04 April 2003
White House Sets Up Legal Framework for SARS Quarantine
(No quarantine of patients is imminent, spokesman says) (1130)
U.S. government concern over the newly emerging respiratory illness
severe acute respiratory syndrome (SARS) was indicated April 4 when
President Bush added the disease to a list of conditions that could
warrant government declaration of a quarantine.
SARS joins a list of other virulent and contagious diseases such as
tuberculosis, plague and smallpox. With placement of SARS on this list
by presidential executive order, SARS becomes one of those conditions
for which health officials could exercise the legal powers vested in
them to impose a quarantine. Those powers, according to the executive
order, provide for "the apprehension, detention or conditional release
of individuals to prevent the introduction, transmission or spread of
suspected communicable diseases."
The law requires the Secretary of Health and Human Services (HHS) to
make an actual declaration of quarantine, if circumstances warrant.
HHS spokesman Bill Pierce said the health authorities "don't have any
plans whatsoever" to call for a quarantine of SARS patients. Pierce
says the White House issuance of the order is simply a "pro forma,
prudent measure" recognizing the legal requirement that the president
designate those diseases that could be subject to quarantine
regulations.
HHS' Centers for Disease Control and Prevention (CDC) is in charge of
monitoring the U.S. caseload of the disease, numbering 100 cases as of
April 4. Officials have expressed confidence that occurrence of the
disease in the United States is limited to those people who have
recently traveled in the affected areas and persons who have had close
personal contact with the travelers.
CDC issued a fact sheet April 4 explaining the procedures for
isolation or quarantine of patients with infectious diseases.
Further information is available at http://www.cdc.gov/ncidod/sars/
Following are the texts of the White House announcement and the CDC
fact sheet:
(begin text of White House announcement)
THE WHITE HOUSE
Office of the Press Secretary
April 4, 2003
EXECUTIVE ORDER
REVISED LIST OF QUARANTINABLE COMMUNICABLE DISEASES
By the authority vested in me as President by the Constitution and the
laws of the United States of America, including section 361(b) of the
Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as
follows:
Section 1. Based upon the recommendation of the Secretary of Health
and Human Services (the "Secretary"), in consultation with the Surgeon
General, and for the purpose of specifying certain communicable
diseases for regulations providing for the apprehension, detention, or
conditional release of individuals to prevent the introduction,
transmission, or spread of suspected communicable diseases, the
following communicable diseases are hereby specified pursuant to
section 361(b) of the Public Health Service Act:
(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox;
Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola,
Crimean-Congo, South American, and others not yet isolated or named).
(b) Severe Acute Respiratory Syndrome (SARS), which is a disease
associated with fever and signs and symptoms of pneumonia or other
respiratory illness, is transmitted from person to person
predominantly by the aerosolized or droplet route, and, if spread in
the population, would have severe public health consequences.
Sec. 2. The Secretary, in the Secretary's discretion, shall determine
whether a particular condition constitutes a communicable disease of
the type specified in section 1 of this order.
Sec. 3. The functions of the President under sections 362 and 364(a)
of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are
assigned to the Secretary.
Sec. 4. This order is not intended to, and does not, create any right
or benefit enforceable at law or equity by any party against the
United States, its departments, agencies, entities, officers,
employees or agents, or any other person.
Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked.
GEORGE W. BUSH
THE WHITE HOUSE, April 4, 2003
(end text)
(begin text of CDC fact sheet)
U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION
April 4, 2003
To contain the spread of a contagious illness, public health
authorities rely on many strategies. Two of these strategies are
isolation and quarantine. Both are common practices in public health
and both aim to control exposure to infected or potentially infected
individuals. Both may be undertaken voluntarily or compelled by public
health authorities. The two strategies differ in that isolation
applies to people who are known to have an illness and quarantine
applies to those who have been exposed to an illness but who may or
may not become infected.
Isolation: For People Who Are Ill
Isolation of people who have a specific illness separates them from
healthy people and restricts their movement to stop the spread of that
illness. Isolation allows for the focused delivery of specialized
health care to people who are ill, and it protects healthy people from
getting sick. People in isolation may be cared for in their homes, in
hospitals, or at designated health care facilities. Isolation is a
standard procedure used in hospitals today for patients with
tuberculosis (TB) and certain other infectious diseases. In most
cases, isolation is voluntary; however, many levels of government
(federal, state, and local) have basic authority to compel isolation
of sick people to protect the public.
Quarantine: For People Who Have Been Exposed But Are Not Ill
Quarantine, in contrast, applies to people who have been exposed and
may be infected but are not yet ill. Separating exposed people and
restricting their movements is intended to stop the spread of that
illness. Quarantine is medically very effective in protecting the
public from disease.
States generally have authority to declare and enforce quarantine
within their borders. This authority varies widely from state to
state, depending on the laws of each state. The Centers for Disease
Control and Prevention (CDC), through its Division of Global Migration
and Quarantine, also is empowered to detain, medically examine, or
conditionally release individuals suspected of carrying certain
communicable diseases. This authority derives from section 361 of the
Public Health Service Act (42 U.S.C. 264), as amended.
SARS and Isolation
SARS patients in the United States are being isolated until they are
no longer infectious. This practice allows patients to receive
appropriate care, and it contains the potential spread of the illness.
Those who are more severely ill are being cared for in hospitals.
Those whose illness is mild are being cared for at home. Individuals
being cared for at home have been asked to avoid contact with other
people and to remain at home until 10 days after their symptoms have
resolved. (For more information on SARS infection control precautions,
visit CDC's SARS Web site.)
SARS and Quarantine
To date, CDC has recommended isolation of individuals with SARS, but
has not compelled quarantine or isolation of these individuals.
(end text)
(Distributed by the Office of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)
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