MARITIME

HEALTH
DECLARATI
ONS

Procedures on maritime declarations

of health upon arrival

The captains or owners of vessels that make

international journeys will announce their arrival at
port in advance by phone or signals to the port's
health authorities. When they come within vision,
the corresponding flag of the International Signals
Code is raised.

Yellow flag, letter Q, in case of lack of

communication, means the vessel is
healthy (see figure A-18)

Two vertical yellow flags letter QQ, means

there has been an infectious illness on
board before the last five days, or an
unusual death toll of rats (see figure A -19).

Yellow and black squared flag under a yellow

one, letters QL, means there has been an
infectious illness in the last five days (see
figure A-20).

At night, we can ask for health-care by

placing a red light above a white one,
separated by a maximum of two metres.
While the signals remain hoisted all
communication with the vessel is
prohibited except for pilots and tug boats;
those vessels that are denied free talk
cannot make contact with land or any other
vessels, and must remain anchored or
moored where the port authorities indicate.

The health authorities will solicit, should it be deemed

necessary, the Maritime Declaration of Health,
endorsed by the on board doctor, if there is one. This
complies with the International Health Regulations,
article 90. In this respect, the subsequent measures can
be taken :

Exempt all vessels docking, no matter where they are coming from,
or only those arriving from the Bonded Health Zone (member
countries of the European Council) from presenting the declaration.
Exclusively require that those vessels coming from certain
expressly mentioned areas, and in cases where there is something
positive to report.

What is IHR?

are legally binding regulations (forming international

law) that aim to a) assist countries to work together
to save lives and livelihoods endangered by the
spread of diseases and other health risks, and b)
avoid unnecessary interference with international
trade and travel.
The purpose and scope of IHR are to prevent, protect
against, control and provide a public health response
to the international spread of disease in ways that are
commensurate with and restricted to public health
risks, and which avoid unnecessary interference with
international traffic and trade. (Art. 2, IHR 2005)

Definition of Terms(from IHR

1969)

Arrival of Ship - (a) in the case of a

seagoing vessel, arrival at a port; in the
case of an inland navigation vessel,
arrival either at a port or at a frontier
post, as geographical conditions and
treaties or arrangements among the
States concerned, under Article 85 or
under the laws and regulations in force
in the territory of entry, may determine.

Baggage - means the personal effects of a traveller or of a

member of the crew.
Container or freight container - means an article of transport
equipment
(a) of a permanent character and accordingly strong
enough to be suitable for repeated use;
(b) specially designed to facilitate the carriage of goods, by
one or more modes of transport, without intermediate reloading;
(c) fitted with devices permitting its ready handling,
particularly its transfer from one mode of transport to another;
(d) so designed as to be easy to fill and empty. The term
"container (freight container)" does not include vehicles or
conventional packing

Crew - means the personnel of a ship,

an aircraft, a train, a road vehicle or
other means of transport who are
employed for duties on board.
Diseases subject to the regulations
(quarantinable diseases) means
cholera, including cholera due to the
eltor vibrio, plague, and yellow fever.

Disinfecting - means the operation in

which measures are taken to kill the
insect vectors of human disease present
in ships, aircraft, trains, road vehicles,
other means of transport, and
containers.
Epidemic - means an extension of a
disease subject to the Regulations by a
multiplication of cases in an area.

Free pratique - means permission for a

ship to enter a port, disembark and
commence operation, or for an aircraft,
after landing, to disembark and commence
operation.
Health administration - means the
governmental authority responsible over
the whole of a territory to which these
Regulations apply for the implementation
of the health measures provided herein.

Health authority - means the authority

immediately responsible in its jurisdiction
for the appropriate health measures
permitted or prescribed by these
Regulations.
Infected person - means a person who is
suffering from a disease subject to the
Regulations or who is subsequently shown
to have been incubating such a disease.

In quarantine - means that state or

condition during which measures are
applied by a health authority to a ship,
an aircraft, a train, road vehicle, other
means of transport or container, to
prevent the spread of disease,
reservoirs of disease or vectors of
disease from the object of quarantine.

International voyage
(a) in the case of a ship or an aircraft, a voyage
between ports or airports in the territories of more than
one State, or a voyage between ports or airports in the
territory or territories of the same State if the ship or
aircraft has relations with the territory of any other
State on its voyage but only as regards those
relations;
(b) in the case of a person, a voyage involving
entry into the territory of a State other than the
territory of the State in which that person commences
his voyage.

Isolation - when applied to a person or

group of persons, means the separation
of that person or group of persons from
other persons, except the health staff on
duty, in such a manner as to prevent the
spread of infection.

Medical examination - includes visit to

and inspection of a ship, an aircraft, a
train, road vehicle, other means of
transport, and container, and the
preliminary examination of persons,
including scrutiny of vaccination
certificates, but does not include the
periodical inspection of a ship to
ascertain the need for deratting.

Ship - means a seagoing or an inland

navigation vessel making an
international voyage.
Suspect - means a person who is
considered by the health authority as
having been exposed to infection by a
disease subject to the Regulations and
is considered capable of spreading that
disease.

Valid Certificate - when applied to

vaccination, means a certificate
conforming with the rules and the model
laid down in Appendix 2

Article 26

22
22
1. A health authority shall, when so requested, issue free of charge to the
carrier
a certificate specifying the measures applied to a ship, aircraft, train, road
vehicle,
other means of transport, or container, the parts thereof treated, the methods
employed, and the reasons why the measures have been applied. In the case
of an
aircraft this information shall, on request, be entered instead in the Health Part
of the
Aircraft General Declaration.
2. Similarly, a health authority shall, when so requested, issue free of charge:
(a) to any traveller a certificate specifying the date of his arrival or departure
and the measures applied to him and his baggage;

Article 28

Except in case of an emergency constituting a

grave danger to public health, a ship or an
aircraft, which is not infected or suspected of being
infected with a disease
subject to the Regulations, shall not on account of
any other epidemic disease be
refused free pratique by the health authority for a
port or an airport; in particular it
shall not be prevented from discharging or loading
cargo or stores, or taking on fuel or
water.

Article 29

A health authority may take all

practicable measures to control the
discharge from any ship of sewage and
refuse which might contaminate the
waters of a port,
river or canal

Article 30

1. The health authority for a port or an airport or for

the area in which a frontier
post is situated shall take all practicable measures:
(a) to prevent the departure of any infected person or
suspect; (b) to prevent the introduction on board a
ship, an aircraft, a train, a road vehicle, other means
of transport, or container, of possible agents
of infection or vectors of a disease subject to the
Regulations.
2. The health authority in an infected area may
require a valid vaccination
certificate from departing travellers.

3. The health authority referred to in paragraph 1 of this Article may, when

it
considers it necessary, medically examine any person before his departure
on an
international voyage. The time and place of this examination shall be
arranged to take
into account any other formalities, so as to facilitate his departure and to
avoid delay.
4. Notwithstanding the provisions of subparagraph (a) of paragraph 1 of
this
Article, a person on an international voyage who on arrival is placed under
surveillance may be allowed to continue his voyage. The health authority
shall, in
accordance with Article 27, notify by the most expeditious means the health
authority
for the place to which he is proceeding.

Article 32

1. No health measure shall be applied by

a State to any ship which passes
through waters within its jurisdiction
without calling at a port or on the coast.
2. If for any reason such a call is made,
the laws and regulations in force in the
territory may be applied without exceeding,
however, the provisions of these
Regulations.

Article 33

1. No health measure, other than medical

examination, shall be applied to a
healthy ship, as specified in Part V, which passes
through a maritime canal or
waterway in the territory of a State on its way to a
port in the territory of another
State, unless such ship comes from an infected
area or has on board any person
coming from an infected area, within the incubation
period of the disease with which
the area is infected.

2. The only measure which may be applied to such a ship

coming from such an
area or having such a person on board is the stationing on board,
if necessary, of a
sanitary guard to prevent all unauthorized contact between the
ship and the shore, and
to supervise the application of Article 29.
3. A health authority shall permit any such ship to take on, under
its control, fuel,
water and stores.
4. An infected or suspected ship which passes through a
maritime canal or
waterway may be treated as if it were calling at a port in the same
territory.

Article 35

Whenever practicable States shall authorize

granting of free pratique by radio to a ship
or an aircraft when on the basis of
information received from it prior to its
arrival, the health authority for the intended
port or airport of arrival is of the opinion
that its arrival will not result in the
introduction or spread of a disease subject
to the
Regulations.

medical examination

Officers in command of aircraft and

ships should make known as long as
possible before arrival to airport and port
authorities any case of illness on board,
in
the interests of the patient and the
health authority and to facilitate the
clearance of the aircraft or ship

Article 38

On arrival of a ship, an aircraft, a train, a

road vehicle, or other means of transport,
an infected person on board may be
removed and isolated by the health
authority. Such removal by the health
authority shall be compulsory if it is
required by
the person in charge of the means of
transport.

Article 41

Subject to Article 73, a ship or an aircraft shall not

be prevented for health reasons from calling at
any port or airport.If the port or airport is not
equipped for
applying the health measures which are permitted
by these Regulations and which in
the opinion of the health authority for the port or
airport are required, such ship or
aircraft may be ordered to proceed at its own risk
to the nearest suitable port or airport
convenient to the ship or aircraft.

Article 44

1. Except as provided in paragraph 2 of this Article, any

ship or aircraft, which is unwilling to submit to the
measures required by the health authority for the port or
airport in accordance with these Regulations, shall be
allowed to depart forthwith, but
it shall not during its voyage call at any other port or
airport in the same territory.
Such a ship or an aircraft shall neverthelessbe
permitted, while in quarantine, to take
on fuel, water and stores. If, on medical examination,
such a ship is found to be
healthy, it shall not lose the benefit of Article 33.

2. A ship or an aircraft arriving at a port or an airport

situated in an area where
the vector of yellow fever is present shall not, in the
following circumstances, be
allowed to depart and shall be subject to the measures
required by the health authority
in accordance with these Regulations:
(a) if the aircraft is infected with yellow fever;
(b) if the ship is infected with yellow fever, and Aedes
aegyptihave
been found on board, and the medical examination shows
that any
infected person has not been isolated in good time.

Article 46

1. Cargo and goods shall be submitted to the health

measures provided for in
these Regulations only when coming from infected areas
and when the health
authority has reason to believe that the cargo and goods
may have become
contaminated by the agent of a disease subject to the
Regulations or may serve as a
vehicle for the spread of any such disease.
2. Goods, other than live animals, in transit without
transhipment shall not be
subject to health measures or detainedat any port, airport,
or frontier.

3. The issue of a certificate of

disinfection of merchandise which is the
subject of
trade between two countries may be
governed by bilateral agreements
between the
exporting and the importing countries.

Article 47

Except in the case of an infected person

or suspect, baggage may be disinfected
or disinsected only in the case ofa
person carrying infectious material or
insect vectors of a disease subject to the
Regulations.

Plague Article 50

For the purposes of these Regulations

the incubation period of plague is six
days.

Article 51

Vaccination against plague shall not be

required as a condition of admission of
any person to a territory.

Article 52

1. Each State shall employ all means in its power to diminish

the danger from the
spread of plague by rodents and their ectoparasites. Its health
administration shall
keep itself constantly informed by systematic collection and
regular examination of
rodents and their ectoparasites of the conditions in any area,
especially any port or
airport, infected or suspected of being infected by rodent
plague.
2. During the stay of a ship or an aircraft in a port or an airport
infected by
plague, special care shall be taken to prevent the introduction of
rodents on board.

Article 53

1. Every ship shall be either:

(a) permanently kept in such a condition that it is free of rodents and the
plague vector; or
(b) periodically deratted.
2. A Deratting Certificate or a Deratting Exemption Certificate shall be
issued
only by the health authority for a port approved for that purpose under
Article 17.
Every such certificate shall be valid for six months, but this period may be
extended
by one month for a ship proceeding to such a port if the deratting or
inspection, as the
case may be, would be facilitated by the operations due to take place there.
3. Deratting Certificates and Deratting Exemption Certificates shall conform
with the model specified in Appendix 1.

4. If a valid certificate is not produced, the health authority for a port approved
under Article 17, after inquiry and inspection, may proceed in the following manner:
(a) If the port has been designated under paragraph 2 of Article 17, the health authority may derat
the ship or cause the deratting to be done
under its direction and control. It shall decide in each case the
technique which should be employed to secure the extermination of
rodents on the ship. Deratting shall be carried out so as to avoid as far
as possible damage to the ship and to any cargo and shall not take
longer than is absolutely necessary. Wherever possible deratting shall
be done when the holds are empty. In the case of a ship in ballast, it
shall be done before loading. When deratting has been satisfactorily
completed, the health authority shall issue a Deratting Certificate.
(b) At any port approved under Article 17, the health authority may issue a Deratting Exemption
Certificate if it is satisfied that the ship is
free of rodents. Such a certificate shall be issued only if the inspection
of the ship has been carried out when the holds are empty or when they
contain only ballast or other material, unattractive to rodents, of such a
nature or so disposed as to make a thorough inspection of the holds
possible. A Deratting Exemption Certificate may be issued for an oil
tanker with full holds.

5. If the conditions under which a deratting

is carried out are such that, in the
opinion of the health authority for the port
where the operation was performed, a
satisfactory result cannot be obtained, the
health authority shall make a note to that
effect on the existing Deratting Certificate.

Article 55

Before departure on an international

voyage from an area where there is an
epidemic of pulmonary plague, every
suspect shall be placed in isolation by
the health
authority for a period of six days
reckoned from the date of the last
exposure to
infection.

Article 56

1. A ship or an aircraft on arrival shall be regarded as infected if:

(a) It has a case of human plague on board; (b) a plagueinfected rodent is found on board.
A ship shall also be regarded as infected if a case of human plague
has occurred on board more than six days after embarkation.
2. A ship on arrival shall be regarded as suspected if:
(a) it has no case of human plague on board, but such a case has
occurred on board within the first six days after embarkation;
(b) there is evidence of an abnormal mortality among rodents on
board of which the cause is not yet known;
(c) it has a person on board who has been exposed to pulmonary
plague and has not met the requirements of Article 55.

3. Even when coming from an infected area

or having on board a person coming
from an infected area, a ship or an aircraft
on arrival shall be regarded as healthy if, on
medical examination, the health authority is
satisfied that the conditions specified in
paragraphs I and 2 of this Article do not
exist.

Article 57

1. On arrival of an infected or suspected ship or an

infected aircraft, the
following measures may be applied by the health
authority:
(a) disinsecting of any suspect and surveillance for a
period of not more than six days reckoned from the date
of arrival;
(b) disinsecting and, if necessary, disinfection of:
(i) any baggage of any infected person or suspect; and
(ii) any other article such as used bedding or linen, and
any part of the ship or aircraft, which is considered to be
contaminated.

2. On arrival of a ship, an aircraft, a train, road vehicle or

other means of
transport having on board a person suffering from
pulmonary plague, or if there has
been a case of pulmonary plague on board a ship within the
period of six days before
its arrival, the health authority may, in addition to the
measures required by paragraph
I of this Article, place the passengers and crew of the ship,
aircraft, train, road vehicle
or other means of transport in isolation for a period of six
days, reckoned from the
date of the last exposure to infection.

3. If there is rodent plague on board a ship, or in its

containers, it shall be
disinsected and deratted, if necessary in quarantine, in
the manner provided for in
Article 53 subject to the following provisions:
(a) the deratting shall be carried out as soon as the
holds have been emptied;
(b) one or more preliminary derattings of a ship with
the cargo in
situ, or during its unloading, may be carried out to
prevent the escape
of infected rodents;

(c) if the complete destruction of rodents cannot be

secured because only part of the cargo is due to be
unloaded, a ship shall not be
prevented from unloading that part, but the health
authority may apply
any measures, including placing the ship in quarantine,
which it
considers necessary to prevent the escape of infected
rodents.
4. If a rodent infected with plague is found on board an
aircraft, the aircraft shall
be disinsected and deratted, if necessary in quarantine.

Cholera Article 61

For the purposes of these Regulations

the incubation period of cholera is five
days.

Article 62

1. If on arrival of a ship, aircraft, train, road vehicle or other means of

transport a
case of cholera is discovered, or a case has occurred on board, the
health authority (a)
may apply surveillance or isolation of suspects among passengers or
crew for a period
not to exceed five days reckoned from the date of disembarkation; (b)
shall be
responsible for the supervision of the removal and safe disposal of any
water, food
(excluding cargo), human dejecta, waste water including bilge water,
waste matter,
and any other matter which is considered tobe contaminated, and shall
be responsible
for the disinfection of water tanks and food handling equipment.

2. Upon accomplishment of (b) the ship,

aircraft, train, road vehicle or other
means of transport shall be given free
pratique.

Article 63

Foodstuffs carried as cargo on board

ships, aircraft, trains, road vehicles or
other means of transport in which a case
of cholera has occurred during the
journey,
may not be subjected to bacteriological
examination except by the health
authorities
of the country of final destination.

Article 64

1. No person shall be required to submit

to rectal swabbing.
2. A person on an international voyage,
who has come from an infected area
within the incubation period of cholera
and who has symptoms indicative of
cholera,
may be required to submit to stool
examination.

Yellow Fever Article 65

For the purposes of these Regulations

the incubation period of yellow fever is
six days

Article 66

1. Vaccination against yellow fever may be

required of any person leaving an
infected area on an international voyage.
2. If such a person is in possession of a
certificate of vaccination against yellow
fever which is not yet valid, he may
nevertheless be permitted to depart, but the
provisions of Article 68 may be applied to
him on arrival.

3. A person in possession of a valid certificate of

vaccination against yellow
fever shall not be treated as a suspect, even if he has
come from an infected area.
4. The yellow-fever vaccine used must be approved
by the Organization, and the
vaccinating centre must have been designated by the
health administration for the
territory in which it is situated. The Organization shall
be assured that the vaccines
used for this purpose continue to be of suitable quality.

Article 67

1. Every person employed at a port or an airport situated in an infected area,

and
every member of the crew of a ship or an aircraft using any such port or
airport, shall
be in possession of a valid certificate of vaccination against yellow fever.
2. Every aircraft leaving an airport situated in an infected area shall be
disinsected in accordance with Article 25, using methods recommended by the
Organization, and details of the disinsecting shall be included in the Health
Part of the
Aircraft General Declaration, unless this part of the Aircraft General
Declaration is
waived by the health authority of the airport of arrival. States concerned shall
accept
disinsecting of aircraft by the approved vapour disinsecting system carried out
in
flight.

3. Every ship leaving a port in an area where

Aedes aegyptistill exists and bound
for an area where Aedes aegyptihas been
eradicated shall be kept free of Aedes
aegypti in its immature and adult stages.
4. An aircraft leaving an airport where Aedes
aegyptiexists and bound for an
area where Aedes aegyptihas been eradicated
shall be disinsected in accordance with
Article 25, using methods recommended by the
Organization.

Article 71

1. On arrival of an infected or suspected ship or aircraft, the

following measures
may be applied by the health authority:
(a) in an area where the vector of yellow fever is present, the
measures provided for in Article 68 to any passenger or member of
the
crew who disembarks and is not in possession of a valid certificate
of
vaccination against yellow fever;
(b) inspection of the ship or aircraft and destruction of any Aedes
aegyptior other vectors of yellow fever on board; in an area where
the
vector of yellow fever is present, the ship may, until such measures
have been carried out, be required to keep at least 400 metres from
land.

2. The ship or aircraft shall cease to be

regarded as infected or suspected when
the measures required by the health
authority in accordance with Article 38
and with
paragraph 1 of this Article have been
effectively carried out, and it shall
thereupon be
given free pratique.

HEALTH DOCUMENTS Article 76

Bills of health, with or without consular

visa, or any certificate, however
designated, concerning health
conditions of a port or an airport, shall
not be required
from any ship or aircraft.

Article 77

1. The master of a seagoing vessel making

an international voyage, before arrival
at its first port of call in a territory, shall
ascertain the state of health on board, and,
except when a health administration does not
require it, he shall, on arrival, complete
and deliver to the health authority for that port
a Maritime Declaration of Health
which shall be countersigned by the ship's
surgeon if one is carried.

2. The master, and the ship's surgeon if

one is carried, shall supply any
information required by the health
authority as to health conditions on
board during
the voyage.
3. A Maritime Declaration of Health shall
conform with the model specified in
Appendix 3.

4. A health administration may decide:

(a) either to dispense with the
submission of the Maritime Declaration
of Health by all arriving ships; or
(b) to require it only if the ship arrives
from certain stated areas, or
if there is positive information to report.
In either case, the health administration
shall inform shipping operators.

Article 78

1. The pilot in command of an aircraft, on

landing at the first airport in a
territory, or his authorized agent, shall
complete and deliver to the health authority for
that airport the Health Part of the Aircraft
General Declaration which shall conform
with the model specified in Appendix 4, except
when a health administration does not
require it.

2. The pilot in command of an aircraft, or

his authorized agent, shall supply any
information required by the health authority
as to health conditions on board during
the voyage.
3. A health administration may decide:
(a) either to dispense with the submission
of the Health Part of the Aircraft General
Declaration byall arriving aircraft; or

(b) to require it only if the aircraft arrives

from certain stated areas,
or if there is positive information to
report.
In either case, the health administration
shall inform aircraft operators.

Article 79

1. The certificates specified in Appendices 1

and 2 shall be printed in English
and in French. An official language of the
territory of issue may be added.
2. The certificates referred to in paragraph 1
of this Article shall be completed in
English or in French. Completion in another
language in addition is not excluded.

3. International certificates of vaccination must be

signed in his own hand by a
medical practitioner or other person authorizedby
the national health administration;
his official stamp is not an accepted substitute for
his signature.
4. International certificates of vaccination are
individual certificates and shall in
no circumstances be used collectively. Separate
certificates shall be issued for
children.

5. No departure shall be made from the model of

the certificate specified in
Appendix 2, and no photograph shall be included.
6. A parent or guardian shall sign the
international certificate of vaccination
when the child is unable to write. The signature of
an illiterate shall be indicated in the
usual manner by his mark and the indication by
another that this is the mark of the
person concerned

7. If a vaccinator is of the opinion that

vaccination is contraindicated on
medical
grounds he shall provide the person with
reasons, written in English or French,
underlying that opinion, which health
authorities should take into account.

Article 80

A vaccination document issued by the Armed

Forces to an active member of those Forces shall
be accepted in lieu of an international certificate in
the form shown
in Appendix 2 if:
(a) it embodies medical information substantially
the same as that required by such form; and
(b) it contains a statement in English or in French
recording the nature and date of the vaccination
and to the effect that it is issued in
accordance with this Article.

Article 81

No health document, other than those

provided for in these Regulations, shall
be required in international traffic