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Quarantine Stations at Ports of Entry: Protecting the Public's Health (2006)

Chapter: Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations

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Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
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C
Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations

PROPOSAL FOR CDC QUARANTINE STATION DISTRIBUTION

Division of Global Migration and Quarantine (DGMQ)

Centers for Disease Control and Prevention (CDC)

September 16, 2003

Overview

DGMQ used the following criteria to select cities to receive new quarantine stations:

  1. Volume of international human travelers

    • Airports with >500,000 arriving international air travelers per year.

    • Seaports in major cities with >150,000 arriving international maritime travelers per year.

    • Land crossings in major cities with >10 million arriving international travelers.

  1. Total volume of human travelers

    • Airports with >25 million arriving international and domestic air travelers per year.

  1. Volume of imported wildlife

    • Major cities that serve as designated or nondesignated ports of

Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×

entry by the U.S. Fish and Wildlife Service to receive international shipments of wildlife.

  1. National security concerns

Analysis
  1. By volume of arriving international air travelers:

    1. Ports of highest priority by this criterion are New York JFK, Miami, Los Angeles, Chicago O’Hare, Newark, San Francisco, Atlanta, Houston Intercontinental, Honolulu, Washington Dulles, Dallas-Ft. Worth, Boston, Detroit, San Juan (PR), Philadelphia, Seattle, Minneapolis, and Orlando International.

    2. 75.2% direct-arriving international air traveler coverage if CDC is present in the ports described in 1.a. that have >500,000 arriving international air travelers per year.

    3. 77.3% coverage if ports near the above international airports (indirect coverage)—that is, Ft. Lauderdale (Miami), Chicago Midway (Chicago O’Hare), Sanford Orlando (Orlando International), Oakland and San Jose (San Francisco), and Baltimore (Washington Dulles)—are considered.

    4. 17.4% of arriving international air travelers are precleared in Canada (13.0%), Bahamas (2.1 %), U.S. Virgin Islands (1.1 %), Aruba (0.7%), and Bermuda (0.5%)

  1. By volume of total (international and domestic) air travelers:

    1. Ports of priority (>25 million air travelers per year) by this criterion not already listed in 1.a. are Phoenix, Denver, and Las Vegas.

    2. 78.8% arriving international air traveler coverage if Phoenix (0.7%), Denver (0.4%), and Las Vegas (0.4%)—which rank 5, 6, and 7, respectively, in traveler volume in North America—are added to those listed in 1.b. and 1.c.

    3. All ports identified in 1.a. are included in the top 30 ranked airports in traveler volume in North America.

    4. Nine of 10 DHHS regional offices (that is, all but Region VII office in Kansas City, MO) located in the ports identified in 1.a. and 2.a.

  1. By volume of arriving international maritime travelers:

    1. Ports of priority (> 150,000 maritime travelers per year) in major U.S. cities not already listed in 1.a. and 2.a. are San Diego and New Orleans.

    2. Anchorage, AK … serves as the major city through which

Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×

400,000 travelers, many of whom are international, cruise (source: International Council of Cruise Lines) and participate in land tours in Alaska and the Yukon Territory; therefore, Anchorage is listed as a port of high priority.

  1. 80.1% arriving international air traveler coverage if San Diego (0.2%), New Orleans (number of international air travelers, 58,093 or 0.1%; source: New Orleans International Airport, 2002), and Anchorage (data not available from Anchorage International Airport but estimated to be less than 0.1%) are added to ports already listed.

  1. By volume of arriving international travelers by land crossings:

    1. Ports of priority (>10 million land crossing travelers per year) in major U.S. cities between the United States and Mexico are San Diego and El Paso; San Diego is already described in 3.a.

    2. El Paso has international air traffic that contributes negligibly to the coverage of arriving international air travelers.

    3. Ports of U.S.–Canada land crossings are not considered.

  1. By volume of arriving international wildlife shipments:

    1. Eleven (85%) of 13 ports of entry designated by the U.S. Fish and Wildlife Service for international shipments of wildlife are covered by the ports described in 1–4; Baltimore is indirectly covered as described in 1.c., but Portland, OR, is not covered.

    2. Six (38%) of 16 nondesignated ports of entry are covered by the ports described in 1–4; of the ports not covered, only Buffalo, NY, and Tampa, FL, are major cities.

  1. Summary table

Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×

Port

Int’l Air >500,000/yr

Total Air >25 million/yr

Maritime >150,000/yr

Land > 10 million/yr

Wildlife*

Anchorage

 

X

 

X

Atlanta

X

X

 

X

Boston

X

 

X

 

X

Chicago

X

X

 

X

Dallas

X

X

X

Denver

 

X

 

Detroit

X

X

 

X

X

El Paso

 

X

X

Honolulu

X

 

X

 

X

Houston

X

X

X

 

X

Las Vegas

 

X

 

Los Angeles

X

X

X

 

X

Miami

X

X

X

X

Minneapolis

X

X

 

X

New Orleans

 

X

 

X

New York JFK

X

X

X

X

Newark

X

X

 

X

Orlando

X

X

X

 

Philadelphia

X

 

X

Phoenix

 

X

 

San Diego

 

X

X

X

San Francisco

X

X

X

 

X

San Juan

X

 

X

 

Seattle

X

X

X

 

X

Washington, D.C. (Dulles)

X

 

*Designated and nondesignated ports of entry used by the U.S. Fish and Wildlife Service to receive international shipments of wildlife.

Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×
Page 124
Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×
Page 125
Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×
Page 126
Suggested Citation:"Appendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine Stations." Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press. doi: 10.17226/11435.
×
Page 127
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To mitigate the risks posed by microbial threats of public health significance originating abroad, the Centers for Disease Control and Prevention (CDC) places small groups of staff at major U.S. airports. These staff, their offices, and their patient isolation rooms constitute quarantine stations, which are run by CDC's Division of Global Migration and Quarantine (DGMQ).

Congress began to allocate funds in fiscal 2003 for the establishment of new quarantine stations at 17 major U.S. ports of entry that comprise airports, seaports, and land-border crossings. In a significant departure from the recent past, both the preexisting 8 quarantine stations and the new 17 are expected to play an active, anticipatory role in nationwide biosurveillance. Consequently, DGMQ asked the Institute of Medicine (IOM) to convene an expert committee to assess the present CDC quarantine stations and recommend how they should evolve to meet the challenges posed by microbial threats at the nation's gateways. DGMQ specifically requested "an assessment of the role of the federal quarantine stations, given the changes in the global environment including large increases in international travel, threats posed by bioterrorism and emerging infections, and the movement of animals and cargo." To conduct this assessment and provide recommendations, IOM convened, in October 2004, the Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry.

At the sponsor's request, the committee released the interim letter report Human Resources at U.S. Ports of Entry to Protect the Public's Health in January 2005 to provide preliminary suggestions for the priority functions of a modern quarantine station, the competences necessary to carry out those functions, and the types of health professionals who have the requisite competences (Appendix A). This, the committee's final report, assesses the present role of the CDC quarantine stations and articulates a vision of their future role as a public health intervention.

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