Early Warning Infectious Disease Surveillance (EWIDS) Program Activities on the Northern and Southern Border States

Background

In 2003, the Department of Health and Human Services (HHS), Assistant Secretary for Preparedness and Response designated $4 million, and since 2004 over $5 million, per year to be allocated to the northern and southern states bordering Canada and Mexico for the U.S. Border State Early Warning Infectious Disease Surveillance Project. The existing Centers for Disease Control (CDC) Public Health Emergency Preparedness Cooperative Agreement is the funding mechanism for the twenty states that have chosen to participate. In Fiscal Year 2007, eighteen of the 20 eligible U.S. border states are participating in EWIDS (Illinois and Ohio chose not to participate).

Distribution of Funding

Funding began in Fiscal Year 2003, and is distributed based on the number of border crossings, which include passenger train and land crossings. For 2007, awards range from $15,000 to over $2 million. Funding is distributed to states through the Public Health Emergency Preparedness Cooperative Agreement. This funding is not part of the Cooperative Agreement base funding, and is managed in conjunction with HHS.

Proposed Activities

The Early Warning Infectious Disease Program (EWIDS) is a unique collaboration of state, federal and international partners who collaborate to provide rapid and effective laboratory confirmation of urgent infectious disease case reports in the border regions of the United States, Canada, and Mexico. Activities can include assessing surveillance and laboratory capacity on each side of the international border, improving electronic sharing of laboratory information, maintaining a database of all sentinel/clinical labs, and work to develop and agree on a list of notifiable conditions.

Current Activities

Since the inception of EWIDS, many states have chosen to group into regions to work with their Canadian and Mexican counterparts in order to maximize the funding they are given to complete activities. On the northern border, the Pacific Northwest, Northeastern and Great Lake groups have made significant progress in accomplishing capacities outlined in the CDC Cooperative Agreement.

The Pacific Northwest alliance (Alaska, Idaho, Washington, Montana and North Dakota) hosted their fourth cross border meeting in May 2007 in Victoria, British Columbia to address surveillance, laboratory, communication, information technology and legal issues.
The Great Lakes Border Health Initiative Legal Subcommittee has completed a formal agreement on cross border sharing of resources during an emergency. They completed the Fourth Annual Conference in June 2007.
The southern border states have been working with laboratories in Mexico for several years, and the current focus is to ease transport of laboratory samples across the border. The first US-Mexico Border Health and Infectious Disease Conference occurred in El Paso, Texas in July 2005.
The Eastern Health Initiative (Maine, New Hampshire, New York, Vermont) hosted their spring meeting with Canadian partners from New Brunswick, Nova Scotia and Quebec in May 2007 in Burlington, Vermont.
The first Security and Prosperity Partnership of North America Trilateral Workshop on Early Warning Infectious Disease Surveillance was conducted in El Paso, Texas in March 2007.

Public Health Regional Collaboration

Twenty border states have or are in the process of clustering into regional collaborative groups across the northern and southern border of the United States. These collaborative groups and their geographical across the border neighbors are:
Eastern Border Health Initiative – Maine, New Hampshire, Vermont, New York (New Brunswick, Nova Scotia, Quebec)
Great Lakes Border Health Initiative – Michigan, Ohio, Wisconsin, Minnesota, Pennsylvania, Indiana, Illinois and New York (Ontario)
Pacific Northwest Alliance –Alaska, Washington, Idaho, Montana, North Dakota (British Columbia, Saskatchewan, Manitoba, Alberta and the Yukon Territory)
U.S.-Mexico Border Region Group – Texas, New Mexico, Arizona, California (Coahuila, Chihuahua, Sonora, Nuevo Leon, Baja California and Tamaulipas)

Progress Areas

Regional U.S. Border States groups and Federal partners are conducting a wide range of activities across the border including:

Establishing a database directory of laboratories
Drafting Memoranda of Understanding (MOU’s) to share data, personnel and equipment between jurisdictions during an infectious disease public health emergency.
Laboratory surveillance through PulseNet and FoodNet.
Working with tribes whose land is on the border and crosses into Mexico and Canada.
Expanding the Laboratory Response Network (LRN) into Canada and Mexico.
Conducted tabletop workshops to discuss bi-national communication strategies.
Developing bi-national communication strategy including bi-national crisis and emergency health alert communication, case reporting and notification protocols.
Expanding sentinel and active surveillance for infectious diseases.