U.S.-Mexico BorderU.S.-Mexico Border

Rate Ratios, Border RegionVersus National; 1990-98

0 1 2 3 4 5 6 7 8

TYPHOID FEVER

MUMPS

HEPATITIS B

SHIGELLOSIS

CHOLERA

STREP, INVASIVEGRP A

PLAGUE

HEPATITIS A

MEASLES

HUMAN RABIES

DIPHTHERIA

BOTULISM, FOODBORNE

BRUCELLOSIS

Dis

ease

Rate Ratio

1.19 (1.03-1.50)

1.33 (1.23-1.43)

1.63 (1.60-1.66)

1.84 (0.87-3.74)

1.88 (1.57-2.25)2.00

3.32 (3.27-3.37)

4.27 (4.12-4.41)

4.33

5.41

7.84 (5.01-12.21)

8.64 (7.1-10.6)

1.34 (1.30-1.39)

BIDS: Bridging the Gap• Conduct active, binational sentinel

surveillance• Develop strong epidemiology and

laboratory border infrastructure• Provide data for preventive strategies

California

Arizona New Mexico

TexasBajaCalifornia

Sonora

Chihuahua

Coahuila

NuevoLeón Tamaulipas

Nogales

Nogales

San Dieg

o

Tijuana

Las Cruces

El Paso

Ciudad Juárez

Reynosa

McAllen

Group I

Group II Group III

Group IV

!

Need for Binational InfectiousDisease Surveillance for

Bioterrorism Preparedness in theCalifornia-Mexico Border

Region

Unannounced event

U.S. – Mexico Collaboration onBioterrorism Preparedness

• Binational collaboration to improveinfrastructure and coordination– Training– Laboratory– Emergency response– Communication and information systems

CDC Funding to California forBioterrorism/Public health

Preparedness• $60 million in 2002• Focus areas

– Planning– Surveillance and epidemiologic capacity– Laboratory capacity– Health Alert Network– Health Risk Communication– Education and Training

Binational Region PublicHealth/Bioterrorism Preparedness

– Key Issues• Dedicated funding at the federal, state, and

local levels• Reduce barriers to sharing resources• Coordinated planning effort• Formal agreement for rapid information

exchange• Agreement for shared laboratory testing• Communications infrastructure