MONITORING THE SPREAD OF INFECTIOUS DISEASE AT THE BORDER

Infectious diseases, also known as contagious or communicable diseases, are a significant health threat chiefly because of their high probability of transmission and increased virulence, or ability to cause disease.

Infectious diseases are caused by organisms such as bacteria, viruses, parasites or fungi, according to the World Health Organization.

This health threat is intensified in border communities.

Fortunately, the Border Infectious Disease Surveillance (BIDS) Program was created in 1997 to combat this threat.

The program is a part of the Arizona Department of Health Services and was formed by the Center for Disease Control and Prevention, the Mexican Secretariat of Health and various border health officials.

"BIDS is a collaboration of federal, state and local public health authorities from both sides of the border to study infectious diseases. These collaborations are intended to improve knowledge gaps of known and emerging diseases along the border. They also improve the exchange of disease surveillance and epidemiological data [...]" said Orion McCotter, infectious disease surveillance epidemiologist for the Office of Border Health, in an e-mail.

The program works to establish an active, binational sentinel surveillance system, exchange disease incidence rates and risk factor information, enhance the public health infrastructure along the U.S. - Mexico border as well as improve binational communication and data exchange, said Robert Guerrero, office chief for the Office of Border Health, in an e-mail.

"There is no system to assess infectious diseases throughout the border as a unit. The large population movement across the border will allow for the disease to reach populations on both sides. The surveillance of infectious diseases by BIDS will allow detection of outbreaks and epidemics," McCotter said.

These agencies include nine clinical facilities in four geographically grouped cities along the border, Tiajuana–San
Diego, Nogales-Nogales, Las Cruces–Ciudad Juarez–El Paso, and Reynosa-McAllen.

The geographically widespread participation in the BIDS program allows participants to focus on a variety of diseases, McCotter said.

Within the BIDS program there is an executive committee and three subcommittees, epidemiology, laboratory and communications. There are nine “sentinel” site surveillance coordinators who are responsible for interviewing patients, completing data entry and also specimen shipping and tracking, according to a CDC report.

The increased participation and surveillance is critical because the proximity of border cities such as Nogales, Ariz. and Nogales, Sonora.

“From an epidemiological perspective, the border population must be considered as one, rather than different populations on two sides of a border, pathogens do not recognize the geopolitical boundaries established by human beings,” also according to the report.

Despite efforts to build walls and fences, as one of the busiest international portals, the constant migration of people across the border amplifies the spread of infectious pathogens. Thus, the BIDS program works to manage the transmission of these infectious diseases.

These diseases can be passed directly, from one person to another, or indirectly through some sort of vector, a mechanism for transporting disease, such as a mosquito.

There are several different types of infectious diseases including, the Avian Flu, leprosy, yellow fever, small pox and cholera.

BIDS past surveillance projects include, the West Nile virus, pediatric influenza, viral hepatitis (A, B, C, D and E), fever and rash syndromes such as, measles , rubella, dengue fever, typhus and ehrlichiosis, Guerrero said. The program’s current focus is Valley Fever, he added.

Past BIDS surveillance projects in Tucson have included, hospitalized pediatric influenza, hospitalized West Nile virus and Dengue Fever, Guerrero said.

This program demonstrates a collaboration of binational organizations as well as infectious disease surveillance strategies.

However, the program has encountered some obstacles along the way such as, language barriers, coordination of information as well as moving equipment, supplies and specimens, according to the report.

Man-made boundaries cannot contain disease-causing pathogens that spread rapidly, infect and can cause death.

"Infectious diseases are among the most critical health issues in the border region. Enhancing the network of surveillance for infectious diseases helps estimate distribution and spread of diseases," McCotter said. "The surveillance activities can also provide early detection of outbreaks. These efforts can lessen the morbidity and mortality of infectious diseases in border communities."