Systematic Review on Outbreaks of SARS-CoV-2 on Cruise, Navy and Cargo Ships.

The confined environment of a ship promotes the transmission of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) due to close contact among the population on board. The study aims to provide an overview of outbreaks of SARS-CoV-2 on board of cruise, navy or cargo ships, to identify relevant outbreak management techniques, related problems and to derive recommendations for prevention. Four databases were searched. The study selection included reports about seroprevalences or clinically/laboratory confirmed infections of SARS-CoV-2 on board ships between the first of January, 2020 and the end of July, 2020. A total of 37 studies were included of whom 33 reported outbreaks of SARS-CoV-2 on cruise ships (27 studies referred to the Diamond Princess). Two studies considered outbreaks on the Grand Princess, three studies informed about Nile River cruises and one study about the MS Westerdam (mention of multiple outbreaks possible in one study). Additionally, three studies reported outbreaks of SARS-CoV-2 on navy vessels and one study referred to a cargo ship. Problems in handling outbreaks resulted from a high number of asymptomatic infections, transportation issues, challenges in communication or limited access to health care. Responsible operators need to implement infection control measures which should be described in outbreak management plans for ships to prevent transmission risks, including, e.g., education, testing strategies, communication lines, social distancing and hygiene regulations.

Fatal and serious injuries on board merchant cargo ships.

BACKGROUND: Merchant seafaring is one the most dangerous occupation over the world which hosts the physical, ergonomic, chemical, biological, psychological and social elements, which could lead to occupa- tional accidents, injuries and diseases. Therefore, it is a field that should be studied on meticulously and frequently. The aim of this study is to investigate the frequency, circumstances, and causes of occupational accidents on board merchant cargo ships and to identify the risks factors during the daily routine works and dangerous works to be fulfilled. MATERIALS AND METHODS: Data used in this study obtained various occupational accident reports issued by countries' accident investigation units or maritime authorities such as Marine Accident Investigation Branch (MAIB), Marine Safety Investigation Unit (MSIU) and Australian Transport Safety Bureau (ATSB). A total of 331 reports met the inclusion criteria for the 11-year period from 2006 to 2016. Descriptive statistics were given related to data and chi-square analysis was used to test for significant association between categorical variables (seafarer's age, accident type and etc.) and injury severity. RESULTS: Several findings were notable in this study. Ratings (63.5%) were the most affected group suffe- red from occupational injuries among the crew and the most critical cause of occupational accidents was found the dangerous work practices and ignorance of rules and instructions. CONCLUSIONS: Occupational accidents are still crucial concern in maritime industry which imposes a major burden on both seafarers and shipping companies. Reduction in occupational injuries could be achieved by improving the working environment and the quality of life on board, mitigating the mental and physical burden of work and developing policies to encourage the seafarers to obey safety rules and instructions.

A quantitative risk assessment (QRA) of the risk of introduction of the Japanese encephalitis virus (JEV) in the United States via infected mosquitoes transported in aircraft and cargo ships.

Following a qualitative risk assessment, in which we identified and assessed all viable pathways for the introduction of the Japanese encephalitis virus (JEV) into the United States (US), we identified entry through infected vectors via aircraft and cargo ships as the most likely pathway, and thus considered it further in a quantitative risk assessment (QRA) model. The objective of this study was to evaluate the risk of introduction of JEV in the US via infected mosquitoes transported in aircraft and cargo ships arriving from Asia, using a QRA model. We created a stochastic model to quantify the probability of introduction of at least one infected mosquito in the continental US via aircraft and cargo ships, per at-risk period (March to October) or year, respectively. We modeled the following parameters: number of flights (per at-risk period, i.e., March to October) and cargo ships (per year) and per region, number of mosquitoes per flight and ship, number of mosquitoes that were not found and sensitivity of the mosquito collection method in aircraft, mosquito infection rates, and number of mosquitoes coming in aircraft per at-risk period (March to October) and cargo ships per year. Flight and cargo ship data pertained to years 2010-2016. For model building purposes, we only considered port-to-port vessels arriving from Asia to the US, we assumed that mosquitoes survive the trans-Pacific Ocean ship crossing and that the number of mosquitoes in cargo and passenger flights is similar. Our model predicted a very high risk (0.95 median probability; 95% CI = 0.80-0.99) of at least one infected mosquito being introduced in the US during the at-risk period, i.e., March to October, via aircraft transportation from JEV-affected countries in Asia. We also estimated that a median of three infected mosquitoes can enter the US during the at-risk period, i.e., March to October (95% CI = 1-7). The highest probability of introduction via aircraft was attributed to the Mediterranean California ecoregion (0.74; 95% CI = 0.50-0.90). We predicted, however, a negligible risk (0; 95% CI = 0.00-0.01) of at least one infected mosquito being introduced via cargo ships. Although the risk of introduction of JEV-infected mosquitoes by cargo ships was negligible, the risk via aircraft was estimated to be high. Our findings indicate the need to prioritize JEV prevention and control methods for aircraft-based pathways, such as aircraft disinfection. The quantitative estimates provided in this study are of interest to public health entities and other stakeholders, as they may support future interventions for preventing JEV introduction, as well as other vector-borne diseases, in the US and other countries.

Knowledge and Attitudes on Food Hygiene among Food Services Staff on Board Ships.

BACKGROUND: Ships have long been sites for outbreaks of infectious diseases, particularly gastrointestinal diseases. The ship environment has the potential to facilitate the spread of such diseases, infecting susceptible cohorts of embarked passengers and crew. Gastrointestinal disorders among seafarers are fairly common and usually represent the first or second cause of requests for medical assistance aboard ships in international waters. STUDY DESIGN: The purpose of this study was to evaluate food safety and the level of knowledge among food service personnel on board merchant ships, where food handlers could be a cause of health problems for all crew members. METHODS: An anonymous self-administered questionnaire containing specific questions about food hygiene and safety knowledge was administered. RESULTS: The overall score of correct answers for the food safety aspects tested was 51.77 (SD 3.87) out of 76 points, corresponding to 68.12% of questions answered correctly. Food workers who followed a training course showed higher mean knowledge score (p < 0.05) compared to not-trained workers. The most relevant significant differences (p < 0.05) were noticeable in the personal hygiene, cross-contamination, safe storage, and knowledge of foodborne pathogens sections. CONCLUSION: Food services staff on board cargo ships should be adequately trained and should understand basic and fundamental aspects of food hygiene, related pathologies and sanitation, as they are responsible for the health and wellbeing of many seafarers.