[NVIC] Quarantining for Fever and Diarrhea

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UNITED WAY/COMBINED FEDERAL CAMPAIGN

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BL Fisher Note:

Will Flight Attendants be sticking thermometers in our mouths before or

after we buckle up? If they throw you in lock-down for low grade fever, IBS

and a migraine, there will be an awful lot of grumpy frequent flyers out

there.

http://www.timesleader.com/mld/timesleader/living/health/13234289.htm

Times Leader

Posted on Tue, Nov. 22, 2005

CDC seeks better quarantine rules; safeguards such as easy access to

passenger lists

MIKE STOBBE

Associated Press

ATLANTA - Federal health officials are seeking to update quarantine and

contact-tracing regulations, hoping changes such as easier access to airline

passenger lists could better protect Americans from foreign infectious

diseases, including bird flu.

The proposed changes, announced Tuesday by the federal Centers for Disease

Control and Prevention, include easier CDC access to airline and ship

passenger lists, a clearer appeals process for people subjected to

quarantines, and explicit authority to offer vaccinations and medical

treatment to quarantined people.

The changes are part of a multi-pronged attempt to guard against infectious

agents from abroad. In the past 1 1/2 years, the CDC also has increased the

number of quarantine stations at airports, ship ports and land-border

crossings from eight to 18.

Concerns about a potentially deadly bird flu immigrating from Asia are among

the motivators for the change, said Dr. Cetron, director of the CDC's

division of global migration and quarantine. Health officials fear the form

of bird flu could spark a pandemic should it mutate into a form easily

passed from human to human.

CDC officials say federal quarantine and contact-tracing regulations are

antiquated. This is the first substantial overhaul of such regulations in at

least 25 years, they said.

States have their own laws for the isolation and quarantine of sick or

infected individuals, and states use those powers occasionally. Federal

powers are exercised less often - the last time the U.S. government ordered

someone quarantined was in 1962, CDC officials said.

But because pandemics would spread through international and interstate

travel, federal regulation will be increasingly important, CDC officials

said.

The need for new federal regulations was made clear during international

outbreaks of the SARS virus in 2003, when public health officials had

difficulty getting passenger information from airlines to trace the contacts

of people who had been infected, Cetron said.

" SARS put it really front and center where the gaps were, " he said.

One proposal would require airlines and cruise lines to maintain passenger

and crew lists and submit them electronically to CDC upon request. The

measure could cost as much as $108 million a year for airlines and $800,000

for cruise lines, according to one government estimate. However, that

assumes a dramatic revamping of electronic record-keeping, which may not be

necessary, Cetron said.

The airline industry has not yet calculated the cost of changing data

systems to comply with the regulations, said Andrus, assistant

general counsel for the Air Transport Association, a Washington. D.C.-based

trade organization.

The association is still reviewing the proposal, she said. Airlines want to

protect their customers' privacy, but they don't expect much protest from

passengers if providing the information helps contain an epidemic, she

added.

" We believe most people would want to cooperate voluntarily because their

own health may be at stake, " she said.

Another CDC proposal would set forth the legal rights of a person placed

under quarantine, including the right to request a hearing. Some legal

scholars said such guidelines have been missing from federal law, and their

absence could lead to a legal tangle that might stall government quarantine

actions during an outbreak.

" It could mean uncertainty and delay while federal powers were litigated

during an emergency, " said Lawrence Gostin, a public health law expert at

town University.

The rules were being published in the Federal Register, and will be open for

public comment for 60 days. CDC officials say they hope to make the

regulations final by next spring.

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On the Net: The proposed regulations are at http://www.cdc.gov/ncidod/dq.

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