Brazilian preparedness for public health emergencies on points of entry

Transcription

1 General Office for Ports, Airports and Ground Crossing Brazilian preparedness for public health emergencies on points of entry September 2013

2 Brasil

3 190.7 million people 5th most populated country in the world Brasil

4 National airports disembarks International disembarks National disembarks

5 National civil aeronautical system Public Health Authority ATS Authority Civil Aviation Authority Migratory, Customs Authorities Airlines associations Airports Comissão Nacional de Autoridades Aeroportuárias - CONAERO Conselho de Aviação Civil CONAC/MD Secretaria de Aviação Civil da Presidência da República - SAC/PR

6 Brazilian milestones on public health at airports 1808 Opening the ports with imperial portuguese family 1893 Begining of General Ports Health Inspection Service 1925 Quarantine stations stop working 1960s Conformation to International Health Regulations 1991 Finished health requirements for foreigners 1999 Created Brazilian Health Surveillance Agency 2007 Finished requirement of International Certification of Vaccionation or Profilaxy agains Yellow Fever 2008 Assessment of core capacities of Annex 1B of International Health Regulations 2011 CAPSCA assistance visit at Guarulhos International Airport

7 United Health System (SUS) and points of entry Trade Tourism Epidemiology LACEN- Lsb Hospital Travellers Conveynces cargo Groundcr ossing Health Surveillance Agriculture Migration Point of Entry Customs Port Aviation EADI Airport Facilities workers Others health unities Industry Afected areas

8 38 Airtports with Health Surveillan ce Stations Travel Health Control

9 Travel Health Control

10 Travel Health Control Yellow Fever risk areas

11 Travel Health Control International Certificate of VaccinationorProphylaxis Brazil do not require the Certificate from travellers coming from international areas at risk of transmission of yellow fever This document is issued at the main airports by Health Authority and by designed services in the the main cities

12 Public Health Event Management

13 Public Health Event Management General Declaration The airline deliver the document after the flight has being arrived.

14 Public Health Event Management Passenger Locator Form This to document are not used for Brazilian Health Authority Term of health control of travelers This document is used to notified the airline that a person can travel after a evaluation

15 Experience fear of communicable disease Public Health Event Management On 20 august 2013, the crew and PIC stop stop the departure because a child present rash. The parents said that the child has a chronic disease. A passenger on board identified himself like a doctor and explained that the health condition are not a communicable disease. The PIC notified the tower that send the medical service to the airplane to evaluate the child. The doctor said that was not a communicable disease and the PIC require a prescription for resume de flight departure. The health authority was not notified.

16 Assessment of core capacities for Airports 12 airports were assessment using a tool developed by MERCOSUL public health committee Core capacity Improvement Communicate 42% 72% 30% All times 50% 69% 19% Responding to PHEIC 27% 45% 18%

17 Responding to PHEIC at Airports Airplane Health Surveillance Station at Airport Local epidemiology Central epidemiology / National Focal Point WHO Public Health Event

18 SARS experience: assessment of screening measures Responding to PHEIC at Airports Traveller Health Declarations Traveller Health Declarations registered at a datawarehouse 19 suspected SARS cases NIL confirmed Discussion Traveller gathering related to fill and check the Health Declarations increase the transmission risk Almost one quarter have not address or contact information Low prevalence of SARS cases and low efective screening measures results on positive predictive value next to zero, like in another countries Gap of on board notification bring dificulties to case health management

19 SARS experience: Traveller Health Declaration Form Responding to PHEIC at Airports

20 Influenza A H1N1experience Responding to PHEIC at Airports

21 Responding to PHEIC at Airports Anvisa and ANAC developed a framework based on: OMS CAPSCA/OACI Mercosul Health Ministry (Draft)

22 Monitoring Core Capacities of IHR Responding to PHEIC at Airports

23 Challenges Implementation of case and risk management based on Advanced Passenger Information and Passenger Name Record data Establish and maintain the contingency plan for PHEIC at international airports for WHO certification Develop a plan for case management at airport on mass gathering

24 Thank You! Gracias! (55 61) The Dom Bosco Profecy Brasilia