Mouchtouri Varvara A, Nichols Gordon, Rachiotis George, Kremastinou Jenny, Arvanitoyannis Ioannis S, Riemer Tobias, Jaremin Bogdan, Hadjichristodoulou Christos
Gastrointestinal, Emerging, and Zoonotic Infections Department, Health Protection Agency, Centre for Infections, London, United Kingdom.
Int Marit Health. 2010;61(2):49-98.
The purpose of this report is to describe issues relevant to public health and to review all passenger ship associated diseases and outbreaks. Moreover, legislation and practices on sanitation and diseases surveillance related to ships internationally were also reviewed. Some relevant historical information about infections on merchant ships is provided as well.
The methods used to develop the state-of-the-art report included a scientific literature review and an extensive and thorough search of the websites of organisations and government departments. A considerable effort was made to capitalise on previous experience in the field. In particular, for the literature review, a total of 158 scientific articles were used including 91 full papers and 67 abstracts, 7 guidelines published by the WHO, and 13 guideline documents published by other organisations. Moreover, 5 international conventions relevant to passenger ships were identified.
At the international level, public health issues related to ships are regulated by the revised International Health Regulations (2005). Other conventions of the International Maritime Organization regulate safety on board ships and waste and ballast water management, while conventions of the International Labour Organization regulates issues related to working conditions on board ships. Guidelines for preventing and controlling public health threats on board ships can be found in seven Guidelines published by the World Health Organization, including the WHO Guide to Ship Sanitation, which provides a framework for policy making and local decision making. The literature review results revealed that the infections/outbreaks that occur on passenger ships include Norovirus, Legionella spp., Salmonella spp., E. coli, Vibrio spp., and influenza A and B virus. The modes of transmission include person to person, waterborne, foodborne, airborne, and vector-borne, and shore excursions are responsible for some outbreaks.
The industry (especially the ferry industry) and sanitary organisations can enhance collaboration in order to implement integrated hygiene programmes and prevent the occurrence of communicable diseases aboard passenger ships.
本报告旨在描述与公共卫生相关的问题，并回顾所有与客船相关的疾病及疫情。此外，还对国际上与船舶卫生及疾病监测相关的立法和实践进行了回顾。同时也提供了一些有关商船上感染情况的相关历史信息。
撰写本前沿报告所采用的方法包括科学文献综述，以及对各组织和政府部门网站进行广泛而深入的搜索。充分利用了该领域先前的经验。特别是在文献综述方面，共使用了158篇科学文章，包括91篇全文和67篇摘要、世界卫生组织发布的7份指南，以及其他组织发布的13份指南文件。此外，还确定了5项与客船相关的国际公约。
在国际层面，与船舶相关的公共卫生问题由修订后的《国际卫生条例（2005）》进行规范。国际海事组织的其他公约则规范船上安全以及废物和压载水管理，而国际劳工组织的公约则规范与船上工作条件相关的问题。世界卫生组织发布的7份指南中包含了预防和控制船上公共卫生威胁的指南，其中《世界卫生组织船舶卫生指南》为政策制定和地方决策提供了框架。文献综述结果显示，客船上发生的感染/疫情包括诺如病毒、军团菌属、沙门氏菌属、大肠杆菌、弧菌属，以及甲型和乙型流感病毒。传播方式包括人传人、经水传播、经食物传播、空气传播和病媒传播，部分疫情是由岸上短途旅行导致的。
该行业（尤其是渡轮行业）和卫生组织可加强合作，以实施综合卫生计划，防止客船上传染病的发生。
