Is it time for Kansas to pass new quarantine laws?
It’s Labor Day weekend and hundreds of people are gathered along the Arkansas River for a fireworks festival. What the happy group doesn’t realize is that a terrorist is spraying an aerosol form of the small-pox virus into the crowd.
This scenario seems extreme, but public health officials realize that it could be a reality one day and that rural states like Kansas can be targets for biotcrrorism. In addition, people who travel from remote and rural sites to areas considered at higher risk for a bioterrorism attack may be exposed to an agent and return to their homes during the disease incubation period. Their first symptoms may appear hundreds or thousands of miles away from the site where they became infected.
In the event of natural or terrorism-related contagious disease outbreaks, local public health officials may have to authorize quarantine or isolation. The Centers for Disease Control and Prevention (CDC) may assist state and local governments with the control of communicable diseases, but the legal authority for quarantine and isolation falls primarily on state and local government officials. Kansas, like most other states, has laws and regulations to deal with quarantine and isolation of its citizens and livestock.
First, it is important to understand the difference between the terms quarantine and isolation. Quarantine is “the limitation of freedom of movement of well persons or domestic animals that have been exposed to a communicable disease.” Isolation is “the separation, for the period of communicability, of infected persons or animals from others, in places and under conditions that prevent the direct or indirect conveyance of the infectious agents from those infected to those who are susceptible or who may spread the agent to others.” Quarantine applies to seemingly healthy individuals who might have been infected with a contagious agent, while isolation is enforced on sick individuals, often (but not exclusively) in health care facilities.
Some Kansas laws that support quarantine and isolation are antiquated and may not be able to handle the complexity that can erupt from a bioterrorism event. Kansas laws authorize public health officials to quarantine or isolate people with contagious diseases and impose penalties for violation of these laws. However, the laws do not address several important issues:
* the length of time public health officials can impose a quarantine or isolation;
* the proximity of healthy individuals to sick individuals during contagious disease investigations (such as the length of time officials require an airplane full of healthy individuals to remain on board with a sick person);
* the manner of notifying people they must comply with quarantine or isolation;
* housing or facilities for quarantine and isolation;
* an individual’s job status after being quarantined or isolated; and
* due process for quarantined and isolated individuals if they feel they have been unfairly treated.
Kansas attorney Marvin Stottlemire is the Assistant Director of the University of Kansas Public Management Center. He has researched and written about public health law for more than 20 years. “We [Kansans] are pretty much dependent on voluntary quarantine,” Stottlemire said. During the last several years, quarantine has been imposed. A Kansas man who might have been exposed to SARS after a trip to Asia was voluntarily quarantined. A problem arises if individuals do not voluntarily agree to enter quarantine or isolation. How will public health officials deal with this situation? The Kansas Department of Health and Environment (KDHE) identified this and other potential problems with the current public health quarantine and isolation laws.
During the 2003-2004 legislative session, a bill was introduced that included details on how isolation or quarantine could be imposed and would have granted public health officials unquestionable authority to perform these actions when necessary. The House passed H.B. 2890, but it was not heard in the Senate.
Stottlemire believes the public’s health is not in serious jeopardy if officials are forced to handle a public health emergency with the current state laws. “The public health community is extremely dedicated, and as long as there is a public need, they will find a way to meet it using every law they have,” Stottlemire said. However, he added, “they may not have all of the tools to do what they need to do.”
Copyright Kansas State Nurses Association Jan 2005
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