The Ministry of Public Health today sounded an alert over the Ebola Virus outbreak in the Democratic Republic of the Congo which the World Health Organisation has deemed a public health emergency of international concern.
A statement by the Ministry of Public Health follows:
The recent outbreak of Ebola in the Democratic Republic of Congo (DRC) is a global concern, and as such it is referred to as a Public Health Emergency. One has to be concerned about the regional spread of the Ebola virus after a new spike in cases. According to Dr. Tedros Adhanom Ghebreyesus, the World Health Organization Director General, “ it is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system”. Dr Ghebreyesus emphasised that great work has been done amidst challenging circumstances. Those contributing to this success include the WHO, national governments, international partners and communities.
Guyana, a third world country in South America, is no less safe than its neighbours, thus, to this effect, it is imperative that measures be adopted to as advised by the WHO relevant to safe guarding all passengers and our ports of entry.
Particularly, emphasis is always placed on monitoring civil aviation activities (International Travel) given that this medium can facilitate the movement of communicable diseases via infected passengers and thereby spreading the threat. The processes related to air travel, specifically, processes associated with outgoing passengers, incoming passengers and activities on board an aircraft can be managed to control the spread of any communicable diseases. At this time, the risk of contracting Ebola currently has diminished and as such only the basic measures/SOPs shall be implemented.
The WHO has established Phases of a Pandemic which can be compared to colour-coded Alert Levels. These are Alert Levels: Green, Yellow, Orange and Red. Alert Green requires no security measures to be adopted because there is no risk of the disease being communicated. Nevertheless, it is important to conduct periodic exercises to test the effectiveness of equipment and the communication channels and to ensure that personnel are adequately trained. Alert Yellow would require basic security measures, whilst Alert Level Orange would require maximum security. Alert Red would be the stage where WHO would have declared a Pandemic and the commencement of a ‘activation of security measures’ would be executed.
The following measures were considered and are recommended for implementation during the current Alert Level Yellow.
1. Travel Agencies And Airlines Sales Offices 1) This sensitization can be done by advising passengers on the precautionary measures and hygiene practices that should be observed during travel. These would include the possession of hand sanitizers, and practices such as washing hands, wearing of gloves or wiping of surfaces when using the water taps or lavatories.
All travel agencies and airlines selling seats or tickets for travel must take on the responsibility of sensitizing their clients on the risk of Ebola:
2. Airport Passenger Check-In Areas
1. Develop and display signage around the airport check-in area and arrival area for information purposes. Appropriate message content to be developed; this may be recommended by Ministry of Public Health.
2. Establish an isolated/sterile facility at the airport which is remote from public access should there be a suspected case or cases of Ebola victims.
3. Make available personal protective equipment (PPE) to all airport staff when necessary.
4. Appropriate monitoring and surveillance shall be implemented at the VIP Screening checkpoint; this must be implemented by the Airport Management and Port Health. Requisite awareness training and sensitization on measures to detect and combat the Ebola Virus must be provided to all personnel operating at or within these facilities (VIP and Executive Lounges).
5. Sensitisation and training of frontline and other staff must be conducted at the check-in counters and elsewhere at the airport; these personnel includes the following: 1) Airline Check-In Staff
2) Contracted Handling Companies
3) Contracted Security Personnel
4) Security Screening Personnel
5) Cleaners and Cleaning Companies
6) Immigration Officers. Red-caps (porters)
7) Taxi-drivers
All of the categories of personnel as described above can be used to conduct initial observation and evaluation of outgoing traveling passengers. However, they will be required to pay close attention to the following:
1) Maintaining a safe distance of 3 feet from persons with suspected illness;
2) Take precautionary measures when handling all travel documents and other personal effects of passengers with suspected illness;
3) Report any suspicious cases of illness to Port Health Officers.
4) Port Health Officials along with medical support team from Ministry of Public Health will subject suspected cases to further evaluation and determine if and when such cases should be taken to isolated/ sterile area.
Airport Arrival Areas
The Presence of Health Care workers or Port Health personnel at the entrance to arrival area will help to emphasize the importance of identifying, preventing and preparing for Ebola.
1) Sensitisation and training of frontline staff at the arrival immigration counters (including healthcare workers, port health, cabin crew and other relevant personnel)
2) Evaluation of arriving passengers – this will entail the deployment of Port Health personnel to evaluate passengers at a specific location. The use of thermal scanning (Portable Thermal hand-held scanners) can also be introduced.
Airline Operation – Airborne and On-the-Ground
The sensitisation and training of flight crew, cabin crew and other relevant personnel are crucial to this process; they must be trained to:
1) Recognise suspected cases displaying symptoms which may be associated with Ebola
2) Take precautionary measures when dealing with ill passengers or suspected cases.
3) Be able to disinfect these utilities should bodily fluids be visible (vomit, blood, urine, etc.)
4) Establish appropriate SOPs for the removal or disembarkation of suspected cases.
Other measures which are considered critical to preventing the entry and spread of Ebola are outlined below:
1) For suspicious cases identified on-board or during flight, Flight Crew and Cabin Crew will be required to prepare and provide comprehensive information on the General Declaration forms; this must be communicated to Port Health Officials at earliest opportunity.
Flight Crew and Cabin.
1) Crew are asked to confirm to this requirement since this process will be crucial in identifying suspected cases and further facilitate appropriate interventions by the relevant health and response agencies.
2) Port Health Officials along with medical support team from Ministry of Public Health will subject suspected cases to further evaluation and determine if and when such cases should be taken to isolated zone/area (GAC hangar of other appropriate facility).
3) Flight Crew and Cabin Crew are asked to make an effort to observe and evaluate persons displaying symptoms of illness as outlined in Note No. 3. The crews are required to report suspected cases to Air Traffic Control and Port Health Officials in Guyana at earliest opportunity.
4) All personnel from cleaning companies, handling companies, and airline security who are involved in aircraft cleaning, security clean sweeping, and other similar duties will be required to: a. Be trained and sensitized on precautionary measures for cleaning and disposing of aircraft waste;
b. Take precautionary measures when dealing with /cleaning/removing bodily fluids in aircraft, including lavatories;
5) Sensitisation and training of staff that operates in arrivals – Immigration, Customs, Porters/Red-Caps, and Taxi Drivers at the airport are also necessary; these personnel generally facilitate the re-entry of passengers into Guyana.
6) Advance Passenger Information System (APIS) – All airlines conducting international operations are required to provide all relevant particulars/information for each passenger on board the aircraft to the Port Health Authority before arriving at Guyana’s international Port-of Entries. To the extent practicable, each passenger’s previous destinations must be provided. APIS information required must consist of the following (but not limited to):
1) Identification details
2) Full name
3) Gender
4) Date of birth
5) Nationality
6) Country of residence
7) Country visited in within the last 6 weeks
7) Air operators are required to ensure that waste (garbage, faeces, vomit, rubbish, etc.) are removed and disposed of in an extremely safe manner. Lavatories waste and waste removal equipment should be treated with appropriate additives (as advised by the Ministry of Public
Health) that will neutralise any form of contagious diseases. Where appropriate, incineration should also be considered as part of the waste disposal process.
DR. Kay Shako
Director Regional and Clinical Services
Chief Medical Officer (Ag).
Ministry of Public Health