Division of Global Migration and Quarantine's Accomplishments in Fiscal Year 2011
The U.S. Centers for Disease Control and Prevention's (CDC) Division of Global Migration and Quarantine (DGMQ) focuses on improving the health of globally mobile populations to prevent the introduction, transmission, and spread of communicable diseases. From October 2010 through September 2011, DGMQ responded to emergencies, modernized regulations and policy, conducted communication and training, provided support to state and local partners, and implemented outbreak response and surveillance.
Responded to Public Health Emergencies
Cholera in Haiti
- Distributed approximately 73,000 Travel Health Alert Notices (T-HANs) in four languages to travelers arriving from Haiti at four U.S. airports.
- Conducted an evaluation of the cholera T-HAN and found that reading the T-HAN can influence travelers to seek medical attention after they arrive in the United States.
- Investigated the risk of cholera spread through seafood by water released from ships, resulting in cholera prevention recommendations to the International Maritime Organization for cargo ships departing from Haiti.
Earthquake in Japan
- Responded to the Japan earthquake, tsunami, and radiation disaster by developing health information and guidance documents for travelers and U.S. citizens living in Japan.
- Developed enhanced radiation screening and decontamination protocols for travelers arriving from Japan, which resulted in U.S. Customs and Border Protection (CBP) screening nearly 550,000 travelers.
Measles around the World
- Developed health messages in response to the increase in measles around the world, which were posted on electronic monitors by CBP at 18 U.S. international airports, providing a measles advisory to over 2.7 million arriving international travelers each month.
- Demonstrated that electronic messaging is less expensive, $1,050 compared with $180,000 to print SARS T-HANs in 2003, more environmentally friendly, and a faster method of reaching more travelers than traditional print methods.
Modernized Regulations, Policy, and Guidance
- Developed “Guidance for School Administrators to Help Reduce the Spread of Seasonal Influenza in K-12 Schools during the 2010-11 School Year” and “How to Clean and Disinfect Schools to Help Slow the Spread of Flu Guide” in English and Spanish.
- Developed 5 new guidelines for U.S. Domestic Medical Examination for Newly Arriving Refugees, which are available on a new website, Guidelines for the U.S. Domestic Medical Examination for Newly Arriving Refugees.
- Implemented the Technical Instructions for Tuberculosis Screening and Treatment using Cultures and Directly Observed Therapy in eight additional countries, resulting in improved screening of 68% of all refugees and immigrants coming to the United States and leading to an increased rate of TB diagnosis.
Conducted Communication, Education, and Training Activities
- Published the 2012 version of the CDC Health Information for International Travel: The Yellow Book, regarded as the gold standard travel medicine reference for health care providers.
- Posted 42 travel notices on the Travelers' Health website, which was ranked 6th among all CDC sites, with over 23 million page-views and 5.6 million visits.
- Conducted training summits in Thailand and Peru and launched a Panel Physician Portal, to provide information for panel physicians who implement the required medical screening for U.S. immigration applicants.
- Posted flu materials for refugee populations in 11 languages on Immigrant and Refugee Resources.
- Launched an International Adoption website to provide guidance on health-related immigration processes for adopting a child from other countries.
- Expanded the infectious disease surveillance system network and developed a training package for refugee camp medics to provide primary health care, hygiene, and sanitation in nine refugee camps along the Thailand-Myanmar border.
Provided Support to State and Local Health Departments
- Conducted 135 contact investigations, involving 190 flights, for travelers exposed to infectious diseases.
- Sent out 1,216 notifications to state and local public health partners for 4,641 people who were exposed to communicable diseases during air travel.
- Evaluated the Chicago Quarantine Station's referral program for arriving immigrants with TB, demonstrating a 400% increase in starting their medical follow-up and timeliness in getting to a local health department.
- Completed a review of communicable disease response plans for all CDC Quarantine Stations, and conducted seven communicable disease response exercises with port, state health, and local health partners.
Implemented Outbreak Response and Surveillance Activities
- From October 2010 to September 2011, the GeoSentinel network, a worldwide surveillance system for travel-related illness, surpassed 150,000 records, with 196,000 final diagnoses covering traveler exposures in over 237 countries.
- Conducted surveillance of respiratory diseases, diarrhea, fever, and dengue in refugee camps in Kenya.
- Responded and provided technical assistance to over a dozen disease outbreaks (including cholera, dengue, diphtheria, malaria, measles, meningitis, mumps, rubella, and varicella) in refugee camps and migrant populations throughout Africa and Asia.
- Responded to rabies exposures among travelers exposed to a rabid zebra at a safari lodge in Kenya.
- Conducted an investigation of dengue cases in travelers returning from missionary work in Haiti.
- Responded to and investigated binational US-Mexico outbreaks of Legionnaires' disease and Guillain-Barre syndrome.
- Launched the Bio-Mosaic Project, designed to map the demographic and migration health data of foreign-born populations in the United States for 105 countries of birth and to assess the risk of international spread of infectious diseases.
- Opened a clinical laboratory in the Dadaab refugee camp in Kenya; the new lab allows swifter lab confirmation of potential outbreaks and detection of new pathogens in the camp, and minimizes importation of infections to the United States.
- Coordinated a multistate and international outbreak investigation for imported measles cases in refugees, leading to recommendations and implementation of measles vaccinations for all refugees from Malaysia.