To mitigate the risks posed by microbial threats of public health significance originating abroad, the Centers for Disease Control and Prevention (CDC) places small groups of staff at major U.S. airports. These staff, their offices, and their patient isolation rooms constitute quarantine stations, which are run by CDC's Division of Global Migration and Quarantine (DGMQ). Congress began to allocate funds in fiscal 2003 for the establishment of new quarantine stations at 17 major U.S. ports of entry that comprise airports, seaports, and land-border crossings. In a significant departure from the recent past, both the preexisting 8 quarantine stations and the new 17 are expected to play an active, anticipatory role in nationwide biosurveillance. Consequently, DGMQ asked the Institute of Medicine (IOM) to convene an expert committee to assess the present CDC quarantine stations and recommend how they should evolve to meet the challenges posed by microbial threats at the nation's gateways. DGMQ specifically requested "an assessment of the role of the federal quarantine stations, given the changes in the global environment including large increases in international travel, threats posed by bioterrorism and emerging infections, and the movement of animals and cargo." To conduct this assessment and provide recommendations, IOM convened, in October 2004, the Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry. At the sponsor's request, the committee released the interim letter report Human Resources at U.S. Ports of Entry to Protect the Public's Health in January 2005 to provide preliminary suggestions for the priority functions of a modern quarantine station, the competences necessary to carry out those functions, and the types of health professionals who have the requisite competences (Appendix A). This, the committee's final report, assesses the present role of the CDC quarantine stations and articulates a vision of their future role as a public health intervention.

Examines America's experience with a wide range of quarantine practices over the past 400 years and the political, economic, immigration, and public health considerations that have prompted success or failure within the evolving role of public health. The novel strain of coronavirus that emerged in late 2019 and became a worldwide pandemic in 2020 is only one of more than 87 new or emerging pathogens discovered since 1980 that have posed a risk to public health. While many may consider quarantine an antiquated practice, it is often one of the only defenses against new and dangerous communicable diseases. Tracing the United States' quarantine practices through the colonial, postcolonial, and modern eras, Germs at Bay provides an eye-opening look at how quarantine has worked despite routine dismissal of its value. This book is for anyone seeking to understand the challenges of controlling the spread of COVID-19 and helps readers internalize the lessons learned from the pandemic. Few titles provide this level of primary source data on the United States' long reliance on quarantine practices and the political, social, and economic factors that have influenced them.