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Severe Acute
Respiratory Syndrome (SARS) |
Introduction
- Isolation and quarantine are
two common public health strategies designed to protect the public
by preventing exposure to infected or potentially infected persons.
- In general, isolation refers
to the separation of persons who have a specific infectious illness from
those who are healthy and the restriction of their movement to stop
the spread of that illness. Isolation is a standard procedure used
in hospitals today for patients with tuberculosis and certain other
infectious diseases.
- Quarantine,
in contrast, generally refers to the separation and restriction
of movement of persons who, while not yet ill, have been exposed to
an infectious agent and therefore may become infectious. Quarantine
of exposed persons is a public health strategy, like isolation,
that is intended to stop the spread of infectious disease.
- Both isolation and quarantine may be conducted on a voluntary
basis or compelled on a mandatory basis through
legal authority.
State and Local Law
- A state's
authority to compel isolation and quarantine within its borders is derived
from its inherent "police power" -- the authority
of a state government to enact laws and promote regulations to safeguard
the health, safety, and welfare of its citizens. As a result of this
authority, the individual states are responsible for intrastate
isolation and quarantine practices, and they conduct their activities
in accordance with their respective statutes.
- State and local laws and regulations regarding the issues of compelled
isolation and quarantine vary widely. Historically, some states have
codified extensive procedural provisions related to the enforcement
of these public health measures, whereas other states rely on older
statutory provisions that can be very broad. In some jurisdictions,
local health departments are governed by the provisions of state
law; in other settings, local health authorities may be responsible
for enforcing state or more stringent local measures. In many states,
violation of a quarantine order constitutes a criminal misdemeanor.
- Examples of other public health actions that can be compelled by
legal authorities include disease reporting, immunization for school
attendance, and tuberculosis treatment.
Federal Law
- The HHS Secretary has statutory responsibility for preventing the
introduction, transmission, and spread of communicable diseases from
foreign countries into the United States , e.g., at international ports
of arrival, and from one state or possession into another.
- The communicable diseases for which federal isolation and quarantine
are authorized are set forth through executive order of the President
and include: cholera, diphtheria, infectious tuberculosis,
plague, smallpox, yellow fever, and viral hemorrhagic
fevers . Severe acute respiratory syndrome (SARS)
was added to this list in April 2003.
- By statute, U.S. Customs and Coast Guard officers are required
to aid in the enforcement of quarantine rules and regulations. Violation
of federal quarantine rules and regulations constitutes a criminal
misdemeanor, punishable by fine and/or imprisonment.
- Federal quarantine authority includes the authority to release
persons from quarantine on the condition that they comply with medical
monitoring and surveillance.
Interplay between Federal and State/Local Laws
- States and local jurisdictions have primary responsibility for
isolation and quarantine within their borders. The federal government
has residual authority under the Commerce Clause of the U.S. Constitution
to prevent the interstate spread of disease.
- The federal government has primary responsibility for preventing
the introduction of communicable diseases from foreign countries
into the United States .
- By statute, the HHS Secretary may accept state and local assistance
in the enforcement of federal quarantine regulations and may assist
states and local officials in the control of communicable diseases.
- It is possible for federal, state, and local health authorities
simultaneously to have separate but concurrent legal quarantine power
in a particular situation (e.g., an arriving aircraft at a large
city airport).
- Because
isolation and quarantine are "police power" functions,
public health officials at the federal, state, and local levels may
occasionally seek the assistance of their respective law enforcement
counterparts to enforce a public health order.
For
more information, visit CDC's
SARS Web site, or call the CDC public response hotline at (800) CDC-INFO
(English), (888) 246-2857 (EspaƱol), or (888) 232-6348 (TTY)
CDC
protects people's health and safety by preventing and controlling diseases
and injuries; enhances health decisions by providing credible information
on critical health issues; and promotes healthy living through strong
partnerships with local, national, and international organizations.
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