Centers for Disease Control and Prevention

Division of Global Migration and Quarantine

Sena BlumensaadtQuarantine Inspector

Organization

Department of Health and Human Services (DHHS)

U.S. Public Health Service (PHS)

Centers for Disease Control and Prevention (CDC)

National Center for Infectious Diseases (NCID)

Division of Global Migration & Quarantine (DGMQ)

U.S. Quarantine Stations

Our Mission

… to prevent the introduction, transmission, and spread of communicable disease from foreign countries into the United States.

Quarantine Stations, United States, 2004

Martha Remis, Officer In Charge Sena Blumensaadt, Quarantine Inspector Shannon Bachar, Quarantine Inspector Lisa Poray, Quarantine Inspector Andre Berro, Public Health Specialist Jaclyn Chapman, Public Health Specialist Lenkisha Jenkins, Administrative Assistant

Chicago Quarantine Station

DGMQ Duties Screening medical records of arriving

permanent residents Illness response

Layers of surveillance Responding to notification of illness Information sharing

Emergency response plans Memoranda of Agreement More illness response

(what we can do for you!)

Screening Medical Records of Arriving Permanent ResidentsRefugees, Asylees, Parolees, Immigrants, (and

dozens more designations!) Refugees, asylees: notify State health dept. If history of TB: notify state and local TB

coordinators If untreated or partially treated syphilis:

notify state STD manager If HIV positive: notify state health dept. If history of Hansen’s disease: notify

Hansen’s Disease Center in Louisiana

Layers of Surveillance

Flight crew Medical facility (under contract with

airline) Airline arrivals staff Fire, Police, Paramedics Customs and Border Protection (CBP) Airport Wheelchair Service Family members and work colleagues

Illness Response (Passive Surveillance)

Initial Steps Flight crew notices that someone is ill on

board and notifies the pilot Pilot radios the ground crew Ground crew radios closest quarantine

station (airline required by law to notify closest quarantine station of illness or death on board)

Illness Response (Passive Surveillance)

Quarantine Inspector and/or paramedic meets plane at gate as it arrives

All passengers remain seated on board Ill person (or family or flight crew) is

interviewed Others who may assist:

Paramedics, Customs and Border Protection inspectors, Police Dept. , Local public health office (if suspected smallpox)

Illness Response(Passive Surveillance)

If believed to be non-infectious: All passengers released

If believed to be potentially infectious: Passenger is masked and transported to

hospital by ambulance Others on board provide “locator” info Quarantine Station notifies the hospital,

State and local health departments, CDC headquarters, other federal agencies, as needed

Illness Response (Active Surveillance)

Meet each flight from countries with disease of interest (e.g., SARS)

Ask lead flight attendant if any illness on board Watch each person disembark and isolate and

interview all those exhibiting symptoms of illness

Hand a health alert notice to every person

Presidential List of Quarantinable Diseases Cholera Diphtheria Infectious Tuberculosis Plague Smallpox Yellow Fever Viral Hemorrhagic Fevers Severe Acute Respiratory Syndrome (SARS)

Information Sharing Train federal partners to be familiar with our

regulations and notify us, when necessary Remind airline staff of their responsibilities

under 42 CFR Part 71 Update airport authorities on our activities at

their airport Train emergency response staff (police, fire,

paramedics, etc.) on public health regulations.

Information Sharing

Review our regulations with vessel agencies who represent seagoing vessels so they understand vessel captains’ responsibilities under 42 CFR Part 71

Learn roles of others in public health (state and local) so we may better serve

Emergency Response Plans We are attempting to discover where

assistance is needed: In Chicago, we can stage a tabletop, then

write the final document Outside Chicago, we can participate in a

tabletop and add our comments to the draft copy of the document

Some Emergency Response Plans include airport plans, pandemic flu, SARS preparedness. Your suggestions welcome!

Definitions

IsolationSeparation of ill persons with contagious

diseaseOften in a hospital settingApplied to individual level

QuarantineRestriction of persons presumed exposedApplied at the individual or community level

►May be voluntary or mandatory

More Illness Response Please notify us of imported cases of infectious

disease (measles, TB, diphtheria, etc.) so that we can: Gather information from airline and CBP Provide this passenger “locator” information to

state/local public health depts. Please notify us if persons with airborne infectious

disease attempt to fly overseas so that we can: Provide you with airline information so you can

request that they refuse boarding to this person

Phone: 24-hr Phone: 773-894-2960 Fax: 773-894-2970

E-mail: Martha Remis (msr1@cdc.gov) Sena Blumensaadt (sib1@cdc.gov)

Office hours: Mon-Fri 8 am-8 pm Sat-Sun 12:00-8 pm

Contact CDC (Chicago)

Contact CDC (Atlanta)

DGMQ headquarters: 404-498-1600 CDC Emergency Operations Center

(24- hour): 770-488-7100 BT Preparedness and Response Program:

404-639-0385 Emergency Preparedness and Response:

http://www.bt.cdc.gov/emcontact/index.asp

Questions and Answers

Please feel free to ask questions now or later by e-mail, fax, phone!!