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Pandemic Flu - Public Health Research Guide

This guide focuses on the law related to efforts in preventing, detecting and containing human influenza on the international, regional and national level.

Sources of Legal Authority

International / Regional

  • The World Health Organization

    The World Health Organization is charged with the coordination and monitoring of disease outbreaks across the globe. Specifically, under the revised International Health Regulations, IHR (2005) (entered into force in June, 2007), deals with the public health response framework public health emergencies.

    International Health Regulations background information and FAQs of IHR.

    Global Alert and Response framework of best practices, disease list, and core functions of the alert and response system.

    The Food and Agriculture Organization confirms no link to pigs or the food chain but is under constant surveillance of the food supply and the health of the animal population.

  • The European Union

    The Europa official EU web site is monitoring the coordination of control,

    The Extraordinary Council of EU Health Ministers will meet to consider further steps and coordination,

United States - Federal

Like police powers, most public health authority is based in the states (10th Amendment to the Constitution). However, federal public health recommendations significantly influence state public health practice. Besides, the federal government has authority to control entries of persons, goods and conveyances from other countries and impose quarantine. Moreover, emergency responses needed in Louisiana and Mississippi because of the devastating hurricane Katrina in 2005 have sparked debates over the role of the military in responding to disasters.

Below is a selected list of statutes that give the federal government authority to deal with large scale emergencies:

  • National Emergencies Act (50 U.S.C. § 1601 et seq.) provides the President with the power to declare an emergency.
  • Homeland Security Act (6 U.S.C. § 101 et seq.) creates the Department of Homeland Security and grants the Secretary of Homeland Security a broad leadership role in planning for and responding to emergencies.
  • Stafford Act (Robert T. Stafford Disaster Relief and Emergency Assistance Act or Disaster Relief Act of 1974, 42 U.S.C. § 5121 et seq.) establishes provisions for federal assistance to states in the event of a disaster.
  • Public Health Service Act (PHSA) (42 U.S.C. § 201 et seq.) "creates important vehicles for federal funding of public health activities in state and communities."
    • Section 319 of the Public Health Service Act (42 U.S.C. § 247d) authorizes the HHS Secretary to declare a public health emergency and "take such action as may be appropriate to respond" to that emergency consistent with existing authorities.
    • Section 361 of the Public Health Service Act (42 U.S.C. §264) gives the Secretary of Health and Human Services responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the US and within the US and its territories/possessions. The statute is implemented through regulations found at 42 C.F.R. Parts 70 and 71. Under its delegated authority, the Centers for Disease Control and Prevention (CDC) is empowered to detain, medically examine, or conditionally release individuals reasonably believed to be carrying a communicable disease. As of October 31, 2007, the CDC maintains 20 quarantine stations in the U.S.
  • Federal Food, Drug and Cosmetics Act (FFDCA) (21 U.S.C. § 301 et seq.) "authorizes the FDA to regulate the safety of food and cosmetics, and the safety and effectiveness of pharmaceuticals, biologics, and medical devices." The HHS Secretary can authorize emergency use of unapproved products or approved products for unapproved uses under section 564 of FFDCA (21 U.S.C. §360bbb-3).
  • Executive Order 13375 (April 1, 2005) amending the Executive Order 13295 by adding "influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic" to the list of quarantinable diseases.
    For more information, check Questions and Answers on the Executive Order Adding Potentially Pandemic Influenza Viruses to the List of Quarantinable Diseases.

Appendix E: Legal Authorities to the HHS Pandemic Influenza Plan outlines key pandemic response issues (such as public sector vaccine or antiviral drug purchase, indemnification of manufacturers, compensation for persons injured by vaccine or antiviral medications, etc.) and legal authorities. For statutes not listed above or in Appendix E to the Plan, check the United States Codes (Title 21 - Food and Drugs, Title 24 - Hospitals and Asylums, and/or Title 42 - Public Health) available at:

  • Official and Annotated Codes in print - Reading Room and 5th Floor
  • Lexis (Legal > Area of Law - By Topic > Health Care > Find Statutes, Regulations, & Legislative Materials > USCS - Health - Titles 15, 21, 24 and 42)
  • Westlaw (FHTH-USCA)
  • United States Code 
  • Health Care Law Sourcebook (Lexis: Legal > Area of Law - By Topic > Health Care > Find Health Care Analytical Sources > Matthew Bender (R) > Health Care Law Sourcebook) - Updated 3 times per year.

For proposed legislation, check:

  • (for the full text and status of pending and recently enacted health legislation, try a word search in the current Congress)
  • Lexis (Legal > Legislation & Politics - U.S. & U.K.> U.S. Congress > Congressional Full Text Bills - Current Congress)
  • Westlaw (CONG-BILLTXT)
  • Health Care Law Sourcebook (Lexis: Legal > Area of Law - By Topic > Health Care > Find Health Care Analytical Sources > Matthew Bender (R) > Health Care Law Sourcebook) - Updated 3 times per year.
  • Newsletters, such as BNA publications, and other current awareness tools (discussed later in this research guide) are also good sources of proposed federal legislation.

United States - States

Many state public health statutes were enacted in response to specific diseases or health threats. In 2000, the Turning Point Public Health Statutes Modernization Collaborative was formed to address the need to reform state statutes to improve the public health system. The Collaborative created and presented in September 2003 the Model State Public Health Act which is designed to serve as a tool for state, local, and tribal governments to use to revise or update public health statutes and administrative regulations. Other model state acts that relate to public health are:

  • Model State Emergency Health Powers Act (MSEHPA)
    Originally developed by the Center for Law & the Public's Health at Georgetown and Johns Hopkins Universities which won the CDC contract for its development. States were encouraged to use the model act to revise their laws to ensure adequate response to public health emergencies.
  • The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA)
    Developed by the Uniform Law Commission (ULA) in the aftermath of Hurricanes Katrina and Rita, it "provides uniform legislative language to facilitate organized response efforts among volunteer health practitioners."
  • State Quarantine and Isolation Laws
    Summary of state laws (does not include District of Columbia, or other territories) regarding quarantine and isolation. Created by the Health Policy Tracking Service (HPTS) at iNETSCAN Publishing (now part of Thomson) for Trust for America's Health (TFAH). The review was conducted from July to November 2004.
    • District of Columbia - D.C. Code Ann. §7-131 et seq. The Mayor may, upon the advice of the Commissioner of Public Health, issue rules to prevent and control the spread of communicable diseases...; D.C. Mun. Regs. tit. 22 §200 et seq.
    • Maryland - MD. Code Ann., [Health-Gen.] §18-905 et seq. The Secretary of Health may issue an isolation and quarantine order.
    • Virginia - VA. Code Ann. §32.1-43 et seq. The State Health Commissioner shall have the authority to require quarantine, isolation, immunization, decontamination, or treatment of any individual or group of individuals when he determines any such measure to be necessary; 12 VA. Admin. Code § 5-90-105, 5-90-110.Summary of state laws (does not include District of Columbia, or other territories) regarding quarantine and isolation.

Other resources for state public health statutes are:

  • Cornell's Legal Information Institute's State Statutes by Topic: Health links to state health laws by state. The currency of the statutes varies by state.
  • Westlaw's 50 State Surveys is a potential resource for a 50-state survey of statutes. It is usually found on the right hand side of WestlawNext when in the Statutes section.