User:BD2412/Vaccine law resources/Quarantine

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The United States has only exercised the federal quarantine power on two occasions since the 1960s. Nevertheless, following the West African Ebola virus epidemic of 2013-2016, the CDC promulgated a new rule expanding the circumstances under which it could use this power.


Quarantine in the United States

The United States puts immediate quarantines on imported products if the disease can be traced back to a certain shipment or product. All imports will also be quarantined if the diseases breakout in other countries. According to Title 42 U.S.C. §§264 and 266, these statutes provide the Secretary of the Department of Health and Human Services ("the Secretary") peacetime and wartime authority, respectively, to control the movement of persons into and within the United States to prevent the spread of communicable disease.

Communicable diseases for which apprehension, detention, or conditional release of persons are authorized must be specified in Executive Orders of the President.[1] Executive Order 13295 (Revised List of Quarantinable Communicable Diseases, April 4, 2003) and its amendments (executive orders 13375 and 13674) specify the following infectious diseases: (1) cholera, (2) diphtheria, (3) infectious tuberculosis, (4) plague, (5) smallpox, (6) yellow fever, (7) viral hemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named), (8) severe acute respiratory syndromes, and (9) influenza, from a novel or re-emergent source.[2] In the event of conflict of federal, state, local, and/or tribal health authorities in the use of legal quarantine power, federal law is supreme.[3]

The Division of Global Migration and Quarantine (DGMQ) of the US Center for Disease Control (CDC) operates small quarantine facilities at a number of US ports of entry. As of 2014, these included one land crossing (in El Paso, Texas) and 19 international airports.[4][5]

  • Anchorage
  • Atlanta
  • Boston
  • Chicago
  • Dallas/Ft. Worth
  • Detroit
  • Honolulu
  • Houston
  • Los Angeles
  • Miami
  • Minneapolis
  • New York JFK
  • Newark
  • Philadelphia
  • San Diego
  • San Francisco
  • San Juan
  • Seattle
  • Washington, D.C. (Dulles)

Besides the port of entry where it is located, each station is also responsible for quarantining potentially infected travelers entering through any ports of entry in its assigned region. These facilities are fairly small; each one is operated by a few staff members and capable of accommodating 1-2 travelers for a short observation period.[5] Cost estimates for setting up a temporary larger facility, capable of accommodating 100 to 200 travelers for several weeks, have been published by the Airport Cooperative Research Program in 2008.[5]

United States – history edit

Quarantine law began in Colonial America in 1663, when in an attempt to curb an outbreak of smallpox, the city of New York established a quarantine. In the 1730s, the city built a quarantine station on the Bedloe's Island.[6] The Philadelphia Lazaretto was the first quarantine hospital in the United States, built in 1799, in Tinicum Township, Delaware County, Pennsylvania.[7] There are similar national landmarks such as Swinburne Island and Angel Island (a much more famous historic site, Ellis Island, is often mistakenly assumed to have been a quarantine station, however its marine hospital only qualified as a contagious disease facility to handle less virulent diseases like measles, trachoma and less advanced stages of tuberculosis and diphtheria; persons afflicted with smallpox, yellow fever, cholera, leprosy or typhoid fever, could neither be received nor treated there). During the 1918 flu pandemic, people were also quarantined. Most commonly suspect cases of infectious diseases are requested to voluntarily quarantine themselves, and Federal and local quarantine statutes only have been uncommonly invoked since then, including for a suspected smallpox case in 1963.[8]

In 2007, Andrew Speaker, an Atlanta attorney on his honeymoon in Europe, was diagnosed by the U.S. Centers for Disease Control and Prevention (CDC) with extensively drug-resistant tuberculosis (XDR-TB), which is contagious, untreatable, and potentially lethal. Speaker returned to the U.S. against the instructions of the CDC, and he was served with a federal order of quarantine by the CDC at a New York hospital, the first such order to be issued in nearly half a century.[9] Speaker challenged the diagnosis, resulting in a new diagnosis of a milder form of tuberculosis and the lifting of restrictions on his movements. The Speaker case drew significant public attention, and Congress held formal hearings about the incident. Speaker's case highlighted a vital issue in public health law: the circumstances, if any, under which public officials may detain individuals against their will to protect the public from communicable diseases, and the conflict between the utilitarian principle of social good and the individual rights guaranteed by the United States Constitution.[10]

Also other TB carriers who refuse to wear a mask in public have been indefinitely involuntarily committed to regular jails, and cut off from contacting the world.[11][12] Some have complained of abuse there.[13]

References edit

  1. ^ "Regulations to control communicable diseases". gpo.gov. Retrieved 30 Oct 2014.
  2. ^ "Specific Laws and Regulations Governing the Control of Communicable Diseases". cdc.gov. bottom of page, in "Executive Orders" paragraph. 31 July 2014.
  3. ^ Schultz, edited by Kristi Koenig, Carl (2009). Koenig and Schultz's disaster medicine : comprehensive principles and practices. Cambridge University Press. p. 205. ISBN 9780521873673. {{cite book}}: |first1= has generic name (help)CS1 maint: multiple names: authors list (link)
  4. ^ Quarantine Station Contact List, Map, and Fact Sheets (CDC)
  5. ^ a b c Stambaugh, Hollis; Sensenig, Daryl; Casagrande, Rocco; Flagg, Shania; Gerrity, Bruce (2008), Quarantine Facilities for Arriving Air Travelers: Identification of Planning Needs and Costs (PDF), TRB's Airport Cooperative Research Program (ACRP) Report 5
  6. ^ "Lazaretto Quarantine Station, Tinicum Township, Delaware County, PA: History". ushistory.org. Retrieved 24 April 2008.
  7. ^ "Contagious Disease Control, The Lazaretto". City of Philadelphia. Archived from the original on 8 May 2008. Retrieved 21 November 2007.
  8. ^ "Get In That Bubble, Boy! When can the government quarantine its citizens?". Slate magazine. 1 June 2007. Retrieved 30 September 2011. In fact, until this recent situation, the CDC hadn't issued such an order since 1963, when it quarantined a woman for smallpox exposure. Even during the SARS epidemic in 2003, officials relied mostly on voluntary isolation and quarantine. And the last large-scale quarantine in the U.S. took place during the Spanish flu epidemic of 1918–19. ...
  9. ^ Meena Hartenstein, Timeline of Speaker's TB Odyssey, abcnews.com (1 Jun. 2007) (available at http://abcnews.go.com/US/story?id=3235763&page=1) (Speaker was diagnosed with tuberculosis after receiving a chest x-ray in connection with a bruised rib)
  10. ^ Jorge L. Contreras, "Public Health versus Personal Liberty – the Uneasy Case for Individual Detention, Isolation and Quarantine", The SciTech Lawyer, Vol. 7, Issue 4 (Spring 2011)
  11. ^ "Man Isolated with Deadly Tuberculosis Strain". NPR.
  12. ^ "Drug-proof TB strain poses ethical bind - Health - Infectious diseases _ NBC News.htm".
  13. ^ "TB Patient Flees U.S. "Abuse" For Russia".