OBJECTIVES

1. Be able to understand the history of quarantine and its evolution.
2. Be able to explain "Geosentinel" and its role as a tool to monitor the global occurrence of emerging infectious diseases in mobile populations.
3. Be able to understand the role and value of medical screening for immigrants and refugees coming into the US and understand what is meant by "enhanced refugee health assessments."

INTRODUCTION

The title of this talk is "The Changing Faces of Quarantine," in fact the changing nature of quarantine. The first part is a summary of the history of quarantine to give a sense for its evolution--how it started, what it is, where it has been. Then we will talk about emerging infections and the impact of global migration on emerging infectious diseases. Finally, part three is a wrap up in which you will get to interpret for yourselves if we have done a good job of where quarantine should be in the next millennium.

A reference that I highly recommend to you, for those of you who are interested in medical history, is a book called Quarantine by Howard Markel. It offers a perspective on quarantine from the perspective of immigrants who came to the US between 1910 and 1930, mostly poor, eastern European immigrants. Various scourges hounded them as they came over; the migration of that group actually played a major part in consolidating the US Federal quarantine laws. The first series of slides on the history of quarantine include a number of slides from a colleague, David Rogers, who has been with the Quarantine Division for a long time in the Program Operations Branch.

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