Quarantine
Quarantine is a public health practice involving the isolation or confinement of individuals, animals, or goods to prevent the spread of contagious diseases. Originating from the Latin word "quaranta," meaning "forty," the practice dates back to the fourteenth century when ships were held for observation upon entering European ports. Quarantine periods vary in duration based on the disease, ranging from as little as five days for measles to up to forty days for more serious illnesses like poliomyelitis. Historically, individuals with diseases such as leprosy and tuberculosis faced strict isolation measures, while modern quarantine protocols typically involve staying in designated facilities or homes until cleared by health officials.
Quarantine remains relevant today, especially during outbreaks of infectious diseases like Ebola and SARS. However, it raises ethical considerations, particularly regarding human rights and the treatment of individuals refusing medical care. The American Medical Association and the World Health Organization have developed guidelines promoting the use of less restrictive measures, timely treatment, and public education to address these concerns. As such, quarantine serves as a critical tool in managing public health crises while balancing ethical responsibilities.
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Quarantine
Definition
Quarantine is a state of compulsory or enforced isolation, confinement, or segregation to contain the spread of disease or other forms of contamination. It can be applied to people, animals, and imported goods. The word “quarantine” comes from the Latin term quaranta (“forty”), which referred, in this case, to the number of days of confinement for ships coming into European ports in the fourteenth century.
Human quarantine periods vary according to the time necessary to prove that a person can no longer transmit a given disease. The quarantine may range from five days for measles to forty days for poliomyelitis and whooping cough.
Quarantine Conditions
Persons with leprosy were once exiled to leper colonies to isolate them from general populations. Persons with tuberculosis were once confined in sanatoriums and, later, in locked wards of hospitals for six months. In the twenty-first century, persons under quarantine must remain in their homes, hospitals, or other designated healthcare facilities until cleared by a public health official or a healthcare provider.
Quarantine is still used in cases of emerging and infectious diseases that are difficult to treat. Diseases for which people may be quarantined include cholera , diphtheria, tuberculosis, smallpox, yellow fever, and Ebola and Marburg viruses. In 2003, a ten-day period was used in Canada and China to limit the spread of severe acute respiratory syndrome (SARS) epidemic. Quarantine plans were prepared but not implemented for the swine influenza A (H1N1) outbreak in the United States in 2008. In 2014, a nurse who was serving with the organization Doctors Without Borders in Sierra Leone during the Ebola outbreak was quarantined in New Jersey and then Maine after her return to the United States. During the height of the COVID-19 pandemic in 2020 and 2021, the United States and other countries implemented policies for quarantine in an attempt to contain the virus.
Quarantine is ineffective, however, for diseases in which the carrier is contagious before showing symptoms. In addition, lengthy quarantine periods raise human rights concerns, and the confinement of infected persons who refuse medical treatment remains controversial.
Impact
In November 2005, after debating the ethical and practical considerations of quarantine, the American Medical Association adopted guidelines, which are specified in “The Use of Quarantine and Isolation as Public Health Interventions.” These guidelines include the promotion of least-restrictive measures, timely detection and treatment, and education of the population. In October, 2006, the World Health Organization developed similar guidelines for addressing ethical issues in the planning of responses to pandemic influenza.
Bibliography
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Gan, Nectar, and Jessoe Yeung. “China Has Built a 5,000-Room Quarantine Center for Overseas Arrivals. It Could Be the First of Many.” CNN, 29 Sept. 2021, edition.cnn.com/2021/09/29/china/guangzhou-covid-quarantine-center-mic-intl-hnk/index.html. Accessed 8 Jan. 2025.
Giles-Vernick, Tamara, et al. Influenza and Public Health: Learning from Past Pandemics. Washington: Earthscan, 2015.
“Guidance on Coronavirus Quarantine.” United States Government, 12 Mar. 2020, www.state.gov/wp-content/uploads/2020/03/2020-03-12-Circular-Note-Self-Isolation-IOs.pdf. Accessed 8 Jan. 2025.
Hodge, James G., Jr. “Protecting the Public’s Health in an Era of Bioterrorism: The Model State Emergency Health Powers Act.” Accountability in Research 10 (2003): 91–107.
Hunter, Nan D. The Law of Emergencies: Public Health and Disaster Management. Burlington: Butterworth-Heinemann, 2009.
Tognotti, Eugenia. "Lessons from the History of Quarantine, from Plague to Influenza A." Emerging Infectious Diseases 19.2 (2013): 254.