• Military
• WMD
• Intelligence

• Security Menu                     

• Systems
• Industry
• Operations
• Hot Documents
• News
• Reports
• Policy
• Budget
• Congress
• Links

• Space

Early Warning Infectious Disease Surveillance (EWIDS)

Program Activities on the Northern and Southern Border States

In 2003, the Department of Health and Human Services (HHS) designated $5 million per year to be allocated to the northern and southern states bordering Canada and Mexico for the Early Warning Infectious Disease Surveillance System. The existing Centers for Disease Control (CDC) Public Health Emergency Preparedness Cooperative Agreement is the funding mechanism for the twenty states that have chosen to participate. Twenty of the 21 border states participate in EWIDS (Illinois chose not to participate).

The goal of EWIDS was to improve cross-border activities in early detection, identification, and reporting of infectious diseases associated with potential bio-terrorism agents or other major threats to public health.

EWIDS Objectives were to:

• Detect, identify, and report outbreaks of infectious diseases (whether terrorist-induced or naturally occurring)
• Conduct epidemiological investigations
• Develop laboratory capability to rapidly identify and characterize biological agents
• Share clinical, laboratory and epidemiological information electronically with public health officials in neighboring jurisdictions (both Mexican and U.S.)
• Train public health personnel in surveillance and epidemiology

The Early Warning Infectious Disease Program (EWIDS) was a unique collaboration of state, federal and international partners who collaborate to provided rapid and effective laboratory confirmation of urgent infectious disease case reports in the border regions of the United States, Canada, and Mexico. Activities can include assessing surveillance and laboratory capacity on each side of the international border, improving electronic sharing of laboratory information, maintaining a database of all sentinel/clinical labs, and work to develop and agree on a list of notifiable conditions. However, the states decided to expand beyond laboratory and epidemiology issues that include working on cross border Memoranda of Understanding (MOUs), pandemic influenza tabletop exercises, expanding the Health Alert Network (HAN) into Canada and cross-training in laboratory procedures. There were many issues surrounding working with countries on our borders, including stockpiling prophylaxis medications, quarantine and movement of documented workers into their home country in the event of a public health emergency.

Since the inception of EWIDS, many states have chosen to group into regions to work with their Canadian and Mexican counterparts in order to maximize the funding they were given to complete activities. On the northern border, the Northwest and Great Lakes groups have made significant progress in accomplishing capacities outlined in the CDC Cooperative Agreement. The Pacific Northwest alliance (Alaska, Idaho, Washington, Montana and North Dakota) hosted their Second Cross Border Meeting in April 2005 in Vancouver, Canada. During the first cross border workshop in Bellingham, Washington in August, 2004, workgroups were formed to address surveillance, laboratory, communication, information technology and legal issues. These cross border workgroups conduct regular conference calls to report progress on formulated goals and measures of effectiveness. The Draft Summary Report for the April 18-20, 2005 workshop was completed and distributed to the Department Of Health and British Columbia Center for Disease Control leadership. The cross border workshop follow-up issues included a plan for identifying workgroup leads and tasks. The next conference will be hosted by Washington State in April 2006.

• The Great Lakes Border Health Initiative was finalizing a Guiding Work plan which was requested by the Ontario Ministry of Health and Long-Term Care. The Legal Subcommittee was continuing its efforts to develop a formal agreement on cross border activities. Planning included a data sharing agreement as the first step in resource sharing between the States and Province. The Second Great Lakes Border Health Initiative Conference occurred in September 2005. Part of the conference included a Pandemic Influenza Binational Tabletop Exercise.
  
• The southern border states agreed during the last Cooperative Agreement application process to work more closely as a region. California has been working with laboratories in Mexico for several years, with the focus to ease transport of laboratory samples across the border. The first US-Mexico Border Health and Infectious Disease Conference occurred in El Paso, Texas in July 2005. This conference included the US-Mexico Binational Commission Core Group on Epidemiologic Surveillance. The Core Group was working on a draft of binational outbreak investigation protocols and legal ramifications. The draft report covered existing laws in California and across the border, but many states did not yet have laws regarding cross border outbreaks.
• The southern-border states that have had the opportunity to work with Mexico for several years through another funding source, were working on cross border protocols for outbreaks. The northeastern states of Maine, New Hampshire, New York and Vermont hosted a meeting with Canadian partners from New Brunswick, Nova Scotia and Quebec in Burlington, Vermont in late March 2006. A tabletop exercise was conducted using a food borne outbreak scenario.