THiS Hotel Based Surveillance

The Tourism and Health Information System (THiS), which can be accessed at THiS.carpha.org is a real-time web-based application for facilities housing stay over arrivals such as hotels and guesthouses to monitor the health of their visitors and staff. The information serves as an early warning and response system for hotels/guest houses to monitor and rapidly respond public health issues that may occur at their establishment. Guests/staff from participating hotels/guesthouses can report their symptoms to staff and complete a short online questionnaire. 

This form of reporting allows hotel management and public health officials to identify events such as outbreaks early before it spreads All information collected is strictly confidential (with data restriction policy) and the data is solely used for identifying public health threats for rapid response

This novel and innovative real time tourism early warning health information surveillance, monitoring and response syndromic surveillance system for visitors is crucial for strengthening existing core national health surveillance systems of tourism-dependent Caribbean economies to collect real-time data for early alerts and triggering a rapid coordinated response to travel related public health threats, which has the potential of improving the capacity to monitor the health and wellness of locals and visitors. It can also easily inform health service delivery decisions/policies, strengthen national and regional health monitoring efforts, and, all the while strengthening adherence to IHR requirements.

Facilities can register at THiS.carpha.org.  The THiS instructional video (available below), Guidelines for Visitors and Guidelines for Hotel Staff are also available for countries.

 

 

Self-Reporting

A unique feature of the THiS is self- reporting. This feature allows for the collection of that that in many instances would have gone unreported. Visitors and staff can easily self-report their illness online on their smart phones by accessing the THiS web application from their browser and selecting the ‘Self-Reporting’ option: THiS.carpha.org

After accessing the THiS web application complete a quick questionnaire, which includes symptoms, as well as the country, type of facility (hotel/guest houses, cruise ship, etc.), and name of the facility from where the illness is being reported. All information collected is strictly confidential (with data restriction policy) and the data is solely used for identifying public health threats for rapid response.

 

 

Passenger Ship Surveillance

Public health surveillance of communicable diseases on cruise ships, through medical logs and active monitoring, is essential for assessing the burden of communicable disease and to allow the early detection and management of outbreaks. Most public health surveillance currently conducted on cruise ships in the Caribbean is done at the national level, not the regional/international level. Currently, ships are required to send a m For these reasons. The IHR(2005) requires the use of the Maritime Declaration of Health (MDH) for reporting and information sharing . The MDH should be submitted each and every time a vessel arrives in a port of call, not only when there is an illness/death on board; however, it is up to each country as to whether to enforce this, since submission of an MDH is only required under the IHR (2005) when an illness/death has occurred on board the vessel.

CARPHA is the regional public health agency for the Caribbean and the lead authority for regional surveillance and response. It has three main roles with respect to surveillance of and response to public health issues occurring among visitors to the Caribbean arriving on passenger ships in the Caribbean:

Surveillance
Collect, analyze, and disseminate information on illnesses/outbreaks on ships coming to the Caribbean, to inform and evaluate various national and regional programs
Notify member countries and relevant agencies of illnesses/outbreaks on ships coming to the Caribbean

Response
Facilitate communication between member countries of illnesses/outbreaks occurring on ships going between Caribbean ports (i.e. CARPHA will notify next ports of call of incoming ship with illness/outbreak)
Aid in outbreak investigation (if requested)
Coordinate public health action to crises with relevant partners at national and international levels

Training
Train public health authorities and other competent authorities in the surveillance/detection, investigation, and reporting of travel-related illnesses and outbreaks
CARPHA has developed this protocol and guidelines to facilitate disease surveillance on cruise ships visiting the region

In this regard CARPHA has developed the Caribbean Vessel Surveillance System (CVSS) for rapid information flow and coordinated multisectoral response for public heath events occurring among visitors from passenger ships This also involved in the establishment of protocols to facilitate the standardized submission of the Maritime Declaration of Health from ships to competent national authorities. This involves supporting the development of data flow and reporting mechanisms by countries, databases for storage of data at the country level, and sharing of information with CARPHA to facilitate regional surveillance and response. Further development and implementation of these surveillance protocols and infrastructure is currently underway

Regional Hotels and Passenger Ship Guidelines

A key challenge in the tourism-dependent Caribbean countries is the marked variation and lack of standardization in the surveillance and response to travel-related public issues occurring among visitors arriving by air and sea. Although the core capacity requirements and competencies for preventing, investigating, and reporting public health emergencies on ships are described in the 2005 International Health Regulations (IHR), how these are implemented in the Caribbean varies by country, as they are sovereign. 

The confluence of tourism-based illnesses (like Norovirus), nearby borders, and frequent travel (both intra-regional and international) in the Caribbean necessities the need for uniform and harmonised surveillance and response to travel-related public health events. This standardization aims to mitigate the introduction of new diseases, spread of illness, and to protect the health and security of visitors and locals and our region.

CARPHA, as the Caribbean authority for public health surveillance has developed the following Regional Guidelines for responding to travel-related public health illnesses occurring among visitors:
Regional Guidelines for Managing Issues of Public Health Significance on Passenger Ships Coming to the Caribbean (Caribbean Vessel Surveillance System)
Regional Guidelines for Managing Issues of Public Health Significance in Stay-Over Arrivals (Hotel-Based Surveillance) in the Caribbean

These documents are meant to provide harmonized surveillance and response guidelines for travel related public health threats for Caribbean countries (particularly national public health and surveillance departments, port and environmental health officers, and private and public tourism organizations). It aims to support stakeholders in carrying out public health action to manage issues of public health importance in stay over facilities (hotels, guesthouses) and passenger ships in a timely and coordinated fashion. An intended outcome of this coordination is the strengthening of countries national surveillance systems, the collection of surveillance data to establish baselines for outbreak detection, and a harmonized regional response to public health events