Introduction:
To prevent the spread of pathogens in the maritime sector, an effective approach to the prevention and management of outbreaks on board ships and in ports as points of entry is crucial. This sub-study examines what training is already being provided for stakeholders involved in outbreak events and where training is still needed. The data are gained/are derived by/from the overarching study ‘Healthy Ports, Strong Together (GESA)’, which aims to harmonize and consolidate the necessary capacities for maritime health safety in German ports.

Methods:
A total of 35 guided, semi-structured qualitative interviews were conducted with relevant stakeholders in Germany’s top five major ports. These included port medical services, port authorities, terminal operators, pilots, agents, seamen's missions, federal and waterway police, fire and rescue services and other. Current practice and training needs were assessed. The interviews were transcribed and analyzed using a coding system with software MAXQDA.

Results:
Reported training practices and formats largely vary depending on the initial function of stakeholders. There is an increased need for training in infectious disease emergencies, particularly among non-medical personnel. The main areas of identified needs are communication and interface work, operational procedures, background knowledge of infectious diseases and risk assessment, as well as hygiene and proper use of personal protective equipment.

Conclusions:
Although full-scale exercises are considered helpful, their implementation is limited by high costs. Less resource-intensive exercises, such as table-top exercises, are suitable to training communications and procedures. Regular training is necessary to keep knowledge up to date and to achieve sustainable preparedness. Further, efficient ad-hoc training strategies are essential for dynamic and potentially new outbreak events of unknown origin. The GESA study aims to develop standardized training formats based on identified needs to support sustainable training practices in the area of infectious disease emergencies in German ports.