CDC's Legal Authority to Keep Diseases Out of the United States

What to know

• The Public Health Service Act gives the Department of Health and Human Services (HHS) — and, by delegation, CDC — authority to make regulations to prevent communicable diseases from entering or spreading within the United States.
• The Immigration and Nationality Act (INA) gives HHS and CDC authority to set rules for the medical examination of immigrants and refugees who intend to live permanently in the U.S.
• CDC's Division of Global Migration Health (DGMH), part of the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), carries out these authorities.

What the regulations let CDC do

DGMH administers interstate and foreign quarantine regulations, including public health work at U.S. ports of entry, and sets requirements for immigrant and refugee medical exams. Under them, CDC can:

• write medical screening protocols for the physicians who examine immigrants and refugees before they are admitted;
• restrict imports that threaten public health — certain animals, animal products and human remains;
• defend against infectious disease through 20 port health stations at or near the busiest ports of entry, where CDC and partners such as U.S. Customs and Border Protection and local emergency medical services check arriving travelers for signs of serious communicable disease.

Who and what the rules cover

Arriving from another country by land, air or sea:

• any person — U.S. citizens, permanent residents and foreign nationals — as needed to prevent disease spread;
• conveyances: airplanes, ships, buses and trains;
• animals CDC regulates;
• items that might spread disease to people — bushmeat, hunting trophies and other products of CDC-regulated animals, some goatskin drums, and others;
• human remains.

Some rules also apply to people and conveyances moving between U.S. states and territories, and, in an emergency, to items that could spread disease. Others apply to immigrants and refugees required by immigration law to have a medical exam.

Port health protection

Port health stations are the focal points for responding to possible outbreaks brought by sick or exposed travelers or imported items. See laws governing the control of communicable diseases.

International Health Regulations

Under the International Health Regulations (IHR, 2005), 196 countries have agreed to work with the World Health Organization to stop serious public health threats from crossing borders: to build capacity to prevent, detect and respond to emerging threats, while avoiding unwarranted travel and trade restrictions. The U.S. has designated CDC's port health stations as the authority for applying the IHR at U.S. ports of entry.

Sources

Based on "Laws and Regulations," National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; a work of the United States government in the public domain. A stock photograph is left out.