Communicable Disease Control: International Aspects of Communicable Disease Control

This section covers:

• International aspects of communicable disease control including port health

The Public Health Act 1872 provided for the establishment of Port Health Authorities (PHA).

Currently Port Health Authorities are Local Authority environmental health departments (this may change) and have powers to control the public health aspects of port activity involving ships, international trains and aircraft. Each Port Health Authority appoints port health officers and port medical officers.

Functions of Port Health Authorities

1. Prevent the importation of disease e.g. visit and inspect aircraft
2. Rodent control e.g. ships must be inspected every 96 months for rats
3. Imported food e.g. inspection and clearance of Products of Animal origin into the EU
4. Fish and shellfish e.g. FSA monitor quality of local shellfish
5. Food premises inspections e.g. monitors standards in shore-based premises & in-flight catering
6. Animal health e.g. assist with enforcement of rabies controls

Port Medical Officer

1. May act as a Port Medical Inspector (PMI) providing advice to Immigration and Nationality service
2. Refer to PMI for medical clearance (including Chest X-ray) in any person intending to remain in the UK for 6 months or more or those who are unwell
3. Medical clearance may take place in country of origin
4. Persons with infectious diseases likely to endanger health of others in the UK may be refused entry
5. Unless entry refused, details of immigrant and results of any examination are passed to CCDC in the proposed area of residence
6. Subsequent action can vary but include invitations to attend for further medical assessment

(Source: J. Hawker. Communicable Disease Control Handbook. Blackwell 2005)

WHOs International Health Regulations (IHR)

In 2005 the World Health Organization revised its International Health Regulations (IHR). These regulations have been enforced since 15th June 2007. Under the IHR (2005), all cases of the following four diseases must be automatically notified to WHO:

• smallpox;
• poliomyelitis due to wild-type poliovirus;
• SARS;
• cases of human influenza caused by a new subtype.

In addition the IHR (2005) requires States to notify WHO of all events that may constitute a public health emergency of international concern and to respond to requests for verification of information regarding such events. IHR 2005 defines a limited set of criteria to assist in deciding whether an event is notifiable to WHO.

The International Health Regulations (2005) are an international law which helps countries work together to save lives and livelihoods caused by the international spread of diseases and other health risks. The IHR (2005) aims to prevent, protect against, control and respond to the international spread of disease while avoiding unnecessary interference with international traffic and trade.

The previous IHR of 1969 had limited scope and only required the reporting to WHO of three main diseases: cholera, yellow fever and plague.

© Sarah Anderson, Gayatri Manikkavasagan 2008