Since WHO declared mpox outbreak a public health emergency of international concern, the Association has provided advice on mpox prevention at ships in LP 21/2024. With the disease spreading to more countries, WHO and partners have established an access and allocation mechanism for mpox countermeasures. Although very few specific measures have yet been introduced in their ports or airports, health and port authorities are calling for increased vigilance and hygiene measures. They may make on-the-spot decisions when faced with a potential mpox case. Based on information provided by our correspondents including Brazil P&I, BUDD, Globalpandi, INTERPORT, PROINDE, and TCI Africa, we update affected countries and ports as below.

CONAKRY/GUINEA

Please note that there are currently no specific or special measures taken by the authorities in Conakry, Guinea. So far, it is business as usual at Guinean ports.

For vessels loading at Kamsar, there is very little contact between authorities / stevedores and the crew. Given this limited contact, there is minimal risk of contamination.

There are currently no reported cases nationwide. Therefore, we recommend maintaining usual safety/ health measures and avoiding direct contact with local people.

DAKAR/SENEGAL

As far as Dakar port is concerned, please be informed that no case of mpox has been recorded in Senegal to date. The port is operating normally, and no particular compulsory measures are being implemented by the port Authorities so far. Nevertheless, for the sake of prudence, the crew should be encouraged to limit shore movements and to wear face masks. Once alongside, the gangway must also be permanently monitored and boarding only allowed subject to the proper enforcement of preventive measures (use of face masks, sprays, gloves, distancing, etc…).

ABIDJAN/IVORY COAST

The Cote d’Ivoire is witnessing a resurgence of mpox cases with two cases reported on 3rd July 2024. As of 2nd August 2024, six further mpox cases have been confirmed in three health districts of the Ivory Coast: Tabou, Koumassi, and Yopougon-Ouest-Songon.

DOUALA/CAMEROON

Two people have died after being infected with mpox in Cameroon. The information made public by the Minister of Public Health Manaouda Malachie also reveals that, for the year 2024, the country has already recorded 30 suspected cases with five confirmed cases.

The Cameroonian government has activated its maximum alert system. The objective is to limit and control the spread of the disease within the borders as well as its importation. Meanwhile, the port is operating normally, and no particular compulsory measures are being implemented by the port Authorities so far. The crew should be encouraged to limit shore movements and to wear face masks.

POINTE-NOIRE/CONGO

There are no measures taken locally in The Congo; big cities not concerned, but the government advised that they will take in charge contaminated patient(s) – if any.

LOME/TOGO

There are no recorded cases of mpox in Togo to date, but constant surveillance is still required. Currently no particular measures are being taken at Lome Port. However, like all infectious diseases, when a crew member shows any sign of infection, the health authorities must be informed, and the patient must be taken into quarantine at the nearest health center for appropriate treatment.

TEMA/GHANA

Tema Port Health advised on 28/08/2024 that so far in Ghana there is no reported cases. A civilian team has been placed at all entries (Airport, Ports, Borders) to monitor and check all persons crossing the borders.

In Tema Port, Port Health is now carrying out a full inspection of ships’ crew members on arrival to check whether any crew can be seen with symptoms. Probably, in case of symptoms the vessel will be sent in quarantine.

KENYA/MOMBASA & DAR ES SALAAM/TANZANIE

With regards to the mpox virus in Kenya, the ministry of health has beefed up surveillance within the borders of Kenya for persons entering the country. To date there have been two reported cases discovered from persons entering the country from the Western neighboring countries of Uganda.

Both these cases were contained and treated.

The situation in Tanzania is the same as Kenya and they have not had any cases to date according to the ministry of health.

On the matter of restrictions, testing is being done on persons entering the country and specifically from the western border points.

Kenya and Tanzania thus remain positive on the mpox situation and due to the measures put in place business within the Country and specifically within the Ports remains normal with no restrictions placed.

MONROVIA/LIBERIA

The National Public Health Institute of Liberia (NPHIL) noted the nature of the mpox outbreak and its rapid spread over several countries, and will heighten its surveillance system, strengthen its outbreak preparedness plan and will work in collaboration with the Ministry of Health to activate measures and specific response mechanism to address any impending outbreak of Mpox in Liberia. Since the beginning of this year 2024, Liberia has accounted for 5 confirmed cases in 3 counties.

In recent times, new cases have been confirmed in neighboring countries like Nigeria and Cote d’Ivoire in the region.

Meanwhile, the public is strongly advised to take the following preventive measures such as constant handwashing, avoid close contact with persons suspected of mpox symptoms, avoid animal contact, and report to the nearest medical facility should you experience or observe any of the Mpox symptoms listed above. For any questions, please call NPHIL on the following numbers: +231 77597 2252/ +231 77756 5299/ +231 77737 2655/ +231 77591 2252/ +231 77027 6493.

NIGERIA-PORT HARCOURT- ONNE/LAGOS

The Nigeria Port Health has confirmed that there are no cases or record of mpox so far in Nigeria ports (Lagos Port, Port Harcourt Port, Onne Port etc.).

The Port Health Authorities maintain that the situation in Nigeria remains the same regarding entry into the Ports/boarding of the vessel and that they have not recorded any case of the infection from the Crew as their usual boarding activities still remain to check the temperatures of the crew members on arrival.

NOUAKCHOTT-NOUADHIBOU/MAURITANIA

There is no case or record of M-pox so far in the Mauritanian ports of Nouakchott and Nouadhibou. There are also no special precautions/instructions to be observed by the vessel’s crew.

MAJ UNGA-TOAMASINA-ANTANANARIVO/MADAGASCAR

No case of mpox has been recorded in Madagascar to date. However, the Ministry of Health has issued the following important information regarding restrictions and measures for vessel coming from mpox active countries:

In case of suspicious MPOX case reported on board a vessel (MPOX symptoms discovered on a Crew Member), the Master must inform the ship’s agent who will then turn the information to the port and health authorities.

The suspected sick crew member will undergo a 72-hour test at the “Institute Pasteur” at Antananarivo. During this period the vessel will be quarantined on the roads waiting for the results of the test. If the result of the test is positive, the sick Crew Member will be disembarked and will stay in an isolated room. The ship will be quarantined on the road for 7 to 21 days. If the result of the tests is negative, the vessel will be allowed to enter in the port.

Here below implemented compulsory measures:

-              The crew must wear mask

-              Washing hands and using hydro-alcoholic gel during vessel’s call

-              Respect social distancing (more than 1 meter)

-              The crew are not allowed to go ashore during vessel’s alongside and until departure

-              When arriving alongside, the vessel will have to proceed with disinfection of deck and gangway.

COTONOU/BENIN

No cases of mpox were reported in Benin in 2024, but the State of Benin is closely monitoring the situation. The technical teams involved in the response to the mpox epidemic have been on high alert for several weeks and a dedicated health center will become operational as soon as the first case is confirmed.

Currently in Benin no quarantine or maritime border surveillance measures are planned in view of the Mpox epidemic. However, we would suggest that the Master of any inbound vessel reports any signs or symptoms (rash which may last for 2-4 weeks) to the vessel’s local agent and P&I Club correspondents.

MATADI- KINSHASA/DEMOCRATIC REPUBLIC OF CONGO

As of September 11, 2024, 223 suspected cases of mpox, including 12 confirmed cases, have been reported in the Kongo Central province of the Democratic Republic of Congo. The provincial Ministry of Health has provided medications to some affected health zones. An incident management system has been established as part of the mpox response. DRC has reported more than 18,000 cases with 629 deaths so far this year, and the country remain of high risk.

On September 10, a crisis committee meeting was held during which the government set up an incident management system and developed a response plan. The possibility of vaccination is being considered due to the increasing number of cases. The Ministry of Health has recommended adhering to barrier measures to combat this outbreak.

LOBITO-LUANDA/ANGOLA

The Angolan Health Ministry declared on September 2 that no cases of the mpox had been discovered in the provinces of Cabinda and Lunda Syl, ensuring that the country remains free of the disease. The Health Ministry continues to enforce its contingency plan to prevent the entry and spread of mpox in the country, given the presence of the disease in neighboring regions.

To bolster preparedness and to ensure the effective implementation of control measures to safeguard public health, provinces are being continuously reinforced with biosafety materials and medical products, particularly in border areas with neighboring countries.

LIBREVILLE/GABON

On August 22^nd, 2024, the Government declared the first case of mpox in Gabon. Six further suspected cases matching the mpox case symptoms have been reported, isolated, managed, and tested. Of the six tested samples sent to the National Public Health Laboratory, one has tested positive for mpox.

The confirmed case involves a 30-year-old Gabonese national who had recently returned from Uganda, a country affected by the outbreak.

In response, the Government has urged the public to remain vigilant and calm, avoid panic, and adhere to recommended hygiene measures that are frequent handwashing, using hand sanitizer, practicing social distancing, and wearing masks where appropriate.

INDONESIA

According to Budd Indonesia, the port authorities of Sabang Port (Aceh province) and Banda Aceh both refused to allow a vessel to enter the port to disembark a suspected mpox case.

They were finally able to disembark the crew member in the larger port of Batam, Riau. However, all the other crew members were quarantined ashore until the authorities declared that the vessel could sail from Indonesia.

CHITTAGONG-MONGLA-PAYRA/BANGLADESH

Although there are no confirmed cases in Bangladesh yet, the health ministry has issued a high alert. The Directorate General of Health Services has launched a hotline for reporting cases of mpox. If anyone shows symptoms of the disease, they are advised to contact 16263 or 10655 as quickly as possible. Screening measures have been implemented at national airports. As of 16 August 2024, authorities at Dhaka's Hazrat Shahjalal International Airport have begun screening the temperatures of arriving passengers.

Additionally, the Chittagong, Mongla, and Payra Port Authorities have issued guidelines and frequently asked questions to raise awareness among stakeholders, ships and seafarers arriving at these ports.

Please note that the hotline numbers (16263 & 10655) for reporting mpox cases are accessible only from local/Bangladeshi numbers. Therefore, we recommend that vessels arriving at the Bangladeshi ports, report any suspected case(s) of mpox directly to the respective port authorities using the contact numbers provided below:

Chittagong Port Authority:

• Chittagong Port Control Room: Tel: +880 2 333326916, or VHF Channel-12
• Chittagong Port Authority Hospital: Tel: +880 1703-284969

Mongla Port Authority (Medical Department):

• Chief Medical Officer: Tel: +880 1329-699013
• Medical Officer: Tel: +880 1404-411986
• Lady Medical Officer: Tel: +880 1793-439587

Payra Port Authority:

• Payra Port Control Room: Tel: +880 1700-641650 (WhatsApp)
• Payra Port VHF Control Room: Tel: +880 9610202222

We advise all vessels to keep these contact numbers readily available and report any suspected case(s) as soon as possible to ensure prompt response and containment measures.

BRAZIL

Since January 2024, the Ministry of Health has confirmed 709 cases of mpox, including 16 deaths, mainly in Southeast Brazil, notably in the states of Sao Paulo and Rio de Janeiro. 

On 15 August 2024, the National Health Surveillance Agency (ANVISA), Brazil’s port health authority, issued Technical Note 14/2024. The regulation updates procedures for epidemiological surveillance at ports, airports, and ground crossings to address the new variant currently circulating in African territory.

ANVISA does not impose specific health measures to be taken by visiting ships. However, it advises health authorities and professionals at all levels of the federation to take the following steps:

• Update and enforce local contingency plans and protocols for responding to the PHEIC at the points of entry;
• Remain vigilant to signs and symptoms typical of mpox; and
• Report suspect or confirmed cases to the health authority at the point of entry as soon as possible

Attendance onboard vessels with suspect cases must be performed wearing personal protective equipment (PPE), including protection goggles or face shields, aprons, masks and surgical gloves. Used PPE and waste should be disposed of following the ship’s solid waste management plan. While ANVISA recommends isolating suspected cases in individual cabins with daily monitoring, it advises against segregating asymptomatic close contacts. Instead, these individuals should be monitored for clinical signs and symptoms for 21 days after the onset of symptoms in the infected person.

All suspected, probable or confirmed cases must be reported to the local health surveillance service through ANVISA. Failing to report a disease of compulsory notification (or any evidence of a public health risk on board) breaches health regulations and may result in penalties, including fines. 

ANVISA requires shipmasters to document all health events in the hospital’s logbook and the Maritime Declaration of Health (MDH), strictly in the format mandated by the WHO under the International Health Regulations (IHR 2005), when requesting free pratique or sanitary inspection for renewal of ship sanitation certificates. The master must mark “Yes” on the relevant field on the MDH to report any condition that could be a symptom of an infectious disease, including “fever, persisting for several days, glandular swelling, and acute skin rash or eruption”, to flag a suspected case of mpox.

The technical note is silent on whether vessels with isolated suspected or confirmed cases on board are allowed to operate cargo or move crew and passengers. This decision would be made on a case-by-case basis at the discretion of ANVISA in conjunction with the Ministry of Health and municipal health surveillance services.

To date, no restrictions have been imposed on the boarding or disembarkation of seafarers (or passengers) from vessels and platforms in Brazilian territorial waters due to the ongoing mpox outbreak. Nevertheless, shipmasters must record and report health events that may indicate the circulation of infectious diseases among those on board and ensure that the crew is aware of the measures and practices recommended by the health authorities to prevent the spread of the disease.

VENEZUELA

Back on 12^th June 2022 Venezuela confirmed a first diagnosed case of mpox in a flight passenger coming from abroad. From that moment on, epidemiological surveillance protocols were put in place to contain this infection. More recently, on 19^th August 2024, the Ministry of Popular Power for Health (MPPS) issued a Protocol for the surveillance of mpox at points of entry, emphasizing that at this time there are no specific measures or restrictions or tests to travel or trade to any country, not even those affected by mpox. Secondly, it emphasizes the dissemination of information about the disease to travellers in order to protect themselves and others when traveling to countries that currently have reported cases.

Although there are not yet any specific protocols aimed at the maritime field, the statement announced the reinforcement of health measures at ports and airports for travellers coming from affected countries. Travelers and crew members who enter the country must report their health status and personal data in the epidemiological surveillance sheet for medical follow-up with the aim of early detecting any suspicious case. It is advisable then to contact local agents and P&I Correspondents well in advance, in case any specific symptoms are noticed among the seafarers onboard to assist accordingly.

For more information, please contact Managers of the Club.