Ehs 315

NATIONAL OPEN UNIVERSITY OF NIGERIA
SCHOOL OF SCIENCE AND TECHNOLOGY
COURSE CODE: EHS 315
COURSE TITLE: INTERNATIONAL PORT HEALTH

SERVICES
53
EHS 315 MODULE 3
COURSE
GUIDE
EHS 315
INTERNATIONAL PORT HEALTH SERVICES
Course Team Barrister Rotimi Adeyemi (Course Developer)-

Environmental Health, Local Government Service
Commission, Akure
Dr. Ibrahim Omoniyi Shehu (Course Coordinator) -
NOUN
Prof. Adebanjo Afolabi(Programme Leader)-
NOUN
NATIONAL OPEN UNIVERSITY OF NIGERIA
54
EHS 315 INTERNATIONAL AND PORT HEALTH SERVICES
National Open University of Nigeria

Headquarters
14/16 Ahmadu Bello Way
Victoria Island, Lagos
Abuja Office
5 Dar es Salaam Street
Off Aminu Kano Crescent
Wuse 11, Abuja
e-mail: [email protected]
URL: www.nou.edu.ng
Published by
National Open University of Nigeria
Printed 2014
ISBN: 978-058-029-8
All Rights Reserved
55
EHS 315 MODULE 3
CONTENTS PAGE
Introduction ……………………………………………………… iv
What you will Learn in this Course……………………………… iv
Course Aims ……………………………………………………... iv
Course Objectives ……………………………………………….. v
Working through this Course ……………………………………. v
Course Materials ………………………………………………… vi
Study Units ………………………………………………………. vi
Presentation Schedule……………………………………………. vii
Assessment ………………………………………………………. vii
Tutor-Marked Assignment (TMA) ………………………............. viii
Final Examination and Grading …………………………………. viii
Course Marking Scheme ………………………………………… viii
Facilitators and Tutorials ………………………………………… ix
Summary …………………………………………………............ ix
56
INTRODUCTION
International and Port Health Services, is a semester course. It is a two-

credit unit course available to all students of Bachelor of Science (B.Sc.)
Environmental Health and other related sciences. Health and sanitation
aspects of international traffic have been of concern to the World Health
Organisation (WHO) since 1951, when the Fourth World Health
Assembly recommended that all governments should ―improve sanitary
and environmental conditions, especially in and around ports and
airports‖ (Resolution WHA4.80); at the same time, the need for ―the
sanitary protection of populations in mass movement‖ was also
expressed (Resolution WHA 4.8l). Subsequent resolutions of both the
World Health Assembly and the Executive Board emphasised the
importance of maintaining high standards of hygiene and sanitation in
international traffic (particularly in relation to the cross-border spread of
diseases, provision of safe water and food and the correct procedures for
the collection and disposal of wastes).
WHAT YOU WILL LEARN IN THIS COURSE
The course content consist of a unit of Course Guide, which informs you
briefly what the course is about, what course materials you need and
how to work with such materials. It also gives you some guideline for
the time you are expected to spend on each unit, in order to complete it
successfully.
It guides you concerning your tutor-marked assignment, which will be

placed in the assignment file. Regular tutorial classes related to the
course will be conducted and it is advisable for you to attend these
sessions. It is expected that the course will prepare you for challenges
you are likely to meet in the field of International Port Health Services.
COURSE AIMS
The course aim is to provide you with an understanding of port health

and cross border public health issues. It is intended to let you the
existing International Sanitary Regulations, especially the provisions of
Article 14, in providing safe food for international air traffic, and in
maintaining satisfactory control of, and protection from, malaria vectors
at frontiers.
In view of the growth of international traffic, continuous attention

should be given to the safety of food and water and the handling of
wastes in such traffic‖, stressed ―the need for each country to clarify the
ultimate responsibility for the safety of food and water and the proper
handling of wastes in international traffic‖ and, furthermore,
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EHS 315 MODULE 3
recommended that ―countries coordinate and ensure the close and active
participation in such a responsibility of health authorities, port and
airport management, aircraft operators, shipping companies, tourist
associations, and any other service or agency concerned with
international traffic‖.
COURSE OBJECTIVES
To achieve the aim set out, there are sets of objective for the course.
Each unit has specific objectives which are stated at the beginning of the
unit. You are advised to read the objectives before you study to be able
to track your understanding of the course and your progress. It is also
good that you endeavor to check the unit objectives after the completion
of each unit to work out your level of accomplishment. After going
through the course, you should be able to:
 explain the fundamentals of port Health services

 discuss the function of environmental health officers on land, air
and sea port
 collaborate with international organisations and agencies
operating at the ports
 list and implement the environmental public health services at the
ports
 plan and implement disease surveillance at the ports
 list and describe international collaboration and cooperation in
port health
 enumerate and implement international health regulations,
agreement, constitutions, treaties and other related local policies,
regulations and laws.
WORKING THROUGH THIS COURSE
To complete this course, you are expected to read each study unit, read
the textbooks and other materials, which may be provided by the
National Open University of Nigeria. Each unit contains self-assessment
exercises. In the course, you would be required to submit assignment for
assessment. At the end of the course, there is final examination. The
course should take about fifteen weeks to complete. Listed below are the
components of the course, what you have to do and how to allocate your
time to each unit, in order to complete the course successfully and
timely. The course demands that you should spend good time to read
and advice for you is that you should endeavour to attend tutorial
session, where you will have the opportunity to comparing knowledge
with colleagues.
58
COURSE MATERIALS
The main components of the course materials are:
1. The Course Guide

2. Study Units
3. References/Further Reading
4. Assignments
5. Presentation Schedule
STUDY UNITS
The study units in this course are as follows:
Module 1 Fundamentals of Port Health Services
Unit 1 Introduction to Port Health Services

Unit 2 Terminologies Used in Port Health Services .
Unit 3 Divisions and Sections in Port Health Services
Unit 4 Environmental Health Services Implemented at the Ports
Module 2 Duties of Environmental Health Officers in Port

Health Services
Unit 1 Pest and Vector Control

Unit 2 Health Emergencies
Unit 3 Water Hygiene in Air Travels
Module 3 International Entry Measures and Procedure against

Diseases Subject to IHR
Unit 1 Diseases Surveillance and Notification

Unit 2 Immunisation and Issuance of Yellow Fever Certificate
Unit 3 Implementation of International Health Regulations, 2005
Module One explains the fundamentals of port health services. There

are four units in the module. The first unit focuses on the introduction to
port health services, while the second unit deals with the terminologies
use in port health services. The third unit dwells on divisions and
sections in port health services while unit four also deals with
environmental health services implemented at the ports.
The second module is on the duties of environmental health officer in
port health services. It has three units starting from 1 to unit 3. The first
unit deals with pest and vector control in port health while Unit 2
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EHS 315 MODULE 3
discussed health emergencies in port health. Unit 3 deals with water

safety and hygiene in air travels.
The third and last module is entitled international entry measures and
procedure against diseases subject to IHR. It has three units starting
from Unit 1 which deals with diseases surveillance and notification.
Unit 2 focuses on immunisation and issuance of yellow fever certificate
while Unit 3 also deals with implementation of international health
regulations 2005.
Each unit consist of one or two weeks‘ work and include an
introduction, objective/s, main content, reading materials, exercises,
conclusion, summary, tutor-marked assignments, references/further
reading and other resources. The various units direct you to work on the
exercises related to the require reading.
In general, the exercises test you on the materials you have just covered
or require you to apply it in a way that it will assist you evaluate your
own progress and to reinforce your understanding of the materials.
Alongside the TMAs these exercises will help you achieve the stated
learning objectives of the individual units and course as a whole.
PRESENTATION SCHEDULE
Your course materials have important dates for the early and timely
completion and submission of your TMAs and attending tutorials. You
are expected to submit all your assignments by the stipulated time and
date and guard against falling behind in your work.
ASSESSMENT
There are three parts to the course assessment and these include self-
assessment exercises, tutor-marked assessments and the written
examination or end of course examination. It is advisable that you do all
the exercises. In tackling the assignments, you are expected to use the
information, knowledge and techniques gathered during the course. The
assignments must be submitted to your facilitator for formal assessment
in line with the deadlines stated in the presentation schedule and
assignment file. The work you submit to your tutor for assessment will
count for 30% of your total course work.
At the end of the course, you will need to sit for a final end of course
examination of about three hours duration. This examination will count
for 70% of your total course mark.
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TUTOR- MARKED ASSIGNMENT
The TMA is a continuous component of your course. It accounts for

30% of the total score. You will be given four (4) TMAs to answer.
Three (3) of these must be answered before you are allowed to sit for the
end-of-course examination. The TMAs would be given to you by your
facilitator and returned after you have done the assignment. Assignment
questions for the units in this course are contained in the assignment file.
You will be able to complete your assignment from the information and
material contained in your reading, references and study units.
However, it is desirable in all degree level of education to demonstrate

that you have read and researched more into your references, which will
give you a wider view point of the subject. Make sure that each
assignment reaches your facilitator on or before the deadline given in
the presentation schedule and assignment file. If for any reason you
cannot complete your work on time, contact your facilitator before the
assignment is due to discuss the possibility of an extension. Extension
will not be granted after the due date unless there are exceptional
circumstances.
FINAL EXAMINATION AND GRADING
The end-of-course examination for international and port health services

will be for about 3 hours and it has a value of 70% of the total course
work. The examination will consist of questions, which will reflect the
type of self-testing, practice exercise and tutor-marked assignment
problems you have previously encountered. All area of the course will
be assessed. Use the time between finishing the last unit and sitting for
the examination to revise the whole course. You might find it useful to
review your self-assessment exercises TMAs and comments on them
before the examination. The end-of -course examination covers
information from all parts of the course.
COURSE MARKING SCHEME
Assignment Marks
Assignments 1-4 Four assignments, best three marks
of the four counts 10% each for the
3course marks amounting to 30%.
End-of-course examination 70% of overall course marks
Total 100% of course materials
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EHS 315 MODULE 3
FACILITATORS/TUTORS AND TUTORIALS
There are 15 hours of tutorials provided in support of this course. You

will be notified of the dates, times and location of the tutorials as well as
the name and the phone number of your facilitator, as soon as you are
allocated a tutorial group.
Your facilitator will mark and comment on your assignments, keep a

close watch on your progress and any difficulties you might face and
provide assistance to you during the course. You are expected to mail
your Tutor-Marked Assignment to your facilitator before the schedule
date (at least two working days are required). They will be marked by
your tutor and returned to you as soon as possible.
Do not delay to contact your facilitator by telephone or e-mail if you

need assistance. The following might be circumstances in which you
would find assistance necessary, hence you would have to contact your
facilitator if:
 you do not understand any part of the study or the assigned

readings
 you have difficulty with self-tests
 you have a question or problem with an assignment or with the
grading of an assignment.
You should endeavour to attend the tutorials. This is the only chance to
have face to face contact with your course facilitator and to ask question
which are answered instantly. You can raise any problem encountered in
the course of your study. To gain more benefit from course tutorials,
prepare a question list before attending them. You will learn a lot from
participating actively in discussions.
SUMMARY
International and Port Health Services have been of concern to the

World Health Organisation (WHO) since 1951, when the Fourth World
Health Assembly recommended that all governments should ―improve
sanitary and environmental conditions, especially in and around ports
and airports‖ (Resolution WHA4.80). At the same time, the need for
―the sanitary protection of populations in mass movement‖ was also
expressed (Resolution WHA4.8l). Subsequent resolutions of both the
World Health Assembly and the Executive Board emphasised the
importance of maintaining high standards of hygiene and sanitation in
international traffic (particularly in relation to the cross-border spread of
diseases, provision of safe water and food and the correct procedures for
the collection and disposal of wastes).
62
Upon completing this course, you will be equipped with the knowledge
and professional skill to accomplish effective International and Port
Health Services. You will be able to identify professionals involved in
International and Port Health Services and the role/s played by each
professional health group at achieving effective trans-border
transmission of internationally notify able diseases, the containment
strategies and control measures at curtailing the spread of these diseases.
You will understand the dimension of the problem of international and

port health services as well as the socio-cultural and occupational factors
contributing to their occurrences. You will also know the role that can
be played by individuals, the community, the government, international
agencies as well as non-governmental organisations in the prevention
and control of trans-border transmission of internationally notifiable
infectious diseases. In addition, you should be able to answer questions
on the subject such as:
 the fundamentals of port health services

 the function of environmental health officers on land, air and sea
port
 collaborate with international organisations and agencies
operating at the ports
 list and implemented the environmental public health services at
the ports
 plan and implement disease surveillance at the ports
 list and describe international collaboration and cooperation in
port health
 implement international health regulations.
The above list is just a few of the question expected and is by no means
exhaustive. To gain most from this course, you are advised to consult
relevant books to widen your knowledge on the topic. I wish you
success in the course. It is my hope you will find it both illuminating
and useful.
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EHS 315 MODULE 3
MAIN
COURSE
CONTENTS PAGE
Module 1 Fundamental of Port Health Services ……… 1
Unit 1 Introduction to Port Health Services…………... 1

Unit 2 Terminologies used in Port Health Services…... 5
Unit 3 Divisions and Sections in Port Health Services 12
Unit 4 Environmental Health Services Implemented
at the Ports ……………………………………... 16
Module 2 Duties of Environmental Health Officers in

Port Health Services …………………….......... 29
Unit 1 Pest and Vector Control……………………….. 29

Unit 2 Health Emergencies……………………………. 38
Unit 3 Water Hygiene in Air Travels…………………. 44
Module 3 International Entry Measures and Procedure

against Diseases Subject To IHR…………….. 53
Unit 1 Diseases Surveillance and Notification……….. 53

Unit 2 Immunisation and Issuance of Yellow Fever
Certificate............................................................. 60
Unit 3 Implementation of International Health
Regulations 2005……………………………….. 68
64
MODULE 1 FUNDAMENTALS OF PORT HEALTH

SERVICES
Unit 1 Introduction to Port Health Services

Unit 2 Terminologies used in Port Health Services
Unit 3 Divisions and Sections in Port Health Services
Unit 4 Environmental Health Services Implemented at the Ports
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definition of Port Health Services
3.2 History of Port Health Services in Nigeria
3.3 Organisational Structure
3.4 Port Health Locations in Nigeria
3.4.1 International Airports
3.4.2 Seaports
3.4.2 Land Borders
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading
1.0 INTRODUCTION
The world over has become a global village, with millions of people
travelling daily from one location to the other. The need to curtail the
possible spread of disease of international concern is paramount in
international health. Port health services has a major role to play in the
control of communicable diseases in the migrating population,
particularly the environmental health officers who are the first contact to
anyone entering the country frontier be it air, land or water.
Environmental Health Officers therefore play important role in the
international control measures for cross-border or trans-boundary
transfer of diseases.
2.0 OBJECTIVES
At the end of this unit, you should be able to:
 define port health services

 narrate a brief history of port health services in Nigeria
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EHS 315 MODULE 3
 illustrate the organisational structure of port health services in

Nigeria
 list the port health services locations in Nigeria.
3.0 MAIN CONTENT
3.1 Definition of Port Health Services
Port health services are defined as those key measures put in place to
prevent cross-border disease transmission. Port health officers are also
responsible for protecting the health and well-being of the crew and
citizens by carrying out statutory obligations in relation to food safety,
imported food control, air, land, ship sanitation and animal health. It
aims to guard against the importation and exportation of diseases, thus
keeping the indigenous population reservoir as small as possible and
honestly notifying World Health Organisation (WHO) of the situation in
the country. Port health authority is internationally recognised for
responsible for all appropriate health measures permitted in the
International Health Regulations (IHR) as applicable in the country‘s
jurisdiction.
Therefore, port health is a measure taken to protect and promote

complete physical, mental and social well-being of individual across
international borders with minimal interference with international trade
and traffic.
3.2 History of Port Health Services in Nigeria
Measures to prevent the introduction of infection were recorded in the

early 1500s, when ships were isolated in Marsamxett Harbour. An
organised organisational enforcement body, the ‗Magistri Sanitatis,‘
was set up in 1538, during the time of the Order of St John. Strict
enforcement of the law was practiced and emphasis was made on the
construction of intricate sewage and drinking water systems, some of
which are still operational to this very day. In January 1799, an
inspector, Matthew Pulis, was shot by the French as his ‗right of entry‘
enabled him to act as a go-between with Maltese insurgents both inside
and outside the walls of Valletta.
Following a Royal Commission in 1838, the Water Police and the

Quarantine Departments were amalgamated under the Superintendent
of Quarantine. A review of measures to prevent disease gave rise to a
comprehensive set of regulations which were later consolidated in a
special ordinance embodied in Maltese law. The next major changes
took place in 1885 and 1895, with the formation of the Public Health
Department. Someone who left his mark during this time was Sir Temi
66
Zammit, a medical officer of health who was instrumental in the

initiation of chlorination of water supplies; six months after its benefits
were discovered in the United Kingdom. In 1887, together with Sir
Robert Bruce, a British army doctor, Dr. Zammit isolated the Brucella
melitensis organism from the spleen of a dead British soldier. Another
sanitary inspector of note was the writer Ninu Cremona who was
appointed as a sanitary inspector in 1904 after having attended a course
in the Ashton School of Hygiene at the University of Liverpool. The
designation of sanitary inspector was changed to that of health
inspector by means of Act XX of the 12th December 1957.
In Nigeria, port health services started with the first problem that faced
the modern day Nigerian Sanitary Inspectors as early as the 1920s when
there was the outbreak of bubonic plaque in 1924. The professionals
were actively involved in the control of the plaque epidemic. Dr.
Oluwole Isaac revamped port health services and sanitation inspection at
the country frontiers as a vital instrument for the control of
communicable diseases, using entirely the Nigerian sanitary inspectors
now environmental health officers.
3.3 Organisational Structure
Staffing – The port health team forms part of the public health
department of the Federal Ministry of Health in Nigeria. It is being
managed on a day-to-day basis by a director of port health services.
3.4 Port Health Locations in Nigeria
The location of port health services are at a country‘s frontiers, that is

the airport, seaport and land borders. These are:
3.4.1 International Airports: There are Five (5) Designated

Ports
 Murtala Mohammed International Airport, Lagos

 Port Harcourt International Airport, Port Harcourt
 Margaret Ekpo International Airport, Calabar
 Aminu Kano International Airport, Kano
 Nnamdi Azikiwe International Airport, Abuja – FCT.
3.4.2 Seaport: There are Five (5) Designated Seaports in

Nigeria
 Apapa Port, Lagos

 Tin Can Island Port, Lagos (TCIP), Lagos
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EHS 315 MODULE 3
 Warri Port, Warri

 Port Harcourt Port
 Calabar Port, Calabar
3.4.3 Land Borders
There are presently twenty-two (22) designated/ official land frontiers in

the 36 States of the Nigeria federation.
4.0 CONCLUSION
In concluding this unit, it is important to state that public health‘s

safeguard of our country‘s points of entry/frontier is a sure means of
controlling cross border diseases migration. The role of environmental
health officer in the maintenance of high public health standard at port
health being the first contact at the frontier back to the era of plaque
epidemic is worthy of mention and note.
5.0 SUMMARY
We have so far discussed the definition of port health services, the

history of port health services in Nigeria, the organisational structure of
port health services in Nigeria and the various port health services
location in Nigeria
6.0 TUTOR-MARKED ASSIGNMENT
1. What are port health services?

2. Where are the various ports of entry into Nigeria?
3. Give a short history of public health in Nigeria.
7.0 REFERENCES/FURTHER READING
http://www.westerncape.gov.za/eng/directories/services/11515/6455.
https://ehealth.gov.mt/HealthPortal/public_health/environmental-
health/health_inspectorate/port_health_services/port_health_services_ob
jective.aspx
http://tsaftarmuhalli.blogspot.com/2011/04/environmental-health-in-
nigeria.html.
http://www.euro.who.int/_data/assets/pdf_file/0004/151375/e95783.pdf.
68
UNIT 2 TERMINOLOGIES USED IN PORT HEALTH

SERVICES
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Terminologies used in Port Health Services
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
In the last unit, we introduced international port health services and

traced the history, and organisational structure and staffing. In this unit,
we shall be discussing the technical words used in port health.
Terminologies and acronyms are specialised vocabulary: the expressions

and words, or a set of expressions and words, used by people involved
in a specialised activity or field of work or discipline. It is a word or
group of words used to give particular emphasis to an idea or sentiment.
The special emphasis is typically accomplished by the user's conscious

deviation from the strict literal sense of a word, or from the more
commonly used form of word order or sentence construction. From
ancient times to the present, such figurative locutions have been
extensively employed by orators and writers to strengthen and embellish
their styles of speech and composition.
2.0 OBJECTIVES
 list different terminologies used in port health services

 define terminologies used in port health services
 enumerate the importance acronyms used in port health services.
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EHS 315 MODULE 3
3.0 MAIN CONTENT
3.1 Terminologies Used in Port Health Services
 Accessible- Capable of being exposed for cleaning and inspection

with the use of simple tools, such as a screwdriver, pliers or an
open-end wrench.
 Adequate hygiene - Level of hygiene sufficient for the prevention
of public health risk.
 Aircraft water system - Water service panel, filler neck and the
onboard water storage tanks and all of the plumbing and fixtures
on the aircraft.
 Airport water system- On-site airport distribution system and
possibly water treatment facilities if the airport is a producer of
potable water.
 Backflow- Flow of water or other liquids, mixtures or substances
into the distribution pipes of a potable supply of water from any
source or sources other than the potable water supply. Back-
siphonage is one form of backflow. See also Back-siphonage.
 Backflow preventer-Approved backflow prevention plumbing
device that would typically be used on potable water distribution
lines where there is a direct connection or a potential connection
between the potable water distribution system and other liquids,
mixtures or substances from any source other than the potable
water supply. Some devices are designed for use under
continuous water pressure, whereas others are non-pressure
types.
 Back-siphonage-Backward flow of used contaminated or polluted
water from a plumbing fixture or vessel or other source into a
water supply pipe as a result of negative pressure in the pipe.
 Biohazard bag-Bag used to secure biohazard waste that requires
microbiological inactivation in an approved manner for final
disposal. Such bags must be disposable and impervious to
moisture and have sufficient strength to preclude tearing or
bursting under normal conditions of usage and handling.
 Cleaning - Removal of visible dirt or particles through
mechanical action, normally undertaken on a routine and frequent
basis. The cleaning process and some products used for cleaning
also result in disinfection. See also Disinfection.
 Communicable disease- Illness caused by organisms such as
bacteria, viruses, fungi and parasites that can be directly or
indirectly transmitted from an infected person to others.
Sometimes the illness is due not to the organism itself, but rather
to a toxin that the organism produces after it has been introduced
into a human host.
70
 Competent authority-Authority responsible for the

implementation and application of health measures under the
International Health Regulations (2005).
 Control measure - Those steps in the drinking-water supply that
directly affect drinking-water quality and that collectively ensure
that drinking-water consistently meets health-based targets. They
are activities and processes applied to prevent hazard occurrence.
 Corrosion resistant-Capable of maintaining original surface
characteristics under prolonged influence of the use environment,
including the expected food contact and the normal use of
cleaning compounds and sanitizing solutions. Corrosion-resistant
materials must be non-toxic.
 Cross-connection-Any unprotected actual or potential connection
or structural arrangement between a potable water plumbing
system and any other source or system through which it is
possible to introduce into any part of the potable system any used
water, industrial fluid, gas or substance other than the intended
potable water with which the system is supplied. Bypass
arrangements, jumper connections, removable sections, swivel or
change-over devices and other temporary or permanent devices
through which backflow can occur are considered to be cross-
connections.
 Disinfection-The procedure whereby measures are taken to
control or kill infectious agents on a human or animal body, on a
surface or in or on baggage, cargo, containers, conveyances and
goods by direct exposure to chemical or physical agents.
 Environmental system control - System that provides air supply,
thermal control and pressurisation for the passengers and crew
travelling on an aircraft used for airline operations.
 Food Contact surfaces - Surfaces of equipment and utensils with
which food normally comes in contact. These include the areas of
ice machines over the ice chute to the ice bins. See also Non-food
contact surfaces.
 Food handling area - Any area where food is stored, processed,
prepared or served.
 Food preparation are - Any area where food is processed, cooked
or prepared for service.
 Food service area - Any area where food is presented to
passengers or crew members (excluding individual cabin
service).
 Food storage area - Any area where food or food products are
stored.
 Food transport area - Any area through which unprepared or
prepared food is transported during food preparation, storage and
service operations (excluding individual cabin service).
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EHS 315 MODULE 3
 Health based target- A benchmark to guide progress towards a

predetermined health or water safety goal. There are four types of
health-based targets: health outcome targets, water quality
targets, performance targets and specified technology targets.
 Non-food contact surfaces - All exposed surfaces, other than food
contact or splash contact surfaces, of equipment located in food
storage, preparation and service areas.
 Non-toxic materials - Materials that, when used in the water
distribution system, do not introduce harmful or injurious
ingredients or substances into the water.
 Operational monitoring - Methods to assess the performance of
control measures at appropriate time intervals.
 Personal protective equipment - Equipment and materials used to
create a protective barrier between a worker and the hazards in
the workplace.
 Portable - Description of equipment that is readily removable or
mounted on casters, gliders or rollers; provided with a
mechanical means so that it can be tilted safely for cleaning; or
readily movable by one person.
 Potable water- Fresh water that is intended for drinking, washing
or showering; for handling, preparing or cooking food; and for
cleaning food storage and preparation areas, utensils and
equipment. Potable water, as defined by the WHO Guidelines for
Drinking-water Quality, does not represent any significant risk to
health over a lifetime of consumption, including different
sensitivities that may occur between life stages.
 Potable water tank-All tanks in which potable water is stored for
distribution and use as potable water.
 Public health authority - Government agency or designee
responsible for the protection and improvement of the health of
entire populations through community-wide action.
 Public health surveillance - The ongoing, systematic collection,
analysis and interpretation of data about specific environmental
hazards, exposure to environmental hazards and health effects
potentially related to exposure to environmental hazards, for use
in the planning, implementation and evaluation of public health
programmes.
 Readily removable-Capable of being detached from the main unit
without the use of tools.
 Removable - Capable of being detached from the main unit with
the use of simple tools, such as a screwdriver, pliers or an open-
end wrench.
 Safe material - Article manufactured from or composed of
materials that may not reasonably be expected to result, directly
72
or indirectly, in their becoming a component of any food or water

or otherwise affecting the characteristics of any food or water.
 Transfer point - Site of intermittent connection for water transfer
between the hard-plumbed airport water distribution system and
the aircraft water system. Sometimes referred to as Watering
point.
 Traveller - A person in transit between locations.
 Turbidity - Light-scattering cloudiness or lack of transparency of
a solution due to the presence of suspended particles. Turbidity is
not necessarily visible to the eye.
 Validation - Investigative activity to identify the effectiveness of
a control measure. It is typically an intensive activity when a
system is initially constructed or rehabilitated. It provides
information on reliably achievable quality improvement or
maintenance to be used in system assessment in preference to
assumed values and also to define the operational criteria
required to ensure that the control measure contributes to
effective control or hazards.
 Verification - Final monitoring for reassurance that the system as
a whole is operating safely. Verification may be undertaken by
the supplier, by an independent authority or by a combination of
these, depending on the administrative regime of a given country.
It typically includes testing for faecal indicator organisms and
hazardous chemicals.
 Watering point - See Transfer point.
 Water safety plan - Documented comprehensive strategy for
managing and operating a water supply system.
 Water supply surveillance-Continuous and vigilant public health
assessment and review of the safety and acceptability of
drinking-water supplies. There are two types of approaches:
audit-based approaches and approaches relying on direct
assessment. In the audit approach, assessment activities,
including verification testing, are undertaken largely by the
supplier, with third-party auditing to verify compliance. In direct
assessment, the drinking-water supply surveillance agency carries
out independent testing of water supplies.
 Mooring station – Is usually referred to as quarantine anchorage.
It is a place within the seaport which is specified by the port
health officer where the collector of customs for the area in which
the part is situated and the harbour master for the mooring of ship
for medical inspection so that they do not come in contact with
other ships in the port.
 Quarantine station – Premises and facilities for the prompt
isolation and care of infected persons
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EHS 315 MODULE 3
Important acronyms used in port health services:
 ACI - Airports Council International

 APHA - Association of Port Health Authorities (United
Kingdom)
 GDWQ - Guidelines for Drinking-water Quality
 HPC - Heterotrophic Plate Count
 IATA - International Air Transport Association
 ICAO - International Civil Aviation Organisation
 IHR (2005) - International Health Regulations (2005)
 IMO – International Maritime Organisation.
 NTU - Nephelometric Turbidity Unit
 PVC - Polyvinyl Chloride
 PWS - Potable Water System
 SARS - Severe Acute Respiratory Syndrome
 NESRA – National Environmental Standard Regulation Agency
 USEPA - United States Environmental Protection Agency
 VOC - Volatile Organic Chemical
 WHA - World Health Assembly
 WHO - World Health Organisation
 WSP - Water Safety Plan.
4.0 CONCLUSION
In concluding this unit, it is important to state that the environmental

health officer should be abreast of terminologies frequently used in port
health services as well as the acronyms.
5.0 SUMMARY
We have defined several technical words and terminologies frequently

in use in port health services, as well as the acronyms. You must,
however, note that there are several others not captured in this unit, you
are therefore advised to read wider to enable you capture the ones not
contained in this topic.
1. List twenty terminologies used in port health services?

2. Define the first ten terminologies used in port health services?
3. List and write out ten acronyms used in port health services.
74
https://ehealth.gov.mt/HealthPortal/public_health/environmental.health/
health_inspectorate/port_health_services/port_health_services_ob
jective.aspx.
nigeria.html.
http://www.euro.who.int/_data/assets/pdf_file/0004/151375/e95783.pdf.
International Health Regulations, 2005. WHO, Geneva. (2006).
World Health Organisation. Communicable Diseases Surveillance and

Response, Epidemic and Pandemic Alert and
Response. Frequently Asked Questions about International
Health Regulations.
IHR (2005). From the Global to the Local.
Lawrence, O. Gostin (2004). ―International Infectious Disease Law,

Revision of the World Health Organisation‘s International Health
Regulations‖. Journal of the American Medical Association.
75
EHS 315 MODULE 3
UNIT 3 DIVISIONS AND SECTIONS IN PORT HEALTH

SERVICES
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Divisions and Sections in Port Health Services in Nigeria
3.2 Functions of the Various Divisions and Sections in Port
Health Services in Nigeria
3.3 Organogram
4.0 Conclusion
5.0. Summary
1.0 INTRODUCTION
In the last two units, you have been introduced to port health services in
Nigeria. We have also discussed some of the technical words used in
international port health services.
In this unit, we shall be looking into the divisions and sections in port
health services in Nigeria. I will advise that you pay attention as you
read along. The provision of an effective port health services is a
combined effort of several professionals working at different levels and
places simultaneously for the common objective of ensuring and
accomplishing the international control measures for cross-border or
trans-boundary transfer of diseases. The professionals working in port
health services are in various divisions and sections and coordinated by
the various heads of this division for the delivery of a common disease
management and control goal.
2.0 OBJECTIVES
 list the divisions and sections in port health services in Nigeria

 state the functions of the various divisions and sections in port
health services in Nigeria
 draw the organisational organogram of port health services in
Nigeria.
76
3.0 MAIN CONTENT
3.1 Divisions and Sections in Port Health Services in Nigeria
The various divisions in port health services in Nigeria are:
 Medical and Clinical Services

 Quarantine Services
 Environmental Health and Pollution Control
 Ad-hoc Duties
 Monitoring and Evaluation
 Planning, Programme Development and Administration and
Accounts
 Medical Laboratory and Immunisation.
3.2 Functions of the Various Divisions and Sections in Port

Health Services in Nigeria
 Medical and Clinical Services

The medical and clinical services division is headed by a medical doctor
duly assisted by nurses and other health staff. This division is
responsible for the curative, rehabilitative and promotional healthcare
services within the port health.
 Quarantine Services
Quarantine services division is responsible for the enforcement of the
international law providing that people or animals that may have been
exposed to a contagious or infectious disease and could not show prove
of vaccination against such infectious disease be isolated when entering
a country for that period that will allow for the manifestation of the
disease signs and symptom.
 Environmental Health and Pollution Control

The division is responsible for the taming and controlling all those
deleterious factors in the port environment be it air, land or water that is
capable of affecting man and animal.
 Ad-hoc Duties
This division is responsible for assignments and schedules occurring by
emergency or that are not carried out on day-to-day basis. These
assignments and schedules among others include: accident emergency
response, Hajj operation and Christian pilgrimage.
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EHS 315 MODULE 3
 Monitoring and Evaluation
The division is responsible for the daily tracking of events and activities
within the port health and to determine whether or not the planned
programme of action is on track. The division is also in constant liaison
with other divisions, measuring the performance level and identifying
factors militating effective performance and the way out.
 Planning, Programme Development and Admin and

Accounts
The division is responsible for the coordination of all administrative

activities of programme planning and development. The division is also
responsible for staffing and its welfare, including making funds
available for the operational needs and demand import health services.
 Medical Laboratory and Immunisation
The medical laboratory and immunisation unit is a section directly

responsible to the medical and clinical services division. The section
carries out routine immunisation of suspected and quarantined persons
and animals. It also carries out laboratory investigation of samples,
specimens and other materials sent to it.
3.3 Organogram
Permanent Secretary
Director of Public
Health
HOD Port Health Services
Medical and Quarantine Environmental Ad-hoc Monitoring Planning, Prog.

Clinical Services Health & Pollution Duties and Dev/Admin &
Services Control Evaluation Accounts
Medical lab, South-West North-West North-East North Central South-South

Immunization
Fig.1.1: Organogram
78
4.0 CONCLUSION
In concluding this unit, it is important to state that the environmental

health officer should be abreast of terminologies and the acronyms
frequently used in the divisions, their duties as well as the organisational
organogram in port health services.
5.0 SUMMARY
So far, we have discussed the definition of terminologies frequently in

use in port health services, as well as the acronyms.
1 List twenty terminologies used in port health services?

2 Define the first ten listed in one above.
3 List and write out ten acronyms used in port health services.
4 Draw the organisational organogram of port health services in
Nigeria.
Olugbenga, Olorunda; Adeolu, Omonayajo & Micheal Aibor.(2010). A

Technical Handbook of Environmental Health in the 21st Century
for Professionals and Students. (2nd ed.).
World Health Organisation (2004). Vaccination Certificate

Requirements and Health Advice for International Travel.
www.capsca.org/Meetings/Globa l2011/CAPSCAGlobal2-9.pdf.
Abiodun-Fowowe, M. T. (2001). Handbook on Health Agencies and

Port Health. Akure: School of Health Technology.
79
EHS 315 MODULE 3
UNIT 4 ENVIRONMENTAL HEALTH SERVICES

IMPLEMENTED AT THE PORTS
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 List Environmental Health Services Implemented at the
Port Health
3.2 State Airport Health Control measures
3.3 Boarding an Aircraft
3.4 Define Seaport Health Control Measures
3.5 Boarding a ship
3.6 State Land Border Health Control Measure
3.7 Requirements of a Designated Approved Port
3.8 Diseases of International Health Regulation or
International Notifiable Disease
3.9 Other Port Health Duties
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
In the last three units, we studied the introduction to port health services,
some of the several technical words and terminologies used and the
various divisions and sections in port health services.
In this unit, we shall be looking into the various environmental health

services being implemented in our various port of entries be it air, land
or sea.
The purpose of environmental health services in port health is to

develop and implement environmental health policy as well as ensuring
that environmental health goals are met. This include the management
of relevant operations including planning, coordination, setting
standards, monitoring and evaluation of environmental health services
as well as providing technical support and guidance to
partners/stakeholders within port health.
80
2.0 OBJECTIVES
 list environmental health services implemented at the port health

 state airport health control measures
 define seaport health control measures
 state ship health control measures
 state land border health control measures
 state the requirements of a designated approved port
 list the diseases of international health regulation or international
notifiable disease
 list other port health duties.
3.0 MAIN CONTENT
3.1 Environmental Health Services Implemented at the Port

Health
The environmental health services that are being implemented at port

health are as follows:
 Implementation of the international health regulations

 Disease surveillance within the ports and frontier post of entry
and exit
 Quarantine administration
 Inspection and certification of vessels (aircraft, ship, train or road
vehicle)
 Environmental sanitation within ports and frontier posts to
control nuisances such as noise, dust, smoke and odour problems
 Vector/vermin control within and around ports and frontiers
 Food safety measures for both imports and exports
 Vaccination of travellers and issuance of vaccination certificates
 Respond to any health emergencies within and around the port
area
Scrutinise plans and documentation regarding improvement of
port area for approval
 Liaise with other stakeholders in implementation of port health
activities.
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EHS 315 MODULE 3
3.2 Airport Health Control Measures in a Designated

Airport
It is an airport designated by the health authority of the national

concerned and approved by the World Health Organisation for
international voyage of journey. Airport health control measures are put
in place to reduce incident of trans-border disease spread, this include
but not limited to the following:
 Screening of passengers from countries affected by

internationally notifiable diseases and taking appropriate action
as necessary
 All incoming travelers at the International Airport are required to
be immunised against yellow fever
The following information is contained in the yellow fever vaccination

card:
1. Dosage given
2. Date of manufacture of the vaccine and name of manufacturer
3. Date of expiration
 Medical teams are at the airport to cater for travelers showing
symptoms of suspected notifiable infectious diseases and such
traveler may be referred to hospitals for further management.
 All people arriving at international airport, including transit
passengers, are required to have yellow fever certificate or card.
Anyone not having yellow card is suspected and quarantined.
3.3 Boarding of Aircraft
Aircraft in relation to port health means an aircraft making an

international voyage. It includes any machine, which can derive support
in the atmosphere from the reactions of the air and is intended for aerial
navigation. Immediately the aircraft lands, the commander of the aircraft
has to complete an aircraft declaration of health and submit it to the port
health authority. He must also give other information as regards to the
health condition of the aircraft as this information is required by the port
health. He must also report to the authority of any case of death on
board during the voyage. If the authority is satisfied with the health
condition of the aircraft, ―free pratique‖ is granted.
―Free Pratique‖ here implies, ―permission for an aircraft after landing to

disembark and commence operation‖. Then all the health certificates of
the passengers are thus checked. Those with expired papers are re-
vaccinated and put under surveillance, depending on the type of disease.
If the health authority is not satisfied with the health condition or the
82
aircraft is suspected or infected, such aircraft shall be detained

depending on its health condition and proceed to apply all measures that
shall make the aircraft free of infection.
The passengers of such aircraft shall not leave the vicinity, unless
authorised. But, if such aircraft lands in any other airport (which is not
international sanitary airport), the commander of the aircraft shall notify
the medical officer of health in that area, who shall take measures
appropriate to the circumstances.
3.4 Seaport Health Control Measures
Seaport health control measures are put in place to reduce incident of

trans-border diseases spread. This includes but not limited to the
following:
 Screening of passengers from countries affected by

internationally notifiable diseases and taking appropriate action
as necessary.
 All incoming travelers at the seaport are required to be
immunised against yellow fever.
 The following information are contained in the yellow fever
vaccination card:
1. Dosage given
2. Date of manufacture of vaccine and name of manufacturer
 Medical team are at the seaport to cater for the travelers showing
symptoms of suspected Notifiable infectious diseases and such
traveler may be referred to hospitals for further management.
 All people arriving at seaport, including transit passengers, are
required to have yellow fever certificate or card. Anyone not
having yellow card is suspected and quarantined.
 Investigation of any case of infectious diseases report at the port
or aboard any vessel (aircraft, ship, train or road vehicle) entering
the country
 Notification of any diseases as per IHR (2005)
 Quarantine of passenger(s) suspected of having an infectious
disease
 Fumigation of infected vessels and quarantine as need arises
 Quarantine any vessel disinfected or disinfested as per IHR
(2005) and other existing local laws and regulations
 Inspect all types of commercial vessels to ensure appropriate
sanitary conditions and hygiene standards are maintained
 Review of documents on Maritime Declaration of Health
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EHS 315 MODULE 3
 Issuance of Ship Sanitation Control Exemption Certificate/Ship

Sanitation Control Certificate
3.5 Ship Inspection
Ship has been defined as mobile or floating premises and therefore, the
inspection of the ship is very similar to house – to –house inspection.
―Premises‖ - means and includes messuages, buildings, lands,

tenements, hereditaments, vehicles, tents, vans, structures or any ship or
vessel in any port or on any inland water.
Ship inspection involves a routine, regular and systematic inspection in

order to detect nuisances and abate them. It is pertinent to mentioned
that sometimes, inspection could be as a result of investigation of
complaints of nuisances and infectious diseases.
It is worthy of note that ship inspection is in compliance with the IHR. It

starts from outside. All Ships are expected to use either or all of these
methods to prevent rats in the ship, including health education. The
methods are:
 The use of rat-guards in the rope

 Use of coal-tar (black) on all cables and wires of the ship
 Blocking the holes in the ship
 Use of electricity (bulbs) on the gang-way at night.
Whenever the ship fails to use any of the aforementioned devices, a ―rat-
guard notice‖ is served compelling the captain to put on and to prevent
reoccurrence.
In case of reoccurrence, the captain of the ship is prosecuted. The health

officer has to seek the permission of the captain or his assistant (chief-
mate) before he carries out the inspection of the ship. The following
information is collected:
a. Name of the ship

b. Nationality
c. Agent
d. Birth
e. Date of Arrival
f. Estimated time of departure
g. Type of certificate
h. Port of issue of the certificate
i. Last port of call
j. Next port of call
84
k. Rat-guard (present or absent)

l. Last port of water supply or does the ship make her water on
board
m. Date of supply of water on board
n. How often does the ship clean its water tank in a year
o. Livestock on board
p. Any sick crew/passenger on board
After the information, the health officer carries out a keen and thorough
inspection of the ship.
3.6 State Land Border Health Control Measure
Land frontier or post health control measures are those plan of actions
put in place to reduce incident of trans-border diseases spread, this
include but not limited to the following;
 All arrivals at land border control points and cross-boundary

buses and vehicles are screening of internationally notifiable
diseases and taking appropriate action as necessary
 All incoming travelers at land border are required to be
immunised against yellow fever
 The following information are contained in the yellow fever
vaccination card:
1. Dosage given
2. Date of vaccine was manufactured and name of manufacturer
 Medical team are at the land border to cater for the travelers
showing symptoms of suspected notifiable infectious diseases
and such traveler may be referred to hospitals for further
management.
 All people arriving at land border are required to have yellow
fever certificate or card. Anyone not having yellow card is
suspected and quarantined.
3.7 Requirements of a Designated Approved Port
 An organised organisational medical and health services with

adequate trained health personnel.
 Equipments of a wireless station for easy communication
between the ship and the health authority.
 Safe drinking water supply.
 Provision of mooring station which should always be kept clean
85
EHS 315 MODULE 3
 Effective system and equipment for the removal and safe disposal
of excrement refuse waste water, condemned food and other
matter dangerous to public health.
 Waiting rooms or premises for the medical inspection and
examination of persons.
 Premises and facilities for the prompt isolation and care of
infected persons (quarantine station and isolation camp).
 Apparatus means for cleansing, disinfecting and disinfection of
ship, clothing and other article/which can make the port free from
mosquitoes especially aedes aegypti.
 Adequate and accommodation or homes for seamen while in the
port premises.
 Provision of nearby market for easy shopping of passengers and
crews men.
 Laboratory for bacteriological examination of rodents for plague
infection, water and food samples.
 Provision of ambulance vehicle for easy removal of patient to
hospitals.
 Equipment for vaccination and inoculation of passengers and
crews men.
3.8 Diseases of International Health Regulation or

International Notifiable Disease
 Plague
1. Incubation period (6days)

2. Suspected people should be quarantine for 6days
3. All passengers and crews should be put under surveillance for 6
day
4. Disinfection of the ships including baggage and articles of the
infected or suspected people should be carried out.
5. Prophylactic inoculation with anti-plague vaccination of the
passengers and crew is highly important.
6. If it is rodent plague, the ship should be fumigated
7. All dead rats should be burned
8. A certificate dully signed by EHO or a designated Health
Personnel should be issued to ensure that the people could no
longer spread the disease and also such a ship is granted free
pratigue and allowed to stay and berth with other ship since she
has been fumigated and is free for human habitation.
86
 Cholera

2. Disinfection of the ship with special reference to articles of the
infected or suspected person.
3. Condemnation of H20, fish, meat, vegetable or other exposed or
uncooked food items found on board.
4. Inoculate the people whose certificate has expired.
5. All the infected person should be isolated.
6. All suspects should be quarantine.
 Yellow fever

2. Passengers and the crews should be place under surveillance for
six days
3. Re-inoculate all the contacts
4. Isolation of all the infected persons
5. Disinfection of the ship for the destruction of vectors of yellow
fever on board.
 Smallpox
 Typhus fever
Relapsing fever, etc.
3.9 Other Port Health Duties
Health services throughout the world are designed to prevent diseases

and accident, promote physical, social and mental health and to prolong
life, through organised organisational community effort for the
sanitation of the environment, the control of disease and education in
personal hygiene. To achieve these objectives, every country provides
the necessary health infrastructures like hospitals, health centres, health
clinics, maternity and child health services, training institutions to train
health personnel. But owing to contacts (by air, land and water) with the
outside world, no country can achieve the objective of ensuring disease
free environment. This is because the health status of the countries of
the world differs, for example, cholera and yellow fever are endemic in
India and most parts of Africa respectively, while Malaysia and most
parts of Europe are receptive areas of yellow fever.
The implication therefore is that diseases known to be prevalent in a

region could be introduced through trade routes. In Nigeria, it was only
from 1970 that cholera became a health problem.
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EHS 315 MODULE 3
It is clear from the foregoing that disease prevention promotes health

and prolongs life. Thus, our concern must go beyond the national
boundaries. Steps must be taken to prevent importation and exportation
of diseases as people cross and re-cross the political boundaries called
national frontiers. This is the objective of international health. World
Health Organisation therefore, recognises that the only true protection
against inter-borders communicable diseases, is to control them at the
sources, in order to prevent the danger of a disease localised in a region
being spread to within and to other countries. Thus, any measure that
prevents the spread of the communicable diseases would help the
control of these diseases.
Disease prevention is one of the most important functions of the port

health authority. It is a control measure that must be carried out
promptly. Important highlight of this measure include but not limited to:
a. Prompt notification of appropriate health authority by port health

officials of all cases of internationally modifiable infectious and
communicable diseases
b. Investigation, analysis and report of findings by health officials
c. Prompt isolation and quarantine, where necessary
d. Immunisation of all contacts
e. Disinfection , disinfestations and derating
f. Laboratory diagnosis of all collected samples to establish cause
of infection
g. Containment of spread and route of communicability.
 Port Health Welfare Services
Statutory duties of port health authority are services rendered by port

health officials. This includes the ones run of routine, ad-hoc and
emergency. These duties are given recognition under the law. The duties
are:
a. Port welfare services,

b. Management of resuscitation centre,
c. Landing of corpse,
d. Management of quarantine station,
e. Management of isolation camp,
f. Pilgrimage,
g. Airport Health Control,
h. Vessel Inspection,
i. Imported foodstuffs,
j. Pharmaceuticals and medicines,
k. Port exports, etc.
88
a. Port Welfare Service
The port welfare service rendered to seamen is a joint service between

the port health authority and other port welfare committees. In Nigeria,
these committees include:
i. Port health authority

ii. Social welfare service of Lagos City Health Department
iii. All shippers agencies
iv. Mission to seamen (some distinguished seamen)
v. Shipping federation (who recruits all seamen for shipping lines
in Nigeria)
The services rendered include both medical and social. The medicals
are:
 Full medical examination of all crew and seamen every two years
and on retirement
 Free infection examination of the seamen
 Vaccination and inoculation against diseases subject to
regulations
 Treatment of venereal diseases – which are prominent among
seamen. This is in line with the agreement signed on the 1st
December 1924 at Brussels that treatment facilities be given to
merchant seamen for the treatment of venereal diseases.
Article 1 of the Brussels Treaty states that the high contracting parties
undertaken to establish and to maintain each of their principal sea or
river, port services for the treatment of venereal diseases, is open to all
merchant seamen or watermen without distinction of nationality. It
should be made known that all medical treatments and supplies of
necessities to the seamen are free of charge.
In Nigeria, the agent or owner of the particular ship settles the bill for all
the services rendered to seamen. The following are the social activities
that are given to seamen while in the port:
 Personal interviews with the seamen and rendering of help on

various problems
 Exchange of library books and issuing of magazines and
newspaper
 Excursion and visits to places of interest
 Night clubs, pubs, hotels and cinema houses are visited
NOTE: There is a seafarer‘s club house, which solves all the social
problems of the seamen.
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EHS 315 MODULE 3
b. Resuscitation Centre
This is the reception centre for all survivors brought from the scene of
events of an aircraft accident or emergency occurring at the airport. All
injured persons are removed from the crash and given aid or treatment at
this centre before finally transferred to either a hospital for further
treatment to his house for recovery. If during the course of first aid, the
survivor dies, he is removed to mortuary.
Since it is possible and not the wish of port health authority for a plane
to crash, the resuscitation centre is routinely used as first aid base for the
treatment of airport workers to treat minor ailments.
c. Landing of Corpse
Any aircraft or ship bringing a corpse known as ―special cargo‖ is

termed ―suspect‖. The captain must submit the certificate showing the
cause of the death to the port health authority. If the death is of
infectious nature, the aircraft or the ship must be disinfected, if not,
disinfection is not necessary. Then, the health authority should inspect
the embalmed corpse. When thus satisfied, the corpse is handed over to
the owner for burial.
Since the port health does not take responsibility for the burial, she only
prescribes mode of burial or disposal or bodies of those dying from an
infectious diseases, e.g., deaths due to cholera should be soaked in
chlorinated lime or lysol before burial. This prescription must be
followed by the local health department in charge of burial ground. The
same process is followed for an exported corpse. Other welfare services
include:
 Quarantine station
 Isolation camp
 Ambulances service
 Pilgrimage services.
4.0 CONCLUSION
In concluding this unit, we have studied and enumerated the

environmental health services at the port to include among others:
implementation of the international health regulations; disease
surveillance within the ports and frontier post of entry and exit;
quarantine administration including immunisation; inspection and
certification of vessels (aircraft, ship, train or road vehicle);
environmental sanitation within ports and frontier posts to control
nuisances such as noise, dust, smoke and odour problems; vector/vermin
control within and around ports and frontiers; food safety measures for
90
both imports and exports; vaccination of travellers and issuance of

vaccination certificates and respond to any health emergencies within
and around the port area. Environmental health officers should be
abreast of specific activities that take place at the air, sea and land
borders.
5.0 SUMMARY
In this unit, we have listed the environmental health services

implemented at the port as well as the health control measures at the
airport, the seaport and the land borders/frontiers.
1. List 15 environmental health services implemented at the port

health.
2. State airport health control measures.
3. Define seaport health control measures..
4. State land border health control measures.
.health/health_inspectorate/port_health_services/port_health_serv
ices_objective.aspx.
nigeria.html.
http://www.euro.who.int/ data/assets/pdf_file/0004/151375/e95783.pd
f.
WHO (2005). International Health Regulation. Geneva: World Health

Organisation, Communicable Diseases Surveillance and
Response. Frequently Asked Questions about International
Health Regulations.
IHR. (2005). From the Global to the Local.
Lawrence, O. Gostin (2004). ‗International Infectious Disease Law,

Regulations‘. Journal of the American Medical Association.
91
EHS 315 MODULE 3
Olugbenga, Olorunda; Adeolu Omonayajo & Micheal Aibor. (2010). A



92
MODULE 2 DUTIES OF ENVIRONMENTAL HEALTH

OFFICER IN PORT HEALTH
Unit 1 Pest and Vector Control

Unit 2 Health Emergencies
Unit 3 Water Hygiene in Air Travels
In module one, the fundamentals of port health services was explained.

It covers such topics as the introduction to port health services, the
terminologies used in port health services, the divisions and sections in
port health services in Nigeria and environmental health services being
implemented at the ports.
Module two, which is on the duties of environmental health officer in

port health services, has three units. Topics such as pest and vector
control in port health; health emergencies in port health and water safety
and hygiene in air travels will be treated.
UNIT 1 PEST AND VECTOR CONTROL
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Pest and Vectors of Port Health Concern
3.2 Pest and Vector Control Measures
3.3 Equipment used in Pest and Vector Control
3.4 Chemicals used in Control Measures
3.5 Chemicals Banned for use in Pest and Vector Control
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
Throughout history, vector-borne illnesses have troubled mankind. In

the past decade, they have been on the rise around the world and
resurgent in places where they had once been under control. They have
re-emerged not only because the hosts have developed resistance to
pesticides and medical treatment, but also because international trade
and travel continue to expand.
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EHS 315 MODULE 3
Vectors are carriers, usually small animals or arthropods that transfer a

disease causing pathogen from one host to another. Some examples are:
bats, birds, cats, fish, mice, rats, tick mosquitoes and reptiles raccoons
etc.
Pest control within ports is of major importance as pests, such as rats

and mice, are linked to the spread of international disease. The
International Health Regulations (2005) and the Public Health (Ships)
(Amendment) Regulations (2007) provide authorised port health
authorities with the power to issue ship sanitation certificates to declare
ships as being free from disease and the vectors of disease. The
International Health Regulations (2005) make authorised ports
responsible for the control of vectors that may constitute public health
risk.
2.0 OBJECTIVES
 list and discuss pest and vectors of port health concern

 list pest and vector control measures
 enumerate equipment used in pest and vector control
 list the chemicals used in control measures
 list the chemicals banned for use in pest and vector control.
3.0 MAIN CONTENT
3.1 Pest and Vectors of Port Health Concern
Rodent control is one of the major port health duties because of the
nuisance usually created by rodents in terms of diseases transmission,
destruction of valuable property like food, cloths, and books etc.
The word ‗rodent‘ includes rat, mice, and squirrel etc. The two major
ones which have significant effect in port health or international health
concern are presented in a tabular form:
1. Ratus Ratus (RR)

2. Ratus Norvengicus (RN)
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Ratus Ratus (R.R) Ratus Nqrvengicus (R.N)

1. Brownish in colour Black in colour
2. It lives in houses Lives and swim in burrows
3. An excellent climber Excellent swimmers
4. Droppings arc soft spindle in shape Droppings are firm shape and
arid often grouped on run ways scattered on the run way
5. It has appointed muzzle with large It has a blunt muzzle with small
translucent ears. hairy ears
6. It has thin tail longer than head It has tail shorter than head and
and body put together. body put Together
Rat (Ratus-ratus)
Rats and mice can transmit many diseases to humans such as Bubonic
Plague and Weil‘s disease. They are also able to transmit certain types
of food poisoning such as salmonella. Rodents may also pose a nuisance
to humans through the contamination of food and damage to buildings
and other structures due to gnawing and burrowing.
Rodent control both on board ships and within the port area is an
important method by which the spread of international disease is
prevented. All ships travelling internationally must demonstrate that
they do not have rats on board by showing a valid ship sanitation
certificate.
Environmental health officers are authorised to request the master of a

ship to carry out control measures where there is evidence of rats on
board. Control measures may include: trapping, poisoning or fumigation
of the ship. As rats require water, shelter and food to survive, the
elimination of harbourage and standing water may also be required.
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EHS 315 MODULE 3
 Insects
Cockroach
Cockroaches can spread disease via their bodies and droppings. They
can carry dysentery, gastro-enteritis, typhoid and food poisoning
organisms which they spread when coming into contact with our food.
Cockroaches are able to breed rapidly, therefore forming large numbers.

They are also highly resilient to treatment. Like rats, it is important that
cockroaches are controlled on board ships in order to prevent the spread
of disease.
Environmental health officers are authorised to request the master of a

ship to carry out control measures where there is evidence of
cockroaches on board. Control measures may include: trapping and the
use of insecticide. As with rats, the removal of habitat and food sources
may also be required in order to treat an infestation. However,
cockroaches will eat a wide variety of food sources (including leather
and other dead cockroaches) and have been known to go without food
for periods.
 Mosquitoes
Anopheles mosquito
Mosquitoes are found throughout the world, including the Arctic. Their
habitats include both rural and urban locations. Globally, they are
notorious for their biting habit and ability to transmit disease.
Disease transmission from mosquitoes is not only a risk in tropical

countries; there is also a potential risk in other parts of the world. Poor
96
sanitation, housing, bad drainage system and overcrowding promotes

breeding and transmission potential of mosquitoes. This made the
transmission of the disease unsustainable. More recently, there have
been cases of airport malaria where malaria infected mosquitoes have
escaped from flights arriving from foreign counties and then gone on to
bite local residents. There are many other mosquito borne viruses
including: West Nile Virus and Yellow Fever.
 International Health Regulations, 2005
Port health authorities are responsible under the International Health

Regulations 2005, for establishing programmes for controlling vectors
that may transport an infectious agent (hence constituting a public health
risk) to a minimum distance of 400 metres from point of entry facilities
(e.g. docks).
3.2 Pest and Vector Control Measures
The control measures for pests and vectors include:
 Environmental cleanliness
a. The elimination of breeding sites or hideouts e.g. clearing

of drains and canals etc,.
b. Removing their sources of food e.g. prompt clean up after
cooking, regular garbage pickup and clean up.
Environmental cleanliness is very effective for controlling
pests and vectors and can lead to eradication, which can be
sustained though health education and community
sensitisation.
 Traditional method
Time tested and effective methods of pest and vector control are
the use of certain plants or the rearing of certain animals that
repel pests and vector.
 Biological
This is the use of natural enemies of pest and vector such as animal and
bird predators who feeds or prey on the pest and vector. The use of
biological control does not usually lead to eradication, though it may
appear safe and environmental friendly.
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EHS 315 MODULE 3
 Mechanical or physical control
The use of devices, machines, barriers and other mechanised methods to

control pests or alter their environment e.g. traps, screens, fences, nets,
radiation, and electricity etc. This safe and environmentally friendly
method is effective as long as the device is intact and in good working
condition, but does not usually lead to eradication.
 Chemical
The use of chemicals to destroy pest and vector is one of the control
measures against their activity, causing damages and preventing further
spread.
Chemicals either repel or kill the pest. It is the fastest way to get rid of
pest and vector population, though it may not be environmentally
friendly.
3.3 Equipment used in Pest and Vector Control
 Knapsack sprayer – manual sprayer mounted on human back to

spray drains, stagnant water bodies and interior of buildings.
 Motorised or mechanical sprayer – used on large breeding water
surface of canals, where it is impossible to treat manually.
 Swing fog machine – used to spray exterior environment. It oozes
out chemical smoke as against moisture released by knapsack or
motorised sprayer. It can be used to attack or disperse locust and
quillial birds.
3.4 Chemicals used in Control Measures
 Pesticides – generic group name commonly used.
(a) Pyrethoids – have faster knockdown effects and very long lasting
residual action on flies, mosquitoes and cockroaches.
(b) Organophosphates, also called opsl, have extensively been used

in pest and vector control. It should be applied with caution as it
is toxic to untargeted mammals and human. Most
organophosphates deteriorate rapidly and therefore pose no
problem of long term environmental contamination or effect.
 (Ficam) have lower toxicity to mammals. Carbamates have a

similar mode of action to the organophospates. Generally,
carbamates such as carbarly (sevin), propoxur (baygon) and
bedniocarb.
98
 Botanicals are natural insecticides derived from plants.

Botanicals include pyrethrum, rotenone, ryania and nicotine.
Pyrethrum is an oily substance extracted from certain varieties of
chrysanthemums plant. They are often used in combination with
synergists such as pieronys butoxide.
 Fumigants are gaseous pesticides whose vapours enter the pest
system though inhalation.
 Rodenticides are poisons which kill rodents. It comes in various
forms, such as granules, powder, and cakes etc.
3.5 Chemicals Banned for use in Pest and Vector Control
 Heptachlor
 Flouracedtamide
 Chlordane
 Mercury compounds
 Ethylene 1.2-dibromide (EDB)
 Chlordimeform
 Dinoseb and dinoseb salts
 Dicholodiphenxyl trichloroethane (DDT)
 Pentachloropheny 2,4,5-
 Chlorobenizlate
 HCH (mixed isomers)
 Aldrin
 Dieldrin
 Methamidophos
 Methyl parathion
 Parathion
 Paraquat
 Lindane
Severe restriction
 Captafol
 Hexachlorebanzene
 Phosphamidon
4.0 CONCLUSION
In concluding this unit, we have studied and enumerated pest and vector
that are of port health importance.
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EHS 315 MODULE 3
5.0 SUMMARY
In this unit, we have discussed pest and vector of port health importance.
We also listed the equipments and chemicals used in pest and vector
control. Mentioned was also made of banned chemicals.
1 List and discuss 2 pest and vectors of port health concern.

2 List pest and vector control measures.
3 Enumerate some of the equipments used in pest and vector
control.
4 List the chemicals used in control measures.
5 List the chemicals banned for use in pest and vector control.
https://ehealth.gov.mt/HealthPortal/public_health/environmental.health/
health_inspectorate/port_health_services/port_health_services_ob
jective.aspx.
nigeria.html.
http://www.euro.who.int/data/assets/pdf_file/0004/151375/e95783.pdf .
WHO, Geneva (2006). International Health Regulations 2005.

Response: Frequently Asked Questions about International
Health Regulations.

Olugbenga, Olorunda, Adeolu Omonayajo & Micheal Aibor. (2010). A

10
0
World Health Organisation. (2004). Vaccination Certificate


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EHS 315 MODULE 3
UNIT 2 HEALTH EMERGENCIES
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Health Emergency
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
In module 2, unit 1 above, we discussed pest and vector control on port

health. It is important to note that when the breeding and activities of
this pest and vectors are not controlled on port health services, it more
often than not, leads to health emergency.
A Public Health Emergency of International Concern (PHEIC) may be

declared when a State‘s health authority is satisfied that there is an
outbreak or imminent outbreak of a communicable disease that poses a
substantial risk to the population of the state or upon activation.
(According to Annex 2 of the IHR (2005), ―Decision instrument for the
assessment and notification of events that may constitute a public health
emergency of international concern‖).
It is recognised that public health emergencies, other than those posed

by communicable disease, exist e.g. food poisoning and infectious
substances. Public health emergencies other than those associated with
communicable disease are outside the scope of this unit.
2.0 OBJECTIVES
 define health emergency

 state the role of port health authority in health emergencies
 list appropriate actions in health emergency.
10
2
3.0 MAIN CONTENT
3.1 Health Emergency
Health as defined by Public Health Emergency of International Concern

(PHEIC) may be declared when a State‘s health authority is satisfied
that there is an outbreak or imminent outbreak of a communicable
disease that poses a substantial risk to the population of the state upon
activation. (According to Annex 2 of the IHR (2005), ―decision
instrument for the assessment and notification of events that may
constitute a public health emergency of international concerns‖).
 The roles of the aviation authority during a PHEIC are:
a. Ensure the availability, continuity and sustainability of critical air

transport services; and
b. Coordinate and facilitate the implementation of health and non-
health measures to protect the health and welfare of travellers,
staff and the public, as well as to minimise/ mitigate the spread of
communicable disease through air travel.
 Aim
This plan describes the measures to be adopted during a PHEIC. It

complies with the relevant articles in the IHR 2005 and the ICAO
Annexes 6, 9, 11 and 14.
 Principle Considerations
a. The processes and measures to be adopted during a PHEIC are

guided by the following considerations:
i. Coordinated and Timely Response
a. The implementation of health measures is a multi-agency

effort and not the sole responsibility of the aviation
authority. As such, the measures implemented by the
respective agencies should be well-coordinated to avoid
confusion, inconsistencies and duplication of resources. At
the initial outbreak stage, measures may need to be very
rapidly deployed and timely implementation is important.
ii. Effective and Sustainable Measures
a. Response to a public health emergency may continue over a

prolonged period of time. Measures adopted should be effective,
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EHS 315 MODULE 3
and at the same time be sustainable until the emergency situation

ends.
iii. Minimise Inconvenience to Travellers
Processes and measures introduced during a public health emergency

should primarily be targeted to mitigate the risks brought about by the
outbreak of the disease. These processes and measures adopted should
minimise inconvenience to all travellers.
iv. Rapid return to routine operations as the emergency subsides
v. Criteria for determining when the emergency is diminishing

should be in place. An associated process for reducing the
emergency measures is required so that a return to routine
operations is facilitated in line with the reducing health risk.
 Planning Assumptions
The State health authority may issue planning assumptions based on its
own assessment or information provided by neighbouring States or the
WHO. There are two primary scenarios:
a. The first local human case is imported from another affected

State/Administration (rather than developing from within the
State);
b. There has been a local outbreak of a PHEIC within the State and
measures have to be taken to contain the outbreak and minimise
the spread to other States. Note: State Health and Aviation
Authorities are encouraged to refer to the WHO Western Pacific
Regional Office publication ―Guidance for Public Health
Emergency Contingency Planning at Designated Points of Entry;
Requirement under the International Health Regulations (2005)‖
This guide provides a recommended approach, structure and a logical

but simple set of considerations and steps for National Public Health
Authorities (NPHA) to guide public health and emergency planners
responsible for points of entry to develop public health contingency
plans.
 Execution of Health Emergency Plan
The aviation measures adopted should be an integral part of the State‘s

overall plan for a PHEIC. The aviation authority will usually have a
Crisis Management Team (CMT) to develop and execute the public
health emergency plan. These planned measures may be contingent on
104
the State health authority‘s alert levels or according to the WHO phases
of an evolving pandemic.
A risk management concept should be adopted to ensure a phased and

gradual step-up of control measures, in accordance with the changing
circumstances.
 Crisis Management Team (CMT)
As part of its preparedness for non-health related emergencies- accident,

fire, and terrorist activity etc., the aviation authority is likely to have
already established a crisis management team. This team may be
adequate to deal with a public health emergency but it is more likely that
the individuals comprising the team, and perhaps its leader, need to be
revised for such an emergency. The team needs specific representation
from the public health authority, and the individual to provide this
expertise needs to be identified. Further, the individual leading the
CMT and taking responsibility for team decisions involving public
health emergencies requires advance planning. The constitution of the
CMT needs to be flexible, as does its means of communication, since it
may be required to deal with a PHEIC that involves only one, or a few
affected individuals, or on the other hand may affect a whole population.
 Activation/Deactivation Process
The activation of the health measures will usually be initiated by the

State health authority. The CMT will coordinate all measures within the
aviation sector. The number of officers activated to support the crisis
actions is subjected to the decision of the leader of the CMT. The
deactivation or scaling down of measures will be initiated by the State
health authority.
 Measures Adopted in Health Emergencies
The measures adopted at Points of Entry (POE), especially at airports

are crucial to the containment and mitigation efforts of the State. The
import/export of the communicable disease may be mitigated through
the implementation of a specific set of measures corresponding to the
defined alert levels. However, the measures are also subject to changes,
attendant on the State‘s continuing assessment of the situation.
Note: The aviation authority in consultation with the State health

authority and with the cooperation and collaboration of all the
stakeholders is recommended to develop and implement a training
program for airport workers that are likely to be involved in the
implementation of the preparedness plan. These would include (but not
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EHS 315 MODULE 3
be limited to) check-in staff, immigration and customs personnel. This

would also include training on how to pick up (as non medical persons)
travellers that may be suspect cases of a communicable disease of public
health importance. Such training could be similar to that given to cabin
crew and the list of signs and symptoms similar to that used in the
aircraft general declaration.
4.0 CONCLUSION
In concluding this unit, we have studied what is health emergency, the

health emergency preparedness, the roles of port health authorities and
the listing of appropriate action to be taken in cases of health
emergency.
5.0 SUMMARY
A Public Health Emergency of International Concern (PHEIC) may be

declared when a State‘s health authority is satisfied that there is an
outbreak or imminent outbreak of a communicable disease that poses a
substantial risk to the population of the State or upon activation by
WHO (According to Annex 2 of the IHR (2005), ―Decision instrument
for the assessment and notification of events that may constitute a public
health emergency of international concern‖).
It is recognised that public health emergencies other than those posed by

communicable disease exist e.g. food poisoning, and infectious
substances. Public health emergencies other than those associated with
communicable disease are outside the scope of this unit.
1 Define health emergency.

2 State the role of port health authority in health emergencies
3 List appropriate action in health emergency.
nigeria.html.
106
http://www.euro.who.int/ data/assets/pdf_file/0004/151375/e95783.pd
fInternational Health Regulations 2005. Geneva: WHO. (2006).
World Health Organisation, Communicable Diseases Surveillance and

Response Frequently Asked Questions about International Health
Regulations IHR (2005). From the Global to the Local.

Olugbenga, Olorunda, Adeolu Omonayajo & Micheal Aibor.(2010).

A Technical Handbook of Environmental Health in the 21st
Century for Professionals and Students. (2nd ed.).


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EHS 315 MODULE 3
UNIT 3 WATER SAFETY AND HYGIENE IN AIR

TRAVELS
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Water Supply and Transfer Chain
3.2 Water Requirements of an Aircraft
3.3 Health Risks Associated with Water on Aircraft
3.4 Guidelines on Drinking Water Quality (GDWQ) and
Guide to Hygiene and Sanitation in Aviation
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
In unit 2 above, we discussed health emergencies and the various

strategy and plans that can be put in place to remediate the incidence of
health emergency.
In this unit, we shall be considering water safety and hygiene in air

travels. It is important to mention that a process within the aircraft
revolves around water, as water is needed in food preparation, reduction
of thirsty and dehydration and the cleaning activities in the aircraft.
Travel can facilitate the transfer of communicable disease. The volume

and rapidity of travel can have an international impact on disease. This
is particularly true for aircraft, as the global span of the aviation industry
requires the loading and rapid transport of people and supplies from
many locations all over the world. With the 21st-century potential for
millions of people to have access to air travel on a global scale come the
added problems encountered by aircraft operators that transit both into
and out of disease-affected areas or areas with variable and sometimes
inadequate standards of general hygiene and sanitation.
One risk is posed by the potential for microbial contamination of aircraft

water by animal or human excreta. This contamination may originate
from source waters or may occur during transfer operations or while
water is stored on board the aircraft. Waterborne disease burdens in
many parts of the world include cholera, enteric fevers (Salmonella),
bacillary and amoebic dysentery and other enteric infections. These
108
diseases are not unique to water; as food may actually be the dominant
risk vector in some environments. In fact, most airlines have a good
record with respect to known contamination incidents. However, any
location is at risk if proper procedures and sanitation practices are not
continuously followed to ensure the safety of water that is used for
drinking and food processing and preparation.
2.0 OBJECTIVES
 define water supply and transfer chain

 state water requirements of an aircraft
 mention the health risks associated with water on aircraft viz;
(a ) Water quality
(b) Water quantity
 differentiate between bottled water and ice cubes
 mention the uses of potable water on board aircraft
 enumerate water safety plans.
3.0 MAIN CONTENT
3.1 Water Supply and Transfer Chain
If the water at the airport is safe, that does not ensure that it will remain
safe during the transfer to the aircraft and storage activities that follow.
An understanding of the aircraft drinking-water supply and transfer
chain will help to illustrate the points at which the water can become
contaminated en route to the tap on board the aircraft.
Generally, the aircraft drinking-water supply and transfer chain consists

of four major components:
 the source of water coming into the airport;

 the airport water system, which includes the on-site distribution
system. It may also include treatment facilities if the airport
produces its own potable water;
 the transfer point (sometimes referred to as the watering point),
including the water transfer and delivery system. It is typically a
temporary interconnection between the hard plumbed distribution
system of the airport (e.g. at a hydrant) and the aircraft water
system, by means of potable water vehicles and carts, refillable
containers or hoses. This water transfer process provides multiple
opportunities for the introduction of contaminants into the
drinking-water;
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EHS 315 MODULE 3
 the aircraft water system, which includes the water service

panel, the filler neck of the aircraft finished water storage tank
and all finished water storage tanks, including refillable
containers/urns, piping, treatment equipment and plumbing
fixtures within the aircraft that supply water to passengers or
crew.
3.2 Water Requirements of an Aircraft
The water storage capacity required for all purposes on board an aircraft
is based on the number of occupants (passengers and crew) and the
duration of the flight, while being limited by weight, aircraft design and
other practical considerations.
In practice, the capacity of aircraft water systems varies considerably.

Examples of the potable water carrying capacities of different aircraft
are given in Table 1.
Table 1.3: Approximate Capacity of Potable Water Tanks on Select

Aircraft
Aircraft type Number Quantity per tank Total quantity

of tanks (litres) (litres)
1700 (option
A380 6 283.3 (option 377 7)
2266)
A340-
3 356.7 1070
500/600
A340-
2 350 (option 525) 700 (option 1050)
200/300
744 F/P 4 416.3 1665.2
744Combi 3 416.3 1248.9
MD11 4 238.4 953.6
777-200ER 3 412 1236
777-300ER 3 435 1305
A330 2 350 699
Individual size, location and capacity of each tank may vary due to
customer preference and use on the aircraft.
3.3 Health Risks Associated with Water on Aircraft
 Water quality
The importance of drinking-water as a vehicle for the transmission of

infectious disease micro-organisms in water supplies has been well
documented in public and private water supplies.
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The WHO Guidelines for Drinking-water Quality (GDWQ) (WHO,

2004) provide comprehensive guidance to ensure the quality and
safety of drinking-water. Most of the concerns involving the safety
of drinking-water on board aircraft focus on acute risks because of
the short-term and limited exposure conditions. Thus, microbial risks
are the principal concerns, although a few risks associated with
acutely toxic chemicals also exist.
The WHO Guidelines for Drinking-water Quality (WHO, 2004)

(GDWQ) identify the broad spectrum of contaminants, including
micro-organisms, inorganic and synthetic organic chemicals,
disinfection by-products and radionuclide‘s that can reach hazardous
concentrations in potable water supplies and describe systematic
approaches to risk management. As a general definition, safe
drinking-water, as defined by the GDWQ, does not represent any
significant risk to health over a lifetime of consumption, including
different sensitivities that may occur between life stages.
Significant microbial risks are associated with ingestion of water that

is contaminated with human and animal excreta, although exposure
through food preparation and direct human contact are probably
more significant contributors to overall microbial disease risks.
There are no known reports of illness associated with drinking

contaminated water on aircraft. Nevertheless, the potential for serious
illness exists, particularly for those with compromised health (e.g.
individuals with chronic illness).
The water quality guidelines directly applicable to water on aircraft

focus on acute risks from contamination that may be incurred during
transfer from the airport, through the transfer point or on board the
aircraft. The focus on acute risks is because the exposure that would
occur during a flight and be experienced by passengers and crew would
be intermittent and of short duration (hours) rather than long term or
lifetime, which is the basis for most of the guidelines in the GDWQ.
Typically, the GDWQ assume the consumption of 2 litres of drinking-
water per day by an average 60-kg adult for a lifetime (70 years); 1 litre
per day for an l G-kg child and 0.75 litre per day for a 5-kg bottle-fed
infant.
Besides microbial organisms, a few inorganic chemical substances, such

as nitrate and nitrite (which can enter the source water from agricultural
activity, sewage inflow or sewage cross-contamination in plumbed
systems) and copper (which may leach into drinking-water from copper
piping), may also be of health concern due to subpopulations that may
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EHS 315 MODULE 3
be at risk from excess short-term exposures. For instance,

methaemoglobinaemia may be caused by the temporary exposure of
infants to nitrate and nitrite, among other contributing factors; and
gastric irritation may result from short-term exposure to copper (WHO,
2004).
Potentially, significant cumulative effects of repeated short-term

exposures to chemical hazards should not be overlooked, as they may
lead to long-term consequences.
 Water quantity
An insufficient or non-existent quantity of potable water under pressure

on board the aircraft for drinking, culinary purposes and personal
hygiene can have an impact on the health and welfare of not only the
passengers but also the crew.
There may not be enough water for the safe use of lavatories, which may
lead to malfunctioning of some types of toilets, unpleasant odours,
contaminated surfaces and an inability to wash hands. It may also lead
to an inability to prepare or serve food in a sanitary manner, thereby
impacting on the provision of safe food to passengers.
Adequate water intake during flight is also important to maintain health

and well-being, although there is no need to drink more than usual
(WHO, 2008b). The humidity in aircraft cabins gradually decreases on
long-distance, high-altitude flights, sometimes reaching below IQ%
(optimum comfort is at approximately 50% humidity). While this low
relative humidity does not cause central dehydration (Stroud et al., 1992;
WHO, 2008b), it can cause discomfort for passengers and crew. Dry,
itchy or irritated eyes, dry or stuffy nose, dry throat and skin dryness are
among the most common complaints of cabin crew (Lee et al., 2000).
Regular water intake and use of a skin moisturiser will minimise these
symptoms, but it is possible that some individuals may become
intolerant of contact lenses and have to revert to spectacle use.
The amount of water required for hand washing and other sanitation
needs should be adequately dealt with in typical passenger aircraft
designs.
 Difference between bottled water and ice
Bottled water is considered as drinking-water by some regulatory

agencies and as a food by others (WHO, 2004). For many airlines,
bottled water is the primary or exclusive source of water used for direct
consumption on board aircraft, with the exception of hot beverages.
112
International bottled water quality specifications exist under the Codex

Alimentarius Commission (FAO/WHO, 2001) and are derived from the
GDWQ.
For the purposes of this course, ice supplied to aircraft for both drinking
and cooling has been classified as "food‖ (WHO, 2004).
 Uses of potable water on board aircraft
Potable water is used in a variety of ways on board commercial transport

aircraft, including direct human consumption, food preparation and
sanitation hygiene activities. Potential uses include:
a. preparation of hot and cold beverages, such as coffee, tea and

powdered beverages;
b. reconstitution of dehydrated foods, such as soups, noodles and
infant formula;
c. direct ingestion from cold water taps and water fountains;
d. reconstitution and/or ingestion of medications;
e. brushing of teeth in lavatories;
f. hand washing in lavatories and galleys;
g. cleaning of utensils and work areas;
h. preparation of hot, moist towels for hand and face washing;
i. direct face washing in lavatories;
j. onboard showering facilities;
k. emergency medical use.
Although some of these uses do not necessitate consumption, they

involve human contact and possibly incidental ingestion (e.g. tooth
brushing).
 Water Safety Plans
Water Safety Plans (WSPs) are the most effective management

approach for consistently ensuring the safety of a drinking-water supply.
A potable water source at the airport is not a guarantee of safe water on
board the aircraft, as the water may be contaminated during transfer to
or storage or distribution in the aircraft. A WSP covering water
management within airports from receipt of the water through to its
transfer to the aircraft, complemented by measures (e.g. safe materials
and good practices in design, construction, operation and maintenance
of aircraft water systems) to ensure that water quality is maintained on
the aircraft, provides a framework for water safety in aviation.
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EHS 315 MODULE 3
A WSP has three key components, which are guided by health-based

targets and overseen through drinking-water supply chain surveillance.
They are:
1. system assessment, which includes
 description of the water supply system in order to determine

whether the drinking water supply chain (up to the point of
consumption) as a whole can deliver water of a quality that meets
health-based targets;
 identification of hazards and evaluation of risks;
 determination of control measures, reassessment and
prioritisation of risks;
 development, implementation and maintenance of an
improvement plan;
2. operational monitoring, which includes identification of control

measures that will control hazards and risks and verification (to
determine whether the system meets health based targets);
3. management and communication, including preparation of

management procedures and developing supporting programmes
to manage people and processes (including upgrade and
improvement).
3.4 Guidelines on Drinking Water Quality (GDWQ) and

Guide to Hygiene and Sanitation in Aviation
The GDWQ describes reasonable minimum requirements for safe

practices to protect the health of consumers and derives numerical
guideline values for constituents of water or indicators of water quality.
Neither the minimum requirements for safe practices nor the numerical
guideline values are mandatory limits, but rather health-based guidance
to national authorities to establish their own enforceable standards,
which may also consider other factors. In order to define such limits, it
is necessary to consider the GDWQ in the context of local or national
environmental, social, economic and cultural conditions.
Nevertheless, given the global nature of air travel and the need for
aircraft to board water from areas with variable and possibly inadequate
standards of general hygiene and sanitation, the GDWQ or national
standards should be followed, whichever are more stringent. This
approach will provide passengers and crew with consistent reliable
protection from the potential risks posed by contaminated drinking-
water.
114
4.0 CONCLUSION
In concluding this unit, it is important to stress the importance of potable

water to life. There is no gain saying that human body content is made
up of about 75% water and air travels is the fastest and probably one of
the safest mode of human transportation in the recent time. All need
components of air travels requires water be it food preparation, cleaning
services or other essentials within the aircrafts, hence the need for clean
and portable water in the aircraft.
5.0 SUMMARY
In this unit, we have been interactively discussing the water

requirements of an aircraft, health risks associated with water on
aircraft, bottled water and ice in aircraft, water safety plans and
application of the GDWQ to the Guide to Hygiene and Sanitation in
Aviation.
1 Define water supply and transfer chain.

2 State water requirements of an aircraft.
3 Mention health risks associated with water on aircraft.
4 Enumerate water safety plans.
http://www.westerncape.gov.za/eng/directories/services/11515/6455
health/health_inspectorate/port_health_services/port_health_servi
ces_objective.aspx
nigeria.html.
http://www.euro.who.int/_data/assets/pdf_file/0004/151375/e95783.pdf
WHO, Geneva. (2006). World Health Organisation, Communicable

Diseases Surveillance and Response, Epidemic and Pandemic Alert
and Response. Frequently Asked Questions about International
Health Regulations IHR (2005). From the Global to the Local.
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EHS 315 MODULE 3
Lawrence, O. Gostin. (2004). ―International Infectious Disease Law,


World Health Organisation. (2004). Vaccination Certificate


World Health Organisation. (2009). Guide to Hygiene and Sanitation in

Aviation (3rd. ed.).
MODULE 3 INTERNATIONAL ENTRY MEASURES

AND PROCEDURE AGAINST SUBJECT
TO INTERNATIONAL HEALTH
REGULATIONS 2005 (IHR)
Unit 1 Diseases Surveillance and Notification

Unit 2 Immunisation and Issuance of Yellow Fever Certificate
Unit 3 Implementation of International Health Regulations 2005
UNIT 1 DISEASES SURVEILLANCE AND

NOTIFICATION
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main content
3.1 Global Infectious Disease Surveillance
3.2 World Health Organisation in Disease Surveillance
3.3 Advantages of International Diseases Surveillance and
Response (IDSR)
3.4 Formal and Informal Sources of Information
3.5 Legally Mandated Sources of Information
116
4.0 Conclusion
5.0 Summary
6.0 Tutor-marked assignment
7.0 References/further reading
1.0 INTRODUCTION
In Module 2, unit 3 above, we looked into the importance of water

safety and hygiene in air travels. We also examined the inter-link
between water and disease spread.
Disease surveillance, notification and reporting have been defined as the

continuous scrutiny of the occurrence of diseases and health related
events to enable intervention for the control of diseases (CDC, 2009).
Levels of surveillance can be individual, local, national and
international. Most surveillance systems depend on the information on
the occurrence of diseases obtained from health care providers,
hospitals, clinics diagnostic laboratories and research laboratories.
National surveillance systems often depend on a district level

surveillance department for the collection of data (CDC, 2009).
Effective national and international surveillance for diseases therefore
requires efficient and effective local or district surveillance department.
In Nigeria, surveillance and notification involves immediate notification
of eleven diseases and routine notification of 22 diseases (FMOH,
2007). A surveillance officer in the health department is responsible for
the collection of the data and reporting same to the state ministry of
health. The state then forwards the report to the federal ministry of
health. At each level, analysis of the data collected is done to enable
intervention such as instituting control and preventive measures for
disease outbreaks and epidemics. A functional surveillance department
requires trained staff, adequate transport and other logistics for
efficiency and effectiveness. Despite the established system,
surveillance of diseases breaks down in Nigeria leading to avoidable
morbidity and mortality. While various factors are thought responsible,
studies have not yet documented the extant reasons that may be
responsible for the breakdown in surveillance activities. This module
attempts to assess the adequacy of the logistic support available for
timely collection of data and its association with poor reporting of
epidemics in the respective states of the federation.
2.0 OBJECTIVES
 state global infectious disease surveillance
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EHS 315 MODULE 3
 define World Health Organisation(WHO) in disease surveillance

 list advantages of International Diseases Surveillance and
Response (IDSR)
 state formal and informal sources of information
 enumerate the legally mandated sources of information.
3.0 MAIN CONTENT
3.1 Global Infectious Disease Surveillance
Increased movements of people, expansion of international trade in

foodstuffs and medicinal biological products, social and environmental
changes linked to urbanisation, and deforestation are all manifestations
of the rapidly changing nature of the world we live in. Add to that the
rapid adaptation of microorganisms, which has facilitated the return of
old communicable diseases and the emergence of new ones, and the
evolution of antimicrobial resistance, which means that curative
treatments for a wide range of parasitic, bacterial and viral infections
have become less effective, and a communicable disease in one country
today is the concern of all.
During 1996, fatal yellow fever infections were imported into the United
States and Switzerland by tourists who travelled to yellow fever
endemic areas without having had yellow fever vaccination
In industrialised countries where communicable disease mortality has

greatly decreased over the past century, the concern is preventing
diseases from entering and causing an outbreak or re-emergence. In
developing countries, the concern is detecting communicable disease
outbreaks early and stopping their mortality, spread and potential impact
on trade and tourism.
One of the major means of addressing the concerns about communicable

diseases in both industrialised and developing countries is through the
development of strong surveillance systems. However, in view of the
disparity among national surveillance systems, partnerships in global
surveillance are a logical starting point in this area of common
commitment.
3.2 World Health Organisation in Disease Surveillance
Since 1992, alarm over emerging and re-emerging diseases has resulted
in a number of national and international initiatives to restore and
improve surveillance and control of communicable diseases. The
member states of the World Health Organisation (WHO) expressed their
concern in a resolution of the World Health Assembly in 1995, urging
all member states to strengthen surveillance for infectious diseases in
118
order to promptly detect re-emerging diseases and identify new

infectious diseases. The World Health Assembly recognised that the
success of this resolution depends on the ability to obtain information on
infectious diseases and the willingness to communicate this information
nationally and internationally. Improved detection and surveillance,
moreover, will lead to better prioritising of public health efforts.
One of WHOs main means of creating a global surveillance system has

been the development of a "network of networks" which links together
existing local, regional, national and international networks of
laboratories and medical centres into a super surveillance network.
Requirements for monitoring the intentional use of pathogenic microbes
have also been addressed by the network, specifically in the revision of
the International Health Regulations (IHR), and in collaboration with the
ad hoc Group of States Parties to the Biological Weapons Convention.
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EHS 315 MODULE 3
3.3 Advantages of International Diseases Surveillance and

Response (IDSR)
Public health surveillance (also called field epidemiology) as defined by

Centres for Disease Control and Prevention (CDC) is the ongoing
systematic, collection, analysis and interpretation of outcome-specific
data essential to the planning, implementation and evaluation of public
health practises closely integrated with the timely dissemination of these
data to those who need to know. The IDSR is a strategy of the WHO
Afro region adopted by the member states in 1998 as a regional strategy
for strengthening weak national surveillance systems in the African
region.
The DSNOs, under the supervision of the Medical Officers of Health

(MOHs), are responsible for surveillance activities within their local
government catchment area. Therefore, their role is very crucial to the
success of the IDSR strategy.
3.4 Formal and Informal Sources of Information
 Formal sources of information
Government and university centres of excellence in communicable

diseases such as the epidemiological division of the Federal Ministry of
Health, US Centres for Disease Control and Prevention, the UK Public
Health Laboratory Service, the French Pasteur Institutes, the global
network of schools of public health and the Training in Epidemiology
and Public Health Intervention Network (TEPHINET) provide
confirmed reports of communicable diseases. Most of these sites are or
will become part of the WHO Collaborating Centre network. This
network, along with the WHO Regional Offices, WHO country
representatives and other WHO and UNAIDS reporting sites,
contributes to global surveillance along with reporting networks of other
United Nations agencies such as UNHCR and UNICEF. International
military networks such as the US Department of Defence-Global
Emerging Infections System (DoD-GEIS), private clinics, individual
scientists and public health practitioners complete the network of formal
information sources.
There are geographic and population gaps, as well as deficiencies in

expertise in these networks, which must be rectified. As most of these
networks represent the public sector, they should develop means of
including the private sector, as well as other sources of valid information
such as military and research laboratories. They need to represent both
human and animal infections and provide information on antimicrobial
120
resistance and the environment including water, insect vectors and

animal reservoirs.
 Informal sources of information
The rapid global reach in telecommunications, media and Internet access

has created an information society permitting public health professionals
to communicate more effectively. Many groups, including health
professionals, non-governmental organisations and the general public
now have access to reports on disease outbreaks. This is challenging to
the national disease surveillance authorities which were once the sole
source of such information. Public Internet sites are dedicated to disease
news and include medicine and biology-related sites as well as those of
the major news agencies and wire services. ProMed, an early electronic
discussion site on communicable diseases occurrence on the Internet,
provides an example.
Electronic discussion sites, accessible through free and unrestricted

subscription, are valuable sources of information. Their scope may be
worldwide (ProMed, TravelMed), regional (PACNET in the Pacific
region) or national (Sentiweb in France). They exemplify unprecedented
potential for increasing public awareness on public health issues.
The Global Public Health Information Network (GPHIN) is a second

generation electronic surveillance system developed and maintained by
Health Canada. It has powerful search engines that actively trawl the
World Wide Web looking for reports of communicable diseases and
communicable disease syndromes in electronic discussion groups, on
news wires and elsewhere on the Web. GPHIN has begun to search in
English and French and will eventually expand to all official languages
of the World Health Organisation, to which it has created close links for
verification.
Other networks which are likewise sources for communicable disease

reporting include non-governmental organisations such as the Red Cross
and Red Crescent Societies, Medecins sans Frontières, Medical
Emergency Relief International (Merlin), and Christian religious
organisations such as the Catholic and Protestant mission networks.
3.4 Legally Mandated Sources of Information
The International Health Regulations (IHR) is a legal instrument which

requires WHO member states to notify diseases of international
importance such as plague, cholera and yellow fever. Countries have
not uniformly complied with disease notification, often fearing
unwarranted reactions that affect travel and trade. In addition, the
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EHS 315 MODULE 3
official international reporting mechanism has not evolved with the

new communications environment, and does not include many
communicable diseases of importance to international public health. A
revision of the IHR is therefore being directed towards a stronger role
in global communicable disease surveillance and control. The revised
IHR emphasise the immediate notification of all disease outbreaks of
urgent international importance. This concept is currently being
evaluated in a pilot study in 21 countries. Electronic reporting of
specific clinical syndromes, which were developed taking into account
those diseases of importance to public health, will help countries report
immediately. This will facilitate rapid alert and appropriate
international response while awaiting laboratory verification. Once the
confirmed diagnosis is known, it will also feed into the system,
permitting any adjustments to the international response which may be
necessary. When the revision is complete, the IHR will constitute an
important public health tool.
4.0 CONCLUSION
In this unit, we have studied disease surveillance and notification and we

have taken the pain to examine in details what disease surveillance is
and the roles played by WHO and other member states of United
Nation, including other agencies of the United Nation in global
surveillance and notification of internationally and locally
communicable diseases.
5.0 SUMMARY
In this unit, we have been discussing diseases surveillance and

notification. We went ahead to discussed the global infectious disease
surveillance and the role of the World Health Organisation in disease
surveillance, thus listing the advantages of international diseases
surveillance and response. We also looked into the both formal and
informal sources of information gathering and lastly we examined the
legally mandated sources of information. It is my candid opinion that
you require a good knowledge of diseases notification and surveillance.
1 Briefly discuss global infectious disease surveillance.

2 Explain the role of World Health Organisation in disease
surveillance.
3 List the advantages of International Diseases Surveillance and
Response (IDSR).
122
nigeria.html.
http://www.euro.who.int/_data/assets/pdf_file/0004/151375/e95783.pdf .
International Health Regulations (2005). WHO. Geneva. (2006).

Health Regulations.
IHR 2005. From the Global to the Local.
Lawrence, O. Gostin (2004). ‗International Infectious Disease Law,


for Professionals and Student. ( 2nd ed.).

Biodun-Fowowe, M. T. (2001). Handbook on Health Agencies and Port

Health. Akure: School of Health Technology.
World Health Organisation (2009). Guide to Hygiene and Sanitation in

Aviation. (3rd ed.)
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EHS 315 MODULE 3
UNIT 2 IMMUNISATION AND ISSUANCE OF

YELLOW FEVER CIRTIFICATE
Vaccination stimulates the body to resist future infections by particular

diseases. Most vaccines are given with shots.
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Vaccination
3.2 Types of Immunisation
3.3 Immunization Recommended under IHR 2005
3.4 International Certificate of Vaccination or Prophylaxis
(Yellow Fever Certificate)
3.5 Requirements Concerning Vaccination or Prophylaxis for
Specific Diseases
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
Immunisation, also called vaccination or inoculation, a method of

stimulating resistance in the human body to specific diseases using
micro-organisms—bacteria or viruses—that have been modified or
killed. These treated micro-organisms do not cause the disease, but
rather trigger the body's immune system to build a defence mechanism
that continuously guards against the disease. If a person immunised
against a particular disease later comes into contact with the disease-
causing agent, the immune system is immediately able to respond
defensively.
Immunisation has dramatically reduced the incidence of a number of

deadly diseases. For example, a worldwide vaccination programme
resulted in the global eradication of smallpox in 1980, and in most
developed countries immunisation has essentially eliminated diphtheria,
poliomyelitis, and neonatal tetanus.
124
2.0 OBJECTIVES

:
 explain what is vaccination
 list the types of immunisation
 state the immunisation recommended under International Health
Regulations
 model international certificate of vaccination or prophylaxis
 state the requirements concerning vaccination or prophylaxis for
specific diseases
 list the Port Health Services location in Nigeria.
3.0 MAIN CONTENT
3.1 Vaccination
Vaccination stimulates the body to resist future infections by particular

diseases. Most vaccines are given with shots immunisation, also called
vaccination or inoculation, a method of stimulating resistance in the
human body to specific diseases using microorganisms—bacteria or
viruses—that have been modified or killed. These treated
microorganisms do not cause the disease, but rather trigger the body's
immune system to build a defence mechanism that continuously guards
against the disease. If a person immunised against a particular disease
later comes into contact with the disease-causing agent, the immune
system is immediately able to respond defensively.
3.2 Types of Immunisation
Scientists have developed two approaches to immunisation: active

immunisation, which provides long-lasting immunity, and passive
immunisation, which gives temporary immunity. In active
immunisation, all or part of a disease-causing micro-organism or a
modified product of that micro-organism is injected into the body to
make the immune system respond defensively. Passive immunity is
accomplished by injecting blood from an actively immunised human
being or animal.
 Active Immunity
Vaccines that provide active immunisation are made in a variety of

ways, depending on the type of disease and the organism that causes it.
The active components of the vaccinations are antigens, substances
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EHS 315 MODULE 3
found in the disease-causing organism that the immune system

recognises as foreign. In response to the antigen, the immune system
develops either antibodies or white blood cells called Tlymphocytes,
which are special attacker cells. Immunisation mimics real infection but
presents little or no risk to the recipient. Some immunising agents
provide complete protection against a disease for life. Other agents
provide partial protection, meaning that the immunised person can
contract the disease, but in a less severe form. These vaccines are
usually considered risky for people who have a damaged immune
system, such as those infected with the virus that causes acquired
immunodeficiency syndrome (AIDS) or those receiving chemotherapy
for cancer or organ transplantation. Without a healthy defence system
to fight infection, these people may develop the disease that the vaccine
is trying to prevent. Some immunising agents require repeated
inoculations—or booster shots—at specific intervals. Tetanus shots, for
example, are recommended every ten years throughout life.
Active immunisation can also be carried out using bacterial toxins that
have been treated with chemicals so that they are no longer toxic, even
though their antigens remain intact. This procedure uses the toxins
produced by genetically engineered bacteria rather than the organism
itself and is used in vaccinating against tetanus, botulism, and similar
toxic diseases.
 Passive Immunisation
Passive immunisation is performed without injecting any antigen. In this

method, vaccines contain antibodies obtained from the blood of an
actively immunised human being or animal. The antibodies last for two
to three weeks, and during that time the person is protected against the
disease. Although short-lived, passive immunisation provides immediate
protection, unlike active immunisation, which can take weeks to
develop. Consequently, passive immunisation can be lifesaving when a
person has been infected with a deadly organism.
Occasionally there are complications associated with passive

immunisation. Diseases such as botulism and rabies once posed a
particular problem. Immune globulin (antibody-containing plasma) for
these diseases was once derived from the blood serum of horses.
Although this animal material was specially treated before
administration to humans, serious allergic reactions were common.
Today, human-derived immune globulin is more widely available and
the risk of side effects is reduced.
126
3.3 Immunisation Recommended Under IHR
The recommended vaccines or other prophylaxis are specified by WHO

in Annex 7 subject to its approval. Upon request, the state party shall
provide to WHO appropriate evidence of the suitability of vaccines and
prophylaxis administered within its territory under these regulations.
Persons undergoing vaccination or other prophylaxis under these

regulations shall be provided with an international certificate of
vaccination or prophylaxis (hereinafter the ―certificate‖) in the form
specified in this Annex. No departure shall be made from the model of
the certificate specified in this Annex. Certificates under this Annex are
valid only if the vaccine or prophylaxis used has been approved by
WHO.
Certificates must be signed in the hand of the clinician, who shall be a

medical practitioner or other authorised health worker, supervising the
administration of the vaccine or prophylaxis. The certificate must also
bear the official stamp of the administering centre; however, this shall
not be an accepted substitute for the signature.
Certificates shall be fully completed in English or in French. They may

also be completed in another language, in addition to either English or
French. Any amendment of this certificate, or erasure, or failure to
complete any part of it, may render it invalid.
Certificates are individual and shall in no circumstances be used

collectively. Separate certificates shall be issued for children. A parent
or guardian shall sign the certificate when the child is unable to write.
The signature of an illiterate shall be indicated in the usual manner by
the person‘s mark and the indication by another that this is the mark of
the person concerned.
If the supervising clinician is of the opinion that the vaccination or

prophylaxis is contraindicated on medical grounds, the supervising
clinician shall provide the person with reasons, written in English or
French, and where appropriate in another language in addition to
English or French, underlying that opinion, which the competent
authorities on arrival should take into account. The supervising clinician
and competent authorities shall inform such persons of any risk
associated with non-vaccination and with the non-use of prophylaxis in
accordance with paragraph 4 of Article 23.
An equivalent document issued by the Armed Forces to an active

member of those Forces shall be accepted in lieu of an international
certificate in the form shown in this annex if:
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EHS 315 MODULE 3
(a) it embodies medical information substantially the same as that

required by such form; and
(b) it contains a statement in English or in French and where
appropriate in another language in addition to English or French
recording the nature and date of the vaccination or prophylaxis
and to the effect that it is issued in accordance with this
paragraph.
Vaccine or Signature Date Manufacturer Certificate Official stamp

Prophylaxis and and Valid from of
professional batch No. of .................. administering
status of vaccine or until centre
supervising prophylaxis ............
clinician
1.
2.
3.4 International Certificate of Vaccination or Prophylaxis

This is to certify that [name] ..................................., date of birth

..................., sex ..............................., nationality ....................................,
national identification document, if applicable............................. whose
signature follows ………………………………............ has on the date
indicated been vaccinated or received prophylaxis against:
(name of disease or condition)....................................................................
in accordance with the International Health Regulations.
This certificate is valid only if the vaccine or prophylaxis used has been
approved by the World Health Organisation.
This certificate must be signed in the hand of the clinician, who shall be
a medical practitioner or other authorised health worker, supervising the
administration of the vaccine or prophylaxis. The certificate must also
bear the official stamp of the administering centre; however, this shall
not be an accepted substitute for the signature.
Any amendment of this certificate, or erasure, or failure to complete any

part of it, may render it invalid.
The validity of this certificate shall extend until the date indicated for
the particular vaccination or prophylaxis. The certificate shall be fully
completed in English or in French. The certificate may also be
128
completed in another language on the same document, in addition to

either English or French.
3.5 Requirements Concerning Vaccination or Prophylaxis

for Specific Diseases
In addition to any recommendation concerning vaccination or

prophylaxis, the following diseases are those specifically designated
under these regulations for which proof of vaccination or prophylaxis
may be required for travellers as a condition of entry to a state party:
1. Vaccination against yellow fever.
Recommendations and requirements for vaccination against yellow

fever:
(a) For the purpose of this Annex:

(i) The incubation period of yellow fever is six days;
(ii) Yellow fever vaccines approved by WHO provide
protection against infection starting 10 days following the
administration of the vaccine;
(iii) This protection continues for 10 years; and
(iv) The validity of a certificate of vaccination against yellow
fever shall extend for a period of 10 years, beginning 10
days after the date of vaccination or, in the case of a
revaccination within such period of 10 years, from the date
of that revaccination.
(b) Vaccination against yellow fever may be required of any traveller
leaving an area where the organisation has determined that a risk
of yellow fever transmission is present.
(c) If a traveller is in possession of a certificate of vaccination
against yellow fever which is not yet valid, the traveller may be
permitted to depart, but the provisions of paragraph 2(h) of this
Annex may be applied on arrival.
(d) A traveller in possession of a valid certificate of vaccination
against yellow fever shall not be treated as suspect, even if
coming from an area where the organisation has determined that
a risk of yellow fever transmission is present.
(e) In accordance with paragraph 1 of Annex 6 the yellow fever
vaccine used must be approved by the organisation.
(f) States Parties shall designate specific yellow fever vaccination
centres within their territories in order to ensure the quality and
safety of the procedures and materials employed.
(g) Every person employed at a point of entry in an area where the
organisation has determined that a risk of yellow fever
transmission is present, and every member of the crew of a
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EHS 315 MODULE 3
conveyance using any such point of entry, shall be in possession

of a valid certificate of vaccination against yellow fever.
(h) A State Party, in whose territory vectors of yellow fever are
present, may require a traveller from an area where the
organisation has determined that a risk of yellow fever
transmission is present, who is unable to produce a valid
certificate of vaccination against yellow fever, to be quarantined
until the certificate becomes valid, or until a period of not more
than six days, reckoned from the date of last possible exposure to
infection, has elapsed, whichever occurs first.
(i) Travellers who possess an exemption from yellow fever
vaccination, signed by an authorised medical officer or an
authorised health worker, may nevertheless be allowed entry,
subject to the provisions of the foregoing paragraph of this Annex
and to being provided with information regarding protection from
yellow fever vectors. Should the travellers not be quarantined,
they may be required to report any feverish or other symptoms to
the competent authority and be placed under surveillance.
4.0 CONCLUSION
Concluding this unit, it is important that you know vaccination,

prophylaxis and in related certificates under International Health
Regulation. It is imperative to note that most vaccines are given with
shorts and such vaccination stimulates the body to resist future
infections of particular diseases vaccinated against.
5.0 SUMMARY
In the various units above, we have discussed the definition of

vaccination, the types of immunisation, the immunisation recommended
under International Health Regulations, the model international
certificate of vaccination or prophylaxis and the requirements
concerning vaccination or prophylaxis for specific diseases.

1 State three importance of vaccination.
2 What is the significance of international certificate of vaccination
or prophylaxis (Yellow Fever Certificate) in international travels?
3 State the important features of a valid international certificate of
vaccination or prophylaxis (Yellow Fever Certificate).
4 What are the requirements for vaccination or prophylaxis for
specific diseases?
130
nigeria.html.
http://www.euro.who.int/ data/assets/pdf_file/0004/151375/e95
783.pdf
International Health Regulations (2005). WHO. Geneva. (2006). World

Health Organisation, Communicable Diseases Surveillance and
Health Regulations.
IHR 2005: From the Global to the Local.
Lawrence, O. Gostin (2004). ‗International Infectious Disease Law:

Olugbenga, Olorunda, Adeolu Omonayajo & Micheal Aibor. (2010) A

for Professionals and Students.(2nd ed.)

Requirements and health Advice for International Travel.


Aviation. (3rd ed.)
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EHS 315 MODULE 3
UNIT 3 IMPLEMENTATION OF INTERNATIONAL

HEALTH REGULATIONS 2005
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 International Health Regulations 2005
3.2 Evolution of International Health Regulations
3.3 Principles Embodying the IHR (2005)
3.4 Parts and the Chapters in the IHR 2005 and its Headings
4.0 Conclusion
5.0 Summary
1.0 INTRODUCTION
This unit is the most important of all the units taught in this module. It
captures those international regulations guiding local, national and
international travels and the containment and control of diseases spread.
The International Health Regulations 2005 are legally binding
regulations (forming international law) that aim to:
 Assist countries to work together to save lives and livelihoods

endangered by the spread of diseases and other health risks, and
 Avoid unnecessary interference with international trade and
travels
The purpose and scope of IHR 2005 are to prevent, protect against,
control and provide a public health response to the international spread
of disease in ways that are commensurate with and restricted to public
health risks, and which avoid unnecessary interference with
international traffic and trade (Art. 2, IHR 2005).
A central and historic responsibility for the World Health Organisation

(WHO) has been the management of the global regime for the control of
the international spread of disease. Under Articles 21(a) and 22, the
Constitution of WHO confers upon the World Health Assembly the
authority to adopt regulations ―designed to prevent the international
spread of disease‖ which, after adoption by the Health Assembly, enter
into force for all WHO member states that do not affirmatively opt out
of them within a specified time period.
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The International Health Regulations (―the IHR‖ or ―Regulations‖) were

adopted by the Health Assembly in 1969, having been preceded by the
International Sanitary Regulations adopted by the Fourth World Health
Assembly in 1951. The 1969 Regulations, which initially covered six
―quarantine able diseases‖ were amended in 1973 and 1981, primarily to
reduce the number of covered diseases from six to three (yellow fever,
plague and cholera) and to mark the global eradication. In consideration
of the growth in international travel and trade, and the emergence or re-
emergence of international disease threats and other public health risks,
the Forty-eighth World Health Assembly in 1995 called for a substantial
revision of the Regulations adopted in 1969. In resolution WHA48.7,
the Health Assembly requested the Director-General to take steps to
prepare their revision, urging broad participation and cooperation in the
process.
After extensive preliminary work on the revision by WHOs Secretariat

in close consultation with WHO member states, international
organisations and other relevant partners, and the momentum created by
the emergence of severe acute respiratory syndrome (the first global
public health emergency of the 21st century), the Health Assembly
established an Intergovernmental Working Group in 2003 open to all
member states to review and recommend a draft revision of the
Regulations to the Health Assembly. The IHR (2005) were adopted by
the Fifty-eighth World Health Assembly on 23 May 2005. They entered
into force on 15 June 2007.
The purpose and scope of the IHR (2005) are ―to prevent, protect
against, control and provide a public health response to the international
spread of disease in ways that are commensurate with and restricted to
public health risks, and which avoid unnecessary interference with
international traffic and trade.‖ The IHR (2005) contain a range of
innovations, including: (a) a scope not limited to any specific disease or
manner of transmission, but covering ―illness or medical condition,
irrespective of origin or source, that presents or could present significant
harm to humans‖; (b) State Party obligations to develop certain
minimum core public health capacities; (c) obligations on States Parties
to notify WHO of events that may constitute a public health emergency
of international concern according to defined criteria; (d) provisions
authorising WHO to take into consideration unofficial reports of public
health events and to obtain verification from states parties concerning
such events; (e) procedures for the determination by the Director-
General of a ―public health emergency of international concern‖ and
issuance of corresponding temporary recommendations, after taking into
account the views of an Emergency Committee; (f) protection of the
human rights of persons and travellers; and (g) the establishment of
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National IHR Focal Points and WHO IHR Contact Points for urgent
communications between States Parties and WHO.
By not limiting the application of the IHR (2005) to specific diseases, it

is intended that the regulations will maintain their relevance and
applicability for many years to come even in the face of the continued
evolution of diseases and of the factors determining their emergence and
transmission.
The provisions in the IHR (2005) also update and revise many of the
technical and other regulatory functions, including certificates
applicable to international travel and transport, and requirements for
international ports, airports and ground crossings.
This second edition contains the text of the IHR (2005), the text of
World Health Assembly resolution WHA58.3, the version of the Health
Part of the Aircraft General Declaration that entered into force on 15
July 2007, appendices containing a list of states parties and state party
reservations and other communications in connection with the IHR
(2005).
2.0 OBJECTIVES
 define International Health Regulations 2005

 state the evolution of International Health Regulations
 list the principles embodying the IHR (2005)
 state the various parts and the chapters in the IHR 2005 and its
headings
 enumerate port health related Articles of the IHR 2005
3.0 MAIN CONTENT
3.1 International Health Regulations 2005
The International Health Regulations (IHR) is an international legal

instrument that is binding on 194 countries across the globe, including
all the Member States of WHO. Their aim is to help the international
community prevent and respond to acute public health risks that have
the potential to cross borders and threaten people worldwide.
The IHR, which entered into force on 15 June 2007, require countries to
report certain disease outbreaks and public health events to WHO.
Building on the unique experience of WHO in global disease
surveillance, alert and response, the IHR define the rights and
134
obligations of countries to report public health events, and establish a

number of procedures that WHO must follow in its work to uphold
global public health security.
3.2 Evolution of International Health Regulations
The International Health Regulations originated with the International

Sanitary Regulations adapted at the International Sanitary Conference in
Paris in 1851. The cholera epidemics that hit Europe in 1830 and 1847
made apparent the need for international cooperation in public health. In
1948, the World Health Organisation constitution came about. The
Twenty-Second World Health Assembly (1969) adopted, revised and
consolidated the International Sanitary Regulations, which were
renamed the International Health Regulations (1969). The twenty-sixth
World Health Assembly in 1973 amended the IHR (1969) in relation to
provisions on cholera.
In view of the global eradication of smallpox, the thirty-fourth World

Health Assembly amended the IHR (1969) to exclude smallpox in the
list of notifiable diseases.
During the forty-eighth World Health Assembly in 1995, WHO and

member states agreed on the need to revise the IHR (1969). The revision
of IHR (1969) came about because of its inherent limitations, most
notably:
 narrow scope of notifiable diseases (cholera, plague, yellow

fever). The past few decades have seen the emergence and re-
emergence of infectious diseases. The emergence of ―new‖
infectious agents Ebola Hemorrhagic Fever and the re-emergence
of cholera and plague in South America and India, respectively;
 dependence on official country notification; and
 lack of a formal internationally coordinated mechanism to
prevent the international spread of disease.
These challenges were placed against the backdrop of the increased

travel and trade characteristic of the 20th century.
The IHR (2005) entered into force, generally, on 15 June 2007, and are
currently binding on 194 countries (States Parties) across the globe,
including all 193 member states of WHO.
In 2010, at the meeting of the states parties to the convention on the

prohibition of the development, production and stockpiling
of Bacteriological (Biological) and Toxin Weapons and their destruction
in Geneva, the sanitary epidemiological reconnaissance was suggested
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as well-tested means for enhancing the monitoring of infections and

parasitic agents, for practical implementation of the IHR (2005) with the
aim was to prevent and minimise the consequences of natural outbreaks
of dangerous infectious diseases as well as the treat of alleged use of
biological weapons against BTWC States Parties. The significance of
the sanitary epidemiological reconnaissance is pointed out in assessing
the sanitary-epidemiological situation, organising and conducting
preventive activities, indicating and identifying pathogenic biological
agents in the environmental sites, conducting laboratory analysis of
biological materials, suppressing hotbeds of infectious diseases,
providing advisory and practical assistance to local health authorities.
3.3 Principles Embodying the IHR (2005)
The principles embodying the implementation of IHR (2005) shall be:
 With full respect for the dignity, human rights and fundamental
freedom of persons; Guided by the Charter of the United
Nations and the Constitution of the World Health Organisation;
 Guided by the goal of their universal application for the
protection of all people of the world from the international spread
of disease;
 States have, in accordance with the Charter of the United Nations
and the principles of international law, the sovereign right to
legislate and to implement legislation in pursuance of their health
policies .In doing so; they should uphold the purpose of these
Regulations. (Art 3. IHR (2005))
3.4 Parts and the Chapters in the IHR 2005 and its Headings
Part I. Definitions, purpose and scope, principles and responsible

authorities
Part II. Information and public health response
Part III. Recommendations
Part IV. Points of entry
Part V. Public health measures
 Chapter I. General provisions

 Chapter II. Special provisions for conveyances and conveyance
operators
 Chapter III. Special provisions for travellers
 Chapter IV. Special provisions for goods, containers and
container loading areas
Part VI. Health documents

Part VII. Charges
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Part VIII. General provisions

Part IX. The IHR Roster of Experts, the Emergency Committee
and the Review Committee
 Chapter I The IHR Roster of Experts

 Chapter II The Emergency Committee
 Chapter III The Review Committee
Part X. Final provisions
ANNEXES
1. a Core capacity requirements for surveillance and response

b. Core capacity requirements for designated airports, ports
and ground crossings
2. Decision instrument for the assessment and notification of events
that may constitute a public health emergency of
international concern.
Examples for the application of the decision instrument for the
assessment and notification of events that may constitute a public
health emergency of international concern
3. Model Ship Sanitation Control Exemption Certificate/Ship
Sanitation Control Certificate Attachment to model Ship
Sanitation Control Exemption Certificate/Ship Sanitation Control
Certificate
4. Technical requirements pertaining to conveyances and
conveyance operators
5. Specific measures for vector-borne diseases
6. Vaccination, prophylaxis and related certificates Model
international certificate of vaccination or prophylaxis
7. Requirements concerning vaccination or prophylaxis for specific
diseases
8. Model of Maritime Declaration of Health
Attachment to model of Maritime Declaration of Health
9. Health Part of the Aircraft General Declaration.
APPENDICES
1. States Parties to the International Health Regulations (2005

2. Reservations and other State Party communications in connection
with the International Health Regulations (2005) Index to the
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3.4 State Important Port Health Related Articles of the

IHR 2005
PART I. DEFINITIONS, PURPOSE AND SCOPE, PRINCIPLES

AND RESPONSIBLE AUTHORITIES
Article 1 Definitions
For the purposes of the International Health Regulations (hereinafter

―the IHR‖ or ―Regulations‖):―affected‖ means 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;
―Affected area‖ means a geographical location specifically for which

health measures have been recommended by WHO under these
Regulations; ―aircraft‖ means an aircraft making an international
voyage;―airport‖ means any airport where international flights arrive or
depart;―arrival‖ of a conveyance means:
(a) in the case of a seagoing vessel, arrival or anchoring in the

defined area of a port;
(b) in the case of an aircraft, arrival at an airport;
(c) in the case of an inland navigation vessel on an international
voyage, arrival at a point of entry;
(d) in the case of a train or road vehicle, arrival at a point of
entry;―baggage‖ means the personal effects of a traveller;―cargo‖
means goods carried on a conveyance or in a
container;―competent authority‖ means an authority responsible
for the implementation and application of health measures under
these Regulations;
―Container‖ means an article of transport equipment:
(a) of a permanent character and accordingly strong enough to be

suitable for repeated use;
(b) specially designed to facilitate the carriage of goods by one or
more modes of transport, without intermediate reloading;
(c) fitted with devices permitting its ready handling, particularly its
transfer from one mode of transport to another; and
(d) specially designed as to be easy to fill and empty;
―Container loading area‖ means a place or facility set aside for

containers used in international traffic;
―Contamination‖ means the presence of an infectious or toxic agent or
matter on a human or animal body surface, in or on a product prepared
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for consumption or on other inanimate objects, including conveyances,

that may constitute a public health risk;
―Conveyance‖ means an aircraft, ship, train, road vehicle or other means

of transport on an international voyage;
―Conveyance operator‖ means a natural or legal person in charge of a

conveyance or their agent;
―Crew‖ means persons on board a conveyance who are not passengers;
―Decontamination‖ means 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 conveyances, that may constitute a
public health risk;
―Departure‖ means, for persons, baggage, cargo, conveyances or goods,

the act of leaving a territory;
―Derating‖ means the procedure whereby health measures are taken to

control or kill rodent vectors of human disease present in baggage,
cargo, containers, conveyances, facilities, goods and postal parcels at the
point of entry;
―Director-General‖ means the Director-General of the World Health

Organisation; ―disease‖ means an illness or medical condition,
irrespective of origin or source, that presents or could present significant
harm to humans;
―Disinfection‖ means the procedure whereby health measures are taken

to control or kill infectious agents on a human or animal body surface or
in or on baggage, cargo, containers, conveyances, goods and postal
parcels by direct exposure to chemical or physical agents;
―Disinsection‖ means the procedure whereby health measures are taken

to control or kill the insect vectors of human diseases present in
baggage, cargo, containers, conveyances, goods and postal parcels;
―Event‖ means a manifestation of disease or an occurrence that creates a

potential for disease;
―FREE pratique‖ means permission for a ship to enter a port, embark or

disembark, discharge or load cargo or stores; permission for an aircraft,
after landing, to embark or disembark, discharge or load cargo or stores;
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and permission for a ground transport vehicle, upon arrival, to embark

or disembark, discharge or load cargo or stores;
―Goods‖ mean tangible products, including animals and plants,

transported on an international voyage, including for utilisation on board
a conveyance;
―Ground crossing‖ means a point of land entry in a State Party,
including one utilised by road vehicles and trains;
―Ground transport vehicle‖ means a motorized conveyance for overland

transport on an international voyage, including trains, coaches, lorries
and automobiles;
―Health measure‖ means procedures applied to prevent the spread of

disease or contamination; a health measure does not include law
enforcement or security measures;
―Ill person‖ means an individual suffering from or affected with a

physical ailment that may pose a public health risk;
―Infection‖ means the entry and development or multiplication of an

infectious agent in the body of humans and animals that may constitute a
public health risk;
―Inspection‖ means the examination, by the competent authority or

under its supervision, of areas, baggage, containers, conveyances,
facilities, goods or postal parcels, including relevant data and
documentation, to determine if a public health risk exists;
―International traffic‖ means the movement of persons, baggage, cargo,

containers, conveyances, goods or postal parcels across an international
border, including international trade;
―International voyage‖ means:
(a) in the case of a conveyance, a voyage between points of entry in

the territories of more than one State, or a voyage between points
of entry in the territory or territories of the same State if the
conveyance has contacts with the territory of any other State on
its voyage but only as regards those contacts;
(b) in the case of a traveller, a voyage involving entry into the
territory of a State other than the territory of the State in which
that traveller commences the voyage;
―Intrusive‖ means possibly provoking discomfort through close or

intimate contact or questioning;
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―Invasive‖ means the puncture or incision of the skin or insertion of an

instrument or foreign material into the body or the examination of a
body cavity. For the purposes of these Regulations, medical examination
of the ear, nose and mouth, temperature assessment using an ear, oral or
cutaneous thermometer, or thermal imaging; medical inspection;
auscultation; external palpation; retinoscopy; external collection of
urine, faeces or saliva samples; external measurement of blood pressure;
and electrocardiography shall be considered to be non-invasive;
―Isolation‖ means separation of ill or contaminated persons or affected

baggage, containers, conveyances, goods or postal parcels from others in
such a manner as to prevent the spread of infection or contamination;
―Medical examination‖ means the preliminary assessment of a person

by an authorised health worker or by a person under the direct
supervision of the competent authority, to determine the person‘s health
status and potential public health risk to others, and may include the
scrutiny of health documents, and a physical examination when justified
by the circumstances of the individual case;
―National IHR Focal Point‖ means the national centre, designated by

each State Party, which shall be accessible at all times for
communications with WHO IHR Contact Points under these
Regulations;
―Organisation‖ or ―WHO‖ means the World Health Organisation;
―Permanent residence‖ has the meaning as determined in the national

law of the State Party concerned;
―Personal data‖ means any information relating to an identified or

identifiable natural person;
―Point of entry‖ means 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
or exit;
―Port‖ means a seaport or a port on an inland body of water where ships

on an international voyage arrive or depart;
―Postal parcel‖ means an addressed article or package carried

internationally by postal or courier services;
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―Public health emergency of international concern‖ means an

extraordinary event which is determined, as provided in these
Regulations:
(i) to constitute a public health risk to other States through the

international spread of disease and
(ii) to potentially require a coordinated international response;
―Public health observation‖ means the monitoring of the health status of

a traveller over time for the purpose of determining the risk of disease
transmission;
―Public health risk‖ means a likelihood of an event that may affect

adversely the health of human populations, with an emphasis on one
which may spread internationally or may present a serious and direct
danger;
―quarantine‖ means the restriction of activities and/or separation from
others of suspect persons who are not ill or of suspect baggage,
containers, conveyances or goods in such a manner as to prevent the
possible spread of infection or contamination;
―Recommendation‖ and ―recommended‖ refer to temporary or standing

recommendations issued under these Regulations;
―Reservoir‖ means an animal, plant or substance in which an infectious

agent normally lives and whose presence may constitute a public health
risk;
―Road vehicle‖ means a ground transport vehicle other than a train;
―Scientific evidence‖ means information furnishing a level of proof

based on the established and accepted methods of science;
―Scientific principles‖ means the accepted fundamental laws and facts

of nature known through the methods of science;
―Ship‖ means a seagoing or inland navigation vessel on an international

voyage;
―Standing recommendation‖ means non-binding advice issued by WHO

for specific ongoing public health risks pursuant to Article 16 regarding
appropriate health measures for routine or periodic application needed to
prevent or reduce the international spread of disease and minimise
interference with international traffic;―surveillance‖ means the
systematic on-going collection, collation and analysis
of data for public health purposes and the timely dissemination of public
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health information for assessment and public health response as

necessary;
―Suspect‖ means those persons, baggage, cargo, containers,

conveyances, goods or postal parcels considered by a State Party as
having been exposed, or possibly exposed, to a public health risk and
that could be a possible source of spread of disease;
―Temporary recommendation‖ means non-binding advice issued by

WHO pursuant to Article for application on a time-limited, risk-specific
basis, in response to a public health emergency of international concern,
so as to prevent or reduce the international spread of disease and
minimise interference with international traffic;
―Temporary residence‖ has the meaning as determined in the national

law of the State Party concerned;
―Traveller‖ means a natural person undertaking an international voyage;
―Vector‖ means an insect or other animal which normally transports an

infectious agent that constitutes a public health risk;
―Verification‖ means the provision of information by a State Party to

WHO confirming the status of an event within the territory or territories
of that State Party;
―WHO IHR Contact Point‖ means the unit within WHO which shall be
accessible at all times for communications with the National IHR Focal
Point.
Unless otherwise specified or determined by the context, reference to

these Regulations includes the annexes thereto.
Article 2 Purpose and scope
The purpose and scope of these Regulations are to prevent, protect

international traffic and trade.
Article 3 Principles
1. The implementation of these Regulations shall be with full

respect for the dignity, human rights and fundamental freedoms
of persons.
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2. The implementation of these Regulations shall be guided by the

Charter of the United Nations and the Constitution of the World
Health Organisation.
3. The implementation of these Regulations shall be guided by the
goal of their universal application for the protection of all people
of the world from the international spread of disease.
4. States have, in accordance with the Charter of the United Nations
and the principles of international law, the sovereign right to
legislate and to implement legislation in pursuance of their health
policies. In doing so they should uphold the purpose of these
Regulations.
Article 4 Responsible authorities
1. Each State Party shall designate or establish a National IHR

Focal Point and the authorities responsible within its respective
jurisdiction for the implementation of health measures under
these Regulations.
2. National IHR Focal Points shall be accessible at all times for
communications with the WHO IHR Contact Points provided for
in paragraph 3 of this Article.
The functions of National IHR Focal Points shall include:
(a) sending to WHO IHR Contact Points, on behalf of the State Party
concerned, urgent communications concerning the
implementation of these regulations, in particular under Articles
6 to 12; and
(b) disseminating information to, and consolidating input from,
relevant sectors of the administration of the State Party
concerned, including those responsible for surveillance and
reporting, points of entry, public health services, clinics and
hospitals and other government departments.
3. WHO shall designate IHR Contact Points, which shall be
accessible at all times for communications with National IHR
Focal Points. WHO IHR Contact Points shall send urgent
communications concerning the implementation of these
regulations, in particular under Articles 6 to 12, to the National
IHR Focal Point of the States Parties concerned. WHO IHR
Contact Points may be designated by WHO at the headquarters or
at the regional level of the Organisation.
4. States Parties shall provide WHO with contact details of their
National IHR Focal Point and WHO shall provide States Parties
with contact details of WHO IHR Contact Points. These contact
details shall be continuously updated and annually confirmed.
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WHO shall make available to all States Parties the contact details
of National IHR Focal Points it receives pursuant to this Article.
PART II. INFORMATION AND PUBLIC HEALTH

RESPONSE
Article 5 Surveillance
1. Each State Party shall develop, strengthen and maintain, as soon

as possible but no later than five years from the entry into force
of these Regulations for that State Party, the capacity to detect,
assess, notify and report events in accordance with these
Regulations, as specified in Annex 1.
2. Following the assessment referred to in paragraph 2, Part A of
Annex 1, a State Party may report to WHO on the basis of a
justified need and an implementation plan and, in so doing,
obtain an extension of two years in which to fulfil the obligation
in paragraph 1 of this Article. In exceptional circumstances, and
supported by a new implementation plan, the State Party may
request a further extension not exceeding two years from the
Director-General, who shall make the decision, taking into
account the technical advice of the committee established under
Article 50 (hereinafter the ―Review Committee‖). After the
period mentioned in paragraph 1 of this Article, the State Party
that has obtained an extension shall report annually to WHO on
progress made towards the full implementation.
3. WHO shall assist States Parties, upon request, to develop,
strengthen and maintain the capacities referred to in paragraph 1
of this Article.
4. WHO shall collect information regarding events through its
surveillance activities and assess their potential to cause
international disease spread and possible interference with
international traffic. Information received by WHO under this
paragraph shall be handled in accordance with Articles 11 and 45
where appropriate.
Article 6 Notification
1. Each State Party shall assess events occurring within its territory
by using the decision instrument in Annex 2. Each State Party
shall notify WHO, by the most efficient means of communication
available, by way of the National IHR Focal Point, and within 24
hours of assessment of public health information, of all events
which may constitute a public health emergency of international
concern within its territory in accordance with the decision
instrument, as well as any health measure implemented in
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response to those events. If the notification received by WHO

involves the competency of the International Atomic Energy
Agency (IAEA), WHO shall immediately notify the IAEA.
2. Following a notification, a State Party shall continue to
communicate to WHO timely, accurate and sufficiently detailed
public health information available to it on the notified event,
where possible including case definitions, laboratory results,
source and type of the risk, number of cases and deaths,
conditions affecting the spread of the disease and the health
measures employed; and report, when necessary, the difficulties
faced and support needed in responding to the potential public
health emergency of international concern.
Article 12 Determination of a public health emergency of

international concern
1. The Director-General shall determine, on the basis of the

information received, in particular from the State Party within
whose territory an event is occurring, whether an event
constitutes a public health emergency of international concern in
accordance with the criteria and the procedure set out in these
Regulations.
2. If the Director-General considers, based on an assessment under
these Regulations, that a public health emergency of international
concern is occurring, the Director-General shall consult with the
State Party in whose territory the event arises regarding this
preliminary determination. If the Director-General and the State
Party are in agreement regarding this determination, the Director-
General shall, in accordance with the procedure set forth in
Article 49, seek the views of the Committee established under
Article 48 (hereinafter the ―Emergency Committee‖) on
appropriate temporary recommendations.
3. If, following the consultation in paragraph 2 above, the Director-
General and the State Party in whose territory the event arises do
not come to a consensus within 48 hours on whether the event
constitutes a public health emergency of international concern, a
determination shall be made in accordance with the procedure set
forth in Article 49.
4. In determining whether an event constitutes a public health
emergency of international concern, the Director-General shall
consider:
(a) information provided by the State Party;
(b) the decision instrument contained in Annex 2;
(c) the advice of the Emergency Committee;
(d) scientific principles as well as the available scientific
evidence and other relevant information; and
146
(e) an assessment of the risk to human health, of the risk of

international spread of disease and of the risk of
interference with international traffic.
5. If the Director-General, following consultations with the State
Party within whose territory the public health emergency of
international concern has occurred, considers that a public health
emergency of international concern has ended, the Director-
General shall take a decision in accordance with the procedure set
out in Article 49.
Article 13 Public health response
1. Each State Party shall develop, strengthen and maintain, as soon

as possible but no later than five years from the entry into force
of these Regulations for that State Party, the capacity to respond
promptly and effectively to public health risks and public health
emergencies of international concern as set out in Annex 1. WHO
shall publish, in consultation with Member States, guidelines to
support states parties in the development of public health
response capacities.
2. Following the assessment referred to in paragraph 2, Part A of
Annex 1, a State Party may report to WHO on the basis of a
justified need and an implementation plan and, in so doing,
obtain an extension of two years in which to fulfil the obligation
in paragraph 1 of this Article. In exceptional circumstances and
supported by a new implementation plan, the State Party may
request a further extension not exceeding two years from the
Director-General, who shall make the decision, taking into
account the technical advice of the Review Committee. After the
period mentioned in paragraph 1 of this Article, the State Party
that has obtained an extension shall report annually to WHO on
progress made towards the full implementation.
3. At the request of a State Party, WHO shall collaborate in the
response to public health risks and other events by providing
technical guidance and assistance and by assessing the
effectiveness of the control measures in place, including the
mobilisation of international teams of experts for on-site
assistance, when necessary.
4. If WHO, in consultation with the States Parties concerned as
provided in Article 12, determines that a public health emergency
of international concern is occurring, it may offer, in addition to
the support indicated in paragraph 3 of this Article, further
assistance to the State Party, including an assessment of the
severity of the international risk and the adequacy of control
measures. Such collaboration may include the offer to mobilise
international assistance in order to support the national authorities
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in conducting and coordinating on-site assessments. When

requested by the State Party, WHO shall provide information
supporting such an offer.
5. When requested by WHO, States Parties should provide, to the
extent possible, support to WHO-coordinated response activities.
6. When requested, WHO shall provide appropriate guidance and
assistance to other States Parties affected or threatened by the
public health emergency of international concern.
Article 14 Cooperation of WHO with intergovernmental Organisations

and international bodies
1. WHO shall cooperate and coordinate its activities, as appropriate,

with other competent intergovernmental Organisations or
international bodies in the implementation of these Regulations,
including through the conclusion of agreements and other similar
arrangements.
2. In cases in which notification or verification of, or response to,
an event is primarily within the competence of other
intergovernmental Organisations or international bodies, WHO
shall coordinate its activities with such Organisations or bodies in
order to ensure the application of adequate measures for the
protection of public health.
3. Notwithstanding the foregoing, nothing in these Regulations shall
preclude or limit the provision by WHO of advice, support, or
technical or other assistance for public health purposes.
PART III. RECOMMENDATIONS
PART IV. POINTS OF ENTRY
Article 19 General obligations
Each State Party shall, in addition to the other obligations provided for
under these Regulations:
(a) ensure that the capacities set forth in Annex 1 for designated
points of entry are developed within the timeframe provided in
paragraph 1 of Article 5 and paragraph 1 of Article 13;
(b) identify the competent authorities at each designated point of
entry in its territory; and
(c) furnish to WHO, as far as practicable, when requested in
response to a specific potential public health risk, relevant data
concerning sources of infection or contamination, including
vectors and reservoirs, at its points of entry, which could result in
international disease spread.
148
Article 20 Airports and ports
1. States Parties shall designate the airports and ports that shall
develop the capacities provided in Annex 1.
2. States Parties shall ensure that Ship Sanitation Control
Exemption Certificates and Ship Sanitation Control Certificates
are issued in accordance with the requirements in Article 39 and
the model provided in Annex 3.
3. Each State Party shall send to WHO a list of ports authorised to
offer:
(a) the issuance of Ship Sanitation Control Certificates and
the provision of the services referred to in Annexes 1 and
3; or
(b) the issuance of Ship Sanitation Control Exemption
Certificates only; and
(c) extension of the Ship Sanitation Control Exemption
Certificate for a period of one month until the arrival of
the ship in the port at which the Certificate may be
received.
Each State Party shall inform WHO of any changes which may occur to
the status of the listed ports. WHO shall publish the information
received under this paragraph.
4. WHO may, at the request of the State Party concerned, arrange to

certify, after an appropriate investigation, that an airport or port
in its territory meets the requirements referred to in paragraphs
1and 3 of this Article. These certifications may be subject to
periodic review by WHO, in consultation with the State Party.
5. WHO, in collaboration with competent intergovernmental
Organisations and international bodies, shall develop and publish
the certification guidelines for airports and ports under this
Article. WHO shall also publish a list of certified airports and
ports.
Article 21 Ground crossings
1. Where justified for public health reasons, a State Party may

designate ground crossings that shall develop the capacities
provided in Annex 1, taking into consideration:
(a) the volume and frequency of the various types of
international traffic, as compared to other points of entry,
at a State Party‘s ground crossings which might be
designated; and
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EHS 315 MODULE 3
(b) the public health risks existing in areas in which the

international traffic originates, or through which it passes,
prior to arrival at a particular ground crossing.
2. States Parties sharing common borders should consider:
(a) entering into bilateral or multilateral agreements or
arrangements concerning prevention or control of
international transmission of disease at ground crossings in
accordance with Article 57; and
(b) joint designation of adjacent ground crossings for the
capacities in Annex 1 in accordance with paragraph 1 of
this Article.
Article 22 Role of competent authorities
1. The competent authorities shall:
(a) be responsible for monitoring baggage, cargo, containers,

conveyances, goods, postal parcels and human remains
departing and arriving from affected areas, so that they are
maintained in such a condition that they are free of sources
of infection or contamination, including vectors and
reservoirs;
(b) ensure, as far as practicable, that facilities used by
travellers at points of entry are maintained in a sanitary
condition and are kept free of sources of infection or
contamination, including vectors and reservoirs;
(c) be responsible for the supervision of any derating,
disinfection, disinsection or decontamination of baggage,
cargo, containers, conveyances, goods, postal parcels and
human remains or sanitary measures for persons, as
appropriate under these Regulations;
(d) advise conveyance operators, as far in advance as possible,
of their intent to apply control measures to a conveyance,
and shall provide, where available, written information
concerning the methods to be employed;
(e) be responsible for the supervision of the removal and safe
disposal of any contaminated water or food, human or
animal excreta, wastewater and any other contaminated
matter from a conveyance;
(f) take all practicable measures consistent with these
regulations to monitor and control the discharge by ships
of sewage, refuse, ballast water and other potentially
disease-causing matter which might contaminate the
waters of a port, river, canal, strait, lake or other
international waterway;
150
(g) be responsible for supervision of service providers for

services concerning travellers, baggage, cargo, containers,
conveyances, goods, postal parcels and human remains at
points of entry, including the conduct of inspections and
medical examinations as necessary;
(h) have effective contingency arrangements to deal with an
unexpected public health event; and
(i) communicate with the National IHR focal point on the
relevant public health measures taken pursuant to these
Regulations.
2. Health measures recommended by WHO for travellers, baggage,

cargo, containers, conveyances, goods, postal parcels and human
remains arriving from an affected area may be reapplied on
arrival, if there are verifiable indications and/or evidence that the
measures applied on departure from the affected area were
unsuccessful.
3. Disinsection, derating, disinfection, decontamination and other

sanitary procedures shall be carried out so as to avoid injury and
as far as possible discomfort to persons, or damage to the
environment in a way which impacts on public health, or damage
to baggage, cargo, containers, conveyances, goods and postal
parcels.
PART V. PUBLIC HEALTH MEASURES
Chapter I – General provisions
Article 23 Health measures on arrival and departure
1. Subject to applicable international agreements and relevant

articles of these Regulations, a state party may require for public
health purposes, on arrival or departure:
(a) with regard to travellers:
(i) information concerning the traveller‘s destination
so that the traveller may be contacted;
(ii) information concerning the traveller‘s itinerary to
ascertain if there was any travel in or near an
affected area or other possible contacts with
infection or contamination prior to arrival, as well
as review of the traveller‘s health documents if they
are required under these Regulations; and/or
(iii) a non-invasive medical examination which is the
least intrusive examination that would achieve the
public health objective;
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EHS 315 MODULE 3
(b) inspection of baggage, cargo, containers, conveyances,

goods, postal parcels and human remains.
2. On the basis of evidence of a public health risk obtained through
the measures provided in paragraph 1 of this Article, or through
other means, States Parties may apply additional health measures,
in accordance with these Regulations, in particular, with regard to
a suspect or affected traveller, on a case-by-case basis, the least
intrusive and invasive medical examination that would achieve
the public health objective of preventing the international spread
of disease.
3. No medical examination, vaccination, prophylaxis or health
measure under these Regulations shall be carried out on travellers
without their prior express informed consent or that of their
parents or guardians, except as provided in paragraph 2 of Article
31, and in accordance with the law and international obligations
of the State Party.
4. Travellers to be vaccinated or offered prophylaxis pursuant to
these Regulations, or their parents or guardians, shall be informed
of any risk associated with vaccination or with non-vaccination
and with the use or non-use of prophylaxis in accordance with the
law and international obligations of the State Party. States Parties
shall inform medical practitioners of these requirements in
accordance with the law of the State Party.
5. Any medical examination, medical procedure, vaccination or
other prophylaxis which involves a risk of disease transmission
shall only be performed on, or administered to, a traveller in
accordance with established national or international safety
guidelines and standards so as to minimise such a risk.
Chapter II – Special provisions for conveyances and conveyance

operators
Article 25 Ships and aircraft in transit
Subject to Articles 27 and 43 or unless authorised by applicable

international agreements, no health measure shall be applied by a State
Party to:
(a) a ship not coming from an affected area which passes through a
maritime canal or waterway in the territory of that State Party on
its way to a port in the territory of another State. Any such ship
shall be permitted to take on, under the supervision of the
competent authority, fuel, water, food and supplies;
(b) a ship which passes through waters within its jurisdiction without
calling at a port or on the coast; and
(c) an aircraft in transit at an airport within its jurisdiction, except
that the aircraft may be restricted to a particular area of the
airport with no embarking and disembarking or loading and
152
discharging. However, any such aircraft shall be permitted to take

on, under the supervision of the competent authority, fuel, water,
food and supplies.
Article 26 Civilian lorries, trains and coaches in transit
Subject to Articles 27 and 43 or unless authorised by applicable

international agreements, no health measure shall be applied to a civilian
lorry, train or coach not coming from an affected area which passes
through a territory without embarking, disembarking, loading or is
charging.
Article 28 Ships and aircraft at points of entry
1. Subject to Article 43 or as provided in applicable international

agreements, a ship or an aircraft shall not be prevented for public
health reasons from calling at any point of entry. However, if the
point of entry is not equipped for applying health measures under
these Regulations, the ship or aircraft may be ordered to proceed
at its own risk to the nearest suitable point of entry available to it,
unless the ship or aircraft has an operational problem which
would make this diversion unsafe.
2. Subject to Article 43 or as provided in applicable international
agreements, ships or aircraft shall not be refused free pratique by
states parties for public health reasons; in particular they shall not
be prevented from embarking or disembarking, discharging or
loading cargo or stores, or taking on fuel, water, food and
supplies. States Parties may subject the granting of free pratique
to inspection and, if a source of infection or contamination is
found on board, the carrying out of necessary disinfection,
decontamination, disinsection or derating, or other measures
necessary to prevent the spread of the infection or contamination.
3. Whenever practicable and subject to the previous paragraph, a
state party shall authorize the granting of free pratique by radio
or other communication means to a ship or an aircraft when, on
the basis of information received from it prior to its arrival, the
state party is of the opinion that the arrival of the ship or aircraft
will not result in the introduction or spread of disease.
4. Officers in command of ships or pilots in command of aircraft,
or their agents, shall make known to the port or airport control as
early as possible before arrival at the port or airport of destination
any cases of illness indicative of a disease of an infectious nature
or evidence of a public health risk on board as soon as such
illnesses or public health risks are made known to the officer or
pilot. This information must be immediately relayed to the
competent authority for the port or airport. In urgent
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EHS 315 MODULE 3
circumstances, such information should be communicated

directly by the officers or pilots to the relevant port or airport
authority.
5. The following shall apply if a suspect or affected aircraft or ship,
for reasons beyond the control of the pilot in command of the
aircraft or the officer in command of the ship, lands elsewhere
than at the airport at which the aircraft was due to land or berths
elsewhere than at the port at which the ship was due to berth:
(a) the pilot in command of the aircraft or the officer in
command of the ship or other person in charge shall make
every effort to communicate without delay with the
nearest competent authority;
(b) as soon as the competent authority has been informed of
the landing it may apply health measures recommended by
WHO or other health measures provided in these
Regulations;
(c) unless required for emergency purposes or for
communication with the competent authority, no traveller
on board the aircraft or ship shall leave its vicinity and no
cargo shall be removed from that vicinity, unless
authorized by the competent authority; and
(d) when all health measures required by the competent
authority have been completed, the aircraft or ship may, so
far as such health measures are concerned, proceed either
to the airport or port at which it was due to land or berth,
or, if for technical reasons it cannot do so, to a
conveniently situated airport or port.
6. Notwithstanding the provisions contained in this Article, the
officer in command of a ship or pilot in command of an aircraft
may take such emergency measures as may be necessary for the
health and safety of travellers on board. He or she shall inform
the competent authority as early as possible concerning any
measures taken pursuant to this paragraph.
Chapter III – Special provisions for travellers
Article 30 Travellers under public health observation
Subject to Article 43 or as authorised in applicable international

agreements, a suspect traveller who on arrival is placed under public
health observation may continue an international voyage, if the traveller
does not pose an imminent public health risk and the State Party informs
the competent authority of the point of entry at destination, if known, of
the traveller‘s expected arrival. On arrival, the traveller shall report to
that authority.
154
Article 31 Health measures relating to entry of travellers
1. Invasive medical examination, vaccination or other prophylaxis

shall not be required as a condition of entry of any traveller to the
territory of a state party, except that, subject to Articles 32, 42
and 45, these Regulations do not preclude states parties from
requiring medical examination, vaccination or other prophylaxis
or proof of vaccination or other prophylaxis:
(a) when necessary to determine whether a public health risk

exists;
(b) as a condition of entry for any travellers seeking
temporary or permanent residence;
(c) as a condition of entry for any travellers pursuant to
Article 43 or Annexes 6 and 7; or
(d) which may be carried out pursuant to Article 23.
2. If a traveller for whom a state party may require a medical

examination, vaccination or other prophylaxis under paragraph 1
of this Article fails to consent to any such measure, or refuses to
provide the information or the documents referred to in paragraph
1(a) of Article 23, the state party concerned may, subject to
Articles 32, 42 and 45, deny entry to that traveller. If there is
evidence of an imminent public health risk, the State Party may,
in accordance with its national law and to the extent necessary to
control such a risk, compel the traveller to undergo or advise the
traveller, pursuant to paragraph 3 of Article 23, to undergo:
(a) the least invasive and intrusive medical examination that

would achieve the public health objective;
(b) vaccination or other prophylaxis; or
(c) additional established health measures that prevent or
control the spread of disease, including isolation,
quarantine or placing the traveller under public health
observation.
Article 32 Treatment of travellers
In implementing health measures under these Regulations, States Parties

shall treat travellers with respect for their dignity, human rights and
fundamental freedoms and minimise any discomfort or distress
associated with such measures, including by:
(a) treating all travellers with courtesy and respect;

(b) taking into consideration the gender, socio-cultural, ethnic or
religious concerns of travellers; and (c) providing or arranging for
155
EHS 315 MODULE 3
adequate food and water, appropriate accommodation and

clothing, protection for baggage and other possessions,
appropriate medical treatment, means of necessary
communication if possible in a language that they can understand
and other appropriate assistance for travellers who are
quarantined, isolated or subject to medical examinations or other
procedures for public health purposes.
Chapter IV – Special provisions for goods, containers and container

loading areas
Article 33 Goods in transit
Subject to Article 43 or unless authorised by applicable international

agreements, goods, other than live animals, in transit without
transhipment shall not be subject to health measures under these
Regulations or detained for public health purposes.
Article 34 Container and container loading areas
1. States Parties shall ensure, as far as practicable, that container

shippers use international traffic containers that are kept free
from sources of infection or contamination, including vectors and
reservoirs, particularly during the course of packing.
2. States Parties shall ensure, as far as practicable, that container
loading areas are kept free from sources of infection or
contamination, including vectors and reservoirs.
3. Whenever, in the opinion of a State Party, the volume of
international container traffic is sufficiently large, the competent
authorities shall take all practicable measures consistent with
these Regulations, including carrying out inspections, to assess
the sanitary condition of container loading areas and containers in
order to ensure that the obligations contained in these
Regulations are implemented.
4. Facilities for the inspection and isolation of containers shall, as
far as practicable, be available at container loading areas.
5. Container consignees and consignors shall make every effort to
avoid cross-contamination when multiple-use loading of
containers is employed.
PART VI – HEALTH DOCUMENTS
Article 35 General rule
No health documents, other than those provided for under these

Regulations or in recommendations issued by WHO, shall be required in
156
international traffic, provided however that this Article shall not apply to
travellers seeking temporary or permanent residence, nor shall it apply
to document requirements concerning the public health status of goods
or cargo in international trade pursuant to applicable international
agreements. The competent authority may request travellers to complete
contact information forms and questionnaires on the health of travellers,
provided that they meet the requirements set out in Article 23.
Article 36 Certificates of vaccination or other prophylaxis
1. Vaccines and prophylaxis for travellers administered pursuant to

these Regulations, or to recommendations and certificates
relating thereto, shall conform to the provisions of Annex 6 and,
when applicable, Annex 7 with regard to specific diseases.
2. A traveller in possession of a certificate of vaccination or other
prophylaxis issued in conformity with Annex 6 and, when
applicable, Annex 7, shall not be denied entry as a consequence
of the disease to which the certificate refers, even if coming from
an affected area, unless the competent authority has verifiable
indications and/or evidence that the vaccination or other
prophylaxis was not effective.
Article 37 Maritime Declaration of Health
1. The master of a ship, before arrival at its first port of call in the
territory of a State Party, shall ascertain the state of health on
board, and, except when that State Party does not require it, the
master shall, on arrival, or in advance of the vessel‘s arrival if the
vessel is so equipped and the State Party requires such advance
delivery, complete and deliver to the competent authority for that
port a Maritime Declaration of Health which shall be
countersigned by the ship‘s surgeon, if one is carried.
2. The master of a ship, or the ship‘s surgeon if one is carried, shall
supply any information required by the competent authority as to
health conditions on board during an international voyage.
3. A Maritime Declaration of Health shall conform to the model
provided in Annex
4. A State Party may decide:
(a) to dispense with the submission of the Maritime
Declaration of Health by all arriving ships; or
(b) to require the submission of the Maritime Declaration of
Health under a recommendation concerning ships arriving
from affected areas or to require it from ships which might
otherwise carry infection or contamination.
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EHS 315 MODULE 3
The State Party shall inform shipping operators or their agents of these
requirements.
Article 38 Health Part of the Aircraft General Declaration
1. The pilot in command of an aircraft or the pilot‘s agent, in flight

or upon landing at the first airport in the territory of a State Party,
shall, to the best of his or her ability, except when that State Party
does not require it, complete and deliver to the competent
authority for that airport the Health Part of the Aircraft General
Declaration which shall conform to the model specified in Annex
9.
2. The pilot in command of an aircraft or the pilot‘s agent shall
supply any information required by the State Party as to health
conditions on board during an international voyage and any
health measure applied to the aircraft.
3. A State Party may decide:
(a) to dispense with the submission of the Health Part of the
Aircraft General Declaration by all arriving aircraft; or
(b) to require the submission of the Health Part of the Aircraft
General Declaration under a recommendation concerning
aircraft arriving from affected areas or to require it from
aircraft which might otherwise carry infection or
contamination.
The State Party shall inform aircraft operators or their agents of these
requirements.
Article 39 Ship sanitation certificates
1. Ship Sanitation Control Exemption Certificates or Ship

Sanitation Control Certificates shall be valid for a maximum
period of six months. This period may be extended by one month
if the inspection or control measures required cannot be
accomplished at the port.
2. If a valid Ship Sanitation Control Exemption Certificate or Ship
Sanitation Control Certificate is not produced or evidence of a
public health risk is found on board a ship, the State Party may
proceed as provided in paragraph 1 of Article 27.
3. The certificates referred to in this Article shall conform to the
model in Annex 3.
4. Whenever possible, control measures shall be carried out when
the ship and holds are empty. In the case of a ship in ballast, they
shall be carried out before loading.
5. When control measures are required and have been satisfactorily
completed, the competent authority shall issue a Ship Sanitation
158
Control Certificate, noting the evidence found and the control

measures taken.
6. The competent authority may issue a Ship Sanitation Control
Exemption Certificate at any port specified under Article 20 if it
is satisfied that the ship is free of infection and contamination,
including vectors and reservoirs. Such a certificate shall normally
be issued only if the inspection of the ship has been carried out
when the ship and holds are empty or when they contain only
ballast or other material, of such a nature or so disposed as to
make a thorough inspection of the holds possible.
7. If the conditions under which control measures are carried out are
such that, in the opinion of the competent authority for the port
where the operation was performed, a satisfactory result cannot
be obtained, the competent authority shall make a note to that
effect on the Ship Sanitation Control Certificate.
Part VII. Charges

Part VIII. General provisions
Part IX. The IHR Roster of Experts, the Emergency Committee
and the Review Committee
Chapter I. The IHR Roster of Experts
Chapter II. The Emergency Committee
Chapter III. The Review Committee
Part X. Final provisions
4.0 CONCLUSION
The International Health Regulations 2005 are legally binding

regulations (forming international law) that aim to:
 Assist countries to work together to save lives and livelihoods

endangered by the spread of diseases and other health risks, and
 Avoid unnecessary interference with international trade and
travels
The IHR (2005) were adopted by the Fifty-eighth World Health

Assembly on 23 May 2005. They entered into force on 15 June 2007.
The purpose and scope of the IHR (2005) are ―to prevent, protect
international traffic and trade.‖ The IHR (2005) contain a range of
innovations, including:
159
EHS 315 MODULE 3
(a) a scope not limited to any specific disease or manner of

transmission, but covering ―illness or medical condition,
irrespective of origin or source, that presents or could present
significant harm to humans‖;
(b) State Party obligations to develop certain minimum core public
health capacities;
(c) obligations on States Parties to notify WHO of events that may
constitute a public health emergency of international concern
according to defined criteria;
(d) provisions authorizing WHO to take into consideration unofficial
reports of public health events and to obtain verification from
States Parties concerning such events;
(e) procedures for the determination by the Director-General of a
―public health emergency of international concern‖ and issuance
of corresponding temporary recommendations, after taking into
account the views of an Emergency Committee;
(f) protection of the human rights of persons and travellers; and
(g) the establishment of National IHR Focal Points and WHO IHR
Contact Points for urgent communications between States Parties
and WHO.
By not limiting the application of the IHR (2005) to specific diseases, it

is intended that the Regulations will maintain their relevance and
applicability for many years to come even in the face of the continued
evolution of diseases and of the factors determining their emergence and
transmission.
5.0 SUMMARY
In this unit, we defined International Health Regulations 2005, we also

looked into the evolution of International Health Regulations, the
principles embodying the IHR (2005), the various parts and the
chapters in the IHR 2005 and its headings. Of particular importance is
the Part I of the IHR 2005, which contains various definitions, the
purpose and scope, the principles and responsible authorities in the
implementation of the provisions of the IHR.. We also discussed Part II
Information and public health response, Part IV Points of entry, Part V
Public health measures and its Chapter I on general provisions, Chapter
II on special provisions for conveyances and conveyance operators,
Chapter III on special provisions for travellers and Chapter IV on
special provisions for goods, containers and container loading areas.
Mention was also made of Part VI on health documents and Part VIII
on general provisions.
160
1. What is International Health Regulations 2005?

2. State the evolution of International Health Regulations.
3. Enumerate the principles embodying the IHR (2005).
4. State the sub-headings in Part I of IHR 2005.
https://ehealth.gov.mt/HealthPortal/public_health/environmental
health/health_inspectorate/port_health_services/port_health_servi
ces_objective.aspx.
nigeria.html.
http://www.euro.who.int/_data/assets/pdf_file/0004/151375/e95783.pdf
International Health Regulations (2005). WHO. Geneva. (2006).

Health Regulations.
Lawrence, O. Gostin . (2004). ―International Infectious Disease Law,

Revision of the World Health Organisation‘s International
Health Regulations.‖ Journal of the American Medical
Association.




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NATIONAL OPEN UNIVERSITY OF NIGERIA

SCHOOL OF SCIENCE AND TECHNOLOGY

COURSE CODE: EHS 315

COURSE TITLE: INTERNATIONAL PORT HEALTH

Course Team Barrister Rotimi Adeyemi (Course Developer)-

NATIONAL OPEN UNIVERSITY OF NIGERIA

National Open University of Nigeria

All Rights Reserved

International and Port Health Services, is a semester course. It is a two-

WHAT YOU WILL LEARN IN THIS COURSE

It guides you concerning your tutor-marked assignment, which will be

The course aim is to provide you with an understanding of port health

In view of the growth of international traffic, continuous attention

 explain the fundamentals of port Health services

WORKING THROUGH THIS COURSE

The main components of the course materials are:

1. The Course Guide

Unit 1 Introduction to Port Health Services

Module 2 Duties of Environmental Health Officers in Port

Unit 1 Pest and Vector Control

Module 3 International Entry Measures and Procedure against

Unit 1 Diseases Surveillance and Notification

Module One explains the fundamentals of port health services. There

discussed health emergencies in port health. Unit 3 deals with water

TUTOR- MARKED ASSIGNMENT

The TMA is a continuous component of your course. It accounts for

However, it is desirable in all degree level of education to demonstrate

FINAL EXAMINATION AND GRADING

The end-of-course examination for international and port health services

COURSE MARKING SCHEME

FACILITATORS/TUTORS AND TUTORIALS

There are 15 hours of tutorials provided in support of this course. You

Your facilitator will mark and comment on your assignments, keep a

Do not delay to contact your facilitator by telephone or e-mail if you

 you do not understand any part of the study or the assigned

International and Port Health Services have been of concern to the

You will understand the dimension of the problem of international and

 the fundamentals of port health services

Module 1 Fundamental of Port Health Services ……… 1

Unit 1 Introduction to Port Health Services…………... 1

Module 2 Duties of Environmental Health Officers in

Unit 1 Pest and Vector Control……………………….. 29

Module 3 International Entry Measures and Procedure

Unit 1 Diseases Surveillance and Notification……….. 53

MODULE 1 FUNDAMENTALS OF PORT HEALTH

Unit 1 Introduction to Port Health Services

At the end of this unit, you should be able to:

 define port health services

 illustrate the organisational structure of port health services in

3.0 MAIN CONTENT

3.1 Definition of Port Health Services

Therefore, port health is a measure taken to protect and promote

3.2 History of Port Health Services in Nigeria

Measures to prevent the introduction of infection were recorded in the

Following a Royal Commission in 1838, the Water Police and the

Zammit, a medical officer of health who was instrumental in the

3.3 Organisational Structure

3.4 Port Health Locations in Nigeria

The location of port health services are at a country‘s frontiers, that is