Control of imported communicable diseases: preparation and response

Control of imported communicable diseases hitherto has been based on a paradigm of exclusion, isolationism and quarantine. Yet such policy is inconsistent with globalization of communication, commerce and travel, thus ignoring the potential for rapid dissemination of infectious disease worldwide. Prevention and containment strategies founded on such a premise ultimately cannot be effective. Instead, the perspective in control of communicable diseases must become international with monitoring and study of disease emergence, vector and reservoir patterns, and factors which facilitate and impede pathogen traffic. Our public health system must be reorganized with an international focus to ensure adequacy of surveillance mechanisms, related applied research, prevention and control strategies (including vaccination and information dissemination and education), and maintenance of optimal infrastructure--nationally, locally and internationally. Clear national and provincial contingency plans must be developed, ideally with international cooperation, for dealing with emerging infectious disease threats.