Public health and ethical considerations in planning for quarantine.

Abstract

effective, most feared, and most misunderstood methods of controlling communicable disease outbreaks. Its etymological roots are traceable to 14th century public health practices requiring ships arriving in Venice from plague-infected ports to sit at anchor for 40 days (hence, quar-antine) before disembarking their surviving passengers. While in recent times the use of quarantine has been more humane and scientifically based, the historical association with exile and death and the morally negative connotation of sacrifice of a few for the benefit of others remains as an undercurrent of public apprehension. Nevertheless, quarantine was recently implemented successfully in several countries as a socially acceptable measure during the SARS epidemic in 2003 [1]. It is an important component of the Department of Health and Human Services (HHS)† Pandemic Influenza Plan issued in November 2005 [2].‡ The purpose of this article is to review the modern public health approach to quarantine, outline highlights of current plans for its implementation in the event of an avian influenza pandemic, and consider the ethical principles that should be considered.