With the first case of Ebola diagnosed in the United States last week, a state’s authority to quarantine individuals has been has been transformed from a relic of a pre-vaccine society to a current event. Quarantine, which is the isolation of people who have or have been exposed to an infectious disease, has been an accepted power of the state since Connecticut was a colony.
In 1711, the Connecticut General Court passed An Act Providing in Case of Sickness, which empowered the selectmen of towns to place a person sick with a contagious disease in a separate house to prevent the spread of the disease. The law also required the selectmen to provide for assistance and care for the ill person. The cost of the care and assistance was charged to the hometown of the quarantined individual.
By the late 1800s, the language of the law had changed, but the effect was similar. Section 2606 of the 1888 Revision of the Connecticut Statutes provided that a town board of health could order any person that it had reasonable grounds to believe was infected with a “malignant, infectious, or contagious disease” to be confined for as long as the board judged necessary.
Newspapers reported numerous instances of quarantine during the early 1900s, especially during the decade of 1910 to 1920. Common diseases resulting in quarantine were polio, scarlet fever, diphtheria, and smallpox. Quarantine was taken very seriously: people were arrested and fined for violating quarantine orders, quarantined houses were guarded by police officers, and people reported their neighbors for violating quarantine orders.
In one incident, a man was arrested because he allowed his mail to obscure the quarantine sign posted outside his door. In another, the health department ordered that a six-year old with scarlet fever be isolated to one room, and the other family members be quarantined in their house. A neighbor reported that children from the quarantined house were allowed to go outside and play. When the health inspector visited, he found the sick child eating breakfast with the family; she was taken away to the Hartford Isolation Hospital for the duration of her illness.
The Hartford Courant reported an outbreak of polio at a Madison hotel in August 1916. The town ordered 160 guests to stay in the hotel; the adults were allowed to leave after two days, but the children were required to be confined to their rooms for two weeks. The beach hotel, which was at its peak season, had to turn away over 100 guests during the first two days of the quarantine.
As infectious diseases became less prevalent due to vaccination, quarantine became infrequent to nonexistent. State law regarding quarantine remained essentially unchanged until 1984, when the law was substantially revised to add some due process protection for those being confined. The power of the board of health to confine individuals with communicable diseases remained, but the law also provided for the right for a court hearing for the person facing confinement, and established a burden of proof for the board of health of a showing by clear and convincing evidence that the person posed a substantial threat to the public health and that there was no less restrictive way to protect public health.
After the September 11, 2001 attacks, concerns about bioterrorism revived interest in quarantine laws, which resulted in another substantial amendment in 2003. The current law
regarding quarantine is focused on public health emergencies, which includes not only communicable diseases, but bioterrorism, natural disasters, chemical attacks, and nuclear attacks and accidents.
The current law gives the Governor the authority to declare a state-wide or regional public health emergency and thereafter authorize the Commissioner of Public Health to institute a quarantine. There are more detailed and specific requirements for quarantine, but the idea is the same: the Commissioner can order that individuals with communicable diseases be isolated or quarantined to prevent the spread of illness. The due process protections added in 1984 remain, and the burden of proof rests with the Commissioner, who must show by a preponderance of evidence that the conditions of the quarantine law are met.
Title CXLVIII, Chapter I, An Act Providing in Case of Sickness, The Public Statute Laws of the State of Connecticut (1808)
General Statutes of Connecticut, Revision of 1888.
Section 19a-200, General Statutes of Connecticut (2001).
Quarantine Put On Hotel On Saturday Night, Lifted For Adults Monday Morning, Hartford Courant, Aug. 14, 1916, p. 1.
Raising Quarantine in East Hartford – Smallpox Patients Recovering, Hartford Courant, May 12, 1914, p. 5.
Quarantine Sign Hidden By Mail Brings Arrest, Hartford Courant, Dec. 24, 1931, p. 15.
Quarantine Not Met, Child Is Hospitalized, Hartford Courant, Dec. 22, 1935, p. 7.