Public health surveillance using emergency medical service logs - U.S.--Mexico land border, El Paso, Texas, 2009.

In 2008, approximately 358 million travelers entered the United States, of whom 206 million arrived via land ports of entry (POEs) on the U.S.--Mexico border. Effective response to infectious diseases of public health importance among travelers requires timely identification and reporting to state and federal health authorities. Currently, notifications are made primarily by U.S. Customs and Border Protection (CBP) officers to CDC quarantine stations. However, CBP personnel have competing priorities and limited public health training.To evaluate the utility of monitoring emergency medical service (EMS) dispatch and response logs for ill travelers with symptoms or signs suggestive of infectious diseases, CDC screened medical records of patients transported by EMS during 2009 from the four POEs in El Paso, Texas. The screening was conducted using commercial software that monitors EMS logs and sends alerts in real time based on preestablished criteria (i.e., records containing keywords suggesting infectious diseases). Records that met the criteria were forwarded to El Paso Quarantine Station personnel and reviewed within 24 hours. If a reportable infectious disease was suspected, the final diagnosis was requested from the receiving hospital.This report summarizes the results of the evaluation, which found that, of 50,779 EMS responses in the city of El Paso, 455 (0.9%) records met alert criteria, 86 (0.2%) needed diagnostic confirmation, and nine (<0.1%) were for reportable infectious diseases. Monitoring EMS logs can enhance detection of travelers with serious infections at POEs but requires additional screening and follow-up by CDC.