Epidemiological surveillance of land borders in North and South America: a case study

Bruniera-Oliveira, Robson; Horta, Marco Aurélio Pereira; Varan, Aiden; Montiel, Sonia; Carmo, Eduardo Hage; Waterman, Stephen H; Verani, José Fernando de Souza

The political organization of different countries for the entry and movement of people through borders are relevant factors in the comparison of surveillance systems and in the design of health systems for the border regions. The Treaty of Asunción, which gave rise to MERCOSUR, establishes that the States' parties have the freedom of movement for people, goods, and services among them 35 . Hence, the Brazilian Southern Border Arc has an extremely high daily porosity for people entry and exit, once the crossing between countries can be taken without any impediment. As evidenced by the research, there are numerous points of entry, where there are no checkpoints, such as health inspection points or customs. On the other hand, in North America, in addition to the physical barriers along the border, all entry points are controlled by U.S. Customs and Border Protection (CBP). This agency first screens incoming international travelers with the CDC and has the power to detain for the enforcement of isolation and quarantine of individuals with any signs and/or symptoms of infectious diseases 36 . The presence of such agencies as the CBP plays an important role in the containment of infectious diseases entering the United States. Countries that applied travel restrictions on their borders during the epidemic of the influenza virus A (H1N1) observed that both the restriction and the isolation and quarantine of the cases played an important contribution in the delay of the virus in their countries 37, 38 .