Quarantine Stations at Ports of Entry Protecting the Public's Health (2006) / Chapter Skim
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Appendix A: Human Resources at U.S. Ports of Entry to Protect the Public's Health: Interim Letter Report
Appendix A: Human Resources at U.S. Ports of Entry to Protect the Public's Health: Interim Letter Report
Pages 95-120
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Martin Cetron Director Division of Global Migration and Quarantine National Center for Infectious Disease Centers for Disease Control and Prevention 1600 Clifton Road, Mailstop E-03 Atlanta, GA 30333 Dear Dr. Cetron: This interim letter report contains the competences1 and types of health professionals suggested for the CDC quarantine station system by the Institute of Medicine's Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S.
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. HISTORICAL CONTEXT Dismantling of Quarantine Station System More than 500 people staffed the 55 federal quarantine stations at U.S.
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a. If the passenger arrives at a port with a quarantine station, station staff evaluate the individual for signs, symptoms, and travel history consistent with a quarantinable disease (Box A.2)
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5. Inspecting cargo identified as a potential public health threat.
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. Emergence of Infectious Diseases and the Threat of Bioterrorism Once the border quarantine system had been largely dismantled, new and long-absent infectious diseases emerged, reemerged, and spread in humans; nearly 40 newly emerging infectious diseases were identified during the 30 years between 1973 and 2003 (GAO, 2004)
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federal government to commit funding to biosecurity initiatives. A portion of the fiscal year 2004 budget appropriation went to DGMQ for the construction of three new CDC quarantine stations at U.S.
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The shaded boxes with a double border identify the three cities where quarantine stations opened in 2004. The shaded boxes with a single border represent the 14 cities where DGMQ plans to establish more stations beginning in 2005.
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. "The transformed CDC Quarantine Stations will go beyond evaluating ill passengers to encompass a wide range of responses to infectious disease threats, whether intentional -- as in the case of bioterrorism -- or related to emerging pathogens.
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its quarantine station system. The pace of the expansion also led DGMQ to request preliminary guidance early in the course of the IOM study on the types of health professionals and competences needed to meet the stations' new public health mission and traditional statutory responsibilities.
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In addition, the quarantine station staff should be able to demonstrate knowledge of and sensitivity to the cultural norms in interpersonal communication and health care of travelers and crew who typically arrive at their port.
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In some instances, the quarantine station staff sees a significant number of imported animals or the paperwork documenting them; indeed, the staff relies on paper documentation for much of the inspection it conducts. Some imports are cleared by telephone and some by fax.
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Understand and carry out federal regulations applicable to the quarantine stations regarding the importation of plants, animals, and biological specimens (Foreign Quarantine.
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3. If called upon, collaborate with port personnel, private-sector part 7Each quarantine station has responsibility for ports of entry without a quarantine station within a specific geographic area.
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16. Work comfortably with quarantine station staff, DGMQ colleagues, and all relevant partners to coordinate and implement response plans.
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11. Respond to information about outbreaks of infectious diseases of public health concern by conducting disease surveillance and response on appropriate arrivals.
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The clinical aspects of the stations' historic functions are incorporated here for thematic cohesion; all other historic functions are discussed in section I The quarantine stations need access to a clinician who can diagnose infectious diseases of public health concern, including those that are uncommon or absent in the United States but common in or endemic to other parts of the world.
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A) General Communication The quarantine stations routinely interact with multiple partners: port officials, representatives of airlines and cruise ships, federal officials from other agencies, state and local public health officials, hospital officials, emergency responders, and so on.
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B) Risk Communication Many of the public health threats that the quarantine stations encounter will be characterized at the outset by uncertainty.
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C) Health Education The diagnosis of an infectious disease in a passenger or crew member often will require that a member of the quarantine station staff discuss the health implications of the diagnosis with the patient, his or her contacts, representatives of the airline or shipping company, and others.
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In certain situations, it may be appropriate for quarantine station staff to take the lead in collaborative planning and responses based on the applicable incident command structure as well as on state, local, tribal, and regional laws, regulations, and practices. When creating linkages, the station staff must follow privacy laws and practices to protect the confidentiality of patients' information.
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borders and contain those that are imported either by accident or intentionally. We derived these competences and professionals from the six functions that we identified as priorities for the CDC quarantine station system (Box A.4)
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These information-gathering activities will likely include a discussion of the role of the quarantine stations within the National Incident Management System and relevant incident command structures. The committee's deliberations may include consideration of such issues as the degree of centralization or autonomy that the individual stations should have.
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Presentation at the October 21, 2004, Meeting of the IOM Committee on Measures to Enhance the Effec tiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry.
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2003b. Reinventing CDC Quarantine Stations: Proposal for CDC Quarantine Sta tion Distribution.
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