Infectious gastroenteritis is a common and a “two-faced” condition. Medically speaking, it is usually a relatively mild and self-limiting problem. However, from the management and operational standpoint, it is known for the potential to generate significant costs and impact operational capacity if sufficient numbers of personnel are affected. Therefore, organisational preparedness is advised to monitor and manage the risks.
Most outbreaks of diarrhoea and/or vomiting in the northern hemisphere are caused by Norovirus or Rotavirus, and tend to affect the greatest number of people in winter months (hence is also known as ‘winter vomiting bug’). The symptoms usually last 1-3 days and are self-limiting, but vomiting and/or diarrhoea may be quite protracted and troublesome. Treatment is supportive and includes oral fluids, rehydration salts, and paracetamol for fever. The patients are usually quarantined, advised to maintain strict personal hygiene and follow a light diet to facilitate the recovery. The virus is contagious and spreads easily not only through body fluids, but may also be shed from the mouth and surface of the skin up to 2 days after resolution of symptoms. This has to be considered especially in chronically ill or immunocompromised people.
Closed communities, e.g. in the military, health, leisure, maritime and offshore industries, are considered at risk of outbreaks because of the shared common routes of cross-contamination and infection through e.g. tools, door handles, hand rails, and surfaces at work, in the accommodation and in communal areas. It is not possible to eliminate viral gastroenteritis altogether, but robust and timely controls are vital to prevent spread of the infection and reduce the risk of outbreaks.
In recent years MCL Medics have supported our clients during several outbreaks of infectious conditions, including viral gastroenteritis. To ensure effective risk management and control, if a new case or cases are identified, we implement our infectious gastroenteritis procedure which is based on the current recommendations published by the HSE, Health Protection England and Health Protection Scotland, and tailored to the specific requirements of the offshore environment.
Under our procedure, the offshore medic, working together with a topside doctor, OIM and the health and safety manager, implements risk control measurements which include regular meetings with workers to ensure the awareness of the requirement to report symptoms early and to observe strict personal hygiene. Affected individuals are treated in isolation and quarantined as appropriate to eliminate cross-contamination. Special housekeeping procedures and PPE rules are also implemented. To be able to monitor the progress and to promptly respond to a changing situation, we use several custom-made tools. If required, additional risk control measures may be recommended by topside in the accommodation, galley, gym and communal spaces, and further epidemiological and medical investigations and tests may be requested.
By using our response procedure, we have successfully managed and contained several outbreaks offshore which involved from two to eight symptomatic cases, without significant detrimental effect on the operations. Our recent review also indicates that by enforcing some hygiene measures we might have achieved an additional beneficial effect in lowering the occurrence of other communicable diseases and, quite possibly, reducing the risk of new outbreaks.
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