September 1, 2005

US needs better quarantines to fight disease-study

By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - 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

"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.