SURVEILLANCE FOR PNEUMONIC PLAGUE IN THE UNITED-STATES DURING AN INTERNATIONAL EMERGENCY - A MODEL FOR CONTROL OF IMPORTED EMERGING DISEASES

In September 1994, in response to a reported epidemic of plague in Ind ia, the Centers for Disease Control and Prevention (CDC) enhanced surv eillance in the United States for imported pneumonic plague. Plague in formation materials were rapidly developed and distributed to U.S. pub lic health officials by electronic mail, facsimile, and expedited publ ication. information was also provided to medical practitioners and th e public by recorded telephone messages acid facsimile transmission. E xisting quarantine protocols were modified to effect active surveillan ce for imported plague cases at U.S. airports. Private physicians and state and local health departments were relied on in a passive surveil lance system to identify travelers with suspected plague not detected at airports. From September 27 to October 27, the surveillance system identified 13 persons with suspected plague; no case was confirmed. Th is coordinated response to an international health emergency may serve as a model for detecting other emerging diseases and preventing their importation.