Experts have branded quarantine measures imposed by the Trump administration on a US cruise passenger as “authoritarian” and “unconstitutional”, warning that the case sets a dangerous precedent for how the country may handle future outbreaks of Ebola and other pathogens.
“Cavalierly detaining somebody for no good reason, no crime and no significant public risk is arbitrary, it’s capricious and it’s unjust,” said Lawrence Gostin, a health law professor at Georgetown University Law Center. James Hodge, a professor and director of the Center for Public Health Law and Policy at Arizona State University’s Sandra Day O’Connor College of Law, said health officials should never “use unconstitutional, ill-advised, unproven techniques to control infectious diseases”.
The Hantavirus Quarantine Dispute
The case centres on Angela Perryman, an American passenger on the MV Hondius cruise ship where an outbreak of Andes virus — a type of hantavirus — occurred in April 2026. The outbreak resulted in 10 confirmed and 2 suspected cases, with three deaths. Perryman came into contact with a fellow passenger who had been sickened by the virus. She has not tested positive for the virus, which causes Hantavirus Pulmonary Syndrome, a severe respiratory illness with a case fatality rate estimated at 40%.
Eighteen US passengers from the ship were repatriated to the National Quarantine Unit in Nebraska for a 42-day monitoring period. Initially, the stay was described as voluntary. However, on 18 May, two passengers — including Perryman — received mandatory quarantine orders requiring them to remain at the facility until 31 May. The US Centers for Disease Control and Prevention (CDC) asked states to provide in-person symptom checks and round-the-clock guards for returning passengers — an unusual step for the Andes virus, which is typically transmitted between humans only in rare cases and usually through close contact.
Some states agreed to the conditions, and ten other passengers were allowed to return home to self-quarantine. Florida refused. Dr Joseph Ladapo, Florida’s state surgeon general, disagreed with the federal requirement for 24/7 in-person guards and in-person checks. Perryman’s attorney, Steven Hyman, confirmed the state’s refusal.
On 11 June, Michael Bell, deputy director of the division of healthcare quality promotion at the CDC, conducted a medical review and concluded that Perryman could effectively quarantine at home with daily remote symptom monitoring and access to public health support. His analysis, obtained by Inside Medicine, recommended the less restrictive option.
But on 15 June, Robert F Kennedy Jr, the US secretary of health and human services (HHS), issued an order overriding Bell’s recommendation and continuing Perryman’s mandatory quarantine at the National Quarantine Unit. Kennedy’s order cited no scientific rationale, according to a copy also shared with Inside Medicine. HHS spokesperson Courtney Spencer said Kennedy “specifically considered the medical recommendation before deciding to continue the current order”. She added: “In the absence of proper home monitoring by state authorities, the administration’s quarantine order is necessary to ensure both Ms Perryman’s and her community’s wellbeing.”
Perryman has described feeling “betrayed” and “imprisoned”, saying the situation “has nothing to do with public health at all” and that authorities are “using administrative orders to detain American citizens with no judicial oversight”. She believes she is being retaliated against for speaking out.
Constitutional and Precedent Concerns
Health law experts argue that Kennedy’s decision to overrule the CDC’s medical advice is legally and ethically unsound. James Hodge called the move “unprecedented” and warned it acts as “a very bad precedent for just how Americans might expect to be treated if they’re coming back to the United States with highly infectious or even semi-infectious conditions”. He pointed specifically to the ongoing Ebola outbreak in the Democratic Republic of the Congo, saying the CDC had “set a terrible precedent right now with the specific hantavirus cases, and I only hope that we’ll see improvements for that to come”.
Public health officials are expected to use the least restrictive option available to contain threats. “When there are multiple options that are effective in limiting spread, you take the one that’s less restrictive on civil liberties violations or infringements,” Hodge said. Critics say Kennedy’s order violates that principle by continuing a stringent institutional quarantine when a medically sound, less restrictive alternative — home isolation with remote monitoring — was available.
Both Gostin and Hodge were closely involved in drafting the CDC’s updated quarantine rules in 2017 and opposed provisions allowing the HHS secretary to overturn the agency’s medical review. While the rules permit the secretary to take that step, Gostin described it as “just unconstitutional”. He said: “I was assured that this would be very rare, and this was not supposed to happen. This wasn’t supposed to work like this. There is a flagrant violation of her constitutional rights.”
Gostin also condemned the lack of accountability, noting that Kennedy was effectively reviewing his own order. “Secretary Kennedy issued the order, and he’s reviewing his own order, which is outrageous,” he said. “You’ve got a political appointee reviewing his own order, providing no evidence or reasons — a person’s liberty should not hinge on a political calculation, and that’s exactly what this is.”
Hodge stressed that scientific justification is a constitutional requirement for quarantine orders. “That’s exactly what Congress expects,” he said. He warned that heavy-handed measures — such as institutional quarantine for a hantavirus or travel bans on countries affected by Ebola — are likely to lead to people evading rules or not providing sufficient information about their activities, making it harder to contain outbreaks. “The threat is not knowing cases that are actually out there, because we created a climate to which people would not self-report for this,” he said.
Both experts highlighted what they see as hypocrisy in the administration’s approach. Kennedy and other Trump administration officials, including National Institutes of Health director Jay Bhattacharya, have previously criticised the Biden administration and blue states for their handling of Covid-19 — a far more transmissible and novel virus. “Yet their first response is not public health, it’s not science, it’s coercion,” Gostin said. He added: “The whole raison d’etre of Secretary Kennedy’s tenure has been based upon medical freedom, ‘the patient gets to choose’, and yet here they’re issuing immediately a compulsory deprivation of liberty.”
The situation, Hodge said, signals an “authoritarian” approach from top health officials — despite prior opposition from those leaders to “lockdowns” during the pandemic. Perryman’s mandatory quarantine period was set to end on 21 June.