Port health: IHR 2005, the Maritime Declaration of Health and sanitation certificates
1The lesson in plain words
Diseases cross borders on ships. The International Health Regulations tell the master what to declare before arrival, and port health decides what happens next.
The International Health Regulations
The International Health Regulations (2005) (IHR) are a World Health Organization (WHO) treaty that 196 States use to stop disease spreading between countries without needless interference with traffic and trade. For ships they set the Maritime Declaration of Health, the Ship Sanitation Certificates and the role of port health authorities. Amendments adopted in 2024 entered into force on 19 September 2025 for most States, adding a pandemic emergency level of alert.
The Maritime Declaration of Health
The Maritime Declaration of Health (MDH), modelled in IHR Annex 8, is completed and signed by the master, countersigned by the ship’s doctor if one is carried, and sent to the port health authority where the port State requires it. It lists the recent ports and asks about deaths on board other than by accident, suspected infectious disease, more ill people than usual, people ill now, medical advice taken, sanitary measures and sick animals.
Signs to report
Port health wants to hear about illness that may be infectious: fever, especially with weakness, confusion, swollen glands, jaundice, cough or breathlessness, unusual bleeding or paralysis; a new rash; severe vomiting or diarrhoea; or repeated fits. Report early, by radio or through the agent, so the port can assess the risk and prepare assistance. Restrictions may still be necessary.
Free pratique and sanitation
Free pratique is health clearance to enter port, embark or disembark people, and load or discharge cargo or stores; it may be granted by radio. Customs and immigration clearance are separate. A Ship Sanitation Certificate records inspection for health risks: food, water, waste and pests. An exemption certificate records no risks found; a control certificate records measures taken. It is valid for at most six months, extendable by one month.
Your part
Keep medical records, case lists and crew vaccination records ready: they are the evidence behind the MDH. Answer every question honestly. Follow port health instructions on isolation, testing, disinfection and landing patients.
2Key data
- IHR (2005)
- 2024 amendments: 19 Sep 2025 for most States; check applicability
- MDH
- IHR Annex 8; master signs, ship’s doctor countersigns
- MDH covers
- Non-accidental deaths, suspected infections, more ill than usual
- Free pratique
- Health clearance for people, cargo and stores; may be by radio
- Ship Sanitation Certificate
- Exemption or control; max 6 months, +1 month extension
3Key points
- 1
The IHR (2005) set the Maritime Declaration of Health and the Ship Sanitation Certificates.
- 2
The master signs the MDH; a death not caused by an accident must be declared.
- 3
Report suspected infectious illness early so the port can prepare.
- 4
Free pratique is health clearance for people, cargo and stores; it may be granted by radio.
- 5
Ship Sanitation Certificates last at most six months, with a possible one-month extension.
4Frequent mistakes
Wrong: Only declare deaths from infectious disease.
Right: The MDH asks about any death on board other than by accident, such as a heart attack.
Wrong: Wait until arrival to mention a sick crew member.
Right: Report early through the agent or by radio so port health can prepare; restrictions may still be necessary.
Wrong: A Ship Sanitation Certificate lasts a year.
Right: It is valid for at most six months, extendable by one month if the inspection cannot be done.
5Practice case & exam keys
Your ship is due at a European port in 18 hours. A crew member has had fever and a cough for three days and now a new rash. Another crew member died last week of a heart attack. How do you handle port health?
Show the answer
Complete the Maritime Declaration of Health honestly: declare the ill crew member as a suspected infectious case. A heart attack is not an accident, so declare that death too, with the date, the cause given by the doctor and the records. Send the MDH and early notice through the agent as the port requires and follow port health’s instructions: they may board, test and land the patient before granting free pratique.
Exam keys
- IHR (2005), WHO; 2024 amendments took effect on 19 September 2025 for most States.
- MDH: IHR Annex 8; master signs; non-accidental deaths and suspected infections declared.
- Free pratique: health clearance for people, cargo and stores; may be by radio. Customs and immigration are separate.
- Ship Sanitation Certificate: exemption or control; max 6 months, +1 month.
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