Human Resources at U.S. Ports of Entry to Protect the Public's Health Interim Letter Report (2005) / Chapter Skim
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Contents of Letter Report
Contents of Letter Report
Pages 1-18
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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 competencies1 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 CDC Quarantine Station Expansion Plan for U.S.
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4. Optimal locations for the quarantine stations for efficient and sufficient monitoring and response.
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2. Meeting arriving refugees and parolees, visually screening them for signs and symptoms of illness, reviewing the results of their oversees medical examinations, giving local health departments notification of their arrival and the results of their oversees exams, and alerting the health departments to arrivals with Class A or B conditions (Box 1-3)
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; they include: · rapid, high-volume international and transcontinental travel, commerce, and human migration; · mass relocation of rural populations to cities and the prevalence of overcrowded, un sanitary conditions there; · exponential growth of population and the number of individuals susceptible to infec tious disease; · widespread changes in climate, ecology, and land use; · more frequent contact between people and wildlife; · reduced global investment in public health infrastructure; · development of antimicrobial resistance. Numerous scientists, physicians, and public health officers in national and international organizations have voiced concern about these trends and their relationship to such naturally occurring public-health threats as West Nile Virus, SARS, pandemic influenza, and HIV/AIDS.
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border quarantine station system before 1970, as well as a step forward toward national biosecurity based on today's technology and knowledge of microbial threats to human heath. "CDC Quarantine Stations are gearing up to make the transition from the current focus on federal inspection services at airports to become a full partner in public health response," DGMQ states in a 2003 proposal (DGMQ, 2003b, p.1)
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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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on how best to strengthen, improve, and modernize public-health responses and disease surveillance in 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 competencies needed to meet the stations' new public health mission and traditional statutory responsibilities.
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Capacities in Foreign Languages and Cultures The quarantine stations should have access to translators in the languages of the travelers and crew who typically arrive at their port. Staff who conduct any of the priority functions should be able to identify and contact appropriate translators at any time.
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Understand and carry out federal regulations applicable to the quarantine stations regard ing the importation of plants, animals, and biological specimens (Foreign Quarantine.
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II. Plan for Public Health Threats Each quarantine station should be prepared to screen for and respond to the detection of microbial threats to health in arriving passengers and crew.
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12. Develop plans and procedures for educating arriving passengers and crews about the health risks posed by suspected or detected microbial threats in a human traveler or in imported animals, plants, biological specimens, and other substances for which the sta tions have statutory responsibility.
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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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9. Perform rapid diagnostic tests to screen large numbers of passengers for potential expo sure to infectious agents of public health concern.
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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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Understand the signs, symptoms, prophylaxis, treatment, and infection control measures pertinent to infectious diseases of global health concern, especially those rare or absent in the United States.
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PORTS OF ENTRY TO PROTECT THE PUBLIC'S HEALTH VI. Create Linkages across Sectors and Jurisdictions The quarantine stations should develop collaborative relationships with all members of their communities and jurisdictions who respond to public health threats, as well as with relevant private-sector organizations.
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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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