Emergency Response

Graphic of International Travel

DGMQ prevents the importation and spread of infectious diseases into the United States through its regulatory authority. This authority allows DGMQ to focus on public health preparedness as well as respond to health emergencies. Quarantine station staff have the critical job of responding to sick travelers moving through ports of entry. They also monitor certain cargo that might harbor communicable disease – for example, dogs, human tissues, as well as monkeys and other nonhuman primates. With this infrastructure, DGMQ is prepared to expand these services in emergency responses that may require additional activities at ports of entry.

For the past 50 years, DGMQ’s comprehensive quarantine system has been on the front line of public health to protect the United States from communicable disease threats, both foreign and domestic.

DGMQ’s Day-to-Day Activities

Protects public health with the support of 20 quarantine stations located at the busiest US international airports, land borders, and seaports, as well as covering over 300 ports of entry across the United States. For example, quarantine stations

  • Respond to sick travelers who arrive in the United States
  • Restrict the importation of animals and products that may carry diseases
  • Send lifesaving drugs on the next flight to hospitals caring for patients with diseases such as malaria, botulism, or diphtheria.
  • Alert travelers at airports about disease outbreaks abroad and steps they can take to protect themselves and others.

DGMQ’s daily work – including the quarantine station network and traveler education – equips DGMQ to respond to public health emergencies. DGMQ is uniquely positioned and prepared to respond during a major public health emergency by enhancing its normal operations and activities. DGMQ’s ability to coordinate with its network of partners to identify and manage potential health threats, allows the division to prevent disease importation. This network also helps us respond quickly to any infectious disease outbreak that threaten the health of people throughout the world. Keeping people healthy abroad also keeps Americans healthy. Stopping outbreaks where they start and helping countries prevent diseases from spreading across their borders, protects against potential outbreaks in the United States. Here are a few examples of DGMQ’s role in CDC’s efforts to respond to public health emergencies in the United States and around the world.

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COVID-19

Airport worker using a forehead thermometer to check a passenger's temperature during the 2014 Ebola outbreak in West Africa

DGMQ was one of the first programs called in to assist with an outbreak of pneumonia of unknown cause in China in January 2020. Since then, the response to the COVID-19 pandemic, caused by a previously unknown coronavirus, has become CDC’s largest and most complex response to date.

Throughout the response, DGMQ has helped protect travelers and other mobile populations and has reduced the public health risk of COVID-19’s spread associated with rapid global travel. Initiatives include providing guidance, recommendations, and requirements; educating travelers and migrant populations; working with international, federal, state, tribal, local, territorial, and industry partners; and protecting the health of immigrants, migrants, refugees, and communities along U.S. borders.

DGMQ Emergency Response Activities

  • Established public health guidance on the management of domestic and international travelers with potential COVID-19 exposure.
  • Published guidance for domestic and international travelers on how to protect themselves and others before, during, and after travel.
  • Posted Travel Health Notices to alert travelers and other audiences to COVID-19 health threats around the world and advise them on how to protect themselves — more than 1,000 such notices were posted between January 2020 and June 2021.
  • Issued orders and regulatory actions including
  • Stood up, staffed, and conducted public health entry screening for 766,044 air passengers coming to the United States from January through September 2020. Deployed 100 responders in 48 hours, plus 500 additional responders sent to U.S. quarantine stations to support public health entry screening.
  • Launched the COVID-19 Travel Planner to help travelers learn about travel recommendations and requirements at their U.S. destinations, make informed decisions, protect themselves, and reduce virus transmission before, during, and after domestic travel.
  • Developed extensive messaging, including Travel Health Alert Noticespdf icon [PDF, 617K] given to international travelers arriving at major U.S. airports (over 6 million distributed), messages on digital airport monitors, public service announcements for travelers, toolkits for road travel and airline partners, and resources in more than 30 languages to reach people in their native languages.
  • Worked to protect newly resettled and long-term resident refugees, immigrants, and migrants, including agricultural workers, and to provide them with culturally and linguistically appropriate resources.

Ebola

Airport worker using a forehead thermometer to check a passenger's temperature during the 2014 Ebola outbreak in West Africa

The 2014 – 2016 Ebola epidemic in West Africa was one of the most challenging global public health emergencies in recent times. The Ebola outbreak spread to more than nine countries, gave rise to 27,000 suspected cases, and led to more than 11,000 deaths. As part of CDC’s emergency response, DGMQ focused on health screening, monitoring, and outreach to travelers after their trips to West Africa. DGMQ’s quarantine stations at airports throughout the country played a critical role.

DGMQ Emergency Response Activities

  • Recommended that Americans avoid all nonessential travel to the three countries most affected by the Ebola epidemic
  • Worked with airports and federal authorities to divert passengers coming from countries with Ebola outbreaks to five US airports, thus streamlining response efforts
  • Trained US Customs and Border Protection staff at airports to screen people travelling from outbreak countries for signs and symptoms of Ebola or possible exposures
  • Developed the CARE (Check and Report Ebola) program to help travelers monitor and report health concerns for 21 days after they left a country with Ebola outbreaks. DGMQ and US Customs and Border Protection distributed CARE Kits to these travelers, providing them with tools and information to help them successfully complete the required monitoring.

Zika

Healthcare worker providing patient education about Zika to a mother and her child.

During 2015-2016, the Zika virus emerged as the first major infectious disease discovered in the last 50 years to be linked to serious birth defects. Many areas in the United States have a type of mosquito that can become infected with Zika virus and then spread it to people. As part of CDC’s emergency response efforts, DGMQ focused on traveler outreach, particularly for pregnant travelers and their partners. DGMQ’s quarantine stations in areas potentially affected by Zika (US continent and territories) enhanced activities to reduce the risk of the disease’s spread, relying heavily on building partnerships with local governments and organizations.

DGMQ Emergency Response Activities

  • Posted 57 travel notices with information on how to prevent spread of Zika before, during, and after travel
  • Increased traveler outreach through interactive maps, risk assessment tools and text messaging systems.
  • Developed extensive airport messaging for travelers, targeting pregnant travelers and travelers whose partners were pregnant
  • Partnered with the US Olympic Committee to provide targeted traveler communication materials and conduct risk analyses that predicted which countries were at greatest risk of Zika importation from Brazil following the 2016 Olympic and Paralympic Games
  • Focused on areas of the United States that were at higher risk of Zika spreading, such as the US-Mexico border and Puerto Rico, by working with community health workers to alert and teach people who often travel through these areas about their risk for Zika.

H1N1

Image of Influenza Virus H1N1

The 2009 H1N1 virus caused the first flu pandemic in the United States in more than 40 years, with higher rates of hospitalizations in children and young adults than previous seasons. As part of CDC’s emergency response, DGMQ collaborated with state and local health departments to stop the spread of flu. Recommended strategies included temporarily closing child care centers, schools, places of worship, sporting events, concerts, festivals, conferences, and other settings where people gather, as well as hand washing and staying home when sick.

DGMQ Emergency Response Activities

  • Conducted more than 16 investigations throughout the United States and internationally to understand people’s behaviors during flu outbreaks. Investigations involved administering surveys in schools, at ports of entry, and with travelers to the Hajj (the annual Islamic pilgrimage to Mecca, Saudi Arabia), where H1N1 was a potential threat
  • Distributed fact sheets, posters, and tool kits about how nonpharmaceutical interventions could reduce the spread of flu in US schools, workplaces, and communities
  • Organized an award-winning nationwide public awareness campaign to increase public awareness on ways to prevent the spread of flu during travel. Learn more about this and other accomplishments here.
  • Updated the Community Mitigation Guidelines to Prevent Pandemic Influenza – United States, 2017 pdf icon[PDF – 36 pages], to incorporate lessons learned from the H1N1 response. These guidelines serve as a planning tool for local and state health departments in their preparedness efforts for managing any future influenza pandemics.