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American Journal of Epidemiology Advance Access published online on January 18, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj056
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received June 16, 2005
Accepted October 11, 2005

PRACTICE OF EPIDEMIOLOGY

When Is Quarantine a Useful Control Strategy for Emerging Infectious Diseases?

Troy Day 1, Andrew Park 2 *, Neal Madras 3, Abba Gumel 4, and Jianhong Wu 3

1 Department of Mathematics and Statistics, Queen's University, Kingston, Ontario, Canada; Department of Biology, Queen's University, Kingston, Ontario, Canada
2 Department of Biology, Queen's University, Kingston, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada; Current affiliation: Department of Limnology, Swiss Federal Institute of Aquatic Science and Technology (EAWAG), Dübendorf, Switzerland
3 Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
4 Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada

* To whom correspondence should be addressed.
Andrew Park, E-mail: andrew.william.park{at}gmail.com


  Abstract

The isolation and treatment of symptomatic individuals, coupled with the quarantining of individuals that have a high risk of having been infected, constitute two commonly used epidemic control measures. Although isolation is probably always a desirable public health measure, quarantine is more controversial. Mass quarantine can inflict significant social, psychological, and economic costs without resulting in the detection of many infected individuals. The authors use probabilistic models to determine the conditions under which quarantine is expected to be useful. Results demonstrate that the number of infections averted (per initially infected individual) through the use of quarantine is expected to be very low provided that isolation is effective, but it increases abruptly and at an accelerating rate as the effectiveness of isolation diminishes. When isolation is ineffective, the use of quarantine will be most beneficial when there is significant asymptomatic transmission and if the asymptomatic period is neither very long nor very short.

Keywords: communicable diseases, emerging; disease outbreaks; epidemiologic methods; patient isolation; quarantine; SARS virus.
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