Federal and state officials have the authority to isolate someone with an infectious disease.
But that authority is seldom used. Until this week, the last federal involuntary quarantine occurred in 1963, when an airline passenger entering the U.S. was suspected of having smallpox.
In Colorado, once a haven for tuberculosis patients, health officials say they have rarely invoked laws allowing quarantine or isolation, relying instead on agreements with patients to seek treatment and remain isolated to prevent spreading the disease.
“We have a standard letter that we give people … that informs them of their responsibility under state law to remain isolated until they are deemed not infectious,” said Dr. Randall Reeves, medical director at Denver Public Health Department’s Metro Tuberculosis Control Program.
Still, Denver prosecutors in 2004 charged a pair of transients – a population most susceptible to TB – for not complying with their treatment program. Each was placed on probation and completed their medical program, records show.
Earlier this month, public- health officials in Arizona obtained a court order to confine and treat a 27-year-old dual Russian-U.S. citizen who had undergone TB treatment in Russia, where he had often been homeless.
He is under treatment for XDR-TB in a Phoenix hospital.
Once invoked, the authority to quarantine is nearly absolute, said Dr. Ned Calonge, Colorado’s chief medical officer
“It’s a balance between a person’s rights and public safety and health,” Calonge said. “You must recognize there is a significant risk that is outside the individual themselves.”
In fact, public health has trumped personal liberty for more than a century.
A U.S. Supreme Court decision in 1905 established the principle that public-health authorities can isolate individuals with dangerous infectious diseases.
The court said a Massachusetts law requiring smallpox inoculations did not violate the personal-liberty clause of the 14th Amendment.
It set down four key issues for health officials to evaluate before imposing on someone’s freedom: whether a quarantine is necessary, whether the methods will succeed, whether the burden is proportional to the threat and whether no additional harm is created.
Staff writer Karen Augé contributed to this report.
