need to strengthen points of entry to protect against and provide a public health response

to an international spread of disease and threat of deliberate use of biological, radiological

and chemical agents. In many ways these SOPs go beyond just a disease specific focus of

the 'old IHR' to a border public health one. This is an important distinction. The SOPs also

outline algorithms and plans for responding to major events of public health significance

pertaining to borders. Although these SOPs are relevant to our health staff at borders, they

also recognize the importance of inter-Agency coordination in addressing the health

challenges at our nation's borders.

I am also pleased that the project team has adopted sound scientific approach, through a

consultative process in designing these SOPs. In parallel to the development of these SOPs

was the process of enhancing the relevant legal and regulatory environment to ensure

empowerment of the port health officials. This plays an important step for the meaningful

implementation of SOPs. The Chief legal officer of the Ministry of Health, Directorate of

Quarantine and IOM experts were able to also facilitate the required refinements within

domestic laws for consideration through parliamentary process with the express support

of the Hon. Minister of Health.

These SOPs not only offer practical guidance but should be 'living document' constantly

debated and refined through the rigorous or routine practice. These SOPs guide the

practice of border health staff to enable the public health protection of all migrants, and

the country at large.

Dr Palitha Maheepala

Director General of Health Services, Ministry of Health

Message from Director Quarantine

ix

It is reported that more than 900 million international journeys are undertaken every year.

As a country at the cusp of an economic boom, Sri Lanka also experiences a major

population flows along trade, commerce, tourism and labour into the country, within the

country and out of the country. Cross border travel on this scale exposes country's public

health and people in to range of health risks which can be minimized by precautions taken at

the ports of entry.

Being an island nation we are given an opportunity by the nature to protect the country and

its population easier than in land locked countries. Sri Lanka has only 2 international

airports and 5 ports and it's wise to take hold of this opportunity and secure our borders and

be more vigilant at our ports of entry.

Consequently we conducted a rapid assessment of the current health services at the ports of

entries and realized that revision of the legal framework, establishment of information

system and development of Standard Operating Procedures (SOPs) and as vital components

in establishing a sound border health strategy for the country.

While attending to the legal framework and the information system we embarked on

developing SOPs for the Medical Officers and the Public Health Inspectors attached to the

Port Medical Offices. They are the front line in this endeavor and play a vital role in

protecting our borders. Therefore, laying down clear directions on necessary steps to be

followed by them will ensure coherent and efficient operations with minimal disturbance to

the international trade and traffic. Therefore I think this effort on developing (SOPs) for the

port health officers is very much timely. This effort in developing SOPs took a rigorous

technical consultative process with all the key stakeholders and extensive search of

literature on similar progressions. SOPs address the procedures to be followed routinely

and in the events of public health emergencies of international concern.

I thank the working group for their tireless effort achieving this goal within a very short

time period and I also sincerely thank the technical and financial assistance provided by the

International Organization for Migration to make this challenging task a success.

Dr L B H Denuwara

Director (Quarantine), Ministry of Health

Introduction

Sri Lanka's geographical, location in the, Indian ocean has been of paramount strategic

importance to voyage, commerce, geopolitics and cultural exchange historically. Even in the

present day its geographical location influences the complex dynamics of ever increasing

international migration and cross border travel. With the government's vision of

transforming the country into five strategic hubs in the region (aviation, naval, energy,

knowledge and commerce and trade), the points of entry (sea ports & air ports)need to be

strengthened to prevent, protect against, control and provide public health response to

international spread of diseases. This strengthening points of entry will positively contribute

to the country's development goals while avoiding unnecessary interference with

International traffic and trade.

History of port health laws and regulations in Sri Lanka dates back to 1897 with the

establishment of the Quarantine and Prevention of Diseases Ordinance of Sri Lanka, which

was subsequently amended several times, with the latest revision in 1960. The emergence

and re-emergence of infectious diseases, threat of deliberate use of biological and chemical

agents etc, have highlighted the need to strengthen points of entry while adhering to domestic

and international legislations (IHR 2005).

The International Sanitary Regulations, first adopted in 1951 were renamed as the

International Health Regulations (IHR) in 1969. The 1951 IHR intended to monitor and

control only six serious infectious diseases: cholera, plague, yellow fever, smallpox, relapsing

fever and typhus. Developments in international ship/aircraft traffic affected the

international transmission of disease and in May 2005, the World Health Assembly adopted a

revised IHR which entered into force in June 2007. The IHR (2005) identifies four hazards

which may cause a public health emergency of international concern (PHEIC) as manifested

by imported or exported human cases, infected or contaminated vectors, or contaminated

goods caused by infectious diseases, chemical agents, radioactive material and contaminated

food.

This Standard Operating Procedures (SOPs) were developed by the Directorate of Quarantine,

Ministry of Health with the technical and financial assistance of the International

Organization for Migration (IOM).

In the development of these SOPs, a desk review of domestic and international laws,

regulations and literature was carried out initially to identify the best practices related to

points of entry Mapping of current practices at points of entry including stakeholders,

resources was done through field visits and observations at the Bandaranaike International

Airport and the Colombo Harbour.

01

Key informant interviews were conducted from October 2013 to December 2013 using a

check list prepared, based on information gathered through the desk review including the IHR

core capacity requirements. Due to the scarcity of relevant literature from the region,

protocols used by the Port Health Officers of USA and UK were mainly referred in the

preparation of the checklist.

Key Informants included the Medical Officers and Public Health Inspectors of the Colombo

Harbour and the Bandaranaike International Airport, Harbour Master of the Colombo

Harbour, Chief Medical Officer/Medical Centre of the Bandaranaike International Airport,

Chief Judicial Medical Officer and the Judicial Medical Officer of Base Hospital Negombo. In

addition, data collected manually and compiled at the Port Health Offices of the Bandaranaike

International Airport and the Colombo Harbour were analysed to assess trends of relevant

indicators.

A GAP analysis was performed using the services related to Quarantine and Prevention of

Diseases Ordinance (1960) of Sri Lanka and IHR (2005) core capacity requirements for

designated points of entry. Recommendations made by the Collaborative Arrangement for the

Prevention and Management of public health events in Civil Aviation-Asia Pacific (CAPSCA-

AP) Assistance visit to Bandaranaike International Airport were also reviewed.

A series of drafting, discussions and peer-reviews through eight Technical Working Group

meetings were carried out to facilitate the development of the SOPs. A  stakeholder meeting

was conducted with the participation of a diverse group of experts from relevant units within

the Ministry of Health and other Ministries/Agencies. The final version of these SOPs was e

mailed to all relevant stakeholders in March 2014 and was revised according to the comments

received.

This set of SOPs provides written instructions for routine procedures and procedure for

responding to a PHEIC, specified for Sea Ports and Air Ports. It is intended to be used as

reference material for port Medical officers and Port Public Health Inspectors. The SOPs are

made user friendly by colour coding the main sections, by including Flow Charts, check lists,

copies of relevant Forms/Certificates and guidelines for procedures. Training workshops

with simulations/drills onboard ships and air crafts are planned in the future which will

provide an opportunity to test and revise the SOPs.

It is expected that the SOPs will facilitate consistency in the quality and integrity of the

procedures at the Sea Ports and Air Ports in Sri Lanka. They also address the need to

incorporate measures to strengthen and facilitate the multisectoral approach needed to

operationalize the Quarantine and Prevention of Diseases Ordinance of Sri Lanka and the IHR

(2005).

02

Acknowledgments

03

The preparation of the Standard Operating Procedures for the Ministry of Health, Sri Lanka

would not have been possible without the generous technical and logistical support of the

International Organization for Migration (IOM). The valuable technical contribution and observations made by all stakeholders from the

Ministry of Health, other Government Ministries and Agencies who participated in the

numerous consultative meetings and technical workshops over the course of development of

these Standard Operating Procedures are remembered with gratitude. The work of the following individuals was crucial to the development of the Standard

Operating Procedures and is gratefully acknowledged:

Primary Author: Dr. Vindya Kumarapeli, Consultant Community Physician, Ministry of Health

Co-Authors: Dr. L B H Denuwara, Director (Quarantine), Ministry of Health

Dr. Kolitha Wickramage, Head of Health Programs, International Organization for Migration

Dr. Sharika Peiris, National Professional Officer (Migration health), International Organization for Migration

Technical Working Group: Dr. Iresha Dassanayaka, Consultant Community Physician, Directorate of Quarantine

Dr. Sepali Wickramathilaka, Consultant Community Physician, Directorate of Quarantine

Dr. Upendra Sirisena, Chief Port Health Officer, Port Health Office, Colombo Port

Dr. Sanjeeva Siriwardhana, Chief Air port Health Officer, Air Port Health Office, Bandaranaike International Airport

Dr. F.D.Colombage, Chief Port Health Officer, Port Health Office, Galle Port

Mr. Jayatissa Nanayakkara, Public Health Inspector, Port Health Officer, Galle Port

Mr. W.P.Chandrasiri, Public Health Inspector, Air Port Health Office, Bandaranaike International Airport.

Mr. W.G.S.Udayanga, Development Officer, Port Health Office, Galle port.

Ms. W.A.N.Lakmali, Development Officer, Directorate of Quarantine

Scope

This set of Standard Operating Procedures (SOPs) covers the detailed procedures and techniques

for routine activities as well as procedure for responding to a Public Health Emergency of

International Concern (PHEIC), specified under IHR (2005), the Quarantine and Prevention of

Disease Ordinance (1960) and the National Civil Aviation Public Health Emergency Preparedness

Plan (2014 draft).

The SOPs cover both the arriving and departing procedures. They provide information for

determining which public health measures should be adopted for prevention, early warning and

response to Public Health events at Points of Entry (Sea Ports and Air Ports).

The SOPs will be implemented by personnel who are trained in public health i.e. Medical Officers,

Public Health Inspectors as well as representatives of other stakeholders operational at the Points

of Entry.

There are four sections in this document: Parts A and C of this document have been developed to

assist the Port Medical Officers and Public Health Inspectors in carrying out the routine activities

at the Sea Ports and Air Ports. In addition reference has been made to coordinate with Focal Points

of relevant Government Ministries as and when necessary. Examples of such focal points include;

the Quarantine Unit of the Department of Animal Production and Health, local Veterinary Surgeon,

Technical Officers of the Atomic Energy Authority of Sri Lanka, Food and Drug Inspectors (FDI) of

the Food Control Administration Unit, Directorate of Environment & Occupational Unit of the

Ministry of Health, local area Medical Officer of Health (MOH) and Plant Quarantine Division of the

Department of Agriculture.

Parts B and D provide a template for the procedure for responding to a Public Health Emergency of

International Concern (PHEIC). The format of this template follows the IHR (2005). It describes

the seven key areas to be attended: surveillance, prompt risk assessment, notification, rapid

detection, response, preparedness and risk communication. However, the SOPs only address the

preliminary control measures needed to respond to PHEIC by the health officers at points of entry.

Details of specific control measures and inter-agency coordination required to address such

events are beyond the scope of these SOPs. However the SOPs provide guidance and reference to

the specialized experts and relevant agencies that are needed to be contacted or mobilized to

respond to a PHEIC. For instance, if a nuclear/radiological or a chemical event is detected on board

a vessel, references have been provided to contact the Chairman of the Atomic Energy Authority,

Chairman, Central Environment Authority, Disaster Management Centre of the Ministry of

Disaster Management and the Disaster Preparedness and Response Division of the Ministry of

Health

04

Objectives

Objectives of the present SOPs are:

a) To prevent international spread of disease and events of public health interest through

inspection of travellers, baggage, cargo, containers, conveyances, goods, postal parcels

and human remains

b) To ensure surveillance of notifiable diseases among travellers and the staff at points of

entry

c) To ensure sanitary measures and safe environments for travellers and the staff at points of

entry

d) To enable rapid detection, prompt risk assessment, notification, appropriate response,

risk communication and laboratory mechanism to a potential public health emergency of

international concern (PHEIC)

Guiding Principles

a) Avoiding unnecessary interference with international traffic and trade

b) Treat travellers with full respect for the dignity, human rights and fundamental freedoms

of persons and minimize any discomfort or distress associated with such measures

c) Treat all travellers with courtesy and respect, taking into consideration the gender, socio

cultural, ethnic or religious concerns

d) Working coherent to the rules and regulations of other stakeholders involved

05

Contamination -presence of an infectious or toxic Agent or matter on a human or animal body

surface, in or on a product prepared for consumption or on other inanimate objects, including

vessel, aircraft and conveyance, that may constitute a public health risk

Conveyance - an aircraft, Ships, train, road vehicles or other means of transport on an

international voyage

'free pratique'-The permission for a Ship to enter a Port, embark or disembark, discharge or load

cargo or stores

Human Health hazards - as specified in IHR 2005, may be of biological (infectious, zoonotic, food

related and other), chemical, radiological, or nuclear origin or source

Disinfection-The procedure whereby measures are taken to control or kill infectious Agent s on a

human or animal body, on a surface or in or on baggage, cargo, containers, conveyances, goods and

postal parcels by direct exposure to chemical or physical Agents

Disinsect -procedure whereby health measures are taken to control or kill the insect vectors

present in baggage, cargo, containers, vessel, aircraft, conveyances, facilities, goods and postal

parcels

Decontamination -a procedure whereby health measures are taken to eliminate an infectious or

toxic Agent or matter on a human or animal body surface, in or on a product prepared for

consumption or on other inanimate objects, including vessel, aircraft and conveyance, that may

constitute a public health risk

Incubation period - the time elapsed between exposure to a pathogenic organism, a chemical or

radiation, and when symptoms and signs are first apparent. In a typical infectious disease,

incubation period signifies the period taken by the multiplying organism to reach a threshold

necessary to produce symptoms in host

Isolation- separation of ill or contaminated persons or affected baggage, containers, conveyance,

facilities, goods or postal parcels from others to prevent the spread of infection or contamination

06

Definitions

Affected-Persons, baggage, cargo, containers, conveyances, goods, postal parcels or human

remains that are infected or contaminated, or carry sources of infection or contamination, so as to

constitute a public health risk

Communicable disease-Diseases caused by pathogenic microorganisms, such as bacteria,

viruses, parasites or fungi which can be spread, directly or indirectly, from one person to another.

Point of entry - a passage for international entry or exit of travellers, baggage, cargo, containers,

conveyances, goods, and postal parcels as well as agencies and areas providing services to them on

entry to or exit from a country.

Public health emergency of international concern -an extraordinary event which is

determined, according to the IHR, (i) to constitute a public health risk to other Member States

through the international spread of disease and (ii) to potentially require a coordinated

international response

Quarantine- restriction of activities and/or separation from others of, suspect persons who are

not ill or of suspect baggage, cargo, containers, vessel, aircraft, conveyances, facilities, goods and

postal parcels to prevent the possible spread of infection or contamination

Stowaways-is a person who secretly boards a vehicle, such as an aircraft, bus, ship, cargo truck or

train, to travel without paying and without being detected

Suspect- persons, baggage, cargo, containers, vessel, aircraft, conveyances, facilities, goods and

postal parcels considered by the Port health officer as having been exposed, or possibly exposed,

to a public health risk and that could be a possible source of spread of disease

Traveller - any person undertaking an international voyage including crew

Zoonotic diseases -communicable diseases of animals that can cause disease when transmitted

to humans.

07

Routine Procedures

At Sea Ports

Part APart AP

art

A

Pa

rt A

All vessels arriving from a foreign Port should be inspected by the Port Health Medical Officer

(PHMO) before granting ''free pratique''. The 24 hour Berthing programme of the Port received

from the Habour Master is used to plan the inspection process.

· All relevant information given below should be received from the Master of the Ship

· Information will be received either directly (via e mail) or through an Agent approved by the

Sri Lanka Ports Authority (SLPA).

· The information should reach the PHMO before the arrival of the Ship in the Port i.e not more

than 48 hours and not less than 4 hours.

· Information should include the following:

a) Date and time of arrival of the Ship

b) Details about the Ship

c) Nature of the cargo and operations to be carried out in the Port-i.e animals and livestock,

food items, food items of plant origin

d) List of Ports for the past 30 days with arrival and departure dates -If the Ship touched any

Port in the Yellow Fever Endemic Countries (Annexure 1) in the last 30 days-details of

Country, Port, departure date

e) Crew and passenger list -Journey and personal particulars of embarked and disembarking

travellers

f) Details of any deaths, cases, suspect due to infectious diseases and/or Public Health

Emergency of International concern PHEIC on board

g) Details of any stowaways on board as per IMO standard format

h) Details of any pet animals and their vaccination details

i) Details of the Ship Sanitation Control Certificate (SSCC) or Ship Sanitation Control

Exemption Certificate (SSCEC) or Extension to (SSCC or SSCEC) - whether sanitary control

measures were required, if so date of compliance of the measures and the re-inspection date

· PHMO should use the checklist given for assessing the information (Annexure 2)

Surveillance1 Granting ''free pratique'' to Ships01

08

Surveillance1 Granting ''free pratique'' to Ships01

Surveillance1 Process of granting “free Pratique” to shipsFigure 1

Pa

rt A

09

Cautions

I. Imported animals (as cargo or pet) and livestock (as cargo)-prior approval from Director

General of Department of Animal Production and Health is needed. Health clearance from the

Quarantine Unit of Department of Animal Production and Health within the Port or local

Veterinary Surgeon (representative of the Director General of Department of Animal

Production and Health) is needed for imported animals before granting ''free pratique''.

Import of primates as pet from Yellow Fever Endemic areas or where origin the primates

cannot be ascertained, should not be permitted in to Sri Lanka

II. Imported food items (as cargo)- prior approval that the food items are fit for human

consumption is needed from the Director General of Health Services (DGHS) or a person

identified by or a focal point designated by the DGHS. Health clearance from Food and Drug

Inspectors (FDI) of the Food Control Administration Unit, Directorate for Environment &

Occupational Unit, Ministry of Health or the local Medical Officer of Health (MOH) or the Port

Health Public Health Inspector (PHPHI), is needed for food items before granting 'free

pratique'.

III. Food items of plant origin (e.g. kadala) Additional Health Clearance from the Plant

Quarantine Division of the Department of Agriculture is needed.

IV. Travellers- history of Yellow fever vaccination

· Any Ship coming within 30 days from yellow fever affected countries as alerted by WHO

must be inspected by PHMO before granting ''free pratique''

· Any traveller has visited/transited through yellow fever affected countries as alerted by

WHO, having come to Sri Lanka within 6 days of departure and having a valid certificate of

vaccination against Yellow Fever (Annexure 3) should be allowed to enter the country

· Any traveller has visited/transited through yellow fever affected countries as alerted by

WHO, having come to Sri Lanka within 6 days of departure, but unable to produce a valid

certificate of vaccination against yellow fever, should be quarantined until the certificate

becomes valid, or until a period of not more than 6 days, calculated from the date of last

possible exposure to infection, has elapsed, whichever occurs first. Such traveller should be

transferred to Infectious Disease Hospital (IDH) or the local hospital identified for

Quarantine

· Any traveller coming to Sri Lanka, having an exemption from Yellow Fever vaccination,

signed by an authorized Medical Officer or an authorized health worker should not be

quarantined. He/she should be placed under surveillance and be informed by PHMO to

report any fever/other symptoms immediately to PHMO

Pa

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10

Surveillance1 On arrival of a Ship with ''free pratique'' to the Port02

· Import of primates as cargo/ pet from Yellow Fever Endemic areas or where origin the

primates cannot be ascertained should not be permitted in to Sri Lanka. PHMO should

advice the Master of the Ship that such primates should be kept on board in mosquito free

environment/cabin and not to be allowed to move around on board.

I. Ship in transit at the Port - a Ship not requiring any embarking and disembarking of

travellers or loading/discharging cargo and restricted to a particular area of the Port, will be

permitted to take on fuel, water, food and supplies under the supervision of the PHMO

· If the PHMO is satisfied with the information provided, the pratique is granted.

· The Agent will send a vessel with a pilot to the out-harbour to bring the Ship to berth.

Not granting ''free pratique'’

· Master of any Ship who is unwilling to submit the information required by the PHMO

as specified above should not be granted ''free pratique''

Special Note:

· The Ship should be allowed to depart immediately without being permitted to

communicate with the shore or with any other vessel in the Port.

· The Ship will be permitted to take on fuel, water and stores while in quarantine at the

designated place in the Port

· Any passengers in such a Ship, who desire to disembark with or without their baggage or to

tranship from the Ship, may be permitted to do so, on the condition that they agree to

appropriate health measures required by the PHMO.

On arrival to the Port, the Master of the Ship or the Agent should complete and deliver the

following information to the PHMO and provide any further information required regarding

health conditions on board

a) Duly filled in Maritime Declaration of Health form (Annexure 4)

b) Passenger and Crew List-with their Yellow Fever Vaccination history and Yellow Fever

Vaccination Certificates

c) Ship Sanitation Control Certificate (SSCC) or Ship Sanitation Control Exemption

certificate (SSCEC) or extension to SSCC/SSCEC

d) Details of occurrence of any death or cases or suspects due to infectious disease and/or

public health emergency of international concern (PHEIC) after the information

provided to PHMO prior to arrival to the Port.

Pa

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11

Surveillance1Issuing Ship Sanitation Control Certificate (SSCC) or Ship Sanitation

Control Exemption Certificate (SSCEC)03

· Issuing Ship Sanitation Control Exemption Certificate

a) Validity of the Ship Sanitation Control Certificate (Annexure 5) should be assessed by the PHMO

b) To be valid: a SSCC should be issued within 6 months and issued from IHR-2005 Authorized Port's List

c) Port Health Public Health Inspector (PHPHI) should inspect areas, systems and services on board by direct observation and by measurement with testing and sampling equipment (Annexure 6)

d) Under the supervision of the PHMO, the PHPHI should inspect the Ship for public health risks as per the check list given in the “Handbook for Inspection of Ships and Issuance of Ship Sanitation Certificates WHO” (Annexure 7)

e) The PHMO may issue the Ship Sanitation Control Exemption Certificate (SSCEC) if there is a valid SSCC and also satisfied that the Ship is free of infection and contamination on inspection, including vectors and reservoirs on inspection as per the check list provided

Caution

· Ships arriving from Yellow Fever endemic countries - PHMO should request the Master of

the Ship arriving from Yellow Fever endemic countries within 30 days from the date of

departure to disinsect the Ship as per WHO recommended procedures and appropriate

insecticides

· Ships arriving from an area affected by a vector-borne disease - PHMO should request to

the Master of the Ship arriving from an area affected by a vector-borne disease and if the

disease is present in its territory, to apply vector control measures

Pa

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12

Surveillance1Process of issuing Ship Sanitation Control Certificate (SSCC), Ship Sanitation

Control Exemption Certificate (SSCEC) or extensionFigure 2

Pa

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13

· Issuing Ship Sanitation Control Certificate

If the SSCC is not valid or if the PHMO is not satisfied that the Ship is free of infection and

contamination, PHMO should advice the Master of the Ship to apply relevant control

measures to the Ship (deratting, disinfection, disinsection or decontamination) and/or

sanitary measures for travellers

a) Control measures should be carried out under the supervision of the PHPHI

b) Control measures should be applied as per WHO recommended procedures and

appropriate insecticides

c) Control measures should be applied when the Ship and holds are empty, and before

loading in the case of a Ship in ballast

d) Control measures should be applied to: baggage, cargo, containers, goods, postal parcels

and human remains as well as to places in the Ship e.g. crew cabins, deck, pantry, galley

and other places as required

· When control measures are reported as completed by the Master of the Ship or its Agent,

PHPHI should again inspect the Ship under the supervision of the PHMO

· If control measures are satisfactorily completed, the SSCC will be issued by the PHMO

· A note should be made by the PHMO on the SSCC:

a) Evidence found (e.g. presence of vector on board)

b) Control measures taken

c) Recommending the competent authority of the next known Port of call to make any

follow-up inspection required to determine the success of the vector control measures

applied

· Extending the validity of the Ship Sanitation Control Certificate(SSCC) or Ship

Sanitation Control Exemption Certificate (SSCEC)

The PHMO may extend the validity of the SSCC or the SSCEC by one month if inspection or

control measures required cannot be accomplished at the Port.

Pa

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14

· PHMO should advice the SLPA to periodically monitor the discharge from Ships (sewage,

refuse, ballast water and other potentially disease causing matter) which might

contaminate the waters of the Port

· Inspections/taking samples should be done under the supervision of the PHPHI

· Reports of such inspections should be received by the PHMO and entered in the database of

the Port Health Office

Surveillance1 Monitoring the discharge by Ships04

Under the supervision of the PHMO, the PHPHI should oversee the sanitary condition of facilities

(food outlets, water source, Ship catering facilities, public washrooms and solid/liquid waste

disposal services) used by travellers/staff.

PHPHI should:

· Food hygiene

a) Advice all food outlets/catering services of the Port to be registered with the Port Health

Office

b) Inspect the Port kitchen,/food outlets used by travellers or staff within the Port

premises,/raw food supplied to Ships by the Agent, periodically depending on the

grading of the outlet in the Food Act and using the checklist (Annexure 8)

c) Two random food samples per month from the Port kitchen,/food outlets in the

premises/raw food supplied to Ships by the Agent should be taken as per the

guidelines in the Food Act and sent to MRI for analysis (Annexure 9)

d) If the food sold in outlets are supplied from outside, advice the suppliers to get the Food

Safety License from the local authority/Medical Officer of Health (MOH) and submit a

copy to the PHMO.

e) Should check such suppliers annually for the availability of a valid License.

f) Food which is found to be unhygienic, adulterated and unsafe for human consumption

should be discarded as per the guidelines in the Food Act.

g) Any food outlets/catering services or drinking water source found unfit for the purpose

should be ordered for closure as per the guidelines in the Food Act

Surveillance1 Supervising sanitary condition of facilities used by travellers and staff05

Pa

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15

· Water quality

a) Obtain 2 random samples per month, from the drinking water source to the Ships and

staff at the Port (from points of use) as per the guidelines in the Food Act.

b) Details of procedure for sample collection, transportation of samples, interpretation of

result and the format to be sent with the samples for bacteriological investigation are

given in Annexure 10

c) Samples should be sent to the Medical Research Institute (MRI) or the closest Regional

Laboratory of the National water Supply & Drainage Board for microbiological, chemical

and residual chlorine analysis.

· Public washrooms and solid/liquid waste disposal services

a) Inspect the public washrooms and solid/liquid waste disposal services within the Port

area periodically as per the guidelines in the Food Act

Pa

rt A

16

Pa

rt ASurveillance1 Process of supervising sanitary condition of facilities used by travellers and staffFigure 3

17

· Among travellers

a) Information regarding infectious diseases on board are gathered from the Maritime

Declaration of Health Form

b) Details of cases should be entered in the sick crew members' register and the data base at

the Port Health Office

c) A weekly report on notifiable diseases on board should be sent to the Epidemiology Unit

and to the Director(Quarantine) Saturday 12 noon by the PHMO (refer Part B for a

PHEIC)

· Among staff at the Port

PHMO should coordinate with the SLPA for ensuring surveillance of notifiable diseases

among staff at the Port as they could be a source of infection into or out of the country (refer

Part B for a PHEIC)

a) PHPHI should ensure that Standard Notification cards (form H544) are provided to the

Port Medical Centre and information on notifiable diseases are entered in the

Notification Register

b) PHPHI should ensure that the dully filled form H544 are sent by the MOIC of the Port

Medical Centre, SLPA to the MOH of the area where the patient resides

c) PHMO should request the MOIC of the Port Medical Centre, SLPA to submit a weekly

summary regarding notifiable diseases among staff at the Port to the PHMO

d) This information should be entered in the data base at the Port Health Office

e) A weekly report on notifiable diseases among staff at the Port should be sent to the

Epidemiology Unit and to the Director(Quarantine) Saturday 12noon by the PHMO

f) Feedback received from the Epidemiology Unit (Weekly Epidemiological Report) should

be shared with the Port Medical Centre

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

Pa

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18

Pa

rt ASurveillance1 Process of surveillance of notifiable diseases among travellers and staffFigure 4

19

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

Vectors may transport an infectious Agent from areas of the Port that are used for operations

involving travellers, conveyances, containers, cargo and postal parcels, into or out of the country. If

not properly controlled, vectors could board ships, breed and be carried overseas. Furthermore,

vectors on board can, in turn, spread disease to ports in other countries. The main categories of

vectors are: rats, mosquitoes, flies, cockroaches, ticks, mites, midges, fleas. More details about

major vector-borne disease, related pathogens and vectors are given (Annexure 11).

Vector control activities will prevent establishment of vector breeding reservoirs within the

premises of the Port.

· Under the supervision of the PHMO, the PHPHI should monitor the vector status within the

premises of the Port monthly as per the Prevention of Mosquito Breeding Act of Sri Lanka

· The PHMO should submit the report on vector status to the Harbour Master and advice on

the appropriate anti vector measurers to keep their premises free form vector of all types.

· PHPHI should coordinate with the SLPA to apply anti-mosquito measures within the

premises as well as for a distance of at least 400 meters around the perimeter of the Port

with the assistance of the local authority/Municipal Council.

Surveillance1 Vector control in the premises of the Port07

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

· If the Master of a Ship in the out-harbour or Ships sailing alone the sea line of Sri Lanka

informs the PHMO of an illness (regarding PHEIC refer Part B) e.g. medical or surgical

emergency, accident, PHMO may visit the Medical Facility inside the Ship to assess the

traveller.

· After an interview and examination of the traveller, preliminary treatment can be provided

by the PHMO

· If needed, the traveller may be brought in an out-harbour vessel to the Port Medical Centre

for further management

· If needed, PHMO should coordinate with the Habour Master and bring the Ship to berth to

bring the traveller to the Port Medical Centre

· Such travellers should be transferred in the ambulance of the Port Medical Centre to a

government/private medical facility of his/her choice for further management

· The PHMO may provide Radio Medical Services to Ships upon request of the Master of the

Ship

Surveillance1 Attending to Medical/Surgical emergencies of travellers08

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20

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

· Yellow Fever vaccination is provided to the departure travellers at the Assistant Port Health

Office, located at the Medical Research Institute, Colombo 08 and by the Port Health Offices

at Colombo and Galle Harbours. A Certificate of Yellow Fever vaccination is issued.

Surveillance1 Vaccination for Yellow Fever09

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

· In case of any death on board, the PHMO will be informed by the Master of the Ship about the

circumstances of the death and possible cause of death directly (via e mail) or via the Agent

· The PHMO should board the Ship and take a statement from the Master of the Ship and the

Surgeon who attended to the illness

· After satisfying that the death is not due to any illness of PHEIC, PHMO will grant permission

to remove the dead body

· PHMO should request the Police Post of the Port to arrange an inquest and to transport the

dead body to the JMO of the closest hospital for a post mortem

Surveillance1 Death on Board11

Surveillance1·

·

·

·

PHMO should coordinate with Officers of the Anti-Malaria Campaign, Department of

Immigration and other relevant organizations such as the International Organization for

Migration for ensuring that travellers to and from Malaria endemic countries are identified.

PHMO should coordinate with the Anti-Malaria Campaign and ensure the availability and

delivery of malarial prophylaxis for travellers (who seek such drugs) that are departing to,

or arriving from Malaria endemic countries.

PHMO should coordinate with the Anti-Malaria Campaign and support the voluntarily

Malaria Rapid Diagnostic Testing (RDT) for travellers from Malaria endemic countries, and

RDT screening for special groups such as returning irregular migrants.

Results of the Malaria RDT screening should be entered in the data base at the Port Health

Office and notified to the Directorate of Quarantine and Anti-Malaria Campaign

Surveillance1

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21

106 1 Screening and Prophylaxis for Malaria10

Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

· PHMO with the assistance of the Sri Lanka Navy should visit the Ship in the out-harbour.

· All travellers in such Ships/vessels should be assessed by the PHMO.

· After an interview and examination of the traveller, preliminary treatment can be provided

by the PHMO

· If needed, the traveller may be brought in an out-harbour vessel to the Port Medical Centre

for further management.

· If needed, PHMO should coordinate with the Habour Master and bring the Ship to berth to

bring the traveller to the Port Medical Centre

· Such travellers should be transferred in the ambulance of the Port Medical Centre to a

government medical facility for further management

Surveillance1 Maritime interceptions at sea12

Pa

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Surveillance1 Surveillance of notifiable diseases among travellers and staff at the Port06

· PHMO should coordinate with the Sea port police and ensure that trafficked victims are promptly referred to the closest Judicial Medical Officer

· Information regarding referrals of such trafficked victims, including communicable diseases, should be entered in the data base at the Port Health Office and notified to the Director ( Quarantine)

Surveillance1 Victims of human trafficking and Returning Labour Migrant workers13

22

Procedures in Responding to a Public Health Emergency of

International Concern (PHEIC) at Sea Ports

Part BP

art

B

Pa

rt B01 Surveillance

· Surveillance of any infectious disease will be based on:

a) Information received from Ships on travellers through the Maritime Declaration of

Health Form or

b) Information received from staff of the Port through notifications (H 544) sent by the

MOIC of the Port Medical Centre, SLPA

· Such alerts should be verified by the PHMO by communicating with the Master of the Ship or

the MOIC of the Port Medical Centre, SLPA.

· Communication with the Master of the Ship should be done either directly via e mail or

contacting the Agent of the Ship over the phone or by radio messaging the PortControl

Tower

02 Prompt risk assessment

2.1 A Human case/suspected case of having an illness of PHEIC on board

· The Master of the Ship carrying a case/suspect of having an illness of PHEIC, before its

arrival to the Port, will hoist a spacial flag on top of the Yellow Flag to indicate the

occurrence of such illness.

· The Master of the Ship will also inform the PHMO either directly via e mail or through its

Agent or by radio messaging the Port Control Tower about the occurrence of such illness.

· The PHMO, PHPHI and a supportive Staff member should visit the Ship

· A pilot and an out-habour vessel to board the Ship will be arranged by the Agent

· The PHMO, PHPHI and a supportive Staff member should wear appropriate PPE as per

guidelines given (Annexure 13)

· Once on board, the PHMO should request the Master of the Ship to provide the following

information for the assessment of the case/suspect of PHEIC :

a) Maritime Declaration of Health form (Annexure 4)

b) List of Ports for the past 30 days with arrival and departure dates -If the Ship touched any

Port in the Yellow Fever Endemic Countries (Annex 1) in the last 30 days-details of Country,

Port, departure date should be requested.

c) Crew and passenger list -including journey and personal particulars of embarked and

disembarking travellers, Yellow Fever Vaccination list and their Yellow Fever Vaccination

Certificates 23

a) Ship Sanitation Control Certificate (SSCC) or Ship Sanitation Control Exemption

certificate (SSCEC) or extension to SSCC/SSCEC

b) Nature of the public health risk

c) Number of affected/suspected Travellers

· From each case or suspect of PHEIC:

a) Medical history

b) Travel itinerary

c) Vaccination history

d) History of prophylaxis

e) Destination in Sri Lanka (address) and contact details (telephone no.s)

A) Assessment of the case/suspect:

· Assessment should be carried out at a space separate from other travellers

· Case/suspect should be requested to wear a mask unless he/she is unable to tolerate it.

· Include interviews and non-invasive medical examinations.

· Assessment will also include examination of baggage, cargo, provisions, water supply and

any part of the Ship which the PHMO may consider as necessary

· Checklist for assessment of a human case/suspected case of having an illness of PHEIC on

board is given in Annexure 14

B) Assessment of other travellers in the Ship

· If a need arises, other travellers e.g. those who had contacts with the case/suspect, or the

entire Ship should be assessed

· If contact tracing is considered necessary, information to locate the other travellers should

be obtained

a) Name

b) Destination in Sri Lanka (address)

c) contact details (telephone no.s)

Pa

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24

Pa

rt BFigure 5Procedure for prompt risk assessment of a ship suspected of having a

public health emergency of international concern (PHEIC) at Sea Ports

25

· After assessment, the PHMO should classify the Ship as infected (Affected), suspected or

healthy in accordance with special provisions relating to PHEIC

· Affected -If clinical signs and/or symptoms of a PHEIC and other evidence of a public health risk,

including sources of infection and contamination, are found on board, the PHMO should consider

the Ship as affected (infected)

2.2 An animal affected/suspected of having an illness of PHEIC on board

Live animals (cargo or pet) are usually examined by the Quarantine Unit of Department of Animal

Production & Health within the Port.

· If the PHMO is informed by the Master of a Ship or detects on inspection an animal/s

suspected of having an illness of PHEIC on board or a death, the Quarantine Unit of

Department of Animal Production and Health within the Port should be notified immediately

over the phone by the PHMO

· PHMO should receive the clearance of the Quarantine Unit of Department of Animal

Production and Health to grant ''free pratique''

2.3 Cargo containing contaminated food or livestock on board

Cargo containing food items are usually inspected by the Food and Drug Inspectors (FDI) within

the Port who are functioning under the Director, (Environment and Occupational Health),

Ministry of Health or in their absence by the PHPHI. Cargo containing livestock are inspected by

the Quarantine Unit of Department of Animal Production & Health within the Port.

· If the PHMO is informed about cargo containing suspected/contaminated food on board by

the Master of a Ship or detects on inspection, the Food and Drug Inspectors (FDI), if present

within the Ports, should be notified immediately by the PHMO as per the National

Contingency plan for a PHEIC

· If the PHMO is informed about Cargo containing suspected/contaminated livestock by the

Master of a Ship or detect on inspection, the Quarantine Unit of Department of Animal

Production & Health within the Port should be notified immediately by the PHMO as per the

National Contingency plan for a PHEIC

· PHMO should receive the clearance of the Director, (Environment and Occupational Health)

Unit, Ministry of Health or the Quarantine Unit of Department of Animal Production &

Health within the Port to grant 'free pratique'

Pa

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26

2.4 Cargo containing hazardous radioactive/nuclear material on board

· If the PHMO is informed about cargo containing hazardous radioactive/nuclear material on

board by the Master of a Ship or detect on inspection, the Focal Point appointed by the

Chairman of the Atomic Energy Authority should be notified immediately by the PHMO as

per the National Contingency plan for a PHEIC

· PHMO should receive the clearance of the Focal Point appointed by the Chairman of the

Atomic Energy Authority to grant 'free pratique’

2.5 Cargo containing hazardous chemical material on board

· If the PHMO is informed about cargo containing hazardous chemical material on board by

the Master of a Ship, the Focal Point appointed by the Chairman, Central Environment

Authority should be notified immediately by the PHMO as per the National Contingency

plan for a PHEIC

· PHMO should receive the clearance of the Focal Point appointed by the Chairman, Central

Environment Authority to grant 'free pratique'

2.6 Ships affected/suspect of having a PHEIC

· If found affected or suspected of PHEIC, the Harbour Master should be communicated

immediately over the phone by the PHMO

· the PHMO should advice the Harbour Master and the Master of the Ship that the Ship is not

allowed to enter any dock or come along-side of any wharf or have communication with the

shore or with any other vessel in the Port until authorized to do so by the PHMO, except for

navigational reasons

· The Master of the Ship should be advised by the PHMO to park at the designated mooring

point of the Port as per the contingency plan of the SLPA by coordinating with the Harbour

Master

· The PHMO should advice the Master of the Ship that no traveller on board should be allowed

to disembark or no cargo could be removed from the Ship until appropriate health measures

have been taken.

· If found Healthy, the pilot is granted permission by the PHMO to bring the Ship to the habour

Pa

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27

Special note

· A Ship shall not be refused 'free pratique' for public health reasons and should not be

prevented from taking on fuel, water, food and supplies

· The PHMO, for navigational reasons, may permit such Ship to come along-side a specially

controlled wharf where strict vigilance is maintained and enforced to prevent any

communication or contact with the shore or with any other vessel in the Port.

· The PHMO, for navigational reasons, may give written permission to take a boat along-side the

Ship with a pilot, harbour-master, and a mooring crew ,who can only board or leave such Ship

03 Notification

· PHMO should immediately communicate over the telephone about the unexpected PHEIC

and/or any other infectious disease to Director (Quarantine)

· PHMO should also communicate over the phone the immediate public health measures

taken

· The case should be recorded in the sick crew members' register

· According to the National Contingency plan for a PHEIC, Director (Quarantine) should

notify:

a) The Rapid Response Teams (RRT) of the Sea Port

b) Contact points of other points of entry

c) Director General of Health Services

d) Relevant public health and other agencies e.g.

o Contaminated food -Director, (Environment and Occupational Health Unit) Ministry

of Health

o Animals affected/suspected and contaminated livestock - Director General of

Department of Animal Production and Health

o Hazardous radioactive/nuclear material - Chairman, Atomic Energy Authority

o Hazardous chemical material- Chairman, Central Environment Authority

o Disaster Management Centre, Ministry of Disaster Management

o Disaster Preparedness and Response Division, Ministry of Health

· The deactivation/scaling down of health measures will also be initiated by the Director

(Quarantine)

Pa

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28

Pa

rt BFigure 6 Procedure for ships affected/suspect of having a PHEIC

29

04 Rapid Detection

Cruise Liners arriving at the Port will cause a large influx of passengers to the Port.

In a situation of PHEIC, based on the IHR recommendations:

· IHR National Focal Point (NFP) may decide on installation and/or activation of thermal

scanners at pre-designated screening stations to detect patients with fever.

· NFP may also decide to request the arriving travellers to fill in a Health Declaration Form

(HDF) (Annexure 12) which will have a checklist of symptoms and the location/s identified

as outbreak or affected areas.

Special Note

· SLPA staff should be trained by the PHMO to identify travellers who may have a PHEIC based

on the HDF

· PHMO will provide the PPE to both screening staff and travellers suspected of having a

communicable disease (either because of symptoms or close contact with a potentially

infectious traveller) during the temperature screening and subsequent secondary

interview/examination.

· Harbour Master will inform the relevant agencies e.g. Customs, Agents, Port police about the

activation of thermal scanners/HDF.

In case of activation of thermal scanning/requesting a HDF:

· PHMO should coordinate with the Harbour Master for the installation and/or activation of

thermal scanners at pre-designated locations

· PHMO should coordinate with the Harbour Master to assign staff to the thermal scanners

and/HDF

· Personal protective equipment (PPE) recommended for staff assigned to the thermal

scanners/HDF is given (Annexure 13)

· Travellers detected by the thermal scanners/HDF will be interviewed and/or examined by

the PHMO at a pre-designated location.

· Upon screening, if PHMO detects an affected/suspected traveller, such case should be

immediately notified (please refer section 2.4.) and should be managed as detailed in

section 2.5

· Details of travellers detected by the thermal scanners/HDF and sent for secondary

screening by PHMO should be entered in the database of the Port Health Office.

Pa

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30

· Details should include (Annexure 15):

a) Personal identification

b) Travel itinerary

c) Vaccination history

d) History of prophylaxis

e) Destination in Sri Lanka (address) and contact details (telephone no.s)

05 Response

The PHMO should implement additional health measures as decided by the NIHR Focal Points-

Director (Quarantine) and the Epidemiology Unit to prevent and control public health risk during

PHEIC.

5.1 Disembarked travellers : affected, suspected or under surveillance

Affected or suspected travellers should be transferred immediately to the Inspecious Disease

Hospital (IDH) or the designated hospital (depending on the location of the point of entry) which

has diagnostic facilities, adequate staff, equipment and premises to allow further assessment and

care, isolation, quarantine, or other supportive services.

· The PHMO should communicate with the affected or suspected travellers (or parent or

guardian) in a language that they can understand

· He/she should be informed that appropriate medical treatment as well as basic needs,

protection for baggage and possessions and other appropriate assistance during

quarantine or isolation at the hospital will be provided

· Affected or suspected travellers (or parent or guardian) should be informed of any risk

associated with vaccination/with non-vaccination and with the use/non-use of

prophylaxis.

· Written informed consent should be obtained from affected or suspected travellers (or

parent or guardian) for any medical examination, vaccination, prophylaxis or health

measure

· If consent is not given, the traveller/s will be managed under the authority given by the

Quarantine Act

· Director of IDH or the designated hospital should be communicated immediately over the

phone about the transfer of the affected or suspected travellers.

Pa

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31

Special Note

· According to the National Contingency plan for a PHEIC, coordinator for additional

ambulances, staff and equipment will be done through the Disaster Preparedness and

Response Division, Ministry of Health.

· Till the ambulances are brought to the Port, the cases/suspect will be kept in the isolation room

within the Port Health Office.

· Transfer of affected or suspected travellers who may carry infection or contamination,

should be done under the supervision of the PHMO:

a) In ambulance/s with specially designated equipment

b) According to international Infection prevention and control safety guidelines

c) By staff (Medical Officers, Nursing Officers, supportive staff) specially trained to the

transfer of such persons

d) By staff wearing appropriate personal protective equipment.

·

Pa

rt B

32

Pa

rt BFigure 7 Procedure for Disembarked travellers, animals and cargo

33

A) Affected travellers

· Further examinations, investigations and confirmation of diagnosis will be done at IDH or

the designated hospital. Specimen collection, storage, transportation to the designated

laboratory service/MRI will be done at the IDH or the designated hospital as per the

National Guidelines.

· Treatment of affected traveller will be done by the designated medical team (e.g. physician,

paediatrician, epidemiologist) and as per the case management protocols adhering to

international safety guidelines and standards.

B) Suspected travellers

· Suspected travellers will be quarantined at IDH or the designated hospital, if incubation

period is known, for a period not exceeding the incubation period of the PHEIC to which they

have been exposed. The period will be calculated from the time of the last exposure to

infection by the designated medical team.

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as per

the case management protocols. If such person develops symptoms and/or signs during the

incubation period and later confirmed as a case, the person will be managed as in section A

given above

C) Travellers under surveillance

· Persons who have been exposed to infection but allowed to disembark, will be placed under

surveillance for a period not exceeding the incubation period of the PHEIC to which they

have been exposed.

· Such person should be issued a card by the PHMO with clear written instructions for the

duration of surveillance and contact details of the PHMO

· Contact details of persons placed under surveillance should be entered in the database of

the Port Health Office by the PHPHI

· The PHMO should request the person to report to PHMO, if necessary, at specified intervals

during the period of surveillance as noted in the card issued to him/her

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as per

the case management protocols.

· The Medical Officer of Health (MOH) of the area, where the persons intends to stay during

the period under surveillance should be informed over the phone/fax/e mail about such

person/s

· Such person may be permitted to move about freely

Pa

rt B

34

· The PHMO may also request medical investigation and make any inquiries which are

necessary for ascertaining his/her state of health.

· If such person develops symptoms and/or signs during the incubation period, he/she

should be advised to get admitted to the nearest designated hospital as per the National

Contingency plan for a PHEIC. When confirmed as a case, the person will be managed as in

section A given above.

· Such persons should be advised to inform the PHMO if he/she plans to depart for another

place in Sri Lanka

· In such a situation, the PHMO should immediately inform the MOH of the place to which the

person is proceeding and request the MOH to apply the health measures as per the National

Guidelines/circulars issued.

· The person under surveillance should be advised to report to the MOH on arrival to that

place and this information should be updated in the database of the Port Health Office by the

PHPHI

Information on the status of affected travellers, suspected travellers and travellers under

surveillance should be traced by the PHMO and updates in the database.

5.2 Death on board due to a suspected/confirmed illness of PHEIC

· In addition to the routine procedures stated in 1.11, additional health measures should be

applied as per the National Guidelines/circulars issued.

5.3 Affected or suspect animals or cargo with food items or radioactive/nuclear material

or chemical material coming to Sri Lanka

a) Animal/s suspected of having an illness of PHEIC on board

· Assessment, isolation, treatment and other services would be decided by the Quarantine

Unit within the Port in consultation with the Department of Animal Production and

Health.

b) Cargo containing contaminated food or livestock on board

· Seizure and destruction of goods affected would be decided by the Food and Drug

inspectors of the Port in consultation with the Director, (Environment & Occupational

Health) Ministry of Health

Note: laboratory samples, Blood, blood products and lifesaving medicines will be spared from this

inspection. .

Pa

rt B

35

·

within the Port in consultation with the Department of Animal Production and Health

a) Cargo containing hazardous radioactive/nuclear material on board

· Assessment, isolation, treatment of and other support services for persons, and seizure

and destruction of goods affected would be decided by the Focal Point appointed by the

Chairman of the Atomic Energy Authority in consultation with Atomic Energy Authority

b) Cargo containing hazardous chemical material on board

· Assessment, isolation, treatment of and other support services for persons, and seizure

and destruction of goods affected would be decided by the by the Focal Point appointed

by the Chairman, Central Environment Authority

PHMO should coordinate with the SLPA and the relevant officers within the Port to ensure

prevention of introduction of PHEIC to the country

PHMO should communicate with the Director/Quarantine regarding the control measures taken

5.4 Additional sanitary measures for the travellers who continue the voyage, Ships and

premises of the Port

a) Travellers who continue the international voyage

· The PHMO may allow a traveller, placed under surveillance, to continue the voyage if

measures to safeguard the health of other travellers are assured.

· However if there is evidence of an impending public health risk, the PHMO may request

such traveler to undergo additional health measures to control this risk.

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as

per the case management protocols

· The PHMO should record this in the SSCC and communicate to the next Port of call

· The PHMO may allow a traveller placed under isolation, (in exceptional circumstances),

to continue the voyage before the expiry of the isolation period, provided measures to

safeguard the health of other travellers are assured

Seizure and destruction of goods affected would be decided by the Quarantine Unit

Pa

rt B

36

b) Disposable materials in contact/potential contact with the case/suspect

Under the supervision of the PHPHI, all disposable materials in contact/potential contact

with the case/suspect should be removed per the WHO recommendations

c) Baggage, cargo, containers, conveyances, goods or postal parcels arriving in the Ship

Baggage, cargo, containers, conveyances, goods or postal parcels arriving in a Ship with

persons suspected/confirmed as having an illness of PHEIC may have been contaminated by

infection or may serve as a source of vector and reservoir

· PHMO should advice the Harbour Master, Master of the Ship and the Agent/Cargo

handler that baggage, cargo, containers, conveyances, goods or postal parcels which may

be contaminated should be disinsected, derated, disinfected, decontaminated or treated

as per the WHO recommendations.

· This should be done by the Agent at a location specially designated in the Ship and

equipment designated for this purpose and under the supervision of the PHPHI

· PHMO may prevent loading or unloading of above items till the procedures are

completed.

· Once the recommended procedures are completed satisfactorily, the SSCC will be issued

by the PHMO

· Only the affected/suspected Ships with the SSCC issued by the PHMO will be allowed to

leave the harbor

Pa

rt B

37

Pa

rt BFigure 8

Additional sanitary measures for the travellers who continue the voyage,

Ships and premises of the Port

38

d) Areas within the Ship and the premises of the Port

· PHMO should advice the Harbour Master, Master of the Ship and the Agent that areas

within the Ship and the premises of the Port which may be contaminated by persons

suspected/confirmed as having a PHEIC should be disinfected or decontaminated as per

the WHO recommendation

· This should be done by the SLPA or the Agent under the supervision of the PHPHI

e) Ships arriving from affected areas

The PHMO may re-apply health measures for baggage, cargo, containers, conveyances, goods,

postal parcels and human remains arriving from an affected area, if there are verifiable

indications and/or evide

5.5 Disposal of any contaminated water or food, human or animal dejecta, waste water and

any other contaminated matter from the Ship

· PHMO should advice the Harbour Master, Master of the Ship and the Agent thatany

contaminated water or food, human or animal dejecta, waste water, sewage, refuse, ballast

water and contaminated matter from a Ship suspected/confirmed as having a PHEIC which

might contaminate the waters of the Port should be removed and disposed safely

· Under the supervision of the PHMO, the PHPHI should coordinate with the SLPA and make

sure that such contaminated matter are removed and disposed by a pre-designated method.

Special note

· A Ship that has been considered as affected will cease to regard as affected when the PHMO is

satisfied that the recommended measures have been effectively carried out and there are no

conditions on board that could constitute a public health risk.

5.6 Applying entry controls during PHEIC

· The PHMO may apply entry controls for arriving travellers after assessing the following:

a) Travel itinerary

b) Certificates of vaccination or prophylaxis

Caution

· The PHMO should not deny entry to a traveller who has a valid certificate of vaccinations or

prophylaxis, even if coming from an affected area, unless PHMO has verifiable evidence that

the vaccination or other prophylaxis was ineffective

Pa

rt B

39

5.7 A case/suspected case of any PHEIC within the country or among staff at the Port

In a situation of a PHEIC arising within Sri Lanka, measures should be taken to prevent it from

spreading out of the country through the Ports.

A) Staff affected

· All Port workers should be advised to take their temperature before leaving home for work.

0· Any Port worker with fever (temperature of 37.5 C and above, or as per national guidelines)

and/or specified symptoms should be advised not report for work

· Such worker should be advised to get admitted to a designated hospital for treatment.

· If diagnosed with PHEIC, he/she should be advised not to report for work until full recovery

and/or the requisite time recommended in the national guidelines.

· Any Port worker who has been exposed to the PHEIC through a family member at home

should be advised not to report for work till the defined incubation period (as per national

guidelines) is over.

· If a Port worker develops PHEIC during the incubation period he/she should be advised to

get admitted to a designated hospital for treatment and not to report for work until full

recovery and/or the requisite time recommended in the national guidelines.

B) Departure Travellers

· PHMO should grant permission in writing to all person who embark or re-embark

· PHMO may request a valid vaccination certificate from the departing travellers.

· The PHMO may persuade the person to avoid travel or prohibit the embarkation on any Ship

based on the following:

a) if the person shows symptoms of any PHEIC or

b) If the person is a contact of a person showing symptoms of PHEIC

· If needed, the PHMO should request the person to undergo screening and/or other health

measures before departure.

· A certificate should be issued after the medical examination

· PHMO should ensure that all cruise liners departing from any Sri Lankan Port should take

certificate of health clearance from PHMO before departure.

Pa

rt B

40

· Vaccinations and/or prophylaxis for the departing travellers and the staff at the Port will

be decided by the designated medical team and as per the case management protocols

· PHMO should ensure that adequate PPE are available at the Port Health Office

· Specially equipped Ambulances should be identified from the adjacent hospitals for

immediate mobilization at a PHEIC.

· Director(Quarantine) will ensure that Medical Officers, Nursing Officers and Supportive

Staff identified from adjacent hospitals for attending to a PHEIC are trained in advance

· Stockpiling of vaccines and prophylactic drugs for a PHEIC will be done by the

Director(Quarantine) in consultation with the Chief Epidemiologist

06 Preparedness

07 Risk Communication

Communication of information pertaining to risks and prevention of PHEIC to the public will be

done only by the Focal points (spokespersons) already identified in the National Contingency

plan of PHEIC

Pa

rt B

41

Routine Procedures At Air Ports

Part CP

art

C

Pa

rt C01 Granting 'free pratique' to aircraft prior to arrival to the Air Port

· All relevant information given below should be received by the Air Port Medical Officer (APMO) from the Pilot in-command before the arrival of the Aircraft

· Pilot in-command shall inform through Air Traffic Controller/Airline Operating Agency to

the destination Airdrome Tower, which will inform APMO before the arrival of the Aircraft.

· Information should include the following:

a) Date and time of arrival of the Aircraft

b) Nature of the cargo -i.e animals, livestock, food items, food items of plant origin and

operations to be carried out in the Air Port

c) If the Aircraft touched any Air Port in the Yellow Fever Endemic Countries in the last 30

days (Annexure 1)-details of Port, Country, departure date should be given.

d) Crew and passenger list - including journey and personal particulars of embarked and

disembarking travellers, Yellow Fever Vaccination list, any traveller who has visited Yellow

Fever affected country during the last 6 days

e) Details of any death, case, suspect due to infectious diseases and/or PHEIC

f) Details of any stowaways on board as per IMO standard format

g) Details of any pet animals and their vaccination details

· APMO should use the checklist given for confirmation (Annexure 16)

Based on the information received, if the arrival of Aircraft is not likely to result in the introduction

or spread of disease, the APMO may grant Pratique prior to arrival

Not granting 'free pratique’

· Pilot-in-command of the aircraft who is unwilling to submit the information required by the

APMO as specified above should not be granted 'free pratique'

42

Special Note:

· Such aircraft should be allowed to depart immediately without being permitted to

communicate with the Air Port or with any other aircraft in the Air Port.

· Such Aircraft will be permitted to take on fuel, water and stores while in quarantine at the

designated place in the Air Port

· Any passengers in such a Aircraft, who desire to disembark with or without their baggage or to

tranship from the Aircraft, may be permitted to do so, on the condition that they agree

appropriate health measures required by the APMO

Pa

rt C

Figure 9 Process of granting ‘free Pratique’ to Air Crafts

43

On arrival to the Air Port, the Pilot-in-command of the Aircraft or the Agent should complete and

deliver the following information to the APMO and provide any further information required

regarding health conditions on board

a) A duly filled and signed Aircraft General Declaration form, with the Health Part filled by

the Pilot-in-command including

· If arriving from the regions listed by WHOwhether disinfected before landing

· If arriving from Yellow Fever affected countries -whether disinsected thereafter

b) Details of travellers who have visited Yellow Fever affected country during the last 6 days

c) Yellow Fever Vaccination Certificates

d) Details of occurrence of any death or case or suspect due to infectious disease and/or PHEIC

after the information provided to APMO prior to arrival to the Air Port.

e) Valid residual insecticide spray certificate

Cautions

a) Vector control measures

· Presence of vectors on board and the control measures used to eradicate them, should be

stated in the Health Part of the Aircraft General Declaration

· All Aircraft arriving from the regions listed by WHO are required to be disinfected before

landing at any Air Port, as per WHO recommended procedures and insecticides

· Aircraft coming from Yellow Fever affected countries as alerted by WHO are required to be

mandatory disinsected before arrival. The crew cabins, Deck, Pantry, Gallery and other

places in the Aircraft should be disinsected as per WHO recommended procedures and

insecticides

· The Aircraft shall not require disinsection, if the pilot-in-command certifies that the

Aircraft:

o Has not visited a Yellow Fever affected country during the last 30 days or

o Has visited a Yellow Fever affected country during the last 30 days but has been

disinsected thereafter or

o is not carrying on board any passenger who has visited Yellow Fever affected country

during the last 6 days or

o Has a valid residual insecticide spray certificate

On arrival of an Aircraft with 'free pratique' to the Air Port02

Pa

rt C

44

a) Imported animals (as pet) - prior approval from Director General of Department of Animal

Production and Health is needed before granting 'free pratique'. Health clearance is given by

the Quarantine Unit of Department of Animal Production and Health within the Air Port or

local Veterinary Surgeon (representative of the Director General of Department of Animal

Production and Health). Import of primates as pet from Yellow Fever Endemic areas or where

origin the primates cannot be ascertained, should not be permitted in to Sri Lanka

b) Imported food items (as cargo)-prior approval that the food items are fit for human

consumption is needed from the Director General of Health Services (DGHS) or a person

identified by or a focal point designated by the DGHS. Health clearance from Food and Drug

Inspectors (FDI) of the Food Control Administration Unit, Directorate for Environment &

Occupational Unit, Ministry of Health or the local Medical Officer of Health (MOH) or the

APPHI is needed for food items before granting 'free pratique'.

c) Food items of plant origin (e.g. kadala) Additional Health Clearance from the Plant

Quarantine Division of the Department of Agriculture is needed.

d) Travellers-History of Yellow Fever vaccination

· Any traveller has visited/transited through Yellow Fever affected countries as alerted by

WHO, having come to Sri Lanka within 6 days of departure and having a valid certificate of

vaccination against Yellow Fever (Annexure 3) should be allowed to enter the country

· Any traveller has visited/transited through Yellow Fever affected countries as alerted by

WHO, having come to Sri Lanka within 6 days of departure, but unable to produce a valid

certificate of vaccination against yellow fever, should be quarantined until the certificate

becomes valid, or until a period of not more than 6 days, calculated from the date of last

possible exposure to infection, has elapsed, whichever occurs first. Such traveller should be

transferred to Infectious Disease Hospital (IDH) or the local hospital identified for

Quarantine

· Any traveller coming to Sri Lanka, having an exemption from Yellow Fever vaccination,

signed by an authorized Medical Officer or an authorized health worker should not be

quarantined. He/she should be placed under surveillance and be informed by APMO to

report any fever/other symptoms immediately to APMO

e) Aircraft in transit at the Air Port - an aircraft not requiring any embarking and

disembarking of travellers or loading/discharging cargo and restricted to a particular area of

the Air Port, will be permitted to take on fuel, water, food and supplies under the supervision of

the APMO

Pa

rt C

45

Pa

rt CFigure 10 Process after granting ‘free pratique’ to Aircrafts

46

· APMO should advice the Air Port Aviation of Sri Lanak (AASL) to periodically monitor the

discharge from Aircrafts (sewage, refuse, and other potentially disease causing matter)

monthly using the checklist

· Inspections/taking samples should be done under the supervision of the APPHI

· Reports of such inspections should be received by the APMO and entered in the database of

the Air Port Health Office

Under the supervision of the APMO, the APPHI should oversee the sanitary condition of facilities

(food outlets, Aircraft catering services, water source, public washrooms and solid/liquid waste

disposal services) used by travellers/staff:

APPHI should:

a) Food hygiene

· Advice all food outlets within the Air Port premises, Aircraft catering services to be

registered with the Air Port Health Office

· Inspect the Aircraft catering services/Air Port kitchen/food outlets used by travellers or

staff within the Air Port premises periodically depending on the grading of the outlet in the

Food Act and send to MRI for analysis (Annexure 8)

· Two random food samples per month from the Aircraft catering services/Air Port

kitchen/food outlets in the premises should be taken as per the guidelines in the Food Act

(Annexure 9)

· If the food sold in outlets are supplied from outside, advice the suppliers to get the Food

Safety License from the local authority/MOH submit a copy to APMO.

· Should check such suppliers annually for the availability of a valid License.

· Food which is found to be unhygienic, adulterated and unsafe for human consumption

should be discarded as per the guidelines in the Food Act

Pa

rt CMonitoring the discharge by Aircrafts03

Supervising sanitary condition of facilities used by travellers and

staff of the Air Port04

47

· Any food outlets of the Air Port/Aircraft catering services or drinking water source found

unfit for the purpose should be ordered for closure as per the guidelines given in the Food

Act

· Two random samples per month from the drinking water source at the Air Port should be

sent to MRI for analysis as per the guidelines (Annexure 10)

· Inspect the public washrooms and solid/liquid waste disposal services within the Air Port

area monthly using the checklist

· Screen food handlers annually using the checklist

b) Water quality

· Obtain 2 random samples per month, from the drinking water source to the Ships and

staff at the Port (from points of use) as per the guidelines in the Food Act.

· Details of procedure for sample collection, transportation of samples, interpretation of

result and the format to be sent with the samples for bacteriological investigation are

given in Annexure 10

· Samples should be sent to the Medical Research Institute (MRI) or the closest Regional

Laboratory of the National water Supply & Drainage Board for microbiological, chemical

and residual chlorine analysis.

c) Public washrooms and solid/liquid waste disposal services

· Inspect the public washrooms and solid/liquid waste disposal services within the Air

Port area periodically as per the guidelines in the Food Act

Pa

rt C

48

Pa

rt CFigure 11 Process of supervising sanitary condition of facilities used by

travellers and staff

49

A) Among travellers

· Information regarding infectious diseases on board gathered from the Aircraft General

Declaration form should be entered in the data base at the Air Port Health Office by the

APPHI

· A weekly report on notifiable diseases on board should be sent to the Epidemiology Unit

and to the Director (Quarantine) by Saturday 12 noon by the APMO (refer Part D for a

PHEIC)

B) Among staff at the Air Port

APMO should coordinate with the AASL for ensuring surveillance of notifiable diseases among

staff at the Air Port as they could be a source of infection into or out of the country (refer Part D for

a PHEIC)

· APPHI should ensure that Standard Notification cards (form H544) are provided to the

MOIC/AASL Medical Centre, and information on notifiable diseases are entered in the

Notification Register

· APPHI should ensure that the dully filled form H544 are sent by the MOIC/AASL Medical

Centre, to the Medical officer of Health (MOH) of the area where the patient resides

· APMO should request the MOIC/AASL Medical Centre, to submit a weekly summary

regarding notifiable diseases among staff at the Air Port to the APMO

· This information should be entered in the data base at the Air Port Health Office

· A weekly report on notifiable diseases among staff at the Air Port should be sent to the

Epidemiology Unit and to the Director(Quarantine) Saturday 12 noon by the APMO

· Feedback received from the Epidemiology Unit (Weekly Epidemiological Report) should be

shared with the MOIC/AASL Medical Centre

Pa

rt CSurveillance of infectious/notifiable diseases among travellers and

staff at the Air Port05

50

Pa

rt CFigure 12 Process of surveillance of notifiable diseases among travellers and staff

51

Vectors may transport an infectious Agent from areas of the Air Port that are used for operations

involving travellers, conveyances, containers, cargo and postal parcels, into or out of the country. If

not properly controlled, vectors could board ships, breed and be carried overseas. Furthermore,

vectors on board can, in turn, spread disease to ports in other countries. The main categories of

vectors are: rats, mosquitoes, flies, cockroaches, ticks, mites, midges, fleas. More details about

major vector-borne disease, related pathogens and vectors are given (Annexure 11).

Vector control activities will prevent establishment of vector breeding reservoirs within the

premises of the Air Port.

· Under the supervision of the APMO, the APPHI should monitor the vector status within the

premises of the Air Port monthly as per the Prevention of Mosquito Breeding Act of Sri

Lanka

· The APMO should submit the report on vector status to the Ground Manager and advised on

the appropriate anti vector measurers to keep their premises free form vector of all types.

· APPHI should coordinate with the AASL to apply anti-mosquito measures within the

premises as well as for a distance of at least 400 meters around the perimeter of the Air Port

by AASL with the assistance of the local authority/Municipal Council

Pa

rt CVector control in the premises of the Air Port06

· APMO should coordinate with Officers of the Anti-Malaria Campaign, Department of

Immigration and other relevant organizations such as the International Organization for

Migration for ensuring that travellers to and from Malaria endemic countries are identified.

· APMO should coordinate with the Anti-Malaria Campaign and ensure the availability and

delivery of malarial prophylaxis for travellers (who seek such drugs) that are departing to,

or arriving from Malaria endemic countries.

· APMO should coordinate with the Anti-Malaria Campaign and support the voluntarily

Malaria Rapid Diagnostic Testing (RDT) for travellers from Malaria endemic countries, and

RDT screening for special groups such as returning irregular migrants.

· Results of the Malaria RDT screening should be entered in the data base at the Port Health

Office and notified to the Directorate of Quarantine and Anti-Malaria Campaign

Vaccination for Yellow Fever0307

Screening and Prophylaxis for Malaria0308

· Yellow Fever vaccination is provided to the departure travellers at the Assistant Port

Health Office, located at the Medical Research Institute, Colombo 08. A Certificate of

Yellow Fever vaccination is issued.

52

A) Death on Board

· In case of any death on board, the APMO will be informed by the pilot–in-command of the

Aircraft about the circumstances of the death and possible cause of death

· The APMO should board the Ship and take a statement from the pilot–in-command of the

Aircraft and crew members who attended to the illness

· After satisfying that the death is not due to any infectious disease or PHEIC, APMO will

permit removal of the dead body

· APMO should request the Air Cargo Manager of the Air Port not to release the body and to

arrange an inquest. Transporting the dead body to the JMO of the closest hospital for a post

mortem will be done in coordination with the relevant Police Station/Police Post within the

Airport by the Air Cargo Manager of the Air Port.

B) Bringing a dead body/human remains or ashes of cremated bodies

· The Pilot in-command of the Aircraft directly or through its Agent should inform at least 12

hours prior to importation of the dead body/human remains or ashes of cremated bodies to

the APMO.

· All dead bodies/human remains coming from foreign countries should provide the

following documents to the APMO for the health clearance:

a) Embalming certificate stating that the dead body/human remains have been embalmed

and placed in a hermetically sealed (airtight and water proof) casket.

b) Death certificate or a certified true copy with proper translation in English.

c) A certificate/endorsement by the conveyance operator that the casket contains the dead

body/human remains of the person whose documents are presented for clearance to the

APMO.

d) A certificate/endorsement of death from the Sri Lankan Diplomatic Representatives, at

the country of origin. Where there is no such representative, APMO may waive off the

requirement on the basis of accompanying documents.

· A dead body/human remains transported from abroad should be kept at a separate

designated place maintaining proper dignity to the corpse.

Pa

rt C

Monitoring the discharge by Aircrafts03 Death on Board or bringing human remains or ashes of cremated bodies09

53

· APMO should coordinate with the Anti-Malaria Campaign and support the voluntarily

Malaria Rapid Diagnostic Testing (RDT) for travellers from Malaria endemic countries, and

RDT screening for special groups such as returning irregular migrants.

· Results of the Malaria RDT screening should be entered in the data base at the Port Health

Office and notified to the Directorate of Quarantine and Anti-Malaria Campaign

The APMO should assess the following:

· In case where embalming is not undertaken (e.g. in cases of death due to drowning or severe

burns etc.) dead body/human remains should be packed in a hermetically sealed container.

· Un-embalmed dead body/human remains must have additional packing requirements

· If the dead body/human remains have been properly cremated, the cremated ashes need to be

placed in a hermitically sealed urn or a similar container.

· In case where a coffin has been exhumed and proved on examination to be intact, sound and

free from offensive odour, it should be enclosed in hermetically sealed zinc or tin-lined wooden

packing case filled with saw-dust impregnated with carbolic powder.

· In case where a coffin has been exhumed and is not intact and free from odour, its contents

should be.

· Package containing a dead body/human remains or ashes of cremated remains, which is in

transit through Sri Lanka, shall not be subjected to any restrictions if it has been packed and

sealed in the manner prescribed above or in a manner which, considered to be equally

satisfactory.

· The package containing dead body/human remains/ ashes of cremated bodies should not be

opened during its transit and should be in sound sealed condition at the time of arrival. It

should not be removed from the precincts of the Air Port until the APMO has permitted in

writing its removal.

Cautions:

· In cases of deaths due to communicable diseases not reported in Sri Lanka and having

public health risk e.g. viral hemorrhagic fevers (e.g. Lassa, Marburg, Ebola, Congo Crimean),

avian influenza and SARS or others not yet isolated/named, the APMO may restrict the

importation of the dead body/human remains

· APMO may permit the importation of such dead body/human remains with the approval of the

Director (Quarantine)

· Such dead body/human remains, when permitted to import should be cremated under the

supervision of APMO

Pa

rt C

54

Pa

rt CVictims of human trafficking and Returning Labour Migrant workers 10

55

·

report to the APMO as potential victims of abuse and/or trafficked victims are promptly

referred to the closest Judicial Medical Officer

· APMO should also notify such cases to the Help Desk of the Sri Lanka Bureau of Foreign Employment at the Air Port

· Information regarding referrals of such Migrant workers and the trafficked victims, including communicable diseases, should be entered in the data base at the Air Port Health Office and notified to the Directorate of Quarantine

APMO should coordinate with the Airport police and ensure that migrant workers who

Procedure for Responding to A Public Health Emergency of

International Concern (PHEIC) at Air Ports

Part DP

art

D

Pa

rt D

Surveillance of any PHEIC will be based on:

a) Pilot–in -command of the Aircraft through the Aircraft General Declaration form (self-

declared, detected by crew) or

b) from the staff of the Air Port through notifications sent by MOIC/AASL Medical Centre

· Such alerts should be verified by communicating with the Pilot–in -command of the Aircraft

/Air Traffic Controller/Airline Operating Agency or the MOIC/AASL Medical Centre,

· Communication with the Pilot–in -command of the Aircraft should be done through the

Ground Manager

2.1 A Human case/suspected case of having an illness of PHEIC on board

· The Pilot–in command of the Aircraft carrying a case/suspect of PHEIC before its arrival to

the Air Port will inform the APMO through the Air Traffic Control Unit about the

occurrence of such illness.

· The event will also be recorded on the Health Part of the Aircraft General Declaration

Special note

· Any Aircraft having an infected person, (live or dead), on board may be required to land at an

Air Port other than the Air Port of destination.

· The pilot-in-command of the Aircraft would communicate with the nearest Air Traffic

Controller and APHO without delay about the emergency landing.

· The Air Traffic Controller at the Airdrome Tower shall communicate with APMO and the

Ground Manager for the final decision

Surveillance01

Prompt risk assessment02

56

Pa

rt DFigure 13Procedure for assessing an Air Craft suspected of having a public health

emergency of international concern (PHEIC) at Air Port

57

· The APMO should request the Pilot–in command of the Aircraft to provide information needed

for the assessment of the case/suspect of PHEIC :

a) Aircraft configuration

b) Number of persons on board

c) Nature of the public health risk

d) Number of case/s or suspect/s on board

· From each case or suspect of PHEIC

a) Voluntary Health Declaration Form (when applicable)

b) Seat number

c) Travel itinerary

d) Vaccination history

e) History of prophylaxis

f) Destination in Sri Lanka (address) and contact details (telephone nos)

· Checklist for assessment of a human case/suspected case of having an illness of PHEIC on

board is given in Annexure 14

· The APMO, APPHI should visit the Aircraft immediately on arrival and before disembarkation,

· The APMO, APPHI should wear appropriate PPE and practice hand hygiene as per guidelines

given (Annexure 13)

A). Assessment of the case/suspect:

a) Assessment should be carried out at a space separate from other travellers

b) Case/suspect should be escorted from the aircraft to the designated area of the Air Port

c) Case/suspect should be requested to wear a mask unless he/she is unable to tolerate it.

d) Assessment will include interviews and non-invasive medical examinations.

e) Assessment will also include examination of baggage, cargo, provisions, water supply and

any part of the Air Craft which the APMO may consider as necessary

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58

B) Assessments of other travellers in the Aircraft

· If a need arises, other travellers e.g. family members, others in the travel group, those sitting

near to the case/suspect, or the entire aircraft should be assessed

· If contact tracing is considered necessary, the Passenger Locator Form (PLF) is given done for

those travellers seated in the same row and two rows in front and behind the index

case/suspect.

· Before the disembarkation, travellers on the same aircraft as the case, should also remain

segregated from other travellers in the Air Port until appropriate health measures are taken

· After assessment, the APMO should classify the Aircraft as infected (Affected), suspected or

healthy in accordance with special provisions relating to PHEIC

· Affected -If clinical signs and/or symptoms of a PHEIC and other evidence of a public health risk,

including sources of infection and contamination, are found on board, the APMO should consider

the Aircraft as affected (infected)

2.2 An animal affected/suspected of having an illness of PHEIC on board

Live animals (pet) are usually examined by the Quarantine Unit of Department of Animal Production

and Health within the Air Port.

· If the APMO is informed by the Pilot–in command of the Aircraft of an animal/s suspected of

having an illness of PHEIC on board or a death, the Quarantine Unit of Department of Animal

Production and Health within the Air Port should be notified immediately by the APMO as per

the National Contingency plan for a PHEIC

· APMO should receive the clearance of the Quarantine Unit of Department of Animal Production

and Health to grant permission to proceed

2.3 Cargo containing contaminated food or livestock on board

Cargo containing food items are usually inspected by the Food and Drug Inspectors (FDI) within the

Port who are functioning under the Director, Environment and Occupational Health Unit, Ministry of

Health or in their absence by the APPHI. Cargo containing livestock are inspected by the Officers of

the Quarantine Unit of Department of Animal Production and Health within the Air Port.

· If the APMO is informed about cargo containing suspected/contaminated food on board by the

Pilot–in command of the Aircraft, the FDI if present within the Air Port or in their absence the

Director (Environment and Occupational Health)of the Food Control Administration Unit,

Ministry of Health should be notified immediately by the APMO as per the National

Contingency plan for a PHEIC

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59

· If the APMO is informed about Cargo containing suspected/contaminated livestock by the

Pilot–in command of the Aircraft, the Director General of the Department of Animal Production

should be notified immediately by the APMO

· APMO should receive the clearance of the Director,(Environment and Occupational Health)

Unit, Ministry of Health or Qurantire of Department of Animal Production and Health to grant

permission to proceed

2.4 Cargo containing hazardous radioactive/nuclear material on board

· If the APMO is informed about cargo containing hazardous radioactive/nuclear material on

board by the Pilot–in command of the Aircraft, the Chairman of the Atomic Energy Authority

should be notified immediately by the APMO as per the National Contingency plan for a PHEIC

· APMO should receive the clearance of the focal point appointed by the Chairman of the Atomic

Energy Authority to grant permission to proceed

2.5 Cargo containing hazardous chemical material on board

· If the APMO is informed about cargo containing hazardous chemical material on board by the

Pilot–in command of the Aircraft, the Chairman, Central Environment Authority should be

notified immediately by the APMO as per the National Contingency plan for a PHEIC and the

National Civil Aviation Public Health Emergency Preparedness Plan.

· APMO should receive the clearance of the focal point appointed by the Chairman, Central

Environment Authority to grant permission to proceed

2.6 Aircrafts affected/suspect of having a PHEIC

· If found affected or suspected of PHEIC, the Ground Manager should be communicated

immediately over the phone by the APMO

· APMO should advice the Ground Manager and the Pilot-in-command of the Aircraft that the

Aircraft is not allowed to enter the usual parking areas or communication or contact with the

Air Port or with any other Aircraft in the Air Port until authorized to do so by the APMO, except

for navigational reasons.

· The Pilot-in-command of the Aircraft should be advised by the APMO to park at the designated

point of the Air Port as per the National Civil Aviation Public Health Emergency Preparedness

Plan by coordinating with the Ground Manager

· The APMO should advice the Pilot-in-command that embarkation, disembarkation, loading,

unloading and discharge of cargo could not be done from the Aircraft until appropriate health

measures have been taken unless required for emergency purposes

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60

· If the Aircraft is in transit, it would be restricted to a particular area of the Air Port and no

embarkation, disembarkation, loading, unloading and discharge should be allowed: under the

supervision of the APHO, the Aircraft will be permitted to take on fuel, water, food and

medication.

· If found Healthy, the Pilot-in-command of the Aircraft is granted permission by the APMO to

bring the Aircraft to proceed to the Air Port

Special Note

· Such Aircraft shall not be refused 'free pratique' for public health reasons and should not be

prevented from taking on fuel, water, food and supplies

· The APMO, for navigational reasons, may permit such Aircraft to come to a specially designated

area in the Air Port, where strict vigilance is maintained and enforced to prevent any

communication or contact with the Air Port or with any other Aircraft in the Air Port.

· The APMO, for navigational reasons, may give written permission to take a vehicle to the Aircraft

with ground staff who can only board or leave such Aircraft

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61

Pa

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62

· APMO should immediately communicate over the telephone about the unexpected PHEIC

and/or any other infectious disease to Director (Quarantine)

· APMO should also communicate over the phone the immediate public health measures

taken

· According to the National Contingency plan for a PHEIC, Director (Quarantine) should

notify:

a) The Rapid Response Teams (RRT) of the Air Port

b) Contact points of other points of entry

c) Director General of Health Services

d) Relevant public health and other agencies e.g.

o Contaminated food -Director, (Environment and Occupational Health) Unit, Ministry

of Health

o Animals affected/suspected and contaminated livestock - Director General of

Department of Animal Production and Health

o Hazardous radioactive/nuclear material - Chairman, Atomic Energy Authority

o Hazardous chemical material- Chairman, Central Environment Authority

o Disaster Management Centre, Ministry of Disaster Management

o Disaster Preparedness and Response Division, Ministry of Health

· The deactivation/scaling down of health measures will also be initiated by the Director

(Quarantine)

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Rapid Detection04

In a situation of PHEIC, based on the IHR recommendations:

· IHR National Focal Point (NFP) may decide on installation and/or activation of thermal

scanners at pre-designated screening stations to detect patients with fever.

· NFP may also decide to advise the potential travellers through the media that departure

screening will be carried out upon arrival at the Air Port and that travellers with symptoms

or those arriving from a declared infected site may not be allowed to enter the Air Port. 63

· NFP may also decide to request the departing passengers to fill in a Health Declaration Form

(HDF) (Annexure 12) which will have a checklist of symptoms and the location/s identified

as outbreak or affected areas.

Special Note

· Check‐in staff will be trained by the APMO to identify travellers who may have a PHEIC based

on the HDF

· AASL will provide the PPE to both screening staff and travellers suspected of having a

communicable disease (either because of symptoms or close contact with a potentially

infectious traveller) during the temperature screening and subsequent secondary

interview/examination.

· AASL will inform the relevant agencies e.g. Immigration, Customs, ground handling agents,

Air Port police about the activation of thermal scanners/HDF.

In case of activation of thermal scanning/requesting a HDF:

· APMO should coordinate with the Ground Manager for the installation and/or activation of

thermal scanners at pre-designated locations

· APMO should coordinate with the Ground Manager to assign check-in staff to the thermal

scanners and/HDF

· Personal protective equipment (PPE) and practice hand hygiene recommended for staff

assigned to the thermal scanners/HDF is given (Annexure 13)

· Travelers detected by the thermal scanners/HDF will be interviewed and/or examined

by the APMO at the pre-designated location prior to completion of the check‐in

· Upon screening, if APMO detects an affected/suspected traveller, such case should be

immediately notified (please refer section 2.4.) and should be managed as detailed in

section 2.5

· Details of travelers detected by the thermal scanners/HDF and sent for secondary

screening by APMO should be entered in the database of the Air Port Health Office and

shared with the MOIC/AASL Medical Centre for further reference

· Details should include (Annexure 17):

o Personal identification

o Seat number

o Aircraft number

o Travel itinerary

o Vaccination history

o History of prophylaxis

o Destination in Sri Lanka (address) and contact details (telephone nos)

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64

The APMO should implement additional health measures as decided by the NIHR Focal Points-

Director (Quarantine) and the Epidemiology Unit to prevent and control public health risk

during PHEIC.

5.1 Disembarked travellers: affected, suspected or under surveillance

Affected or suspected travellers should be transferred immediately to IDH or the designated

hospital (depending on the location of the point of entry) the which has diagnostic facilities,

adequate staff, equipment and premises to allow further assessment and care, isolation,

quarantine, and other support services

· The APMO should communicate with the affected or suspected travellers (or parent or

guardian) in a language that they can understand

· He/she should be informed that appropriate medical treatment as well as basic needs,

protection for baggage and possessions and other appropriate assistance during

quarantine or isolation at the hospital will be provided

· Affected or suspected travellers (or parent or guardian) should be informed of any risk

associated with vaccination/with non-vaccination and with the use/non-use of

prophylaxis.

· Written informed consent should be obtained from affected or suspected travellers (or

parent or guardian) for any medical examination, vaccination, prophylaxis or health

measure

· If consent is not given, the traveller/s will be managed under the authority given by the

Quarantine Act

· Director of IDH or the designated hospital (depending on the location of the point of entry)

should be communicated immediately over the phone about the transfer of the affected or

suspected travellers.

Special Note

· According to the National Contingency plan for a PHEIC, coordinator for additional

ambulances, staff and equipment will be done through the Disaster Preparedness and

Response Division , Ministry of Health.

· Till the ambulances are brought to the Port, the cases/suspect will be kept in the isolation

room within the Air Port Health Office.

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65

Pa

rt DFigure 15 Procedure for disembarked travellers, animals and cargo

66

· Transfer of affected or suspected travellers who may carry infection or contamination,

should be done under the supervision of the APMO:

a) In ambulance/s with specially designated equipment

b) According to international Infection prevention and control safety guidelines

c) By staff (Medical Officers, Nursing Officers, supportive staff) specially trained to the

transfer of such persons

d) By staff wearing appropriate personal protection (Annexure 13)

A) Affected travellers

· Further examinations, investigations and confirmation of diagnosis will be done at IDH or

the designated hospital. Specimen collection, storage, transportation to the designated

laboratory service/MRI will be done at the IDH or the designated hospital as per the

National Guidelines.

· Treatment of affected traveller will be done by the designated medical team (e.g. physician,

paediatrician, epidemiologist) and as per the case management protocols adhering to

international safety guidelines and standards.

B) Suspected travellers

· Suspected travellers will be quarantined at IDH or the designated hospital, if incubation

period is known, for a period not exceeding the incubation period of the PHEIC to which they

have been exposed. The period will be calculated from the time of the last exposure to

infection by the designated medical team.

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as per

the case management protocols. If such person develops symptoms and/or signs during the

incubation period and later confirmed as a case, the person will be managed as in section A

C) Travellers under surveillance

· Persons who have been exposed to infection but allowed to disembark, will be placed under

surveillance for a period not exceeding the incubation period of the PHEIC to which they

have been exposed.

· Such person should be issued a card by the APMO with clear written instructions for the

duration of surveillance and contact details of the APMO

· Contact details of persons placed under surveillance should be entered in the database of

the Port Health Office by the APPHI

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67

· The APMO should request the person to report to him, if necessary, at specified intervals

during the period of surveillance as noted in the card issued to him/her

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as per

the case management protocols.

· The Medical Officer of Health (MOH) of the area, where the persons intends to stay during

the period under surveillance should be informed over the phone/fax/e mail about such

person/s

· Such person may be permitted to move about freely

· The APMO may also request medical investigation and make any inquiries which are

necessary for ascertaining his/her state of health.

· If such person develops symptoms and/or signs during the incubation period, he/she

should be advised to get admitted to the nearest designated hospital as per the National

Contingency plan for a PHEIC. When confirmed as a case, the person will be managed as in

section A

· Such persons should be advised to inform the APMO if he/she plans to depart for another

place in Sri Lanka

· In such a situation, the APMO should immediately inform the MOH of the place to which the

person is proceeding and request the MOH to apply the health measures as per the National

Guidelines/circulars issued

· The person under surveillance should be advised to report to the MOH on arrival to that

place and this information should be updated in the database of the Air Port Health Office by

the APPHI

Information on the status of affected travellers, suspected travellers and travellers under

surveillance should be traced by the APMO and updates in the database.

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68

5.2 Death on board or human remains brought due to a suspected/confirmed illness of

PHEIC

A) Death on board

In addition to the routine procedures stated in section 9, the additional health measures should be

applied as per the National Guidelines/circulars issued

B) Dead body or Human remains brought

In addition to the routine procedures stated in section 9, the additional health measures should be

applied as per the National Guidelines/circulars issued

· Prior approval of the APHO is needed to bring a human dead body or remains of persons who

may have died of PHEIC or Yellow Fever

· If the death was due to chemical/radiation/nuclear hazard or a food related event, the

package containing dead body/human remains/ashes of cremated bodies should not be

opened during its transit and should be in sound sealed condition at the time of arrival.

· Written permission from APMO is needed for the removal of Dead body/human

remains/ashes of cremated bodies from the precincts of the Air Port

5.3 Affected or suspect animals or cargo with food items or radioactive/nuclear material or

chemical material

a) Animal/s suspected of having an illness of PHEIC on board

· Assessment, isolation, treatment and other services would be decided by the Quarantine

Unit within the Port in consultation with the Department of Animal Production and Health.

b) Cargos containing contaminated food or livestock on board

· Seizure and destruction of goods affected would be decided by the Food and Drug

inspectors of the Port in consultation with the Director, Environment & Occupational

Health, Ministry of Health

Note: laboratory samples, Blood, blood products and lifesaving medicines will be spared from

this inspection.

· Seizure and destruction of goods affected would be decided by the Quarantine Unit within

the Port in consultation with the Department of Animal Production and Health

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69

c) Cargo containing hazardous radioactive/nuclear material on board

·

and destruction of goods affected would be decided by the Atomic Energy Authority

d) Cargos containing hazardous chemical material on board

· Assessment, isolation, treatment of and other support services for persons, and seizure

and destruction of goods affected would be decided by the Central Environment

Authority

APMO should coordinate with the AASL and the relevant officers within the Air Port to ensure

prevention of introduction of PHEIC to the country

APMO should communicate with the Director/Quarantine regarding the control measures taken

5.4 Additional sanitary measures for the travellers who continue the voyage, Aircrafts and

premises of the Air Port

A) Travellers who continue the international voyage

· The APMO may allow a traveller, placed under surveillance, to continue the voyage if

measures to safeguard the health of other travellers are assured.

· However if there is evidence of an impending public health risk, the APMO may request

such traveler to undergo additional health measures to control this risk.

· Vaccinations and/or prophylaxis will be decided by the designated medical team and as

per the case management protocols

· The APMO should communicate to the next Port of call

· The APMO may allow a traveller placed under isolation, (in exceptional circumstances),

to continue the voyage before the expiry of the isolation period, provided measures to

safeguard the health of other travellers are assured

Assessment, isolation, treatment of and other support services for persons, and seizure

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70

Pa

rt DFigure 16Additional sanitary measures for the travellers who continue the voyage,

Aircrafts and premises of the Airport

71

B). Disposable materials in contact/potential contact with the case/suspect

Under the supervision of the APPHI, all disposable materials in contact/potential contact

with the case/suspect should be removed according to the international Infection

prevention and control safety guidelines

C). Baggage, cargo, containers, conveyances, goods or postal parcels arriving in an

Aircraft with persons suspected/confirmed as having an illness of PHEIC

Baggage, cargo, containers, conveyances, goods or postal parcels arriving in an Aircraft with

persons suspected/confirmed as having an illness of PHEIC may have been contaminated by

infection or may serve as a source of vector and reservoir

a) APMO should advice the Ground Manager, Pilot-in-command of the Aircraft and the

Agent/Cargo handler that baggage, cargo, containers, conveyances, goods or postal

parcels which may be contaminated should be disinsected, derated, disinfected,

decontaminated or treated as per the WHO recommendation

b) This should be done by the Agent at a location specially designated in the Air Port and

equipment designated for this purpose and under the supervision of the APPHI

c) APMO may prevent loading or unloading of cargo till the procedures are completed.

d) Once the recommended procedures are completed satisfactorily, a certificate will be

issued by the APMO

e) Only the affected/suspected Ships with the certificate issued by the APMO will be

allowed to leave the Air Port

D). Areas within the Aircraft and the premises of the Air Port

a) APMO should advice the Ground Manager, and Pilot-in-command of the Aircraft that

areas within the Aircraft and the premises of the Air Port which may be contaminated by

persons suspected/confirmed as having an illness of PHEIC should be disinfected or

decontaminated as per the WHO recommendation to prevent the spread of the infection

or contamination

b) This should be done by the AASL or the Agent under the supervision of the APPHI

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72

E). Aircrafts Ships arriving from affected areas

a) The APMO may re-apply health measures for baggage, cargo, containers, conveyances,

goods, postal parcels and human remains arriving from an affected area, if there are

verifiable indications and/or evidence that the measures applied on departure from the

affected area were unsuccessful

Special note

An Aircraft that has been considered as affected will cease to regard as affected when the APMO is

satisfied that the recommended measures have been effectively carried out and there are no

conditions on board that could constitute a public health risk.

5.5 Disposal of any contaminated water or food, human or animal dejecta, waste water

and any other contaminated matter from an Aircraft suspected/confirmed as having a

PHEIC

· APMO should advice the Ground Manager, and Pilot-in-command of the Aircraft thatany

contaminated water or food, human or animal dejecta, waste water, sewage, refuse, ballast

water and contaminated matter from an aircraft suspected/confirmed as having a PHEIC

which might contaminate the waters of the Air Port should be removed and disposed safely

· Under the supervision of the APMO, the APPHI should coordinate with the AASL and make

sure that such contaminated matter are removed and disposed by a pre-designated method

Special note

· An Aircraft that has been considered as affected will cease to regard as affected when the

APMO is satisfied that the recommended measures have been effectively carried out and there

are no conditions on board that could constitute a public health risk.

5.6 Applying entry controls during PHEIC

· The APMO may apply entry controls for arriving travellers after assessing the following:

a) Travel itinerary

b) Certificates of vaccination or prophylaxis

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Caution

· The APMO should not deny entry to a traveller who has a valid certificate of vaccinations or

prophylaxis, even if coming from an affected area, unless APMO has verifiable evidence that

the vaccination or other prophylaxis was ineffective

5.7 A case/suspected case of any PHEIC within the country or among staff at the Air Port

In a situation of a PHEIC arising within Sri Lanka, measures should be taken to prevent it from

spreading out of the country through the Air Ports.

· Staff affected

a) All Air Port workers should be advised to take their temperature before leaving home for

work.

0b) Any Air Port worker with fever (temperature of 37.5 C and above, or as per national

guidelines) and/or specified symptoms should be advised not report for work

c) Such worker should be advised to get admitted to a designated hospital for treatment.

d) If diagnosed with PHEIC, he/she should be advised not to report for work until full

recovery and/or the requisite time recommended in the national guidelines.

e) Any Air Port worker who has been exposed to the PHEIC through a family member at

home should be advised not to report for work till the defined incubation period (as per

national guidelines) is over.

f) If an Air Port worker develops PHEIC during the incubation period he/she should be

advised to get admitted to a designated hospital for treatment and not to report for work

until full recovery and/or the requisite time recommended in the national guidelines.

g) Air Port workers entering the transit area should be advised to get temperature 0screening prior to entry. Those with fever (temperature of 37.5 C and above, or as per

national guidelines) will proceed to see their doctor and treated; if required,

hospitalization at the designated hospital will be instituted.

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74

· Departure Travellers

a) APMO should grant permission in writing to all person who embark or re-embark

b) APMO may request a valid vaccination certificate from the departing travellers.

measures to the travellers, baggage, cargo, containers, Aircraft/conveyances, facilities,

goods and postal parcels appropriate for the PHEIC.

c) APMO may persuade the person to avoid travel or prohibit the embarkation on any Ship

based on the following:

o if the person shows symptoms of any PHEIC or

o If the person is a contact of a person showing symptoms of PHEIC

a) If needed, the APMO should request the person to undergo screening and/or other

health measures before departure.

b) A certificate should be issued after the medical examination

c) Vaccinations and/or prophylaxis for the departing travellers and the staff at the Air Port

will be decided by the designated medical team and as per the case management

protocols

d) A person in transit on an international flight, who is under surveillance, may be allowed

to continue his journey. In such a situation, the APMO should make a note in the Log Book

and inform the APMO of the next Air Port of call regarding this

e) The APMO should request the Pilot-in-command of the Aircraft to apply health measures

to the travellers, baggage, cargo, containers, Aircraft/conveyances, facilities, goods and

postal parcels appropriate for the PHEIC.

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75

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76

Risk Communication07

Communication of information pertaining to risks and prevention of PHEIC to the public will be

done by the Focal points (spokespersons) already identified in the contingency plan of PHEIC

Preparedness06

· APMO should ensure that adequate PPE are available at the Air Port Health Office

· Specially equipped Ambulances should be identified from the adjacent hospitals for

immediate mobilization at a PHEIC.

· Director/Quarantine will ensure that Medical Officers, Nursing Officers and Supportive

Staff identified from adjacent hospitals for attending to a PHEIC are trained in advance

· Stockpiling of vaccines and prophylactic drugs for a PHEIC will be done by the

Director/Quarantine in consultation with the Chief Epidemiologist

· A Drill will be organized by the Director/Quarantine periodically

Surveillance1 Yellow Fever Endemic CountriesAnnexure 1

78

AFRICA CENTRAL AND SOUTH AMERICA

Angola

Benin

Burkina Faso

Burundi

Cameroon

Central African Republic

Chad

Congo,

Republic of the Côte d’Ivoire

Democratic Republic of the Congo

Equatorial Guinea

Ethiopia

Gabon

Gambia

Ghana

Guinea

Guinea-Bissau

Kenya

Liberia

Mali

Mauritania

Niger

Nigeria

Rwanda

Senegal

Sierra Leone

Sudan

South Sudan

Togo

Uganda

Argentina

Bolivia

Brazil

Colombia

Ecuador

French Guiana

Guyana

Panama

Paraguay

Peru

Suriname

Trinidad and Tobago

Venezuela

Surveillance1 Checklist for granting ''free pratique'' to ShipsAnnexure 2

79

CHECKLIST FOR GRANTING 'FREE PRATIQUE' TO SHIPS

Name of ship or inland

navigation vessel

Registration/IMO No arriving from sailing to

Date of arrival Time of arrival

Nature of

cargo

animals livestock food items food items of plant

origin

Operations to be carried out in the Port

Whether pet animals on-board? Yes /No

Are the vaccination details of pet animals available? Yes /No

(please check the list)

Valid Sanitation Control Exemption/Control Certificate

carried on board? Yes /No

Issued at date

Re-inspection required? Yes /No

Has ship/vessel visited Yellow Fever affected area identified by the World Health Organization ?

Yes /No

Port date of visit

List ports of call from commencement of voyage, or within past 30 days, whichever is shorter:

(1) Port (1) Departure date

(2) Port (2) Departure date

(3) Port (3) Departure date

Number of crew members on board

List available (details of Journey and personal particulars included)? Yes/No

Number of passengers on board

List available (details of Journey and personal particulars included)? Yes/No

Are there any stowaways on board? Yes /No

If yes please give details

Are there any deaths, cases, suspect due to infectious diseases and/or PHEIC on board?

Yes /No

If yes please give details

Surveillance1 Certificate of vaccination against Yellow FeverAnnexure 3

80

Surveillance1 Maritime Declaration of Health formAnnexure 4

81

To be completed and submitted to the competent authorities by the masters of ships arriving from

foreign ports.

MARITIME DECLARATION OF HEALTH

Submitted at the port of Date

Name of ship or inland

navigation vessel

Registration/IMO No arriving from sailing to

(Nationality)(Flag of vessel) Master’s name

Gross tonnage (ship)

Tonnage (inland navigation vessel)

Valid Sanitation Control Exemption/Control Certificate

carried on board? Yes /No

Issued at date

Re-inspection required? Yes /No

Has ship/vessel visited an affected area identified by the World Health Organization?

Yes /No

Port date of visit

List ports of call from commencement of voyage with dates of departure, or within past thirty days,

whichever is shorter:

Upon request of the competent authority at the port of arrival, list crew members, passengers or

other persons who have joined ship/vessel since international voyage began or within past 30 days,

whichever is shorter, including all ports/countries visited in this period (add additional names to

the attached schedule):

(1) Name joined from: (1) (2) (3)

(2) Name joined from: (1) (2) (3)

(3) Name joined from: (1) (2) (3)

Number of crew members on board

Number of passengers on board

82

Health questions

(1) Has any person died on board during the voyage otherwise than as a result of accident? Yes/No

If yes, state particulars in attached schedule. Total no. of deaths

(2) Is there on board or has there been during the international voyage any case of disease which

you suspect to be of an infectious nature? Yes /No

If yes, state particulars in attached schedule.

(3) Has the total number of ill passengers during the voyage been greater than normal/expected?

Yes /No

How many ill persons?

(4) Is there any ill person on board now? Yes /No

If yes, state particulars in attached schedule

(5) Was a medical practitioner consulted? Yes /No

If yes, state particulars of medical treatment or advice provided in attached schedule

(6) Are you aware of any condition on board which may lead to infection or spread of disease?

Yes /No

If yes, state particulars in attached schedule.

(7) Has any sanitary measure (e.g. quarantine, isolation, disinfection or decontamination) been

applied on board? Yes /No

If yes, specify, type place date

(8) Have any stowaways been found on board? Yes /No

If yes, where did they join the ship (if known)?

(9) Is there a sick animal or pet on board? Yes /No

Note: In the absence of a surgeon, the master should regard the following symptoms as grounds for

suspecting the existence of a disease of an infectious nature:

(a) fever, persisting for several days or accompanied by (i) prostration; (ii) decreased

consciousness; (iii) glandular swelling; (iv) jaundice; (v) cough or shortness of breath; (vi) unusual

bleeding; or (vii) paralysis.

(b) with or without fever: (i) any acute skin rash or eruption; (ii) severe vomiting (other than sea

sickness); (iii) severe diarrhoea; or (iv) recurrent convulsions.

I hereby declare that the particulars and answers to the questions given in this Declaration of

Health (including the schedule)are true and correct to the best of my knowledge and belief.

Signed Countersigned

Master Ship’s Surgeon (if carried)

Date

83

ATTACHMENT TO MARITIME DECLARATION OF HEALTH

Name Class or

rating

Age Sex Nation

ality

Port,

date

joined

ship/ves

sel

Nature

of

illness

Date of

onset of

symptoms

Reported to

a port

medical

officer?

Disposal

of case

Drugs, medicines

or other

treatment given

to patient

Comments

Beginning with the 1951 IHR, the Deratting Certificate/Deratting Exemption Certificate was a

required document for the international public health control of ships visiting international ports.

The Deratting Certificate helped to reduce the international spread of rodent-borne diseases,

especially plague. In the IHR (2005), the Deratting Certificate/Deratting Exemption Certificate

was replaced by the much broader ship sanitation certificates (SSCs) and was no longer valid after

2007.

SSCC provide internationally recognized documentation regarding the sanitary conditions of a

ship, while reducing the need for further and more frequent inspections of the ship during the

period for which the certificate is valid (but with options for additional inspections under certain

limited circumstances).

On 23 May 2005, the Fifty-eighth World Health Assembly adopted the International Health

Regulations (IHR) (2005), and the Deratting Certificate/Deratting Exemption Certificate

required by the IHR (1969) was replaced by the broader-scope ship sanitation certificates

(SSCs), which came into force on 15 June 2007The IHR (2005) states that parties can authorize

certain ports to issue the SSCs and their extensions, as well as to provide the services referred to in

Annex 1 of the regulations. The authorized ports should have, among other capacities, trained

personnel available to board a ship and to identify any significant risk to public health, as well as to

take control measures.

1Issuing Ship Sanitation Control Exemption Certificate/

Ship Sanitation Control CertificateAnnexure 5

84

85

1 (a) Evidence of infection or contamination including: vectors in all stages of growth, animal reservoirs for

vectors, rodents or other species that could carry human disease; microbiological, chemical and other risks

to human health; signs of inadequate sanitary measures. (b) Information concerning any human cases (to

be included in the maritime declaration of health)

2 Results from samples taken on board. Analysis to be provided to Ships master by most expedient means

and if re-inspection is required to the next appropriate port of call coinciding with re-inspection date

specified in this certificate.

SHIP SANITATION CONTROL EXEMPTION CERTIFICATE AND SHIP SANITATION CONTROL CERTIFICATE

Port Date

This certificates records the Inspection and 1) exemption from control and 2) control measures applied

Name of the ship Flag Registration/IMO NO

At the time of inspection the holds were unladen/laden with…………….tonnes of…………………….cargo

Name of Inspecting Officer

Signature of Inspecting Officer

Ship Sanitation Control Exemption Certificate

Ship Sanitation Control Certificate

Areas (systems

and service)

inspected

Evidence

found1

Sample

results2

Documents

reviewed

Control measures

applied

Re-

inspection

date

Comments

regarding

conditions

founds

Gallery Medical Log

Pantry Ships Log

Stove Other

Hold(s) /Cargo

Quarters

· Crew

· Officers

· Passengers

· Deck

Portable water

Sewage

Ballast Tanks

Solid and

Medical waste

Standing water

Engine room

Medical facilities

Other areas

specified

(attached)

Areas not

applicable (mark

N/A)

No evidence found. Ship/vessel is exempted from control

measures

Control measures indicated were applied on the

date indicated below

Name and designation of issuing officer Signature and stamp Date

· Clean areas should be inspected first, followed by technical areas. This sequence enables the

inspectors to avoid cross-contamination.

· In some critical areas like galleys, inspectors should demonstrate good hygiene practice by

wearing clean disposable clothing (e.g. aprons, gloves, hair covering).

Area Rationale

Inside accommodation Quarters Start at the top of the accom-

modation

Galley, pantry and service

areas

Potentially more clean than

pantry

Pantry Potentially more clean than

stores

Stores Close to galley and pantry

Child-care facilities Usually more dirty than food

areas

Medical facilities After food areas to avoid cross-

contamination

Swimming pools, spas and

saunas

Sometimes inside, sometimes

on deck

Other areas and systems Washing, laundry usually

cleaner than waste

Waste (solid and medical) Most dirty area in accommo-

dation, sometimes on deck

Inside engine room Engine room Overview

Potable water Most parts in the engine room

Sewage Most parts in the engine room

Ballast tanks Access from the engine room,

through the pipe duct, from

open deck or cargo

compartments

Outside Cargo holds Outside

Standing water On deck

1 Sequence of Inspection Areas Annexure 6

86

Evidence

found

Sample

results

Documents

reviewed

Control

measures

applied

Re-

inspection

date

Comments

regarding

conditions

found

Food

• Source

• Storage

• Preparation

• Service

Water

• Source

• Storage

• Distribution

Waste

• Holding

• Treatment

• Disposal

Swimming

pools/spas

• Equipment

• Operation

Medical facilities

• Equipment and

medical devices

• Operation

• Medicines

Other areas

inspected

1Checklist for Inspection of Ships and Issuance of Ship Sanitation Control

Exemption Certificate/ Ship Sanitation Control CertificateAnnexure 7

87

88

1 Inspection of the kitchen/food outlets/catering servicesAnnexure 8

Inspection Rating form H- 800

· PHI should complete two sets of forms, during the first inspection.

· One copy should be handed over to the trader to be kept in the food-handling

establishment file.

· All food handling establishments should be advised to maintain a separate file for Health

800 form.

· The progress of the establishment should be evaluated periodically using Health 800 form

· The findings of the subsequent inspections should be entered in the space provided in

reverse of the form.

· Marks are given to the factors numbered as 1-10 in Health 800, and rating is done

accordingly.

· For each main factor, marks ranging from 0 -10 should be given.

7 - 10 marks A-Satisfactory

4 - 6 marks B-Average

0 - 3 marks C-Unsatisfactory

a. Maintain A grade establishments in satisfactory conditions, inspection should be

carried out least once in six months or as judged by the PHI

b. B grade establishments should be upgraded to A grade, gradually, inspection should

be carried out least once in three months or as judged by the PHI

c. C grade should be upgraded to B or A grade establishments gradually, inspection

should be carried out least once a month or as judged by the PHI

89

FOOD HANDLING TRADES – INSPECTION RATING FORM

Name and address of trade P.H.I. Reference No:-

Number of employers Approval of local authority: Yes/ No

Name of the owner (Building)

Name of the owner (trade)

Type of Trade: Factory/Bakery/Hotel/Snack Bar/ Tea and Coffee kiosks /Grocery / Others : -

Rating scale A Satisfactory 7-10 B Fair 4-6 C Unsatisfactory 0-3

Factor Rating scale Mark

1. Location & Environment Free from pollution, objectionable odours and

animals (flies, cockroaches, ants, dogs, cats, rats, etc. )

2. Building Sound construction, adequate working space, light and

ventilation, maintained in good repair.

3. Processing room General cleanliness, walls, floor, ceiling, doors and

windows possible sources of contamination and deterioration.

4. Equipment & Furniture Cleanliness, maintenance, resistant to corrosion

5. Storage of Goods Protection from contamination and infestation

satisfactory perishable items kept refrigerated suitably, adequate space

for ventilation.

6. Water supply Satisfactory source, an ample supply of water, storage

facilities

7. Waste Control Collection, storage and disposal of solid waste, adequate

toilet facilities ( number and condition )

8. Food Items Appearance, exposure, packaging, expiry dates, labelling,

spoilt food items etc.

9. Health status of Food handlers Personal hygiene, clean working clothes,

caps, masks etc. Medically examined within past one year

10. Training received by food handlers

Total (A = 70 – 100 %, B = 31 – 69 %, C= 0 – 30 %)

Name and Designation of the inspecting officer

Name of seller / Owner:

Signature of the inspecting officer

Signature of seller / Owner

Date Date

90

000

· The assistance of another officer, preferably a PHI should be obtained in all cases of formal

sampling to provide corroborative evidence. Informal sampling may be done individually as

no prosecution is involved.

· Inspect the shop without disturbing other transactions.

· Ordering and payment should be preferably done by the officer in whose area the sampling is

being done. Ask for what you intend sampling & the quantity required. Pay the shop keeper the

market value of food you purchased for examination or analysis. Write the note book on the

spot accurately in detail.

· Shop keeper should be immediately notified that the Article purchased is to be analyzed by the

Approved Analyst.

· Original containers & wrappers should be retained for use in case of prosecution.

· Wherever possible, divide the sample in to requisite three parts. Certain foods require special

attention.

· Milk- Contents of bottles should be poured into a container and should be shaken well.

Transfer the contents in to another container. This process should be done three times. Let the

vendor examine the sample bottles before filling the bottles with the help of a funnel. Add two

drops of formalin and shake the bottles before sealing.

· Butter- No papers to be used. Place samples in wide - mouthed bottles without pressure being

exerted in order that water content does not exude.

· Ghee- If purchased in a large bottle, obtain the samples with the help of a clean equipment. Do

not hit.

· Powders- If purchased in packets of same, make open the packets and put the contents into a

bowl and mix thoroughly before division. Put the empty packets in an envelope and seal. May

obtain the signature of the seller.

· Oils- Sample in bottles; do not use polythene packs.

Sealing of samples

This should be done in good faith. There should be transparency. Mixing, division and sealing

should be carried out in full view of the person from whom the sample was purchased. He may be

allowed to verify the identity of labels attached to the portion of the samples. He may be permitted

to affix his seal or place the thumb impression on all three parts. The PHI shall identify the three

parts as the sample, duplicate and the owner's portion. The part identified as the samples shall be

forwarded to the approved analyst for analysis together with the memorandum set out in the

schedule hereto. If the sample is sent under registered cover the slip issued by the Post Office must

be kept safely. The receipt issued by the shop keeper or the vendor has to be in safe custody. Include

the details of sampling in the food analysis register. Act promptly as soon as the report is received

1 Guidelines for taking food samples from the kitchen/food outlets/

catering servicesAnnexure 9

91

Water Quality surveillance -include testing for microbiological, chemical and residual chlorine

1. Testing for residual free chlorine-use the Comparators and reagents provided

2. Testing for basic chemical parameters-1500 ml of water should be collected in to a clean

bottle. Refrigeration or cold transportation is not necessary

3. Testing for bacteriological parameters

Collect a sample adopting procedures outlined below from the water source and transport it to

Medical Research Institute (MRI) or the closest Regional Laboratory of the National water Supply

& Drainage Board.

Procedure for water sample collection - from a tap in a distribution system

· Use a bottle containing 4-5 drops of Sodium Thiosulphate

· Keep the bottle unopened until sampling procedure begins Remove from the tap any

attachments that may cause splashing and wipe the outlet with a piece of cloth to remove any

dirt.

· Wash your hands with soap and water.

· Open the tap and allow the water to run for 30 seconds.

· Flame the mouth of the tap for 30 seconds with a lighter or an ignited cotton wool swab

soaked in alcohol. If the tap is plastic swab with surgical alcohol and leave it for 2 min.

· Open the tap and allow the water to run for 30 seconds

· Open the lid of the bottle and fill the bottle while leaving a small air space in the bottle. (The

bottle should not be rinsed before collecting water)

· Replace the lidFill up the request form and paste it on to the bottle

· Minimum volume needed is 300ml

Transportation of water samples

· The samples should be immediately placed in a lightproof insulated box such as rigiform box

containing ice cubes or ice-packs with water to ensure rapid cooling

· If ice is not available, the transportation time must not exceed 2 hours

· It is imperative that samples are kept in the dark and that cooling is rapid

· If these conditions are not met, the samples should be discarded

· When water containing even traces of chlorine is sampled, the chlorine must be inactivated. If

it is not, microbes may be killed during transit and an erroneous result will be obtained. The

bottles in which the samples are placed should therefore contain sodium thiosulfate to

neutralize any residual chlorine.

· The following format should be sent with the water samples for bacteriological investigation.

· A copy of this form should be kept at the PH office.

1 Guidelines for taking water samplesAnnexure 10

00092

00093

WATER QUALITY SURVEILLANCE FORM

Water sample for bacteriological investigation

1) Name of the water supply / location :

2) Date of sampling:

3) Time of sampling:

4) Whether the water is subjected to chlorination: Yes/No

5) Residual chlorine level:

Sender’s name

Designation

Date

Interpretation of results-Relevant SLS standards that can be used in interpretation of test results

on water quality are given below.

Interpretation of results of bacteriological testing

Source APC PCC ECC

Pipe borne public

water supplies

(>2000)

No Standard Throughout any year 95% of the

samples shall not contain any

coliforms /100ml

None of the samples examined shall

contain more than 3 coliforms per

100ml

Coliforms shall not be detected in

100ml of any 2 consecutive samples.

Should not be

detected/100 ml

Individual and

small community

supplies

No Standard Should be < 10/100ml Should not be

detected / 100ml

APC- Aerobic Plate Count, PCC- Probable Coliform Count, ECC-Escherichia Coli Count

1 Vector-borne diseases, related pathogens and vectorsAnnexure 11

00094

DISEASE PATHOGEN VECTOR

Parasitic malaria plasmodium Mosquito

Leishmaniasis Leishmania Sand fly

Filariasis Brugia malayi,

Wuchereria bancrofti

Mosquito

Trypanosomiasis Trypanosoma Fly

Viral Dengue fever Dengue virus Mosquito

Yellow fever Yellow fever virus Mosquito

Encephalitis (Japanese

encephalitis, West Nile

encephalitis, Tick-borne

encephalitis et al)

virus Mosquito, tick

Bacterial Cholera Vibrio cholerae Fly, cockroach

Tuberculosis Mycobacterium tuberculosis Fly, cockroach

Others Typhoid Rickettsia Louse, Flea, tick

Scrub typhus R. tsutsugamushi Mite

1 Health Declaration FormAnnexure 12

00095

Health Part of the Aircraft General Declaration (Part of the Aircraft General Declaration,

Promulgated by the International Civil Aviation Organization)

DECLARATION OF HEALTH

Name and seat number or function of persons on board with illnesses other than airsickness or the

effects of accidents, who may be suffering from a communicable disease (a fever- temperature

38°C/100 °F or greater - associated with one or more of the following signs or symptoms, e.g.

appearing obviously unwell; persistent coughing; impaired breathing; persistent diarrhoea; persistent

vomiting; skin rash; bruising or bleeding without previous injury; or confusion of recent onset,

increases the likelihood that the person is suffering a communicable disease) as well as such cases of

illness disembarked during a previous stop…………………………………………………………………………..

…………………...................................................................……………………………………………………………………………………

…………………...................................................................……………………………………………………………………………………

………… Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight.

If no disinsecting has been carried out during the flight, give details of most recent disinsecting

…………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………

Signature, if required, ……………………………………………………………..

Time:………………………………

Date: ……………………………….

…………………………………………………..

Crew member concerned

Name of ship Registration/IMO No Arriving from Sailing to

Date of arrival Time of arrival Valid Sanitation Control Exemption/Control Certificate carried on board? Yes /No

Issued at date

Re-inspection required? Yes /No Has ship/vessel visited Yellow Fever affected area identified by the World Health Organization? Yes /No Port date of visit List ports of call from commencement of voyage, or within past 30 days, whichever is shorter: (1) Port (1) Departure date (2) Port (2) Departure date (3) Port (3) Departure date Number of crew members on board List available (details of Journey and personal particulars included)? Yes/No Number of passengers on board List available (details of Journey and personal particulars included)? Yes/No Are there any stowaways on board? Yes /No If yes please give details Are there any deaths, cases, suspects due to infectious diseases and/or PHEIC on board? Yes /No If yes please give details of the nature of the public health risk Number of affected/suspected Travellers Details from the affected/suspected Traveller Medical history

Travel itinerary

Vaccination history

History of prophylaxis

Examination findings

Destination in Sri Lanka (address)

contact details (telephone no.s)

From those who had contacts with the case/suspect Name

Destination in Sri Lanka (address)

a.

contact details (telephone no.s)

b.

1Checklist for assessment of a human case/suspected case of having an

illness of PHEIC on boardAnnexure 14

00097

1 Personal protective equipment Annexure 13

00096

PERSONAL PROTECTIVE

EQUIPMENT ITEM

INSPECTOR DURING

NORMAL

INSPECTION

INSPECTOR IN CASE OF

PHEIC INVESTIGATION

Safety helmet X X

Hair net X

Safety goggles or face shield X

Ear protection X

Face mask X (FFP3 standard)

Working gloves (e.g. leather

gloves)

X

Rubber examination gloves X X

Kitchen apron X

Watertight apron X

Disposable overalls X

Hand disinfection liquid X X

Signal vest or signal jacket X

Inflatable life vest X

Safety shoes with non-slip and

anti-sparkle soles

X

Insect repellent in some areas X

Name

Travel

itinerary

Vaccination

history

History of

prophylaxis

Destination in

Sri Lanka

(address)

Contact

details

(telephone

no.s)

1 Checklist for secondary screening of travellers detected by thermal

scanners or Health Declaration Form by PHMO during a PHEICAnnexure 15

00098

1 Checklist for granting 'free pratique' to Air CraftsAnnexure 16

00099

CHECKLIST FOR GRANTING 'FREE PRATIQUE' TO AIR CRAFTS

Name of Aircraft Registration Arriving from Departing to

Date of arrival Time of arrival

Nature of cargo animals food items food items of plant

origin

Operations to be carried out in the Air Port

Whether pet animals on-board? Yes /No

Are the vaccination details of pet animals available? Yes /No

(please check the list)

Has Aircraft visited an Yellow Fever affected area identified by the World Health Organization ?

Yes /No

Air Port date of visit

List ports of call from commencement of voyage, or within past 30 days, whichever is shorter:

(1) Air Port (1) Departure date

(2) Air Port (2) Departure date

(3) Air Port (3) Departure date

Number of crew members on board

List available (details of Journey and personal particulars included)? Yes/No

Number of passengers on board

List available (details of Journey and personal particulars included)? Yes/No

Are there any stowaways on board? Yes /No

If yes please give details

Are there any deaths, cases, suspect due to infectious diseases and/or PHEIC on board?

Yes /No

If yes please give details

Name

Travel

itinerary

Vaccination

history

History of

prophylaxis

Destination in

Sri Lanka

(address)

Contact

details

(telephone

no.s)

1 Checklist for secondary screening of travellers detected by thermal

scanners or Health Declaration Form by APMO during a PHEICAnnexure 17

000100

000101

Ministry Of Health Dr. Y.D.NihalJayathilaka Secretary, Health

Dr. Palith Maheepala Director General of Health Services

Dr. Sarath Amunugama Deputy Director General (Public Health Services)1

Dr. Sunil De Alvis Deputy Director General (Education, Training & Research)

Dr P.A.L. Harschandra Director (Public Health Veterinary Services)

Mrs. A.R. Ahamed Acting Chief Legal Officer

Dr. AjithTennakoon Chief JMO, Institute of Legal Medicine& Toxicology

Dr. V.T.S.K.Siriwardhana Regional Director of Health Services, Colombo

Dr. Ananda Jayalal Director (Environment and Occupational Unit)

Dr. Gamini Seneviratne Director, National Programme for Tuberculosis and Chest

Control

Dr. H.D.B. Herath Deputy Director (Environment and Occupational Unit)

Dr. P.M.Rathnayake Director(Estate & Urban Health)

Dr. S. Sridharan Director-Health Care, Quality & Safety

Dr. Lal Panapitiya Director-Medical Services

Dr.M.W.M.K. Mediwaka Medical Superintendent, District General Hospital, Hambantota

Dr. A.I.Jagoda Deputy Director -Private Health Sector Development

Mr. H. Tilakaratne Asst. Director -Food Control

Dr.Iresha Dassanayake Consultant Community Physician, Directorate of Quarantine

Dr.M.S.K.Wickramathilake Consultant Community Physician, Directorate of Quarantine

Dr. Samitha Ginige Consultant Epidemiologist

Dr. Sugandika Perera Consultant Community Physician, Disaster Preparedness

& Response Unit

Dr. C.J.S Jayamaha Consultant virologist

Dr. Chandana Gajanayake Registrar, PGIM

Dr. G.P.C.T.Fonseka Medical Officer, Infectious Disease Hospital

Dr. A.D.S.R.T.Siriwardhana Medical Officer, Air Port Health Office Katunayake

Dr. A.V.N.Adhikaram Medical Officer, Air Port Health Office Katunayake

Dr. J.A.D.R.S.Perera Medical Officer, Air Port Health Office Katunayake

Dr. S.De Silva Medical Officer, Air Port Health Office Katunayake

Dr .R.S.Walpitagamage Medical Officer Air Port Health Office Mattala

Dr .U.I.Sirisena Medical Officer Port Health Office - Colombo Port

Dr. M.B.A.DeSilva Medical Officer Port Health Office - Colombo Port

Dr.M.A.AbdulRakeesthu Medical Officer Assistant Port Health Office - MRI

Dr.F.D.Colombage Medical Officer Port Health Office - Galle Port

Dr.N.Sarawanabawan Medical Officer (Port Health Office – Trincomalee Port)

Dr.Kapila Mallawaarachchi Medical Officer, GMOA

Mr. R.S.Jayarathne Public Health Inspector, Air Port Health Office Katunayake

Mr. W.G.Chandrasiri Public Health Inspector, Air Port Health Office Katunayake

Mr .H.L.L.P.Madusanka Public Health Inspector, Air Port Health Office Mattala

Mr. W.A.D.K.Wickramarachchi Public Health Inspector, Air Port Health Office Mattala

Mr.M.D.Fernando Public Health Inspector, Port Health Office - Colombo Port

Mr.N.A.Jayatissa Public Health Inspector, Port Health Office - Galle Port

Mr.W.G.S.Udayanga Development Officer, Port Health Office - Galle Port

000102

Other Ministries /Agencies

Dr. Bimal Dias CAME FP/CAPSCAR-Ministry of Civil Aviation

Capt. R.A.Jayawikcrama Harbor Master, Sri Lanka Ports Authority

Dr. D. Rajakanthan Chief Medical Officer, Sri Lanka Ports Authority

Dr. N. Wijewardhana Animal Quarantine Officer, Department of Animal Production and

Health

Dr.S.D.A.Nishantha Medical Officer, Airport Aviation Service, Sri Lanka

Dr.S.Karunaratne D.H.S.SLAF, Sri Lanka Army

Dr. N.Janakan NPO-CRS WHO

Mr.T.H.S.Shantha Deputy Director, Atomic Energy Authority

Mr.M.S.M.Rifham Project officer, Sri Lanka Ports Authority, Galle

Col.Sanjaya Perera DML

Mr.Hiran Thilakerathne Assistant Director , Emergency Operation, Disaster Management

Center

Mr.Shiran Sovis Senior Assistant AirPort Manager, Airport Aviation Service, Sri Lanka

Mr.Nihal Alahapperuma Superintendent of custom, SL Custom

Mr.H.A.D.Sudath RO, NPA, Katunayake

Ms. C.Achala Superintendent of custom, Sri Lanka Customs

Mr.Chandana Ranaweera Deputy Controller, Immigration & Emigration

Mr. L.C.Hewage RO, NPQS, Katunayake

Mr. I.K.Warshamana RO, NPQS ,Katunayake

Mr.Pradeep Saputantri Deputy Controller (Legal), Department of Immigration &

Emigration

Mr.P.P.Weerasooriya Law Officer, Sri Lanka Ports Authority

Mr.H.Dissanayake Development Officer (Legal) Ministry of environment

Design by Roshan Rajith (roshan.rajith@gmail.com)