US needs better quarantines to fight disease-study

Maggie Fox:

The current U.S. quarantine system does not do enough to keep out new killer diseases such as avian flu or unknown new bioterrorist threats, a panel of experts cautioned on Thursday.

They said the Centers for Disease Control and Prevention should be given broad new powers to set up and enforce quarantine stations and to monitor for imported infections.

Hundreds more people need to be trained to watch at ports of entry for people who may be carrying diseases, the Institute of Medicine Committee said.

"What happens if you get SARS or have a pandemic or a big outbreak occurs somewhere and you need a big capacity very quickly? That is going to require a lot more planning than is occurring today," Dr. Georges Benjamin, head of the American Public Health Association and chair of the committee that wrote the report, said in a telephone interview.

"They need a lot more resources to do this. This is really an insurance plan that is underfinanced and undersupported."

The report called for an updated approach to a system that is still based on immigration and travel patterns of nearly a century ago.

"In the 1930s and '40s, when people came in, most of them came in by boat. They came in through very few ports," Benjamin said. "If they had an incubating disease, it often would incubate while they were on the ride over here."

Now, with jet travel, a person infected with smallpox, avian flu or Ebola could have landed and traveled to anywhere in the country before becoming ill -- spreading their infection all along the way.

The CDC and other experts have been warning of this danger for years and the panel said it is time to act.

The report said 120 million people travel in and out of the United States each year. The CDC staffs 11 quarantine stations but will have 15 by the end of the year.

"We have 474 ports of entry and 40 people," Benjamin said.

He said the CDC would be able to spread its thin resources better by training surrogates, such as customs and security personnel, airline staff and others, to screen.

They also need updated methods, the report says.

"Quite frankly right now, how they identify who is sick is they stand at the causeway where people get off the plane and look for sick people," Benjamin said.

He said there is still a role for such old-fashioned surveillance.

"People hide monkeys under their shirts, believe it or not," Benjamin said. "They bring in rats and rodents, pets in with them. Sometimes they bring them in for food from countries they are coming from."

But health screeners also need up-to-date computer information, access to travel medical records and to seating charts so they can easily trace those who have been close to someone who turns out to have an infection, Benjamin said.

"Over the years we have had two things happen -- the belief that the infectious threat has gone, with the result that resources have dwindled away," he said. "And the environment has changed and we are now looking at emerging infectious threats and bioterrorism."

These include severe acute respiratory syndrome or SARS, which emerged in China in 2002 and swept to several countries around the world via jet, infecting 8,000 people and killing around 800 before it was stopped with strict quarantines.

The H5N1 avian flu in considered another potential threat should it pass easily into humans, and experts fear bioterrorists could use smallpox or other infections.

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