CDC Proposes Modernizing Control of Communicable Disease Regulations

The Centers for Disease Control and Prevention (CDC) today proposed critical updates to existing regulations that will allow the agency to move more swiftly to control a potential outbreak of disease that may result when a sick passenger arrives in the United States via commercial airline or ship. The new proposed regulations are being published in the Federal Register for public comment.

"CDC is committed to protecting health by preventing the introduction of

communicable diseases into the United States," said CDC director Julie

Gerberding, MD, MPH. "These updated regulations are necessary to expedite and improve CDC operations by facilitating contact tracing and prompting immediate medical follow up of potentially infected passengers and their contacts."

The changes are designed to ensure that CDC has the tools in place to respond to any public health threat that may emerge. Key updates to existing regulations include:

-- Expanded reporting of ill passengers on board interstate flights as well as airline flights and ships arriving from foreign countries

-- Requirements that ships and airline flights arriving from foreign countries and certain

interstate flights maintain passenger and crew lists and submit lists electronically to CDC upon request

-- Explicit due process provisions for persons subject to quarantine

Most public health actions are voluntary because ill and infected travelers often understand the importance of keeping themselves separated from others and remaining in a safe location where they receive care. CDC's quarantine authority generally would only be used if someone posed a threat to public health and refused to cooperate with a voluntary request.

In 2003, CDC experienced a number of challenges in contacting airline passengers who may have been exposed to SARS during travel. Building on the SARS experience, CDC began increasing the number of quarantine stations and enhanced the training and response capacity of all staff. In addition, work began after the outbreak was controlled

to evaluate and analyze what changes were necessary in federal regulations to modernize control of communicable disease and quarantine regulations. Existing communicable disease regulations are outdated, have not kept up with advances in disease control measures and have not been substantially updated for more than 25 years.

The Public Health Service Act authorizes the Department of Health and Human Services (DHHS) to make regulations to prevent the introduction, transmission, and spread of communicable diseases into the United States and from one state or possession into any other state or possession. A communicable disease is one that can pass from a person or animal to another person. CDC protects Americans' health by contacting individuals who may have been exposed to a communicable disease and recommending appropriate treatments, or through public health actions including isolation and quarantine.

 HS is empowered to prevent persons who are believed to have one of nine specific communicable diseases from entering the country through the use of isolation and quarantine. Pandemic influenza is one of these nine diseases. Cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers and SARS complete the list.

CDC carries out these regulations, which can be found at 42 CFR Parts 70 and 71. The proposed regulations are available for a 60-day public comment period at www.regulations.gov and CDC and DHHS encourage the public, industry, and other stakeholders to review and comment on the proposed update.