ity, authority, and resources for orchestrating the activities of the Quarantine System to protect the U.S. population from microbial threats of public health significance that originate abroad.
To fill this void, the primary activities of the CDC quarantine stations should shift from the legacy activity of inspection to the provision of strategic national public health leadership for Quarantine System activities. Such leadership, carried out in collaboration with DGMQ and the scientific and organizational capacity of CDC, would improve national preparedness for crises caused by microbial threats of public health significance that originate abroad.
The triad of (1) the CDC quarantine stations, (2) DGMQ headquarters, and (3) the scientific and organizational capacity of CDC form a functional unit in the context of this report. To refer to this unit, the committee coined the term “Quarantine Core.” (Additional terminology developed by the committee is presented in the following section). The Quarantine Core should provide strategic public health leadership for the broad, international network of organizations whose actions and decisions affect the CDC quarantine stations at U.S. ports of entry.
Quarantine is the separation and restriction of movement of apparently healthy people or animals that may have been exposed to a microbial threat and therefore may become infectious (DGMQ, 2004). CDC quarantine stations and many of their public health partners have the legal authority to quarantine specific individuals and animals to protect the public’s health. In addition, a CDC quarantine station may assure2 the isolation of specific individuals or animals that are reasonably believed to be carrying a communicable disease of public health significance. Through isolation, the infected persons or animals are separated from the population at large, and their movement is restricted to prevent the microbial threat from spreading (DGMQ, 2004). Quarantine and isolation at national borders are nonmedical components of the public health toolkit for limiting and containing the spread of microbial threats. Their utility varies, however, depending on the nature of the threat and the extent to which it has spread.
The microbes of concern to the Quarantine Network are bacteria, viruses, protozoa, fungi, and prions that can replicate in humans. A microbial threat of public health significance causes serious or lethal human
In this report, “to assure” means to make sure that necessary public health services are provided to all members of society by encouraging the requisite actions, requiring them, or providing the services directly. For an in-depth description of the assurance function in public health, see The Future of Public Health, pp. 45-47 (IOM, 1988).