1. Surveillance and Response to Imported Infectious Disease
Gabe Palumbo, MBA, MPH
Officer in Charge
CDC Detroit Quarantine Station
CENTERS FOR DISEASE CONTROL & PREVENTION Division of Global Migration and Quarantine (DGMQ)

2. CDC Quarantine Stations
2007 Jurisdictions AK ME
Seattle
Minneapolis
Anchorage
Chicago VT NH WA MT ND
Detroit MA
Boston MN NY RI CT CT WI MI
New York OR ID SD PA NJ
Newark WY MD DE IA
Philadelphia OH NE
No.CA IN WV IL NV
Washington, D.C.
San Francisco VA UT CO MO KY KS NC TN
So.CA OK
Dallas SC AR
Atlanta
Map of the 20 Quarantine Stations
CDC has been expanding the Q System from 8 stations in 2004 to 20 currently
The Detroit Station ahs responsibility for 3 states and all ports of entry in those states
Los Angeles AZ NM
North TX AL MS GA
San Diego
West TX
East TX LA
El Paso FL
Houston
Miami
Honolulu GU HI PR
San Juan
CDC Quarantine Station

3. Migration and Health Strategy
Division of Global Migration and Quarantine
Travelers’
Health
Zoonoses
Team
Africa and
Americas
Region
Migration and Health Strategy
Asia & European Region
The Division has three main branches which includes
Geographic medicine and health promotion ( travelers health and zoonoses)
2) immigrant , refugee and migrant health and
3) Quarantine and border health service branch under which fall the quarantine station .
Notice that in 2004 there were only 8 QS’s.
By Dec of 2005, there are now 18 QSs
All branches collaborate with each other to fulfill the mission of the Division
Quarantine Stations
8 in 2004
20 in 2007

4. Our Mission
… To protect the health of the public from communicable diseases through science, partnerships, and response at U.S. ports

5. Accomplishing Our Mission (42 CFR Parts 70 and 71)
Regulate importations
Process migrant documentation
Respond to notification of illness in international travelers

6. Quarantine Diseases Executive Order of the President 13295
CHOLERA
DIPTHERIA
INFECTIOUS TB
PLAGUE
SMALLPOX
YELLOW FEVER
VIRAL HEMORRHAGIC FEVERS
SARS
NOVEL OR RE-EMERGENT INFLUENZA

7. Definitions Isolation:
Separation of ill persons with contagious disease
Often in a hospital setting
Applied to individual or group level

8. Definitions (cont.) Quarantine
Restriction of well persons presumed exposed
Applied at the individual or community level
May be voluntary or mandatory

9. Responding to Illness Passive surveillance:
We wait for notification of illness from-
Airline / vessel pilots
Federal partners
Police, fire, EMTs
Health departments
Family, work colleagues

10. Responding to Illness (cont.)
Active surveillance:
We wait at arrival of each conveyance and visually examine each traveler
Interview those who are ill
Continue to respond to reports of illness

11. Responding to Illness (cont.)
Evaluation of ill person:
Identify symptoms and travel itinerary
Determine if ill person should be isolated and further evaluated
Identify potentially exposed travelers

12. Symptoms of Interest Fever (> 100° F)
Rash (smallpox, measles, etc.)
Severe diarrhea (cholera)
Glandular swelling (plague)
Jaundice (yellow fever)
Stiff neck (meningitis)
Unusual bleeding (viral hemorrhagic fevers)
Respiratory distress (SARS, pan flu)

13. Notification
DGMQ notifies state and local health authorities if ill travelers sent to hospital
DGMQ identifies all travelers potentially exposed to the ill passenger

14. Online Resources
Division of Global Migration and Quarantine:
Centers For Disease Control and Prevention: l

15. Quarantine Medical Officer
DGMQ Staff in Detroit
Gabe Palumbo, MBA, MPH
Officer in Charge
Tel:
Curi Kim, MD, MPH
Quarantine Medical Officer