A survey assessment of infectious disease surveillance, epidemiology and laboratory capacity in the Paso del Norte region of the United States-Mexico border

OBJECTIVE: Survey objectives were to describe the infectious disease surveillance, epidemiology and laboratory capacity in the Paso del Norte region of New Mexico, Texas and Chihuahua, Mexico, and identify areas needing improvement. METHODS: Surveys were mailed to 49 organizations including State/regional public health authorities, hospitals, community health centers, correctional facilities, universities, Federal agencies and the Secretariat de Health in Chihuahua. RESULTS: Survey response rate was 88% (43/49). 55% of respondents have staff to conduct case investigations in Spanish. 87% indicated awareness of procedures for reporting infectious diseases and report accordingly. None of the non-governmental agencies have relationships with agencies in Mexico. 31% of respondents report binational cases, but the majority have limited understanding of what constitutes a binational case. 43% of respondents report interest in collaborating on activities with Mexico. 88% of agencies report ability to test for infectious diseases 24/7/365. None of the respondents coordinate health emergency preparedness plans with agencies in Mexico. CONCLUSIONS: The number of personnel trained to conduct infectious disease epidemiology activities in the region is limited. All agencies and medical service providers report notifiable conditions to reporting authorities, but generally do not understand what constitutes a binational case and most deny ever encountering one, despite the binational nature and mobility of the Paso del Norte population. Emergency laboratory testing capacity is generally available in agencies with on-call medical staff. Ten recommendations are offered for improving infectious disease surveillance based on survey results and interviews with stakeholders in the region.