Monday, August 11, 2014

CDC Quarantine Stations: Not What You May Think

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# 8939

 

There’s a scaremongering meme running on the Internet – usually accompanied by the above map – suggesting that the CDC has set up massive quarantine `centers’ around the country ready to forcibly house people who may have been exposed to Ebola, MERS, or Avian Flu. 

 

These stories are often accompanied by unattributed pictures of barbed wire enclosed facilities, and dire warnings about the recent Revision In the List Of Quarantinable Communicable Diseases signed on August 1st by President Obama.

 

Contrary to popular fiction, and many of these websites, the CDC’s quarantine stations are not massive holding pens for those unfortunate enough to be tagged as having being `exposed’ to a listed infectious disease – in fact, they are merely offices located at 20 busy ports of entry where CDC quarantine officers work.

 

Yes, if you are entering the country and  are visibly ill, and suspected of being infected by a handful of particularly nasty and contagious diseases, you could be placed in isolation – usually at the nearest appropriate hospital – while tests are conducted.  

 

But as far as `quarantine is concerned – we are talking those who may have been exposed, but are not ill – the most common course of action is to ask those people to stay home and report any symptoms to the health department during the incubation period.

 


U.S. Quarantine Stations

U.S. Quarantine Stations are part of a comprehensive system that serves to limit the introduction and spread of contagious diseases in the United States. U.S. Quarantine Stations are located at 20 ports of entry and land-border crossings where international travelers arrive,

They are staffed with medical and public health officers from the Centers for Disease Control and Prevention (CDC) and managed by CDC’s Division of Global Migration and Quarantine. These health officers decide whether ill persons can enter the United States and what measures should be taken to prevent the spread of contagious diseases.

Authority and Scope

CDC has the legal authority to detain any person who may have an infectious disease that is specified by Executive Order to be quarantinable. If necessary, CDC can deny ill persons with these diseases entry to the United States. CDC also can have them admitted to a hospital or confined to a home for a certain amount of time to prevent the spread of disease.

Daily Activities

Medical and public health officers at U.S. Quarantine Stations perform these activities:

Response
  • Respond to reports of illnesses on airplanes, maritime vessels, and at land-border crossings
  • Distribute immunobiologics and investigational drugs
  • Plan and prepare for emergency response
Quarantinable Diseases by Executive Order
  • Cholera
  • Diphtheria
  • Infectious tuberculosis
  • Plague
  • Smallpox
  • Yellow fever
  • Viral hemorrhagic fevers
  • Severe acute respiratory syndromes
  • New types of flu (influenza) that could cause a pandemic
Migration
  • Monitor health and collect any medical information of new immigrants, refugees, asylees, and parolees
  • Alert local health departments in the areas where refugees and immigrants resettle about any health issues that need follow up
  • Provide travelers with essential health information
  • Respond to mass migration emergencies
Inspection
  • Inspect animals, animal products, and human remains that pose a potential threat to human health
  • Screen cargo and hand-carried items for potential vectors of human infectious diseases

 (Continue . . . )

 

While conspiratorialists are sputtering `Yes, but . .  yes, but . . .’  - it is true that the CDC has the legal authority to isolate or quarantine someone against their will.  As do practically every state and local health department in the country, I might add  (see CDC Legal Authorities for Isolation and Quarantine).

        Enforcement

If a quarantinable disease is suspected or identified, CDC may issue a federal isolation or quarantine order.

Public health authorities at the federal, state, local, and tribal levels may sometimes seek help from police or other law enforcement officers to enforce a public health order. 

U.S. Customs and Border Protection and U.S. Coast Guard officers are authorized to help enforce federal quarantine orders.

Breaking a federal quarantine order is punishable by fines and imprisonment.

Federal law allows the conditional release of persons from quarantine if they comply with medical monitoring and surveillance.

Federal Quarantine Rarely used

Large-scale isolation and quarantine was last enforced during the influenza (“Spanish Flu”) pandemic in 1918–1919. In recent history, only a few public health events have prompted federal isolation or quarantine orders.

 

As I’ve said before,  quarantines are politically messy, logistically difficult to administer, and would lose their value quickly in an outbreak. Once a communicable disease is `in the community’, there is rarely a good  reason to pursue them.

 

But implemented early in an outbreakas was done with SARS in 2003 – they can literally turn the tide against an emerging epidemic.

 

Quite frankly, the biggest reason why Ebola is unlikely to spread significantly here in the western world is because we have the laws, infrastructure, and good sense to isolate those who are likely sick, and to ask those who may have been exposed to stay home.

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