Brazilian Sanitary Guide for Cruise Ships

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Transcript of Brazilian Sanitary Guide for Cruise Ships

REPBLICA FEDERATIVA DO BRASIL MINISTRY OF HEALTH BRAZILIAN SANITARY SURVEILLANCE AGENCY

BRAZILIAN SANITARY GUIDE FOR CRUISE SHIPS

President Dirceu Raposo de Mello Director Jos Agenor lvares da Silva General Manager of Ports, Airports and Borders Paulo Biancardi Coury ORGANIZERS: Fabio Miranda da Rocha Camila da Silva Borges Lacerda AUTHORS (in alphabetic order): Acary de Oliveira Adriana Aquino Barbosa Ana Clara Ribeiro Bello Camila da Silva Borges Lacerda Cristiano Gregis Enedina Reis Ericksson Costa Ferreira Fabio Miranda da Rocha Graziela Alvarez Corra da Costa Greice Madeleine Ikeda do Carmo Janana Vieira Pacheco Jlio Csar Colpo Karla Freire Baeta Leonardo Oliveira Leito Luiz Alves Campos Marestela Hupes Schneider Maria Aparecida Oliveira Arajo Marianna Donato Pirrone Noemi Melo Cabral Olimar Santos Patrcia Pereira da Silva de Freitas Viviane Vilela Marques Walkiria Delnero Almeida Prado

SummaryI. INTRODUCTION AND BACKGROUND .......................................................................... 5 1. AUTHORITY ........................................................................................................... 6 2. HEALTH INSPECTIONS IN BRAZIL ............................................................................ 6 3. FREE PRACTICE ...................................................................................................... 8 4. REGISTRATION ON ANVISAS WEBSITE .................................................................. 9 5. OBJECTIVES ........................................................................................................... 9 II. EPIDEMIOLOGIC SURVEILLANCE .............................................................................. 10 1. DETECTING CASES AND OUTBREAKS OF NOTIFIABLE DISEASES ............................... 10 1.1. MEDICAL LOG ....................................................................................................... 10 1.2. REPORTABLE CASES .............................................................................................. 11 1.2.1. Outbreak Declaration ........................................................................................ 12 1.3. CASE NOTIFICATION ............................................................................................. 13 1.3.1. Routine Report .................................................................................................. 13 1.3.2. Special Report ................................................................................................... 13 1.4. EPIDEMIOLOGICAL QUESTIONNAIRES .................................................................. 14 1.5. LABORATORY DIAGNOSIS ..................................................................................... 14 1.5.1. Clinical Specimens Collection............................................................................. 14 1.5.1.1.1. Bacteria ....................................................................................................... 15 1.5.1.1.2. Virus ............................................................................................................ 16 1.5.1.1.3 Parasites ....................................................................................................... 16 1.5.1.2. Influenza-like Illness ....................................................................................... 17 2. CONTROL MEASURES .............................................................................................. 18 2.1. Pre-embarkation Screening .................................................................................. 18 2.2 Control of the Cases, Contacts and Environment ................................................... 20 2.2.1 Planning Actions ................................................................................................. 20 2.2.2 Incident Team Members .................................................................................... 20 2.2.3. Duties of the Incident Team .............................................................................. 20 2.2.4. Environmental Cleaning .................................................................................... 21 2.2.5 Personal Hygiene................................................................................................ 21 2.2.6. Isolation ............................................................................................................ 22 2.2.6.1 For Crew .......................................................................................................... 22 2.2.6.2 For Passengers ................................................................................................ 23 2.2.7. Travelers Guidance ............................................................................................ 24 2.2.8. Other Measures Established by Health Authorities ............................................ 25 III. SANITARY SURVEILLANCE ....................................................................................... 26 1. FOOD ...................................................................................................................... 26 1.1. MANUAL ON GOOD MANUFACTURING PRACTICES FOR FOOD PREPARATION ...... 26 1.2. SUPPLIER SELECTION ............................................................................................ 28 1.3. FOOD RECEIVING.................................................................................................. 28 1.3.1. Physical facilities ............................................................................................... 28 1.3.2. Receiving Condition ........................................................................................... 29 1.3.3. Register ............................................................................................................. 31 1.4. STORAGE .............................................................................................................. 32 1.4.1. Physical facilities ............................................................................................... 32

1.4.2. Quality and control of food products ................................................................. 33 1.4.3. Temperature control ......................................................................................... 34 1.5. GALLEYS ............................................................................................................... 34 1.5.1. Facilities, equipment, furniture and utensils ...................................................... 34 1.5.2. Sanitizing of facilities, equipment and utensils .................................................. 36 1.5.3. Food preparation .............................................................................................. 37 1.5.4. Food handlers ................................................................................................... 40 1.5.5. Health of food handlers ..................................................................................... 44 1.5.6. Handwashing and Toilet Facilities ...................................................................... 44 1.5.7. Solid waste management .................................................................................. 45 1.6. SERVICE AREAS (RESTAURANTS AND DINNING ROOMS) ....................................... 46 1.6.1. Facilities ............................................................................................................ 46 1.6.2. Temperatures and exposure time...................................................................... 47 3. RECREATIONAL WATER FACILITIES (RWF) ................................................................ 48 3.1. SEAWATER SWIMMING POOLS ............................................................................ 48 3.2. RECIRCULATING SWIMMING POOLS..................................................................... 48 3.3. JACUZZIS (OR SIMILAR HOT TUBS FOR COLLECTIVE USE) ...................................... 49 3.4. RECOMMENDATIONS ........................................................................................... 49 4. AIR CONDITIONING ................................................................................................. 50 4.1. OPERATIONAL AND HYGIENIC SANITARY CONDITIONS ......................................... 50 4.2. CLEANING AND MAINTENANCE RECORDS ............................................................ 50 5. HOSPITAL ................................................................................................................ 52 6. VECTORS AND RESERVOIRS ..................................................................................... 54 6.1. INTEGRATED PEST MANAGEMENT PLAN (IPM)..................................................... 54 6.2. MONITORING AND CONTROL ACTIONS ................................................................ 54 6.3. PRODUCTS: LABELING, STORAGE, AND DILUTION................................................. 55 7. SEWAGE .................................................................................................................. 56 8. SOLID WASTE (GARBAGE) ........................................................................................ 58 8.1. REVERSE LOGISTICS .............................................................................................. 58 8.2. MANAGEMENT STAGES ........................................................................................ 59 8.2.1. Generation and segregation .............................................................................. 59 8.2.2. Packaging .......................................................................................................... 59 8.2.3. Storage .............................................................................................................. 60 8.2.4. Treatment .............................................................