Quarantine and Isolation

1
Quarantine and Isolation

• Susan Kang, J.D.
• Policy Director
• Kansas Department of Health Environment

2
Brief History of Quarantine and Isolation

• The Bible refers to the use
• of isolation to control the spread of Hansens
  disease (leprosy).
• In the 14th-15th centuries, Venice imposed a
  harbor quarantine (from the Italian quarante- the
  40-day period during which arriving ships were
  detained) to control the spread of the plague.

3
Brief History in the U.S.

• In 1647 the Massachusetts bay colony restricted
  ships from the west Indies due to the plague. By
  1660s the first colonial quarantine laws were in
  place.

4
Brief History in the U.S.

• In the 1880s, NYC officials inspected ships,
  passengers and cargo for contagion (Staten island
  had an isolation hospital/quarantine station).
• In 1907 Typhoid Mary (Mary Mallon) was required
  life-long involuntary isolation to prevent her
  from working as a cook and infecting others.

5
Brief History in the U.S.

• Mallon was the first person found to be a
  "healthy carrier" of typhoid fever in the United
  States.
• Mallon is attributed with infecting 47 people
  with typhoid fever, three of whom died.

6

• A severe strain of flu emerged in Kansas in
  1918 and spread like wildfire among soldiers at
  Fort Riley's Camp Funston

7
The Existing Law on Quarantine and Isolation

• KSA 65-119 gives a county board of health or
  local health officer the authority to "maintain a
  supervision" over cases of infectious disease and
  to enforce provisions of law relating to
  isolation, restriction of communication,
  quarantine, and disinfection.

8
The Existing Law on Quarantine and Isolation

•  KSA 65-126 gives the Secretary of Health and
  Environment the authority to isolate and
  quarantine individuals when the local health
  officer has failed to act, and gives the
  Secretary the authority to quarantine areas to
  stop the spread of disease.

9
The Existing Law on Quarantine and Isolation

• KSA 65-128 gives the Secretary the authority to
  promulgate rules and regulations for isolation
  and quarantine.

10
Definitions

• Quarantine generally refers to the separation and
  restriction of movement of persons who, while not
  yet ill, have been exposed to an infectious agent
  and therefore may become infectious. Quarantine
  of exposed persons is a public health strategy,
  like isolation, that is intended to stop the
  spread of infectious disease.

11
Definitions

• Isolation refers to the separation of persons who
  have a specific infectious illness from those who
  are healthy and the restriction of their movement
  to stop the spread of that illness. Isolation is
  a standard procedure used in hospitals today for
  patients with tuberculosis and certain other
  infectious diseases.

12
New Quarantine and Isolation Law Per HB 2264

• The QI bill was passed as part of HB 2264.
  Signed into law on 4-12-05.
• Clarifies the local health officer's authority to
  order isolation and quarantine of infected
  persons
• Gives the local health officer the authority to
  order persons exposed to infectious disease to
  seek medical evaluation or treatment

13
New Quarantine and Isolation Law Per HB 2264

• Gives the local health officer the authority to
  order isolation and quarantine of persons
  refusing vaccination or medical treatment
• Gives the local health officer the authority to
  order local law enforcement authorities to assist
  in enforcing orders issued under the statute

14
New Quarantine and Isolation Law Per HB 2264

• Establishes notice and appeal procedures for
  persons subject to an order issued under the
  statute.
• Provides for the provision of counsel for
  individuals who are not represented by counsel in
  court proceedings related to appeals from
  quarantine or isolation orders.