Division of Global Migration Health
 | This page in a nutshell: U.S. government agency responsible for U.S. Quarantine Stations and issuing quarantine orders |
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The Division of Global Migration Health (DGMH), formerly the Division of Global Migration and Quarantine is the part of the U.S. government responsible for U.S. Quarantine Stations and issuing quarantine orders. It is part of the National Center for Emerging and Zoonotic Infectious Diseases within the Centers for Disease Control and Prevention (CDC).
The U.S. Quarantine Stations work at 20 major ports of entry where most international travelers arrive, to help prevent contagious diseases from entering and spreading through the United States. Because of US federal regulations, pilots of ships and planes must report to CDC any illnesses and deaths before arriving into the United States. Quarantine public health officers work with U.S. Customs and Border Protection and emergency medical services to also detect sick travelers entering the country. Quarantine officers also screen imported animals and biologics to ensure safety from diseases dangerous to humans.
Mission
The mission of the Division of Global Migration Health is to keep Americans safe by protecting public health at ports of entry, ensuring the health of travelers, and preventing the introduction, transmission, and spread of communicable diseases. DGMH works to detect, respond to, and control health threats associated with global migration."About DGMH". Centers for Disease Control and Prevention. https://www.cdc.gov/ncezid/dgmq/about.html.
Parent organization
DGMH is housed within the National Center for Emerging and Zoonotic Infectious Diseases at the CDC, which itself is part of the U.S. Department of Health and Human Services."National Center for Emerging and Zoonotic Infectious Diseases". Centers for Disease Control and Prevention. https://www.cdc.gov/ncezid/index.html.
Legislation
The Division was established under the broader framework of the Public Health Service Act of 1944, which grants the CDC the authority to manage public health at national borders."Laws and Regulations". Centers for Disease Control and Prevention. https://www.cdc.gov/quarantine/laws-regulations.html.
Partners
- U.S. Customs and Border Protection for coordination at ports of entry.
- Department of Homeland Security for immigration health screenings.
- International health organizations like the WHO for global health security.
Number of employees
DGMH employs approximately 150 staff members, including public health officers, medical officers, and support staff."Contact Us". Centers for Disease Control and Prevention. https://www.cdc.gov/ncezid/dgmq/contact.html.
Organization structure
DGMH's structure includes:
- Quarantine and Border Health Services Branch for managing health at ports of entry.
- Immigrant, Refugee, and Migrant Health Branch for health screenings and vaccinations.
- Emergency Response and Surveillance Branch for monitoring and responding to health threats.
Leader
The Division is led by a Director.
Divisions
- Quarantine and Border Health Services for preventing disease importation.
- Immigrant, Refugee, and Migrant Health for health assessments of newcomers.
- Emergency Response for rapid response to public health emergencies.
List of programs
- U.S. Quarantine Stations at major ports of entry.
- Medical Examination Program for immigrants and refugees.
- Global Migration and Quarantine Information System (GMQIS) for data management.
Last total enacted budget
The budget for DGMH is not detailed separately but is part of the CDC's overall budget, which was $11.8 billion for FY 2023."FY 2023 CDC Budget Overview". Centers for Disease Control and Prevention. https://www.cdc.gov/budget/documents/fy2023/fy-2023-cdc-budget-overview.pdf.
Staff
Staff includes quarantine officers, epidemiologists, medical officers, and administrative support, all focused on border health and global migration health.
Funding
Funding for DGMH comes through the CDC's budget, allocated by Congress, and is used for operational costs, staff salaries, and emergency response capabilities.
Services provided
DGMH provides quarantine services at U.S. ports, conducts medical examinations for immigrants and refugees, responds to public health emergencies related to travel, and engages in disease surveillance to prevent outbreaks. They also work on health education for migrants and border communities."Programs and Services". Centers for Disease Control and Prevention. https://www.cdc.gov/ncezid/dgmq/programs-services.html.
Regulations overseen
While DGMH does not directly oversee regulations, it operates under the legal framework provided by the Public Health Service Act, including regulations related to quarantine and the medical examination of aliens.
Headquarters address
1600 Clifton Road, Atlanta, GA 30329
History
The Division of Global Migration Health evolved from the Division of Global Migration and Quarantine, with its roots tracing back to the Public Health Service's historical roles in border health management, adapting over time to modern migration patterns and health challenges."About DGMH". Centers for Disease Control and Prevention. https://www.cdc.gov/ncezid/dgmq/about.html.
Early History
Until the 1870s, quarantines were under state and local control. In 1879, the federal government established a National Board of Health with national quarantine authority. It contained equal representation from the three government organizations with medical officers: the Army, the Navy, and the Marine Hospital Service. In 1883, the law authorizing the National Board of Health expired, and quarantine authority devolved solely to the Marine Hospital Service.[1]
In 1899, the Marine Hospital Service split itself into divisions for the first time, and the Division of Foreign Quarantine was created. The Marine Hospital Service changed its name to the Public Health Service (PHS) in 1912 to reflect its expanding scope.[2] In 1943, PHS collected its divisions into three operating agencies, and the Division of Foreign Quarantine became part of its Bureau of Medical Services.[2][3] The 1944 Public Health Service Act enacted the legislation regarding federal quarantine procedures that, with minor amendments, is still in effect as of 2021.[4]
As part of the PHS reorganizations of 1966-1973, the Division of Foreign Quarantine was taken over by the Centers for Disease Control and Prevention (CDC) in 1967.[5][6] At that time there were 55 quarantine stations, present in every port, international airport, and major border crossing. Because of the decline of communicable diseases throughout the twentieth century, the focus was shifted from routine inspections to program-level management, and the number of quarantine stations decreased to seven in 1995.[7] This was the result of a belief that infectious diseases had largely been vanquished by antibiotics and vaccines, and that attention should be focused on chronic diseases such as cancer and heart disease.[8]
In the late 1990s, there was growing recognition of factors that had increased the risk of infectious disease in the prior decades, including high-volume international travel, global urbanization and population growth, increased interaction between humans and wildlife, antimicrobial resistance, and bioterrorism concerns.[8] In 2000, domestic interstate quarantine authority for humans was transferred from the Food and Drug Administration (FDA) to CDC, which FDA had had since the late 1960s, although FDA still retained domestic interstate quarantine authority over animals and other products.[4] After the 2002–2004 SARS outbreak, CDC reorganized the system, creating the Division of Global Migration and Quarantine and expanding to 20 stations.[7]
Activities
U.S. Quarantine Stations are staffed with public health and medical officers from the Quarantine and Border Health Services Branch of the Division of Global Migration and Quarantine. They usually consist of a small group of staff, office space, and patient isolation rooms.[8]
Human health
When illnesses are reported to CDC at ports of entry, quarantine officers are the first responders. They assess health situations with the goal of both protecting communities from disease spread and directing sick travelers to appropriate care. These officers decide whether sick travelers can enter the United States or continue to travel. Quarantine officers collect medical information from new arrivals, including immigrants, refugees, parolees, and asylees and inform local health departments in their destination locations about health issues that need follow-up.[9]
Medical inadmissibility can be based on four conditions: a communicable disease of public health significance, a physical or mental disorder with harmful behavior, drug abuse or addiction, or, for immigrant visa applicants, lack of required vaccinations. These are further divided based on a physician panel into Class A conditions that require a waiver for admission, and Class B conditions do not preclude admission but require follow-up.[8][10]
CDC works closely with airline and ship companies that transport people and cargo to the U.S. ports of entry. Quarantine officers coordinate with airlines, cruise lines, and port officials to investigate illness reports and track the spread of disease. For example, if a sick passenger is on a flight, CDC will work with the airlines, U.S. Customs and Border Protection, and health departments or international ministries of health to contact travelers who were exposed to the sick person as per CDC’s disease protocols. This is known as a contact investigation.[11]
Certain quarantine stations respond to emergency requests from hospitals to provide certain unavailable emergency drugs for botulism, malaria, and diphtheria. Quarantine officers also work with port partners to plan and prepare emergency responses and for mass migration emergencies.[9]
Quarantinable diseases
As a federal agency under the US Department of Human and Health Services, CDC can legally detain, medically examine, and release a person who may have a contagious disease that is quarantinable. Quarantinable diseases are determined by Executive Order of the US President. As of 2020 there are nine quarantinable diseases:[7][8][12]
- Cholera
- Diphtheria
- Infectious tuberculosis
- Plague
- Smallpox
- Yellow fever
- Viral hemorrhagic fevers (such as Ebola)
- Severe acute respiratory syndromes (such as SARS, MERS, and COVID-19)
- Types of flu (influenza virus) that could cause a pandemic
Several vaccine-controllable diseases are not on the list, including measles, mumps, rubella, and chickenpox.[7]
Based on their health assessments, quarantine officers may stop travelers from entering the United States or from continuing to travel, or send them to a hospital for treatment, or connect with a local or state health department for follow up.[12]
Cargo
Quarantine officers routinely monitor animals and cargo entering the United States that may pose a risk to public health. They inspect live animals, including dogs, cats, monkeys, bats, turtles, ticks, mosquitoes, snails, and civets. CDC also regulates the import of animal products like bushmeat, hunting trophies, untanned goat skin drums, and uncured leather. Biological research samples, blood and tissue samples, and human remains are also screened for disease.[13][14]
Locations
The 20 Quarantine Stations are located at major ports of entry where most international travelers enter the country. Two stations, El Paso and San Diego, are located at land-border crossings, while the other 18 are at international airports. Each station is responsible for all the ports of entry in its assigned region, in addition to the major port where it is located.[9]
- Anchorage
- Atlanta
- Boston
- Chicago
- Dallas
- Detroit
- El Paso
- Honolulu
- Houston
- Los Angeles
- Miami
- Minneapolis
- New York
- Newark
- Philadelphia
- San Diego
- San Francisco
- San Juan
- Seattle
- Washington, D.C.
External links
References
- ↑ Smillie, W. G. (1943-08-01). "The National Board of Health 1879–1883". American Journal of Public Health and the Nation's Health 33 (8): 925–930. doi:10.2105/ajph.33.8.925. ISSN 0002-9572. PMC 1527526. PMID 18015860. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1527526/.
- ↑ 2.0 2.1 "Records of the Public Health Service [PHS, 1912–1968"] (in en). 2016-08-15. https://www.archives.gov/research/guide-fed-records/groups/090.html.
- ↑ "Reorganization and functions of the Public Health Service". United States Senate. 1943. pp. 4–6. https://archive.org/details/reorganizationfu00unit/page/4.
- ↑ 4.0 4.1 Shen, Wen W. (2021-04-13). "Scope of CDC Authority Under Section 361 of the Public Health Service Act (PHSA)". pp. 4–5, 11–12. https://crsreports.congress.gov/product/details?prodcode=R46758.
- ↑ "Images From the History of the Public Health Service: Disease Control and Prevention, Fighting the Spread of Epidemic Diseases". 2012-01-16. https://www.nlm.nih.gov/exhibition/phs_history/fighting.html.
- ↑ "History of Quarantine" (in en-us). 2020-07-20. https://www.cdc.gov/quarantine/historyquarantine.html.
- ↑ 7.0 7.1 7.2 7.3 Cliff, Andrew; Smallman-Raynor, Matthew (2013-04-11) (in en). Oxford Textbook of Infectious Disease Control: A Geographical Analysis from Medieval Quarantine to Global Eradication. OUP Oxford. pp. 71–73. ISBN 978-0-19-959661-4. https://books.google.com/books?id=AqhDZkWJjPQC&pg=PA71.
- ↑ 8.0 8.1 8.2 8.3 8.4 (in en) Quarantine Stations at Ports of Entry: Protecting the Public's Health. National Academies. 2005-09-01. pp. 14, 22–23, 28–29. ISBN 978-0-309-09951-6. https://www.nap.edu/catalog/11435/quarantine-stations-at-ports-of-entry-protecting-the-publics-health.
- ↑ 9.0 9.1 9.2 "U.S. Quarantine Stations" (in en-us). 2019-04-24. https://www.cdc.gov/quarantine/quarantine-stations-us.html.
- ↑ Sanford, Christopher A.; Jong, Elaine C. (2008-08-05) (in en). The Travel and Tropical Medicine Manual E-Book. Elsevier Health Sciences. pp. 294. ISBN 978-1-4377-1069-4. https://books.google.com/books?id=gAz-_hBG90sC&pg=PA294.
- ↑ "Protecting Travelers' Health from Airport to Community: Investigating Contagious Diseases on Flights" (in en-us). 2019-05-14. https://www.cdc.gov/quarantine/contact-investigation.html.
- ↑ 12.0 12.1 "Legal Authorities for Isolation and Quarantine" (in en-us). 2020-02-24. https://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html.
- ↑ "Bringing Animal Products to United States" (in en-us). 2019-12-04. https://www.cdc.gov/importation/animal-products.html.
- ↑ "Bringing an Animal into U.S." (in en-us). 2020-02-14. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/index.html.