Genesis of Antibiotic Resistance XXVI: Mitigation of Antibiotic Resistance Pandemic (ARP) by Obdurate Implementation of Guidelines at the International Border Crossing

The outcome of retrospective data analysis of gathered evidence concerned with the movement of persons across ports of entry indicates that there is no mechanism is in place to make determinations or gather substantive date that has the propensity to identify the encroachment of individuals who may carry an antibiotic resistance or an antimicrobial resistance. The following suggestive areas must be considered to identify and mitigate the threat of ARP encroachment through International Border Crossings: i. Health inspection and review of suspected cases or subjects that demonstrate primary symptoms of infectious disease. ii. Publish, declare, and post current information indicating pertinent geographic statistics and data in regard to the morbidity and mortality rate due to antibiotic resistance pathogen induced infectious diseases at the port of entry. iii. Establish microbiology laboratories that are congruent with the global standard to test culture‐sensitivity that maximizes timeliness of testing and cost effectiveness that will provide an immediate antibiogram. iv. A more rigorous screening of personal documents and verification to identify potential carriers of infectious diseases to include humans, animals and plant material. v. Establish measures for inspection, certification and transportation of rejected persons, animals, and plant material back to the country of origin expeditiously within twenty‐four to forty‐eight hours. International reporting of such cases should follow. vi. Periodic medical examination at timely intervals for personal assigned to border crossings to serve as an early warning and to allow congnizant authorities to address avenues for AR resistant pathogen infectious disease. vii. Restrict the transport of over‐the‐counter antibiotics across international boundaries without prescription . viii. Robust and accessible educational programs concerned with antibiotics and AR awareness and its impact of AR infectious diseases with emphasis on training Customs and Border Protection personnel. ix. All persons attempting to cross international borders should be accountable for and to the information solicited at the port of entry and personnel at entry points must maintain data that is readily available for use in establishing ARP threat. x. A calculated surveillance strategy and an information exchange that is concerned with the detection of ARDs must be established that provides a network of information that can flow in a multidirectional manner between and among the general public, physicians in private practice, nursing homes, hospitals, Non‐Governmental Organizations and State and Federal Health Departments. Taken together, implementation of the aforesaid measures has the propensity to slow the rate of transmission and spread of vector‐borne contagious diseases from the animal and human hosts in transit across international borders. Implementation will further assist Customs and Border Protection, United States Department of Agriculture and Animal Plant Health Inspection System personnel in their efforts to ensure public safety and health. The revision of current practices by the multitude of governmental agencies is overburdening and demands urgent reform of processes. Itemized statistical analysis and its significance will be presented in EB2017. Support or Funding Information Professional development funds to Subburaj Kannan