Quarantine Laws in the United States

The law gives the federal, state, and local governments the power to take steps to make sure infectious diseases do not spread unchecked. The powers include the authority to order “isolation” and “quarantine.” The term “isolation” refers to the practice of keeping sick individuals away from people who are not sick, and the term “quarantine” refers to the practice of keeping individuals exposed to contagious diseases away from others to see if they become sick. The U.S. Secretary of Health and Human Services is authorized under federal law to take steps to prevent potentially sick (or persons merely exposed to a virus) from entering the United States. See section 361 of the Public Health Service Act (42 U.S. Code § 264). The Secretary has delegated the authority to the Centers for Disease Control and Prevention (CDC). If individuals have arrived in the United States, the CDC has the power to detain (and to require submission to a medical examination) any person they suspect could be carrying communicable diseases.

For Americans within the United States, the authority falls more to the state and local health authorities. Local governments have the authority to enforce isolation and quarantine. Throughout the United States, each county typically has its own health department along with a health officer who is a medical doctor. Typically, voluntary cooperation with a quarantine is sought, but the state and local health departments ultimately have the same authority the CDC has at the U.S. border. Local laws vary from state to state, but generally speaking the violation of a quarantine or isolation order is a criminal offense.

Although forced quarantines are rare, they have been used over the years in preventing the spread of such diseases as cholera and the Spanish flu. The United States Supreme Court has upheld the authority of the government in ordering isolation and quarantines. In the case of Gibbons v. Ogden in 1984, the Supreme Court unanimously held that state and local governments have this enforcement authority when dealing with sick individuals or persons exposed to infectious diseases. Although no mass quarantines have been ordered for over 100 years, former President Obama did issue an executive order listing Ebola as a “quarantinable communicable disease” and this would have certainly laid the ground work for an enforcement action that the federal, state and local governments could take upon themselves. However, the threat from this disease never did fully materialize within the borders of the United States.

The authority of the government is not completely unfettered, however. Detentions must be done with the support of a medical doctor, and citizens typically have the power to petition for a judge to review the doctor’s decision.  See, for example. a discussion by attorney Steve Graham about the laws of quarantine in Washington state. Additionally, just as a defendant in a criminal case has a right to an attorney at public expense if he cannot afford his own attorney, a person detained under the decree of a health officer theoretically has the same right. One wonders, however, if in a national emergency if the government would truly have the logistics to provide for such a right. In the federal government’s plan (entitled “National Strategy for Pandemic Influenza”) the authorities envision the possibility that in a true catastrophic pandemic, even local police agencies would not be able to keep order due to staff shortages and sickness among their ranks. Under the federal plan, the state national guard would have to be called in, and if they are unable, the United State military would have to assist in keeping order.