NCJ Number
192370
Journal
Journal of the American Medical Association Volume: 286 Issue: 21 Dated: December 5, 2001 Pages: 2711-2717
Date Published
December 2001
Length
7 pages
Annotation
This article reviews the principles that are relevant to the likely effectiveness of a large-scale quarantine following biological terrorism.
Abstract
In the event of a large bioterrorist attack with a communicable disease, the potential for person-to-person transmission of the disease would create serious health care and emergency management problems at the local and Federal levels. One of the first challenges to address is the lack of a precise definition of quarantine. It is most appropriate to use quarantine to refer to compulsory physical separation, including restriction of movement, of populations or groups of healthy people who have been potentially exposed to a contagious disease, or to efforts to segregate these persons within specified geographic areas. When an infectious disease is confined to a specific locale, the authority for quarantine usually rests with local or State public health officials. The Federal Government has the authority to enact quarantine when presented with the risk of transmission of infectious disease across State lines. For travelers seeking to enter the United States, the Centers for Disease Control has the authority to enact quarantine. U.S. history has demonstrated that quarantine actions themselves may cause harm. Some unintended consequences of quarantine implementation have been increased risk of disease transmission in the quarantined population; mistrust in government recommendations leading to violence; and ethnic bias adversely altering public health decision making. Decisions to invoke quarantine should take three questions into consideration. Do public health and medical analyses warrant the imposition of large-scale quarantine? Are the implementation and maintenance of large-scale quarantine feasible? Do the potential benefits outweigh the possible adverse consequences? Alternative disease control methods include investing new information tools and emergency management systems that would improve awareness during disease outbreaks; and providing incentives to foster specific public actions. Also suggested is devoting resources to developing robust public communication strategy commensurate with the critical importance of this action. 60 references