Louisiana Maritime Association 3939 N. Causeway Boulevard, Suite 102 Metairie, LA (504) Phone (504) Fax

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1 Louisiana Maritime Association 3939 N. Causeway Boulevard, Suite 102 Metairie, LA (504) Phone (504) Fax Subject: Novel Coronavirus (NCOV) - Now known as Middle East Respiratory Syndrome Coronavirus (MERS-COV) Background As of June 5, 2013: 55 people have been confirmed to be infected with a new virus! More than half of the people infected have died from the virus! Most cases have originated from the Arabian Peninsula (Jordan, Qatar, Saudi Arabia and United Arab Emirates). Several cases have been reported in Italy, France, the UK and Tunisia; however these cases originated from travel to the Arabian Peninsula or from close contact with a sick person who had traveled to the area indicating a person-to-person transmission. Symptoms Infected persons have suffered a very severe, pneumonia-like illness. Consider a crewmember or passenger as "Suspicious" if they have the following symptoms: An acute respiratory infection, which may include fever of greater than or equal to 38 C or100.4 F Cough and shortness of breath, and History of travel from the Arabian Peninsula or neighboring countries within 14 days; or Persons who develop sever acute lower respiratory illness who are close contacts of an ill symptomatic traveler who developed fever and acute respiratory illness with 14 days after travel from the Arabian Peninsula or neighboring countries.

2 AGENTS - PLEASE SHARE THE FOLLOWING WITH VESSEL MASTERS, OWNERS, OPERATORS AND CHARTERERS Isolate Suspiciously Ill Crewmembers Suspicious ill crewmembers and passengers should be isolated in a private cabin until they are evaluated by a doctor to prevent transmission to others. Contact with other passengers and crew should be minimized. If masks are available, the ill crewmember or passenger should wear a mask while not in isolation to prevent further spread. Notification Requirement U.S. Foreign Quarantine Regulations, 42 CFR Part 71.21, require the master of a ship destined for a U.S. port to immediately report the onboard occurrence of any death or any ill person among passengers or crew to the quarantine station with jurisdiction over the port at which the ship will arrive. Note: For vessels arriving on the Lower Mississippi River, Masters should notify the Quarantine Station in Houston, TX at (281) Houston Quarantine Station Jurisdiction The Centers for Disease Control and Prevention (CDC) operates a quarantine station in Houston. The station s jurisdiction includes all ports in East Texas (Health Districts 4 7) and Louisiana. The station also oversees the Dallas Quarantine Station s jurisdiction of North Central Texas (Health Districts 1 3), Arkansas, Kansas, Oklahoma, and Missouri. Quarantine Station Activities Respond to reports of illness or death on airplanes, cargo vessels, and other conveyances at international ports of entry within jurisdiction. Review medical records of immigrants who will reside permanently in the United States. Notify state and local health departments and refer immigrants with specific medical conditions. Partner with other federal agencies, local and state health departments, private medical providers, and hospitals in preparedness activities related to quarantine and isolation at ports of entry. Monitor importations that may have pathogens infectious to humans. Dispense immunobiologics and investigational drugs upon requests made to CDC

3 VESSEL MASTER'S ARE ALSO HIGHLY ENCOURAGED TO NOTIFY THE US COAST GUARD, US CUSTOMS AND BORDER PROTECTION and ALL PILOT ASSOCIATIONS!!! For vessels arriving on the Lower Mississippi River: United States Coast Guard Port State Control/Arrivals Branch Sector New Orleans Phone: (504) FAX: (504) United States Customs and Border Protection Marine Division New Orleans Tri-Port Phone: (504) Fax: (504) New Orleans BAR Pilot Dispatch: (504) New Orleans Crescent Pilot Dispatch: (504) New Orleans-Baton Rouge Pilot Dispatch: (504) New Orleans Federal Pilots: (504) More Information Reporting guidance can be found at Information regarding CDC Quarantine stations can be found at (Also see below) RWBranch //s// Capt Ron Ronald W. Branch, CAPT. USCG (Ret.) President Louisiana Maritime Association (LAMA) Desk: (504) Cell: (330)

4 Quarantine Station Quick Reference List This is a quick reference guide to the U.S. Quarantine Stations. For full details about any station, click on its name in the Quarantine Station column. Quarantine Station Phone: 24-hour access Anchorage Atlanta Boston Chicago Dallas Detroit (daytime) El Paso (U.S. Mexico Unit) (24-hour access) Honolulu Houston Los Angeles Miami Minneapolis-St. Paul New York Newark Philadelphia (daytime) San Diego (U.S. - Mexico (24-hour Unit) access) San Francisco San Juan Seattle U.S. - Mexico Unit (English) U.S. - Mexico Unit (Español) Washington, DC

5 Advisory Page 1 of 2 06/20/2013 Printed on Thu Jun 20 01:15:16 EDT Advisory #: Date Issued: Jun To: MARINERS Subject: CORONAVIRUS ALL OPERATORS OF U.S. FLAG, EFFECTIVE U.S. CONTROLLED VESSELS, AND OTHER MARITIME INTERESTS 1. AS OF JUNE 5, 55 PEOPLE HAVE BEEN CONFIRMED TO BE INFECTED WITH A NEW VIRUS THAT WAS INITIALLY REFERRED TO AS NOVEL CORONAVIRUS (NCOV), AND IS NOW KNOWN AS MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS (MERS-COV). MORE THAN HALF OF THE PEOPLE INFECTED HAVE DIED FROM THE VIRUS. 2. MOST CASES HAVE ORIGINATED FROM THE ARABIAN PENINSULA (JORDAN, QATAR, SAUDI ARABIA AND UNITED ARAB EMIRATES). SEVERAL CASES HAVE ALSO BEEN REPORTED IN ITALY, FRANCE, THE UK AND TUNISIA; THESE CASES ACQUIRED THEIR ILLNESS EITHER FROM TRAVEL TO THE ARABIAN PENINSULA OR FROM CLOSE CONTACT WITH A SICK PERSON WHO HAD TRAVELED TO THE AREA, INDICATING PERSON-TO-PERSON TRANSMISSION. 3. INFECTED PEOPLE HAVE SUFFERED A VERY SEVERE, PNEUMONIA-LIKE ILLNESS. CONSIDER A CREW MEMBER OR PASSENGER AS SUSPICIOUS IF THEY HAVE THE FOLLOWING: AN ACUTE RESPIRATORY INFECTION, WHICH MAY INCLUDE FEVER ( 38 C, F), COUGH AND SHORTNESS OF BREATH; AND HISTORY OF TRAVEL FROM THE ARABIAN PENINSULA OR NEIGHBORING COUNTRIES WITHIN 14 DAYS; OR PERSONS WHO DEVELOP SEVERE ACUTE LOWER RESPIRATORY ILLNESS WHO ARE CLOSE CONTACTS OF AN ILL SYMPTOMATIC TRAVELER WHO DEVELOPED FEVER AND ACUTE RESPIRATORY ILLNESS WITHIN 14 DAYS AFTER TRAVEL FROM THE ARABIAN PENINSULA OR NEIGHBORING COUNTRIES*. CLOSE CONTACT IS DEFINED AS PROVIDING CARE FOR THE ILL TRAVELER (E.G., A HEALTHCARE WORKER OR FAMILY MEMBER), OR HAVING SIMILAR CLOSE PHYSICAL CONTACT; OR HAVING STAYED AT THE SAME PLACE (E.G. LIVED WITH, VISITED) AS THE TRAVELER WHILE THE TRAVELER WAS ILL. 4. SUSPICIOUS ILL CREW MEMBERS AND PASSENGERS SHOULD BE ISOLATED IN A PRIVATE CABIN UNTIL THEY ARE EVALUATED BY A DOCTOR TO PREVENT TRANSMISSION TO OTHERS. CONTACT WITH OTHER PASSENGERS AND CREW SHOULD BE MINIMIZED. IF MASKS ARE AVAILABLE, THE ILL CREW MEMBER OR PASSENGER SHOULD WEAR A MASK WHILE NOT IN ISOLATION TO PREVENT FURTHER SPREAD. 5. CABIN MATES AND OTHER CLOSE CONTACTS OF ILL PERSONS SHOULD BE ACTIVELY MONITORED FOR FEVER AND RESPIRATORY SYMPTOMS FOR 14 DAYS AFTER THE LAST KNOWN EXPOSURE. 6. HEALTH CARE PROVIDERS SHOULD FOLLOW THE U.S. CENTERS FOR DISEASES CONTROL (CDC) INFECTION CONTROL RECOMMENDATIONS FOR THE SEVERE ACUTE RESPIRATORY SYNDROME (SARS) CORONAVIRUS, WHICH CAN BE FOUND AT 7. U.S FOREIGN QUARANTINE REGULATIONS, 42 CFR PART 71.21, REQUIRE THE MASTER OF A SHIP DESTINED FOR A U.S. PORT TO IMMEDIATELY REPORT THE ONBOARD OCCURRENCE OF ANY DEATH OR ANY ILL PERSON AMONG PASSENGERS OR CREW TO THE QUARANTINE STATION WITH JURISDICTION OVER THE PORT AT WHICH THE SHIP WILL ARRIVE. REPORTING GUIDANCE CAN BE FOUND AT INDUSTRY/CRUISE/NOTIFICATION-PUBLIC-HEALTH-AUTHORITIES-ILL-PASSENGERS-CREW-DESTINED-UNITED- STATES.HTML INFORMATION REGARDING CDC QUARANTINE STATIONS CAN BE FOUND AT 8. TAKING THESE EVERYDAY ACTIONS CAN HELP PREVENT THE SPREAD OF GERMS AND PROTECT AGAINST COLDS, FLU, AND OTHER ILLNESSES:

6 06/20/2013 Advisory WASH YOUR HANDS OFTEN WITH SOAP AND WATER. IF SOAP AND WATER ARE NOT AVAILABLE, USE AN ALCOHOL- BASED HAND SANITIZER. AVOID TOUCHING YOUR EYES, NOSE, AND MOUTH. GERMS SPREAD THIS WAY. AVOID CLOSE CONTACT WITH SICK PEOPLE. 9. PROMPT MEDICAL CARE IS REQUIRED AND MAY INCLUDE LIFE SUPPORT. Page 2 of CDC INFORMATION IS AVAILABLE AT AND A TRAVEL NOTICE IS AVAILABLE AT HOWEVER, THE CDC, WHO, AND U.S. DEPARTMENT OF STATE DO NOT RECOMMEND ANY TRAVEL OR TRADE RESTRICTIONS AT THIS TIME. 11. ADDITIONAL INFORMATION IS AVAILABLE AT FOR FURTHER INFORMATION REGARDING THIS ADVISORY, CONTACT CAPTAIN ROBERT FORD, MARITIME ADMINISTRATION, OFFICE OF SECURITY, CODE: MAR-420, ROOM W25-308, 1200 NEW JERSEY AVE, S.E., WASHINGTON, DC 20590, TELEPHONE , FACSIMILE , TLX II (MARAD DOT WSH), OR MARADSECURITY@DOT.GOV. Maritime Administration. All rights reserved.

7 WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update Page 1 of 2 06/20/2013 Global Alert and Response (GAR) Middle East respiratory syndrome coronavirus (MERS-CoV) - update Share Print 17 JUNE The Ministry of Health in Saudi Arabia has announced an additional three laboratory-confirmed cases with Middle East respiratory syndrome coronavirus (MERS-CoV). The first patient is a 42-year-old man with an underlying medical condition from the Eastern region, the second patient is a 63-year-old woman with underlying medical conditions from Riyadh region and the third patient is a two-year-old child with an underlying medical condition from Jeddah. Additionally, four previously laboratory-confirmed cases have died. Related links Coronavirus infections List of coronavirus infections DONs Revised interim case definition for reporting to WHO Middle East respiratory syndrome coronavirus (MERS-CoV) Travel advice for MERS-CoV Globally, from September 2012 to date, WHO has been informed of a total of 64 laboratory-confirmed cases of infection with MERS-CoV, including 38 deaths. WHO has received reports of laboratory-confirmed cases originating in the following countries in the Middle East to date: Jordan, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). France, Germany, Italy, Tunisia and the United Kingdom also reported laboratory-confirmed cases; they were either transferred there for care of the disease or returned from the Middle East and subsequently became ill. In France, Italy, Tunisia and the United Kingdom, there has been limited local transmission among patients who had not been to the Middle East but had been in close contact with the laboratory-confirmed or probable cases. Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. Specimens from patients lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised. Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS- CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.

8 WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update Page 2 of 2 06/20/2013 All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented. WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions. WHO continues to closely monitor the situation.