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BOX 1-1
Statement of Task

The factors to be considered in an assessment of current and future border quarantine functions would include:

  1. The current role of quarantine stations as a public health intervention and how the roles should evolve to meet the needs of the 21st century.

  2. The role of other agencies and organizations working collaboratively with the CDC’s Division of Global Migration and Quarantine at ports of entry (including federal partners such as Customs and Border Protection, Immigration and Customs Enforcement, U.S. Department of Agriculture, and U.S. Fish and Wildlife Service).

  3. The role of state and local health departments as partners for public health interventions at the nation’ s borders (such as activities focused on emergency preparedness and response, disease surveillance, and medical assessment and follow-up of newly arriving immigrants and refugees).

  4. Optimal locations for the quarantine stations for efficient and sufficient monitoring and response.

  5. Appropriate types of health professionals and necessary skill sets to staff a modern quarantine station.

  6. Surge capacity to respond to public health emergencies.

The perception that humans had effectively controlled microbial threats led to the dismantling of most of the federal border quarantine system in the 1970s; by the end of that decade, fewer than a dozen active stations remained (Cetron, 2004). In mid-2004 there were 8 stations with 37 full-time equivalent staff (Table 1-1). Run by the Centers for Disease Control and Prevention (CDC), their responsibilities and capabilities have consisted of:

TABLE 1-1 Number of Employees and Contractors at Each CDC Quarantine Station at U.S. Ports of Entry, Mid-2004

Quarantine Station

No. of Full-Time Equivalents

Atlanta

3

Chicago

5

Honolulu

3

Los Angeles

4

Miami

7

New York City (JFK)

8

San Francisco

3

Seattle

4

TOTAL

37

 

SOURCE: Personal communication, D. Kim, DGMQ, October 13, 2004, M. Remis, DGMQ, January 18, 2005.

  1. Responding to ill passengers (international travelers, immigrants, and refugees) with suspected infectious disease.

    1. 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 1-2). If the index of suspicion is high, the individual is sent to a healthcare facility for medical evaluation and diagnosis.

    2. If the passenger arrives at port of entry lacking a quarantine station, the station with jurisdic-



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