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Avian flu outbreak in U.S. could lead to quarantines; Bush advocates use of military

Steve Hammons
July 28, 2006

In the event of an outbreak of the avian flu virus in the United States, how far would the U.S. Government go to impose quarantines on the American people?

Questions about quarantines have again surfaced after the death from avian flu of a 17-year-old boy in Thailand on Monday, July 24.

This death has jolted the international public health community. It was the first human bird flu death in Thailand since 2004.

Today, July 28, in New Delhi, India, senior officials from 11 Asian countries participated in a two-day meeting sponsored by the World Health Organization (WHO) to share data about bird flu outbreaks.

Last October, President Bush said the U.S. military could be used to enforce quarantines in the event of such an outbreak.

In April 2005 Bush signed an executive order adding pandemic influenza to a list of diseases that would justify quarantine orders by the government.

Bush urged Congress to grant him authority to use the military to respond to a bird flu pandemic if necessary.

“APPREHENSION, ISOLATION, DETENTION”

Public health experts are concerned that the H5N1 virus that causes avian flu will mutate into a form that will be easily transmitted from person to person. In that case, a global pandemic would probably result.

Concerns about how U.S. Government officials and politicians would deal with a bird flu outbreak include several contingency plans and scenarios.

Many problems would rapidly develop: Acute stress on the health care system, shortage of hospital beds and equipment, illness of health care and public safety personnel and impacts to local, regional and national infrastructure.

Quarantine of citizens, voluntary or involuntary, could take many forms. Officials would have a range of options to facilitate and enforce quarantines.

According to the Web site of the Centers for Disease Control and Prevention (CDC), “HHS [U.S. Department of Health and Human Services] has recommended that influenza caused by new or re-emerging influenza viruses that are either 1) causing a pandemic or 2) are not in global circulation among humans and have the potential to cause pandemics should be added to the list of communicable diseases for which apprehension, isolation, detention, or conditional release are authorized.”

A representative of the Centers for Disease Control and Prevention (CDC) pointed out that voluntary home quarantines would be a first step.

Federal authorities would implement national quarantine protocols in conjunction with, or with authority over state and local governments.

The following is the executive order signed by Bush on April 1, 2005:

EXECUTIVE ORDER: AMENDMENT TO E.O. 13295 RELATING TO CERTAIN INFLUENZA VIRUSES AND QUARANTINABLE COMMUNICABLE DISEASES

By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows:

Section 1. Based upon the recommendation of the Secretary of Health and Human Services, in consultation with the Surgeon General, and for the purpose set forth in section 1 of Executive Order 13295 of April 4, 2003, section 1 of such order is amended by adding at the end thereof the following new subsection:

"(c) Influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic."

Sec. 2. This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.

George W. Bush

The White House,

April 1, 2005.

GLOBAL CONCERN

International public health experts continue to monitor developments regarding cases of avian flu in birds and humans.

The concern that the H5N1 virus may mutate into a form that could easily spread between humans is also resulting in urgent efforts to develop appropriate vaccines.

The death rate of people known to have contracted avian flu exceeds 50 percent. Such a global pandemic would cause the deaths of millions, according to public health experts.

Most human deaths have resulted from close exposure to infected birds. However, there have also been cases where the disease apparently was transmitted from family members.

The human population has little or no immunity against this kind of avian flu virus, according to public health authorities.