Building the Quarantine System
What is the Quarantine System?
An integrated and comprehensive partnership of local, national, and global health authorities to prevent, detect, and contain infectious diseases in countries of origin and at U.S. ports of entry; and to plan responses to public health threats
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Background
Growing concern about the threat of importing infectious diseases through mobile populations, bioterrorism, animals, and cargo has prompted the Centers for Disease Control and Prevention (CDC) to invest in building a Quarantine System that meets the needs of the 21st Century.
As was evidenced in the response to SARS in 2003 and in planning for a possible pandemic, CDC’s Division of Global Migration and Quarantine (DGMQ) provides leadership in coordinating a nationwide response to global infectious disease threats that may cross U.S. borders. DGMQ’s Quarantine System provides the critical infrastructure necessary to support the all-hazards (any public health threat) preparedness activities going on across the United States and throughout the world.
Quarantine System in Action
Prevention, detection, and containment
Around the world, the Quarantine System
- Works to improve the medical screening and detection of diseases in mobile refugee and immigrant populations prior to their travel to the United States
- Supports GeoSentinel, a worldwide communication and data-collection network for the surveillance of travel-related illness
- Responds to disease outbreaks and other public health needs among U.S.-bound refugees
- Provides comprehensive prevention guidance for international travelers in Health Information for International Travelers, known as the “Yellow Book,” and on the Travelers’ Health website
- Implements the Binational Infectious Disease Surveillance Network between United States and Mexico
- Provides an e-mail service for partners to receive instantaneous updates about travel-related information
At U.S. ports of entry, the Quarantine System
- Responds to illnesses or deaths on airplanes, maritime vessels, and at land-border crossings
- Performs passenger notification and contact tracing when a travel-related disease exposure occurs
- Monitors health and collects medical information for immigrants and refugees
- Distributes hard-to-find antitoxins and other drugs for emergency use to save lives
- Inspects animals, cargo, and hand-carried items that pose a threat to human health
- Provides guidance on border strategies to prevent, detect, and respond to a pandemic
Partnership and response
The Quarantine System
- Assists in developing the North American Pandemic Influenza Plan between the United States, Mexico, and Canada
- Assists partners in developing all-hazards preparedness plans and facilitates preparedness exercises
- Provides presentations, trainings, and educational materials to partner agencies
- Notifies state and local health departments of arriving immigrants and refugees who will reside in their area and who have medical conditions of public health interest
- Supports research to evaluate and assess the scientific basis for quarantine activities
- Builds partnerships to build surge capacity for emergency response activities
Accomplishments
Quarantine System accomplishments for 2006–2007 include:
Medical screenings/investigations
- Controlled potential international importation of measles, polio, and Rift Valley fever cases from Kenyan refugee camps
- Continued response activities to an outbreak of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in the Hmong refugee group from Thailand
- Assisted with repatriation of American citizens who were forced to evacuate Lebanon
- Assisted in the control of dengue outbreaks along the U.S./Mexico border
- Investigated a multi-state mumps outbreak to study the risk of transmission on airplanes, leading to creating a new response protocol
- Oversaw the importation and quarantine of more than 27,000 nonhuman primates
Policy and guidelines
- Working to update the Federal Regulations (42 CFR parts 34, 70, and 71) to increase CDC’s ability to prevent and respond to the introduction of a public health threat into the United States
- Participated in the revision of the International Health Regulations and provide ongoing consultation
- Revised the Technical Instructions for Tuberculosis (TB) to improve detection overseas and prevent importation of MDR-TB and extensively drug resistant TB (XDR-TB)
Research
- Awarded $5.2 million for research on non-pharmaceutical interventions
- Analyzed historical and epidemiologic data from the 1918 influenza pandemic
- Surveyed U.S. travelers and healthcare providers to better understand travelers’ behavior and risk for disease exposure
Partnership and Response Planning
- Partnered in developing the Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States–Early, Targeted, Layered Use of Nonpharmaceutical Interventions
- Worked closely with federal partners in DHS, DOT, and HHS to develop draft concept of operations plans for pandemic influenza screening at U.S. ports of entry
- Established intergovernmental collaboration with Australia, Canada, New Zealand, and the United Kingdom for overseas health screening of immigrants and refugees
- Organized a workgroup of U.S. port partner agencies for identifying training and education needs to support public health response
- Conducted a measles outbreak communication campaign for international travelers returning from the World Cup in Germany
- Conducting a malaria and dengue fever awareness campaign for travelers returning from the 2007 Cricket World Cup
- Opening two new U.S. Quarantine Stations: one in Dallas and the other in Philadelphia
- Ensuring infectious disease response plans are in development with port partners at all U.S. Quarantine Stations (QS)
- Conducting several table-top and functional exercises on infectious disease response at QS
- Completing formal agreements with hospitals at high-traffic ports of entry in all QS jurisdictions to care for ill travelers referred by QS
For more information
Visit CDC website: www.cdc.gov/ncidod/dq
Page last modified: May 01, 2008