CDC in Mexico

The Centers for Disease Control and Prevention (CDC) established an office in Mexico in 2000. The CDC Mexico country office is part of CDC’s Division of Global Migration and Quarantine’s, United States-Mexico Unit (USMU). The United States and Mexico share a land border of nearly 2,000 miles. Infectious diseases such as COVID-19, Zika, tuberculosis (TB), influenza, and measles affect both countries. This international border region includes residents who cross daily/weekly for work, social connection, shopping and medical care, as well as seasonal workers (such as H2A visa holders), and truck drivers crossing at cargo ports of entry. Mexico is the second largest supplier of imports in the United States, and its second-largest export market and trading partner. The capital, Mexico City, is one of the world’s largest cities (population of approximately 21 million) and is a frequent site for business meetings, mass gathering events, and tourism.

As new health threats emerge (e.g., COVID-19), the CDC Mexico country office provides technical support for investigation and control of binational and international infectious disease outbreaks; implements initiatives to enhance binational surveillance, laboratory capacity, and illness response; and communicates with U.S. and foreign government officials on policy initiatives critical to binational public health.

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CDC Impact in Mexico

CDC Quarantine Stations

Vehicles waiting to cross the border into the United States at the San Diego Port of Entry. Photo credit: Maureen Fonseca-Ford, USMU

USMU manages CDC quarantine stations in El Paso, TX, and San Diego, CA. These quarantine stations are responsible for sea, air and land ports of entry in the border regions of Arizona, California, New Mexico and Texas.

U.S. quarantine stations are part of a comprehensive quarantine system that serves to limit the introduction and spread of infectious diseases into the United States. USMU works to strengthen surveillance and laboratory capacity in the border regions and in Mexico. Binational collaboration improves our ability to identify pathogens, follow disease trends, and identify outbreaks.

CDC’s quarantine stations are part of a comprehensive quarantine system that serves to limit the introduction and spread of infectious diseases into the United States

CDC’s USMU manages CDC’s quarantine stations in El Paso, TX and in San Diego, CA

COVID-19

To enhance bilateral response coordination and strengthen capacity in core COVID-19-related activities. CDC supports the Mexican Secretariat of Health (SALUD) with $3.168 million in funds through a cooperative agreement with the U.S.-Mexico Foundation for Science (FUMEC). Activities include conducting a SARS-CoV-2 serosurvey, epidemiological surveillance, risk communication, and analysis of population mobility in and throughout Mexico.

$3.168 million in funds for COVID-19 related activities

CDC Mexico and the Mexican Secretariat of Health (SALUD) work to enhance COVID-19 bilateral response coordination and strengthen core response capacity

Binational Technical Working Group (BTWG)

The BTWG established in 2012, addresses mutual public health concerns resulting from the inter-connectedness of populations that traverse the U.S.-Mexico border. Led by CDC Mexico, the group fosters a continuous exchange of information for situational awareness at the border and binationally regarding infectious diseases in the border region.

The group assesses and advises on the management of binational public health issues. It identifies needs and assists with the development of binational public health initiatives or policies for the two countries This work is possible through collaboration with public health officials from the U.S. and Mexico border states, the U.S. CDC, and Mexico’s Directorate of Epidemiology and the National Center for Preventive Programs and Disease Control.

The Binational Technical Working Group addresses public health concerns in the U.S.-Mexico border region. The two countries share a land border of nearly 2,000 miles.

Disease Surveillance

Epidemic Intelligence officer completing field work. Photo Credit: Nirma D. Bustamante, MD, MPH

CDC Mexico collaborates with the Binational Border Infectious Disease Surveillance (BIDS) program to improve disease prevention in the border region. The BIDS network helped identify the H1N1 virus that caused the 2009 influenza pandemic and continues to assist U.S. border states with surveillance efforts of binationally important infectious diseases, including TB, influenza, vector-borne diseases, and foodborne outbreaks.

BIDS sites work with partners in Mexican sister-cities and states to share disease data and collaborate on binational clusters (groups of cases) and outbreaks. For example, the California BIDS program was instrumental in exchanging information with Baja California (BC) on a cluster of a rare antibiotic resistant infection associated with surgery in a healthcare facility in Tijuana, BC, Mexico.

Surveillance for influenza-like illness and severe acute respiratory infection is in place at Binational Border Infectious Disease Surveillance sentinel sites in the U.S.-Mexico border to ensure binational populations are represented in state data.

Tuberculosis

TB remains a leading global cause of infectious disease deaths. CDC provides technical support to fight TB in Mexico. The CureTB program main objective is to prevent TB cases and deaths among mobile populations. They achieve this by linking patients with tuberculosis to care as they move between countries. CureTB collaborates with health authorities throughout the United States and around the world to foster continuity of care for people with TB at their destinations. Health departments, healthcare providers, and others can refer patients to CureTB. Additionally, CDC Mexico supports the National Action Program for the Prevention and Control of Tuberculosis through an operational evaluation of interferon gamma diagnostics for latent TB infection in high risk contacts to TB cases (e.g. HIV, diabetes mellitus and children <5 years of age).

205 TB-positive cases were identified and referred for treatment in Mexico in 2018-2019

Of those cases referred, 146 individuals (71%) have completed TB treatment and/or were cured

CureTB is a program that prevents TB cases and deaths among mobile populations and is supported by CDC

Laboratory

CDC has several international laboratory projects in Mexico. Two TB laboratory projects aim to strengthen drug-sensitive and drug-resistant TB case detection in Sonora and Baja California, Mexico. The goal is to build capacity for the national and state disease control programs to identify state-specific risk groups that would most benefit from rapid molecular TB testing, and yield the highest rates of drug-sensitive and drug-resistant TB (DR TB) disease given limited program resources. As part of the effort in Sonora, CDC is also evaluating rapid molecular testing of new types of samples in children under 10 years of age. The stool and nasopharyngeal aspirate samples that ILD is testing is easier and faster to collect than standard samples and may reduce the need for pediatric patient hospitalization.

CDC global and domestic teams collaborated to update the national electronic surveillance system in Mexico, called Plataforma. This update allowed for inclusion of patients with presumptive TB and DR TB and for inclusion of laboratory test results that were previously excluded. As more patients are entered into the new system, the revisions are being credited with observed ‘increases’ in presumptive and DR TB cases notified to the national program.

Influenza

CDC Mexico played a key role during the 2009 H1N1 Influenza pandemic. CDC and the Mexico Health Secretariat have a decades-long Influenza surveillance collaboration. The year-round surveillance allows for early detection and identification of seasonal influenza viruses and novel influenza A viruses that may have pandemic potential. A virus with pandemic potential is an influenza A virus that enters a new species (animal or human) and in whose population the virus does not normally circulate. The collaboration also includes using technology to improve existing reporting tools.

CDC Mexico played a key role during the 2009 H1N1 influenza pandemic. The novel virus was identified by the Binational Border Infectious Disease program.

Migrant Health

In 2019, there were about 10.9 million Mexican-born people living in the United States. They are the largest immigrant group in the country. Compared to non-Hispanic whites, Mexican-Americans, particularly the Mexico-born, are healthier in several ways such as life expectancy, maternal and child health and tobacco use. They fare worse on other health indicators, such as tuberculosis, diabetes and obesity. CDC Mexico works with CDC’s Migrant Health Team within USMU to enhance the availability of public health surveillance for Mexican origin populations in the United States and to assess health needs and disparities. USMU collaborates with multiple partners, including the Ventanillas de Salud Program, a health education outreach program implemented in Mexican consulates in the United States.

Additionally, there are over 2 million agricultural workers in the United States, and most (69%) were born in Mexico. A vulnerable subgroup are those with an H-2A agricultural worker visa (277,000 in FY 2019) who travel from Mexico for temporary farm work in the United States. Agricultural workers, considered essential workers during the ongoing COVID-19 pandemic, are at high risk of COVID-19 infection due to working and living conditions, underlying chronic conditions, and limited access to health care. To assess the health risks and implement effective public health interventions among agricultural workers in the United States, it is critical to have information on their mobility patterns, including regions of origin and destination, routes used, duration of stay, mode of transportation and housing characteristics.

CDC Mexico is working to describe, quantify, and visualize domestic and international mobility patterns of farmworkers in the United States and Mexico in collaboration with USMU’s Migrant Health Team, COLEF (El Colegio de la Frontera Norte), Mexico’s National Institute of Public Health, and JBS international and HHS (Health and Human Services). CDC Mexico also works to describe demographic characteristics, their health risks, and barriers in access to health.

CDC Mexico is working to describe, quantify, and visualize domestic and international mobility patterns of farmworkers in the United States and Mexico