...to support local Public Health jurisdictions in their efforts to plan for and manage a large-scale isolation and quarantine response. The Toolkit is designed for all types of users and is separated by topic for the ease of use and navigation.

We recommend starting with the User’s Guide and then navigating through the Toolkit based on your topical learning needs. We hope that this toolkit is helpful to you, that it saves you time, and, once you develop your plan – that you never have to implement it.

Both isolation and quarantine are common and valuable Public Health tools routinely used by Public Health authorities to control the spread of communicable diseases. Historically used for the large-scale epidemics of the 19th and first half of the 20th centuries but more recently as an individual strategy that is carried out in a quiet, small-scale manner, out of public view.

Recent events and concern about the deliberate release of biological agents such as plague and anthrax or the spread of emerging diseases such as pandemic influenza and SARS has changed the context of Public Health preparedness. Proactively planning for and managing the implementation of a large-scale isolation and quarantine has once again become part of Public Health’s fundamental responsibility.

DEFINING THE TERMS:

Isolation refers to the separation of persons who have a specific infectious illness from those who are healthy and the restriction of their movement to stop the spread of that illness.

Quarantine refers to the separation and restriction of movement of persons who, while not yet ill, have been exposed to an infectious agent and therefore may become infectious.

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Recent events and concern about the deliberate release of biological agents such as plague and anthrax or the spread of emerging diseases such as pandemic influenza and SARS has changed the context of Public Health preparedness. Proactively planning for and managing the implementation of a large-scale isolation and quarantine has once again become part of Public Health’s fundamental responsibility.

Public Health – Seattle & King County’s plan for dealing with an infectious disease outbreak involves dozens of agencies, including local health care providers, health facilities, emergency management personnel, law enforcement agencies, and community-based organizations. Planning and building strong partnerships takes time.

UNDERSTANDING WHERE WE HAVE BEEN

The practices of isolation and quarantine have been around a long time. Historical writings document rules for isolating lepers from the general public but the first formal system of quarantine took place in Venice during the 14th century. In an effort to protect Venice from the plague epidemic, incoming ships were required to sit at anchor for forty days before landing. ("Quarantine" is derived from the Italian words quaranta giorni or forty days.)

In the United States, continuous yellow fever epidemics led to Federal Quarantine Legislation passed by Congress in 1878. Local quarantine stations were built and by 1921, all quarantine stations were controlled by the United States Federal Government. In order to contain such diseases as cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, and viral hemorrhagic fevers, such as Marburg, Ebola and Congo-Crimean, quarantine stations were located at every port, international airport, and major border crossing.

The development of antibiotics and routine vaccinations almost eradicated the need for large-scale quarantines. Although Isolation and Quarantine were once feared, small scale practices of isolating people with specific infections and separating those that have been exposed to an infectious agent remain an effective technique for public health to ensure public safety. Communities have sought to dispel the myths and demonstrate the essential need for these procedures.

Bioterrorism and emergent diseases like SARS threaten to resurrect the need for large-scale quarantine planning, potentially on the scale of an entire city. Communities across the nation are now working to plan and be better prepared on implementing a response for a large-scale quarantine order.

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