Isolation of sick individuals
Isolation: Separation or restriction of movement of ill persons with an infectious disease to prevent transmission to others
Case isolation: Separation or restriction of movement of ill persons with an infectious disease at home or in a health care facility, to prevent transmission to others.
Patient isolation: Isolation of ill persons with an infectious disease in a health care facility, to prevent transmission to others.
Home isolation: Home confinement of ill persons with an infectious disease (often not needing hospitalization), to prevent transmission to others.
Voluntary isolation: Voluntary separation or restriction of movement of ill persons in a designated room to prevent transmission to others. This is usually in their own homes, but could be elsewhere.
Four epidemiological studies and 11 simulation studies were included in the systematic review.
Six of the 11 simulation studies predicted that case isolation would decrease the number of infections.
One study showed the difficulty in controlling spread when there is a potentially high proportion of asymptomatic transmission.
Isolation of sick individuals could reduce transmission in epidemics and pandemics.
The overall effectiveness of isolation is moderate, and combination with other interventions may potentially improve effectiveness.
Individuals who share a room with an isolated case (family member/ roommate) may be at a higher risk of infection.
A simulation model showed that encouraging voluntary isolation of patients is a more effective strategy than school closure. Case isolation is also relatively inexpensive compared with school closure.
The cost-effectiveness of isolation alone is unclear. Direct costs may have a disproportionate impact on low-income groups, mainly related to employment losses through people staying at home for 7-10 days.
The implementation of case isolation would involve a relatively large amount of resources.
Quality of evidence: There is very low overall quality of evidence that isolation of sick individuals has a substantial effect on transmission of influenza except in closed settings.
Overall strength of recommendation: Recommended
Home isolation is feasible when
- The person is either presymptomatic/asymptomatic, or having mild symptoms
- There is a separate room for isolation, preferably with attached bathroom
- There is facility to provide food and other essentials for the duration of isolation
- The person strictly remains inside the designated room for the duration of isolation
- Such isolation will not result in economic hardships for the concerned person/ person’s family