Tour industry
on guard for flu bugs

By Ann Petersen

Haines tour officials and businesses are stepping up health precautions in response to advice from federal and state health officials and a reported case of swine flu aboard a cruise ship that docked in Skagway Saturday.

News that a crewmember on Serenade of the Seas tested positive for swine flu underscored the need for preparations. The docking came one day after local tour industry officials and businesses participated in a regional teleconference on ship-borne diseases.

In response to Friday’s meeting, tour operator Bart Henderson said his tour company has changed how food is prepared for clients and is encouraging workers wash their hands frequently with sanitizer.

Tourism department employees are the first people to greet passengers as they disembark from cruise ships in Haines. Tourism director Lori Stepansky, who supervises greeters, said she would improve hygiene at the Visitor’s Center, and is considering installing an automatic hand sanitizer.

According to the federal Center for Disease Control and the Alaska Department of Health and Human Services, prevention of swine flu, or any respiratory illness, is no different from steps taken to avoid seasonal flu. Hand-washing and good hygiene are recommended.

In the case of a flu outbreak, Haines public health nurse Monica Acton said that SEARHC and the public health department have received a stockpile of Tamiflu, an antiviral medication used on swine flu patients.

The teleconference with state health officials also revealed holes in the notification chain alerting harbor and tourism workers that a ship is carrying sick passengers.

The teleconference was to provide information about repercussions of the pandemic of swine flu on the cruise ship industry and ports that serve them and targeted port authorities, emergency managers, cruise line representatives, and local health representatives.

Representatives from the Haines Visitor’s Center, Chilkat Guides, and Alaska Nature tours participated.

Port authorities asked how they would be alerted of boats arriving with sick passengers, particularly those suffering novel strains of influenza, such as swine flu.

Authorities in Ketchikan and Juneau expressed frustration that in previous years they weren’t informed before cruise ships carrying hundreds of passengers ill with norovirus docked at their ports.

A Juneau port representative asked if towns had authority to stop a boat from disembarking passengers.

Dr. Beth Funk, an epidemiologist with the Alaska Department of Health and Human Services, said only the CDC Quarantine Station in Anchorage could keep a boat from dropping off passengers.

The chain of notification currently in place for outbreaks of norovirus on a cruise ship in Alaska waters is that at an infection level of 2 to 3 percent of passengers, ship crews are required to notify the Anchorage quarantine station, which in turn notifies the state office of epidemiology.

According to Dr. Funk, the Alaska Department of Health and Human Services then would contact the Haines public health nurse, as well as the emergency manager for Haines.

Funk said that the captain does not directly contact the harbormaster because “it’s not a good idea to have non-health providers talking to other non-health providers” about what to do with sick passengers.

According to Acton, however, a ship captain may alert a port before docking if passengers may be seeking care at a local clinic or hospital. Acton said that she has never been told whom, specifically, she should contact if she were informed of a vessel docking with sick passengers.

Stepansky said she assumed she’d get the news from harbormaster Christian Racich, but Racich said he wasn’t aware who, if anyone, would call him about sick passengers arriving in port, or whom he would notify.

Borough manager Tom Bolen said while there are procedures in place for catastrophic numbers of patients needing immediate emergency aid in Haines, he was not aware of the local chain of notification for a small number of mildly ill passengers.

The first cruise ship of the year, the Spirit of Columbia, docked Tuesday, carrying 65 passengers. According to a company spokeswoman, Cruise West boats all follow guidelines from the CDC for notification of sick passengers to the quarantine station.

Acton said that in previous years, the chain of notification has not been followed for norovirus infections on ships, and that she has found out about sick passengers disembarking because they show up in the SEARHC clinic seeking treatment.

Funk said the state has not previously tracked norovirus closely because “it is as common as the common cold on cruise ships. We don’t notify if someone has the common cold either,” she said.

The swine flu, a novel variant of seasonal flu, is a different case, however, and state officials are still figuring out how to best use the notification chain, Funk said. The crewmember suffering swine flu was quarantined in her cabin, according to a state press release.

The ship continued to disembark passengers at its regularly scheduled ports, including towns in Southeast, according to the state.

Juneau public health nurse Kathleen Miller said after the SARS outbreak, the city’s health providers established a local chain of notification for ships docking with passengers suffering respiratory illnesses.

It does not appear that Haines has a similar chain of notification. Skagway received no advanced notification of the swine flu patient arriving on the Serenade of the Seas.

 

.

.