Outbreaks vs. epidemics, and how a government quarantines its own citizens.

Previously published Slate articles made new.
April 27 2009 11:31 AM

Outbreaks vs. Epidemics

Plus, when can the government quarantine its citizens?

Click here to read more from Slate on the swine flu. 

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States have been broadening their public-health powers in recent years because of bioterrorism and pandemic fears. Sometimes a state will amend its laws to deal with a specific crisis. For instance, Alaska had to pass an amendment during the SARS scare to be able to quarantine and investigate a docked ship.

In certain states, disobeying a quarantine or isolation order can put you behind bars. A 27-year-old man in Arizona diagnosed with the same deadly strain of [tuberculosis] has been quarantined in a prison hospital ward for the past 10 months; state officials said they put Robert Daniels there because he failed to take his medicine and endangered others by going out and entertaining friends without wearing a mask.

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But  in general, the government rarely has to exercise these powers, because most of the time, citizens cooperate. In fact, until this recent situation, the CDC hadn't issued such an order since 1963, when it quarantined a woman for smallpox exposure. * Even during the SARS epidemic in 2003, officials relied mostly on voluntary isolation and quarantine. And the last large-scale quarantine in the United States took place during the Spanish flu epidemic of 1918-19.

Bonus Explainer: What happens in isolation? A patient often lives in a room with negative air pressure to prevent disease from spreading; an ultraviolet light may kill potential pathogens as they're sucked through a HEPA filter. Visitors must wear masks or, in some cases, sterile full-body suits.

Correction, June 8, 2007: The original version said the CDC quarantined a man in 1963. The patient was a woman. (Return to the corrected sentence.)

Michelle Tsai is a Beijing-based writer working on a book about Chinatowns on six continents. She blogs at ChinatownStories.com.

Brendan I. Koerner is a contributing editor at Wired and a columnist for Gizmodo. His first book, Now the Hell Will Start, is out now.