Rapid first-stage tests of on-ship infection

Protection against on-ship infectious disease—whether due to mishap or to harmful purpose—faces special situational problems. Sometimes, when infection levels on board have reached threshold levels, emergency actions are required. Often, the most thorough strategies for responding to threat are not feasible. A rapid first-stage test (RFT) is a fast, minimally invasive procedure used to rule out from possible infection a large percentage of an infection-threatened group. Prevention and control of on-ship infection need to combine various interconnected tactics. When timely criterion tests are not possible, the medical team must adopt fast alternative measures. The methods used to summarize protection against on-ship infectious agents included a scientific literature review and a web search. The fields of the review were maritime, health, and technology sources. Special attention was paid to material dealing with risks and threats of on-ship penetration by infectious agents, on-ship infection prevalence thresholds, and rapid diagnostic screens. The Bayes rule and the law of large numbers were applied to the analysis, for large on-ship populations, of RFT indications of crossing of an infection prevalence threshold. The increasing risk of serious on-ship infection—either accidental or purposeful—calls for a multi-layered protection approach. RFTs are a key part of the outer layer of such a defense. Well-designed and well-administered RFTs provide several advantages for defense against on-ship infection: low-cost, non-invasive, fast, and focuses on a drastically smaller number of infection possibilities.