U. S. Quarantine Stations

What's the Problem?

With 1 billion people traveling internationally and nearly 215 million people entering the United States each year, nowhere in the world are we remote or disconnected from each other. A person with a serious contagious disease can travel the globe and within 24 hours potentially infect other travelers and communities

Who's at Risk?

Other travelers and U.S. communities may be at risk if a person with a contagious disease travels. A single ill traveler can expose others on a plane or a ship and set off a chain of events that can rapidly infect others across the country. Travelers can carry emerging diseases, such as a new strain of influenza, or diseases that do not typically occur in the United States, such as measles which has been eliminated in the United States since 2000. This is why the U.S. Quarantine Stations are so important.

What are U.S. Quarantine Stations?

U.S. Quarantine Stations, managed by the Centers for Disease Control and Prevention’s (CDC) Division of Global Migration and Quarantine (DGMQ), are part of a comprehensive quarantine system that serves to delay or limit the introduction and spread of serious contagious diseases in the United States. The quarantine system includes a network of U.S. federal agencies, travel industry, medical and public health professionals, and international authorities.

There are 20 quarantine stations located at U.S. ports of entry (POEs) where 85% of international travelers arrive. These stations work 24/7 with partners to respond to reports of ill travelers who have serious diseases that could spread to others. They connect newly arrived immigrants who have certain health conditions with state and local public health authorities. Station staff ensure safe importation of animals and cargo that could spread diseases to humans. And some quarantine stations also send life-saving drugs that are only available through CDC to patients with botulism, malaria, and diphtheria.

Can It Be Prevented?

Most of the time, yes. Medical and public health officers at U.S. Quarantine Stations work every day to prevent importation of disease. They plan and prepare for emergency response; respond to reports of illnesses on airplanes, ships, and at land-border crossings; and inspect CDC-regulated animals, animal products, and human remains that pose a potential threat to human health.

Although seldom used, DGMQ has the authority to isolate or quarantine travelers if they are infected with or exposed to one of nine quarantinable diseases to protect the health of the U.S. public. Quarantinable diseases are defined by an Executive Order of the President: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, Severe Acute Respiratory Syndrome, new types of flu (influenza) that could cause a pandemic, and any communicable disease that has been designated by the President under Executive Order.

Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Quarantine is used to separate and restrict movement, for a specific length of time, of well persons who have been exposed to a communicable disease to see if they become ill. Isolation and quarantine both help to limit the spread of communicable disease.

The Bottom Line

• The mission of CDC’s Division of Global Migration and Quarantine is to delay or limit the introduction and spread of serious contagious diseases in the United States.
• Federal regulations require that the captain of a plane or ship report any deaths or ill persons with certain signs and symptoms to CDC before arriving into the United States. CDC staff at U.S. Quarantine Stations assess whether the illness is a serious contagious disease.
• CDC also works with other partners such as U.S. Customs and Border Protection, emergency medical services, and health departments to receive notifications of ill travelers.
• Although seldom used, isolation and quarantine can help to limit the spread of quarantinable diseases. These diseases are defined by Executive Order of the President.
• CDC Quarantine Station staff work 24/7 to ensure that travelers exposed to a serious contagious disease are notified and receive the necessary medications or vaccines to prevent infection.

Case Example

Time is of the essence when measles is concerned. Responding to a measles outbreak can involve working 24/7. Measles is a highly contagious disease and can cause severe illness, even death.

California public health officials notified the Los Angeles Quarantine Station that an unvaccinated 15-year-old refugee from Malaysia was diagnosed with measles. The teenager was contagious during air travel. Thirty refugees who traveled from Malaysia on the same flight and 35 passengers who sat near the ill teenager were now scattered over 12 states.

The CDC Los Angeles Quarantine Station quickly coordinated with internal CDC partners, state and local health departments, Customs and Border Protection, the airline, and the International Organization for Migration to find other refugees and passengers who may have been exposed during travel. Six additional measles cases were identified as a result of this investigation. The Los Angeles Quarantine Station’s swift response in orchestrating the work with many partners helped contain what could have been a more widespread outbreak of measles.