Infection and hygiene
Governing: Table A-VI/4-2 'wounds, wound healing and infection', 'diseases', 'hygiene', 'disease prevention'; MSN 1905 section 7.4; REG Yacht Code 21B.13 and Annex J1; MIN 718.
Why it matters on a yacht
Crew live, eat and share bathrooms in tight quarters; interior crew handle food and guest cabins; and a charter cannot absorb a quarter of the team in their bunks. An outbreak is an operational problem as well as a medical one.
Duties
- MSN 1905 section 7.4: operators, employers and the master have a duty of care, so far as reasonably practicable, including steps to minimise infection and ensure preventive measures such as immunisation.
- REG Yacht Code Annex J1: health protection includes preventive measures, health promotion and education, and immunisation.
Isolation
| Requirement | REG Yacht Code Part A |
|---|---|
| Separate hospital | Vessels with 15 or more seafarers on voyages over three days (21B.13(1)) |
| Sanitary facilities | Exclusive to the hospital or nearby: at least one toilet, washbasin and shower or tub (21B.13(3)) |
| Short-range yachts | Within 60 miles of the coast: exempt from (1), but designate an en-suite cabin for voyages over three days (21B.13(4)) |
| Ventilation | Mechanical exhaust independent of other accommodation ventilation (21B.13(5)) |
Most yachts' hospital is also a cabin in normal use. Know how quickly it can be cleared.
Recognising infection
Fever, fast pulse and breathing, and new confusion are the danger signs (lesson 1.2, NEWS2). Specific patterns to know:
| Pattern | Think of |
|---|---|
| Vomiting and diarrhoea in several people | Norovirus, food poisoning, contaminated water |
| Fever after tropical shore leave | Malaria, dengue; ask where they have been |
| Cough, fever, breathlessness | Respiratory infection including COVID and influenza |
| Genital symptoms, sores or discharge | Sexually transmitted infection, also on the A-VI/4-2 list; confidential |
| Red, hot, spreading skin | Cellulitis, often from a small wound |
MIN 718 notes the SCMG 24th edition added COVID and infectious disease content and updated its antibiotics guide. Antibiotic choice is a TMAS decision.
Controlling spread
- Isolate the patient; one designated carer where possible.
- Hand hygiene for everyone, soap and water for gastrointestinal illness.
- Remove sick crew from food handling and guest areas until clear.
- Clean and disinfect contact surfaces, bathrooms and the patient's cabin.
- Handle laundry and waste as contaminated.
- Investigate food, water and shore exposure.
- Report to TMAS and, if required, port health on arrival.
Prevention
Table A-VI/4-2 lists disinfection, disinfestation, de-ratting and vaccinations. In practice:
- galley hygiene and food temperature control;
- potable water tank cleaning and treatment;
- pest control, especially after provisioning in the tropics;
- crew vaccination records kept by the purser or chief officer;
- insect-bite prevention and, where relevant, malaria advice before cruising.
WARNING — Food handlers A chef or stewardess with vomiting or diarrhoea should not handle food or serve guests. It is an uncomfortable conversation on charter; have it anyway.
TIP — Outbreak kit Keep a sealed box with gloves, aprons, masks, bags, disinfectant and a sign for the door. Assembling it during an outbreak wastes time.