State Legislative Implications of Recent Infectious Disease Outbreaks

Since late 2014, infectious disease outbreaks have been in the headlines in the U.S., with the first confirmed case of Ebola and a measles outbreak that has reached 141 cases in 17 states and DC. These outbreaks have brought increased attention to public health laws, including isolation, quarantine and immunization exemptions. In late 2014, a number of state legislatures held informational hearings on Ebola to understand preparedness and response efforts as well as current legal authorities. The Centers for Disease Control and Prevention (CDC) released guidance on Ebola monitoring and movement of persons with exposure to Ebola. However, a number of states developed screening and monitoring policies that were more strict than the CDC guidance. This led to questions around public health agency authority. Given the attention to isolation and quarantine policies, some states are evaluating existing powers and considering changes to their state laws. In early 2015, public attention seemingly shifted from Ebola to measles. While measles is more contagious than Ebola, it is a vaccine-preventable disease, so the focus has been on immunization exemptions rather than quarantine. All states currently allow for medical exemptions for vaccines, most states allow for religious exemptions (MS and WV are the exceptions), and 20 states allow for personal or philosophical exemptions. Many states are considering proposals this session to amend their laws around immunization exemptions.  This presentation will examine state legislative changes in public health laws related to controlling infectious diseases as a result of our recent experience with Ebola and measles.