Quarantine of exposed individuals
Quarantine: Imposed separation or restriction of movement of persons who may or may not be infected but are not ill, and who may become infectious to others (apparently healthy contacts).
Household quarantine: Confinement (commonly at home) of non-ill household contacts of a person with proven or suspected infectious disease.
Home quarantine: Home confinement of non-ill contacts of a person with proven or suspected infectious disease.
Self-quarantine: Voluntary confinement of non-ill contacts of a person with proven or suspected infectious disease.
- Measures taken by workers who have been exposed and who work in a setting where the disease is especially likely to transmit (or where there are people at higher risk from infection) [Example: people working in old-age homes; nurses in high-risk units]
- Measures taken by health care workers who choose to stay away from their families when off duty, to avoid carrying the infection home.
Maritime quarantine: Monitoring of all ship’s passengers and crew for a defined period before permission is given to disembark.
Six epidemiological studies and 10 simulation studies were included in the systematic review.
Quarantine is generally effective in reducing the burden of disease and transmissibility, and in delaying the peak of the epidemic.
Some studies suggested a significant improvement in effectiveness of quarantine when combined with other interventions such as case isolation, antiviral prophylaxis or school closure.
Home quarantine with infected cases can significantly increase the risk of acquiring infection.
Large-scale quarantine could be resource intensive.
Enforcing quarantine or monitoring compliance could be a challenge due to resource constraints.
Quality of evidence: There is a very low overall quality of evidence that quarantine of exposed individuals has an effect on transmission of influenza.
Overall strength of recommendation: Not Recommended due to feasibility concerns with very low quality of evidence.
The implementation of quarantine may be beneficial only in very specific circumstances- either the very beginning or near the end of an epidemic/ pandemic- when the total number of cases is low, rapid contact tracing is possible (tracing and testing of 100% contacts within 72 hours), and adequate resources are available to strictly enforce implementation.
Wherever quarantine is implemented, exposed persons must be quarantined in separate rooms, and there should be no mixing of such persons with non-exposed/ other exposed persons. Failure to do so will substantially increase the risk of transmission and a ‘super-spreading’ event.