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15 - Quarantine

from PART II - OPERATIONAL ISSUES

Published online by Cambridge University Press:  05 August 2011

By
Donna Barbisch  and
Lawrence O. Gostin
Edited by
Kristi L. Koenig  and
Carl H. Schultz
Kristi L. Koenig
Affiliation:
University of California, Irvine
Carl H. Schultz
Affiliation:
University of California, Irvine
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Summary

OVERVIEW

Quarantine has been used for centuries to sequester potentially infectious individuals, plants, and animals until they are deemed safe for reintroduction to the rest of society. Criteria for the use of quarantine have often been subjective or based on discriminatory practice; individuals and entire communities were often cast from society and denied access to essential services. Crude efforts have been largely ineffective. Definitive protocols on time and distance necessary to contain the disease are often missing, and the efficacy of differing levels of separation is not well documented. The legal authority to quarantine exists within many jurisdictions worldwide, under many state laws in the U.S. Clear and convincing evidence to support the action is, however, frequently difficult to establish, creating significant concerns over civil liberties. When quarantine is instituted, enforcement poses significant challenges. In addition, there are limited effective plans on how to provide or pay for the secondary effects of quarantine: lost wages, impact on business and services, and logistical support such as food, water, and medical services for those individuals in confinement.

The overall objective of quarantine is to prevent the introduction, transmission, and spread of communicable diseases. The World Health Organization (WHO) has determined that crude methods of quarantine are ineffective. Current guidelines diverge from quarantine and predetermined measures concentrated at borders alone to containment strategies focused on real-time epidemiology and evidence-based data.

Keywords

contagious infectious diseasesethical issuesIHR-2005quarantinelegal authoritypublic health laws
Type
Chapter
Information
Koenig and Schultz's Disaster Medicine
Comprehensive Principles and Practices
 , pp. 203 - 212
Publisher: Cambridge University Press
Print publication year: 2009

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