Quarantine

Years ago when someone had a disease like polio, measles, etc, a doctor or the local authorities would attempt to prevent others from exposure by quarantining the infected. My questions are;

  1. Didn’t anyone ever bring up a legal challenge that this violated their rights?

  2. Was the practive of Quarantine effective in stopping the spread of diseases? If so, why don’t we use it today on things like AIDS?

I think the Public Health Service still has the legal authority to quarantene people with extremely infectious diseases. I know they did this for a while with terberculosis.

I don’t know if it was voluntary or not.

Generally quarantines are only used for dangerous diseases that are easily contageous, which AIDS most certainly is not.

As for lawsuits, I believe quarantines would fall under the “greater good” category, i.e., the same justification for locking up looney-tunes; they are a threat to society regardless of actual motivation.

Everything above is likely complete BS, by the way. I’m sure someone who knows what they’re talking about will be here soon. :slight_smile:

The Public Health Service is a federal agency and has quarantine powers only at ports of entry. Quarantine of your home or business would have to be by your local health authorities.

“1) Didn’t anyone ever bring up a legal challenge that this violated their rights?” I wouldn’t be surprised if someone did but clearly the government has a right and duty to protect public health. For example, local health authorities can and do shut down restaurants that don’t meet sanitation standards.

“2) Was the practive of Quarantine effective in stopping the spread of diseases? If so, why don’t we use it today on things like AIDS?” Isolation is definitely effective in stopping the spread of some diseases (not many) but isolation doesn’t require quarantine. You can just tell people to stay home when they are contagious or, if they need medical care, put them in an isolation ward (room) at the hospital.

The big issue today in public versus individual rights is with tuberculosis. In general, local health authorities will insist that persons with active, contagious, and potentially fatal multiple-drug-resistant TB take treatment to render them non-infectious to others. People who have refused such treatment have occasionally been incarcerated. I’m sure lawyers tried to get them out. AFAIK the health authorities have prevailed in such situations.

I remember seeing old movies where people were quarantined inside their homes because of chicken pox or measles. There were usually signs placed on the front door or property telling people why and since there were never any guards standing about, I guessed that it was pretty much voluntary.

These days, what with lawyers eager to encourage people to sue and people not only willing to do so, but wanting to claim rights violations, quarantining probably has been stopped.

I have always been astonished at the lack of social common sense by people, lawyers and the federal government when AIDS first struck the nation and no one had any real idea how it was spread. Not only were the first victims not quarantined in an effort to prevent the spread, but people got lawyers to sue public schools who did not want their AIDS infected kids mingling with the students.

Even later, it turned out that people with AIDS who were caught knowingly infecting others were never quarantined for the protection of the public, but barely punished because no one had set down any laws concerning such acts at that time. Quarantining was used to protect the public from disease, but violated civil rights when forced upon reluctant victims.

I guess lawyers managed to convince the law makers that infectious people have the right to freely infect unsuspecting members of the public, because it is against the civil rights of the sick to suffer enforced isolation of quarantine. No one has yet stood up to enforce the civil rights of the unsuspecting public to not be exposed to potentially deadly diseases by unknown carriers.

Because of the right to privacy, people infected with contagious, potentially lethal diseases may not be publicly listed to alert the general public to use care when dealing with them.

So, thanks to lawyers and their clients twisting and turning the laws, none of us can be really quarantined by force if we are ill, and those infected with lethal, contagious diseases are free to spread the misery. The only recourse so far is, if one catches such a disease from an infected person and can prove that said person was the infective agent, then said person can be sent to prison or sued by being charged with attempted murder. Because something like AIDS does not actually kill, but causes other diseases to do so, and because it can take years before the victim dies, the carrier cannot be charged with murder, even though that is the inevitable result.

I think it is really crappy that we allow rights of the few to override the overall good of the general public and violate their rights.

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And, as we all know, old movies make wonderful guidlines for public health policy. Who needs to study public health and infectious diseases, just rent Outbreak and follow along.

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bzzzzzz, thank you for playing.

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Clearly, the Surgeon General does have the ability to quarantine individuals who present a danger to the public. In fact, the abstract Surveillance for Pneumonic Plague in the United States During an International Emergency: A Model for Control of Imported Emerging Diseases, describes a change in the quarantine protocols of the CDC during an outbreak of plague in India.

(misinformed rant about AIDS snipped in the interest of space)

In the case of AIDS, we’re talking about a disease that is so difficult to transmit that it requires the exchange of body fluids of some type in order to infect another individual. In the course of normal activities, this is hardly a serious problem. It’s not the case that quarantine is impossible, but that it’s not necessary.

If you examine a history of AIDS research, you’d recognize that by the time the researchers were convinced that the disease was transmitted by an infectious agent, they also realized how difficult it was to transmit. As I understand it, quarantine was never really considered as a viable option because of this realization.

I have yet to find any information on a child who has been infected by a schoolmate. If you’ve got a cite to back up your paranoia, I’d be thrilled to see it.

uh-huh… Why am I completely unsurprised by this assertion?

“Clearly, the Surgeon General does have the ability to quarantine individuals who present a danger to the public.” Exemplary use of the internet to find obscure facts, Ankh_Too.

However:

  1. The OP referred to “…when someone had a disease like polio, measles, etc, a doctor or the local authorities would attempt to prevent others from exposure by quarantining the infected…” The SG clearly does not have the kind of power pkbites was thinking of, going around slapping QUARANTINE signs on houses. The USC you cite clearly limits federal power to apprehending someone who is infectious AND “either moving or about to move from a State to another State; or … to be a probable source of infection to individuals who, while infected with such disease in a communicable stage, will be moving from a State to another State…” This greatly limits the SG’s power in any reasonable scenario. Local health authorities do not have this restriction.

  2. Your citation of the CDC’s puff piece about pneumonic plague isn’t relevant. It is agreed that the USPHS runs quarantine stations at US ports of entry (and has for a very long time) and no one has argued differently.

  3. The Public Health Service has no enforcement staff other than the quarantine staff based at 8 US ports of entry. The SG would have to get some federal enforcement agency (the FBI? US Marshalls? MIB?) to enforce a quarantine regulation.

  4. The USC you cite doesn’t appear to me to state that the SG has the power to apprehend someone in the US on his own say so. What it says is that “On recommendation of the National Advisory Health Council, regulations prescribed under this section may provide for the apprehension and examination of any individual reasonably believed to be infected with a communicable disease…”

For your next challenge, Ankh_Too, perhaps you can find evidence of the existence of the National Advisory Health Council whose recommendation the SG needs before prescribing regulations to apprehend infectious individuals who might be planning an interstate move; I couldn’t. The place to start looking for NAHC is probably in the federal directory right under MIB.

I thought it was a pretty neat trick myself, thank you.

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If you’ll note my original post, it was directed to MoonGazer’s assertion that quarantine proceedures have been discontinued due to the threat of litigation by those who were detained. The excerpt of the USC clearly shows that isn’t true, which was all I was attempting to do.

However, I do agree that the state authorities would not have the barriers to act that the Federal government would in such a situation. In fact, a copy of Morbidity and Mortality Weekly Report from 1993 dealing with Tuberculosis states specifically:

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So, at least in the case of TB, the state does have the statutory power to quarantine individuals. It doesn’t require a stretch of the imagination to conclude they can do it in other situations as well, according to one former state health official referring to the new changes in quarantine regulations:

Well, I’m not sure what you mean. The CDC has the requisite statutory enforcement abillities. What they may require is muscle to put those regulations into effect. If the situation was so bad that the CDC had to come in and quarantine a large portion of the population I would hazard a guess that instead of the FBI or U.S. Marshall Service (who have no training for situations such as this, the people to be called would be the boys and girls in green from USAMRIID. They were involved in the cleanup of the outbreak of Ebola Reston during 1989 in Virginia. Admittedly, that was primarily a veternary operation, I don’t know how the jurisdictions would change if an infectious disease hit the human population and there was a need for an enforcement of the regulations.

Nothing on the NAHC yet, but I did find this little tidbit in the Federal Register, dealing with the changes in regulation mentioned in the Gannett Report above. The regulations moved enforcement of quarantine for humans to the CDC while leaving the responsibility for animal quarantine with the FDA.

It does seem, however, I did make the mistake of cutting out some relevant information from the original cite to the USC:

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It seesm somewhat contradictory. The Director of the CDC can act unilaterally to undertake “such measures as he deems reasonably necessary…”, which sounds pretty open-ended. But the detention of individuals is only accomplished by an Executive Order, upon the recommendations of the (so far) mysterious NAHC and the Surgeon General.