Ebola: To Quarantine or Not to Quarantine

Aug 25, 2014 | Saritha Sankarankutty and Sumiko Mekaru | Outbreak News

Throughout the current Ebola outbreak in West Africa, there have been reports of voluntary and government-ordered isolation and quarantine.  The use of these terms has led to significant fear due to misconceptions about the terms Quarantine and Isolation, and what this means in relation to infection with the Ebola virus.

What is quarantine?

Quarantine is the separation and restriction of movement of healthy people, who may have been exposed to an infected person. The duration of Quarantine is generally the length of the disease’s incubation period, taking into consideration the individual’s suspected time of exposure. This is different from Isolation, which is the separation and restriction of movement of already infected individuals.

Why are people quarantined?

Quarantines allow health authorities to prevent further spread of a disease in the event the quarantined individual develops clinical symptoms of the disease of concern.  Quarantine is just a precautionary measure, preventing possibly sick individuals from infecting others (therefore breaking the line of transmission).  Quarantined individuals often turn out to not have the disease, but the risk of spread within a community is so great that health authorities deem it appropriate to watch over the individuals until they know they are uninfected.

There has been much debate over the benefits and drawbacks of significant quarantines, border closures and travel restrictions during this and other outbreaks. The detrimental effects of widespread quarantines were discussed in an article published by the World Health Organization on August 23rd: “WHO reiterated that it does not recommend any ban on international travel or trade. It stresses that closing borders doesn’t work and is detrimental, as affected countries will be pushed towards a humanitarian crisis and the international community’s ability to fight and reverse the Ebola outbreak will be hampered.”

Quarantine efforts directed solely at individuals with exposure opportunity are considered an appropriate measure, while wholesale exclusion of populations with no likely exposure risk is considered excessive and potentially counterproductive as the inability to maintain such a large quarantine undermines authority.  Isolation and quarantine when used appropriately are critical tools in curtailing outbreaks.

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