2017 Accomplishments (Full)
Prevented Yellow Fever Vaccine Depletion
DGMQ’s proactive planning and coordinated response with Sanofi Pastuer helped the US avoid a yellow fever vaccine shortage. Only one yellow fever vaccine was licensed in the US with an impending vaccine depletion and gap in supply from mid-2017 through 2018. With DGMQ’s help, the importation of Sanofi Pasteur’s Stamaril vaccine was accepted by the Food and Drug Administration to avert the shortage. Now, nearly 250 clinics in all states and territories in the US can administer the 44,000 Stamaril vaccine doses to protect US travelers when they visit countries where yellow fever is endemic and still a risk. When there isn’t a shortage, approximately 450,000 doses are used to vaccinate military and civilian travelers each year. About two-thirds of these doses are distributed among approximately 4,000 civilian clinics, authorized by state and territorial health departments with oversight by DGMQ Travelers’ Health Branch.
50th Anniversary of Quarantine System
For the past 50 years, DGMQ’s comprehensive quarantine system has been on the frontline of public health to protect the US from disease threats, both foreign and domestic. DGMQ’s 20 quarantine stations cover more than 300 ports of entry into the United States. Every day, quarantine station staff work with Customs and Border Protection, other federal agencies, the airlines and cruise lines, and state and local public health departments to prevent the spread of infectious diseases to US communities. To commemorate the 50th anniversary, the “Then & Now: Reinventing Quarantine for Globalization” photo exhibit was displayed at CDC David J. Sencer Museum, which highlighted the historical and current activities at airports, seaports, and land borders.
Improved Emergency Response Preparedness in Africa
DGMQ’s Global Border Health Team (GBHT) advances global health security by partnering with ministries of health to improve their border health systems. In 2017, GBHT helped build sustainable preparedness and response capacities for nine West African countries and Tanzania. Their unique approach included integrating non-health staff (immigration, police, airport cleaners) into preparedness activities, which extends the public health capacity of the points of entry workforce beyond Port Health officials. Through workshops conducted at 15 airports, seaports, and ground crossings, partners developed public health emergency response plans and standard operating procedures for detection, notification, management, and referral of ill travelers.
Preventing cross-border spread of infectious diseases is a global challenge that requires coordination and communication, particularly in countries with porous land borders. GBHT worked with the countries of Cote D’Ivoire, Ghana, Togo, Benin, and Nigeria to develop a five-country memorandum of understanding to improve public health information sharing and coordination across borders to prevent disease spread. Successful implementation was demonstrated in the collaboration during a binational Lassa fever outbreak in Benin and Nigeria and a historical cholera data analysis project among Nigeria, Benin, Togo, and, later, Cameroon.
Protected Public Health through US Regulations
As seen in recent years, disease outbreaks of MERS and Ebola rapidly cross national borders and pose a direct threat to the United States. For the first time in decades, DGMQ updated the federal regulation for domestic (interstate) and foreign travel for the control of communicable diseases. The updated rule provides important clarifications regarding CDC’s regulatory authority and improves CDC’s ability to respond to disease outbreaks. The rule strikes the delicate balance of protecting the public’s health from individuals who may be infected with a quarantinable disease without compromising individual civil liberties. The final rule also requires prior informed consent before compulsory medical testing, vaccination, or medical treatment. With an estimated 3.4 billion people traveling by air each year, CDC/DGMQ meets the challenges of maintaining public health security in a globally mobile world by bolstering regulations using the best science possible.
Trained Record Number of Panel Physicians
DGMQ hosted a record number of panel physicians who gathered from around the world for the 2017 Intergovernmental Panel Physicians Training Summit. This year’s event provided training and education to more than 300 panel site staff who are involved in screening over 500,000 immigrants and 50,000 refugees who enter the United States each year. The panel physicians in attendance represented some of the largest source countries such as Mexico, China, India, Philippines, and Haiti as well as from areas of active refugee resettlements, including sub-Saharan Africa. Panel physicians conduct medical examinations for US-bound immigrants and refugees to screen for and treat communicable diseases of public health significance.
Published Key Pandemic Influenza Guidelines
Since the pandemic influenza community mitigation guidelines were released 10 years ago, CDC has engaged in a number of flu responses including the 2009 H1N1 outbreaks. Using lessons learned and new evidence from such responses, DGMQ updated the pandemic influenza guidelines, providing invaluable information for all levels of the public health system. Included in the guidelines is the evidence base to support and guide the use of nonpharmaceutical interventions (NPIs), including school closures, when facing a pandemic threat. DGMQ released Community Mitigation Guidelines to Prevent Pandemic Influenza – United States, 2017 Cdc-pdf[PDF – 36 pages], which is an essential planning tool for state, tribal, local, and territorial public health officials for early planning and preparation on pandemic influenza.
Improved Tuberculosis Treatment for International Patients
In 2017, CureTB became an increasingly integral part of CDC’s toolbox to fight antimicrobial resistance, protect communities in the United States from infectious disease, and collaborate with partners in the global fight against TB. Drawing from DGMQ’s extensive global partner network, the CureTB program improves continuity of TB care by connecting mobile patients with the TB care they need across the globe. When patients move between countries, it can be difficult for them to continue their treatment. Coordination with US and global partners and integrated care improve treatment outcomes of people crossing international borders.