A Review of Malaria, Diphtheria, and Botulism Medication Distributions by CDC Port Health Stations From May 2006 to February 2024.

Details

• Alternative Title:
  Journal of Public Health Management and Practice : JPHMP, 2026, v. 31, no. 6: A Review of Malaria, Diphtheria, and Botulism Medication Distributions by CDC Port Health Stations From May 2006 to February 2024.
• Journal Article:
  Journal of Public Health Management and Practice : JPHMP
• Personal Author:
  Rubin, Lily ; Fowler, Jennifer ; Ranga, Srikar ; Kirley, Máire ; Tchan, Joshua ; Pacheco, Maria ; Preston, Leigh Ellyn ; Waltenburg, Michelle A. ; Akinkugbe, Olubunmi ; Kinzer, Michael H. ; Alvarado-Ramy, Francisco ; Brown, Clive ; Gertz, Alida M.
• Description:
  The Centers for Disease Control and Prevention (CDC) maintains a formulary of biologic agents and drugs not available commercially in the United States. For a subset of these (botulism and diphtheria antitoxins and, until 2022, intravenous artesunate for severe malaria), distribution is coordinated through CDC port health stations (PHS), located mainly at major US international airports. CDC aims for these drugs to reach their destinations within 8 hours of release authorization. We analyzed CDC records to identify areas for efficiency improvement.
  
  We queried records detailing drug distributions from PHS that occurred May 2006 to February 2024, including timing of release authorization and delivery, geographic origins and destinations, mode of transportation, and patient characteristics and outcomes. We conducted descriptive and multivariate analyses to identify variables that may have delayed delivery.
  
  CDC port health stations.
  
  Time from release authorization to drug delivery.
  
  CDC PHS distributed 2912 drug shipments between May 2006 and February 2024 via 17 distribution sites to 54 jurisdictions across the US and 3 countries. Of 850 shipments for which data were available (those occurring December 2019 or later), 83% (n = 702/850) occurred within 8 hours of authorization. Commercial air transport (compared to other types of transport) (aOR: 11.43, 95% confidence interval CI: 6.94-18.81, P < .001) and release authorization time (outside of vs within routine work hours) (aOR: 5.10, 95% CI: 3.31-7.86, P < .001) were significantly associated with delays.
  
  CDC PHS facilitated emergency distributions of life-saving drugs for botulism, diphtheria, and severe malaria to locations throughout the US mostly within 8 hours of authorization. Staffing, distribution locations, and expanded options for ground transportation are important considerations that may minimize delays.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Botulism
  • Malaria
  • Centers for Disease Control and Prevention, U.S.
  • Diphtheria
• Keywords:
  • artesunate
  • artesunic acid
  • botulism antitoxin heptavalent
  • diphtheria antitoxin
  • drug distribution
• Source:
  Journal of Public Health Management and Practice : JPHMP, 2026, v. 31, no. 6
• DOI:
  https://doi.org/10.1097/PHH.0000000000002243
• ISSN:
  1078-4659 ; 1550-5022
• Pubmed ID:
  41117477
• Pubmed Central ID:
  PMC12779171
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  1048-1054 (14 pdf pages)
• Volume:
  31
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/260994/cdc_260994_DS1.pdf
• File Type:
  [PDF - 813.75 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:7fb5fc29955bc738051a6cfd7da8fe1162ba375248ee983924071de3ced9d26cb40134bc4c2858fc688b72bac5e97ea5aad9f7a0cbd31eff9dbd19f75289f36e