A passenger train spent ten hours quarantined in rural Ontario on Friday after one woman died on board and ten others fell ill with mysterious flu-like symptoms. The train was cleared to continue to Toronto after medical personnel were assured that the woman did not die from a contagious disease. The quarantine was one of the first opportunities for Ontario to test its response mechanisms following the SARS outbreak in 2003. 

The 2003 SARS epidemic killed more than 800 people worldwide, including 44 in Canada’s largest city of Toronto, Ontario. Early on there was no reliable test for SARS detection and it was easily confused with nonlife-threatening respiratory infections like the common cold. The highly contagious infection overwhelmed Ontario’s emergency response systems and caused widespread fear, eventually causing authorities to order thousands of citizens to remain at home to prevent further spread.

After SARS was contained, the province created its own agency to track and respond to disease outbreaks dubbed “the CDC of the North.” They also broadened the circumstances under which a quarantine can be called to rapidly respond to emerging threats. Currently, the province has designated $135 million to coordinate responder databases, providing instant information sharing in the event of an outbreak. Authorities consider the quarantined passenger train a “success” under these new response protocols.

During the 2003 outbreak the US had over 200 “suspected” SARS cases but no confirmed deaths. Unlike in Canada, relatively few changes were implemented to adjust to the globalization of disease transmission.

Quarantine laws are still primarily governed by widely divergent state regulations. For the federal government to call a quarantine the disease must be pre-identified on an official list. In the event of a new disease, like SARS, it must first be added to the list by a presidential order before the CDC can intervene.

It took the Department of Health and Human Services over two and a half years after SARS to formulate a nationwide pandemic flu plan. (Shouldn’t there have been a pandemic flu plan already, like before 2003?) The current plan addresses the archaic quarantine system by recommending that officials become “familiar” with their local laws:

State and local public health officers need to be familiar with the legal requirements in their jurisdictions regarding isolation of infectious persons and quarantine of exposed persons. Although most states have laws to compel isolation and/or quarantine, procedures may vary widely from jurisdiction to jurisdiction.

Luckily, pandemic flu was added to the official quarantine list by the president in April 2005. But that still wouldn’t cover a new disease, like SARS was when it first infected people in 2003, so officials would have to rely on the patchwork state-by-state system in a similar situation. Does that make you feel better?