Expanding an old weapon in the struggle against infectious disease, the US Centers for Disease Control and Prevention (CDC) has opened 10 new quarantine stations at major ports of entry in the past 18 months and plans to add several more in the coming year.
The US now has medical officers at 17 airports and at the busy border crossing in El Paso, Texas, to screen people entering the country for communicable diseases. They are particularly alert for travelers showing symptoms of the avian influenza virus that has spread across Asia and into Europe.
The avian flu strain, known as H5N1, has forced the slaughter of millions of chickens and other fowl and has caused 67 human deaths as of late last week, according to the World Health Organization. The virus, while affecting huge numbers of birds, is not yet efficiently transmitted among people. But medical authorities fear that the virus could mutate into a lethal human flu strain and touch off a global pandemic that could kill millions.
William MacKenzie, the medical officer at the CDC quarantine station at Los Angeles International Airport, said things were quiet in his small office. He receives one or two reports a week from international airlines reporting passengers with flu-like symptoms. Those travelers are examined and asked about where they had traveled and whether they had contact with live birds.
No such cases have arisen, MacKenzie said, but if one did, the passenger would not be detained but referred to a local hospital. Because there are few cases of human-to-human infection, the remaining passengers on the aircraft would not be quarantined, he said.
MacKenzie said flight crews have been told to closely monitor passengers for obvious signs of flu -- fever, sneezing, coughs -- and carry masks for sick passengers to limit the spread of airborne germs. In rare cases, he said, airlines are asked to isolate ill passengers and then escort them to quarantine officers at the airport.
But because so few people have become sick from the new avian virus, there is no aggressive surveillance of inbound air passengers, he said.
"At this point, we're not actively looking for sniffles and coughs," MacKenzie said. "Of course, that could change if there was a change in the transmission pattern and human-to-human infection becomes common."
The US' quarantine program essentially died in the 1970s with the eradication of smallpox and several other communicable diseases. But the perceived need for greater medical surveillance at US borders has gained new attention since 2001, when the anthrax attacks brought a new fear of biological terrorism.
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