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 sea and those in stay-over arrivals. Although the core competencies and protocols for investigating and reporting public health emergencies on passenger ships in the Caribbean are described in the 2005 International Health Regulations (IHR), how these are implemented vary by country, since each country is sovereign. The commonality of tourism-based illnesses, nearby borders and frequent travel (both intra-regional and international) in the Caribbean necessitates the need for uniform and harmonized surveillance and response to travel-related public health events. This harmonized approach aims to avoid the introduction of new diseases, mitigate the spread of illnesses, and protect the health and security of visitors and locals.
CARPHA, as the Caribbean authority for public health surveillance, developed the Guidelines for harmonized surveillance and response to travel-related public health illnesses to prevent and mitigate public health events on passenger ships and in stay-over arrivals in the Caribbean region. It will support countries in in carrying out public health action to manage issues of public health importance in a timely and coordinated fashion and thus protect the health and security of visitors and locals. It will also allow for the collection of surveillance data to establish baselines for outbreak detection and strengthen national surveillance
Two sets of regional surveillance guidelines were developed:
- Regional Guidelines for Managing Issues of Public Health Significance on Passenger Ships Coming to the Caribbean (Caribbean Vessel Surveillance System (CVSS)), and
- Regional Guidelines for Managing Issues of Public Health Significance in Stay-Over Arrivals (Tourist Accommodation-Based Surveillance) in the Caribbean
These guidelines, collectively called the Regional Guidelines (Figure 3), were developed to provide instructive guidelines for harmonized scientific response to travel-related public health issues occurring among persons aboard passenger ships and those in stay-over arrivals (tourist accommodations) in the Caribbean.
Figure 3. Regional Guidelines
The Guidelines are based on the IHR (2005), the WHO management of public health events on board ships (2016) and other documents developed over a 3-year period involving country and agency consultations ; and in close collaboration with the Cruise Lines International Association (CLIA) and CDC Vessel Sanitation Program (VSP). It was presented to the 33rd COHSOD, endorsed at the 2018 CARICOM CMOs meeting and supported at the 2018 Regional Tourism & Health Stakeholder workshop (13 agencies, 14 countries).