States prepare to quarantine persons exposed to H1N1

imagesThe net is buzzing today with rumors about an online document from the state of Iowa that outlines compulsory quarantine outside the home. Not being one to automatically believe everything I read on the net, I decided to do a bit of sleuthing and managed to find the referenced document at the CDC servers. It’s a form called “Facility Quarantine Order”, and it is specifically for the state of Iowa.

However, there is also a second document called the Home Quarantine Order, which would lead me to believe that not every person would automatically be forwarded to a holding place (or camp). The state of Iowa is denying that any such plans exist.  Here are excerpts from yesterday’s report at

Polly Carver-Kimm, spokeswoman for the Iowa Department of Public Health, said a reporter from Kentucky called the department Monday, asking about the “facility quarantine order.”

The order is signed by Dr. Patricia Quinlisk, the department’s medical director.
Carver-Kimm said she is not sure where the order originated, but said that templates are often prepared in case they are needed for public health emergencies. [emphasis SKG]

Perhaps, the state’s officials haven’t looked at the CDC website.

If you don’t live in Iowa, you might be breathing a sigh of relief right now. But wait. Here’s a form for the state of North Carolina.  And there are plenty more. Take a look at the list below (taken from the CDC website) that outlines plans for Florida, Iowa, North Carolina, Washington, and Massachusetts. But first, here’s a list of actions already taken by states (note that the CDC considers ‘American Samoa’ a ‘state’ – curious):

State Legal Actions

American Samoa
Office of the Governor, American Samoa, Proclamation: Public Health Emergency, (May 1, 2009).
Governor Togiola T.A. Tulafono has declared a public health emergency in American Samoa in response to concerns that cases of H1N1 have been confirmed in countries with direct travel routes to the region.
(posted 5/07/09)

Governor Arnold Schwarzenegger, State of Emergency – Swine Flu, (April 28, 2009).
Pursuant to his powers under the California Constitution and California Emergency Services Act (Cal. Government Code §§ 8448(b), 8625), the Governor has issued a proclamation in response to identified H1N1 Influenza cases in California.
(posted 4/29/09)

Department of Health, Declaration of Public Health Emergency Supplemental Order #01, (May 5, 2009).
The Florida Surgeon General has suspended Chapters 120 and 287, Florida Statutes, to the extent needed to procure any and all supplies of the antivirals Tamiflu and Relenza needed to cope with this emergency.
(posted 5/05/09)

Department of Health, Declaration of Public Health Emergency Supplemental Order #02, (May 5, 2009).
The Florida Surgeon General has suspended wholesale distribution permit requirements under Chapter 499 Part 1, Florida Statutes, to allow the wholesale distribution of Tamiflu and Relenza.
(posted 5/05/09)

Department of Health, Declaration of Public Health Emergency, (May 1, 2009).
The State Surgeon General has declared a public health emergency in response to confirmed cases of H1N1 influenza in two counties. (posted 5/4/09)

Governor Chet Culver, Proclamation of Disaster Emergency and Public Health Disaster, (May 2, 2009).
The Governor has declared a public health emergency in Iowa, following the confirmation of an H1N1 case in the state.
(posted 5/4/09)

Governor John E. Baldacci, Proclamation of a Civil Emergency Due to a Highly Infectious Agent, (April 29, 2009).
Pursuant to his authority under 37-B M.R.S.A. §§ 741, 742, 824, the Governor has issued a proclamation of civil emergency in response to identified cases of H1N1 influenza in Maine.
(posted 5/1/09)

Insurance Commissioner, Health Insurance Emergency Planning & Procedures (Emergency Rule), (June 16, 2009).
The State Bureau of Insurance issued an emergency preparedness rule “To ensure that all health insurance companies… are adequately prepared to deal with public health emergencies.”

Governor Martin O’Malley, Declaration of Emergency: Influenza Response and Mitigation, Exec. Order No. 01.01.2009.05, (May 1, 2009). The Governor has declared an emergency as a result of the possibility of a pandemic in the state and surrounding jurisdictions, pursuant to his authority under MD. Code Ann. Pub. Safety § 14-3A-02.

Public Health Council Emergency Regulation, (August 12, 2009). The Massachusetts Public Health Council passed emergency regulations to allow the governor to authorize a health care professional, such as a dentist, paramedic or pharmacist, to administer influenza vaccine and to require clinics and hospitals to offer vaccinations for seasonal and novel influenza to all employees.

State Legislature, An Act Relating to Health, Etc. (May 2009).
The Minnesota state legislature passed legislation revising Minnesota statutes, sec. 144.4195, et. seq., to authorize the commissioner of Health to implement mass dispensing of legend drugs and revising certain laws and legal procedures related to isolation and quarantine.

Governor Dave Heineman, Proclamation, (April 30, 2009).
The Governor of Nebraska declared a state of emergency after one confirmed case in the state.
(posted 5/4/09)

New York
Governor David A. Paterson, Governor Paterson Activates Health Emergency Preparedness Plan; Puts State on ‘High Alert’ for Swine Flu, (April 26, 2009).
After eight confirmed cases of H1N1 Influenza in New York City, Governor Paterson activated the state’s emergency preparedness plan.
(posted 4/29/09)

Governor Ted Strickland, Proclamation of Emergency: Authorizing State Agencies and Personnel to Assist with the Receipt, Transportation and Storage of Medicine and Supplies Associated with the Swine Flu Virus, (April 28, 2009).
Following the identification of a patient with H1N1 influenza in Ohio, Gov. Strickland declared a state of emergency and authorized the Ohio National Guard to assist with SNS supplies.
(posted 5/05/09)

Governor Rick Perry, Governor Perry Issues Disaster Proclamation for Swine Influenza, (April 29, 2009).
In response to confirmed cases of H1N1 Influenza in certain Texas jurisdictions, the Governor has announced that a public health emergency exists and has declared a state of disaster.
(posted 04/29/09)

Department of State Health Services, All Schools in Schertz District to Close, (April 26, 2009).
The Department announced that all 14 schools and two district facilities in this school district were to be closed immediately after the discovery of suspected H1N1 Influenza in that jurisdiction.
(posted 4/29/09)

Governor Timothy Kaine, Governor Kaine Announces Precautions to Prepare Virginia to Respond to H1N1 Virus Outbreak, (April 27, 2009).
Prior to the confirmation of H1N1 cases in the state, Virginia Health Commissioner Karen Remley declared a public health emergency.
(posted May 4, 2009)

Governor Jim Doyle, Executive Order #280, Relating to a Proclamation Declaring a Public Health Emergency, (April 30, 2009).
Pursuant to his authority under Wis. Stat. §§ 166.03(1)(b) and 321.39(1)(a), the Governor has issued a proclamation of civil emergency in response in Wisconsin.
(posted 5/01/09)



State Laws, Regulations & Legal Tools

The Florida Department of Health has released the following draft orders suitable for use during the current outbreak:
Voluntary Home Quarantine Agreement
Quarantine to Residence Order
Quarantine to Residence Order 
Quarantine to Facility Order
Quarantine Detention Order
Quarantine of Facility Order
Building Quarantine Closure Order
Area Quarantine Closure Order

The following draft orders were provided by the Iowa Department of Public Health:
Antiviral Shortage Order
Voluntary Home Confinement
Home Quarantine Order
Home Isolation Order
Home Quarantine Release
Facility Quarantine Order
Facility Isolation Order

Procedures for Isolation and Quarantine,105 Mass. Code Regs. 300.210 (2008).

North Carolina
The North Carolina Department of Health and Human Services has released the following draft isolation order:
Isolation Order: Swine Influenza A(H1N1) Infection

Procedures for Isolation and Quarantine, Wash. Admin. Code § 246-100-040.

Washington Department of Health (DOH), templates for isolation and quarantine orders.

The resources posted here for reference purposes were prepared by state agencies; they do not necessarily reflect the policy of CDC or of the federal government.