engleski

Importing a transmissible disease into country: a constant threat

Background International travel and health are close related. Spread of transmissible diseases by mean of transportation stands for very past centuries. Permanent quarantines are not suitable in contemporary dynamical trade of goods and movement of people. During recent years it is common that seafarers travel toward or from distant countries, not exclusively arriving by ship. Short duration of travel by plane during incubation or subclinical period of a transmissible disease could be a new way for importing the disease. Control of international travel is regulated by several laws where stands that every passenger arriving from an infected area must be screened for the disease. However, a positive identification of seafarer either is being sick or only arriving from an infected area is crucial moment in control of importing the disease, and that apply to one's arriving by plane if their last departure site is in an infected area. It is very likely that seafarer could enter the country not only by plane, but also by different means of transportation (car, bus) when no sanitary control is available. In that case, application of control measures is possible only if seafarer individually ask for screening. Aim of the study is to discuss screening against transmissible diseases for seafarers arriving from an infected area. Results We don't know exactly how many seafarers enter the country. In 5-year period (2000-2004) we had vaccinated 2330 seafarers against yellow fever (466 annual mean). In the same period 58 were screened for cholera, 46 for malaria, 7 for yellow fever, 1 for typhoid, 23 for SARS and 13 for haemorrhagic fever (totally 148). If we assume that every seafarer vaccinated against yellow fever entered the country at least only once from an infected area, there were should been at least the same amount of screened seafarers, but not 16 times less. It is obviously that system cannot screen all passengers arriving from infected areas. Furthermore, vast majority of seafarers exit and enter the country several times annually. During the studied period only one passenger arriving from Nepal was diagnosed having non-O1 non-O139 Vibrio cholerae. Sanitary officer at the airport in Croatia has sent 12 passengers to be screened for SARS, and other 11 entered the country by car after arrival to airport abroad and came voluntary for screening. Conclusion Screening for transmissible diseases in seafarers arriving from an infected area can not be performed if the passenger is not identified at the country’ s border and directed to the Institute of public health. It is not feasible to identify all passengers, because every passenger at the border must be asked for their whole route and this is not possible in a case of &laquo ; soft&raquo ; border. Every passenger must be consulted prior departure about necessity of the screening and possible impacts to community’ s health if imports a transmissible disease into the country. Knowledge stands as key preventive measure against importing transmissible diseases.

disease; infection; import; boudary

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