Knowledge is power

Quarantine has been an effective method of protecting the public from disease, and is thought to be a more effective method than drugs at preventing the spread of certain diseases-such as respiratory viruses. Although the practice of quarantine has been around for decades, there is a stigma attached which influences the people under quarantine and a public perception which plays into the problem with quarantine and the danger that can occur. A notable example of this was last year with the case of a man who was the first in 50 years to be quarantined by the CDC for a resistant strain of TB (tuberculosis) known as XDR TB a drug resistant strain. To add to this, the individual had escaped “custody” initially, again this appears to be due to the stigma associated with quarantine, the man was later “captured” it turned out that the individual did not in fact have XDR TB, nevertheless he recounted his tail as being treated like a criminal. Although the threat turned out to be false the man had traveled by plane to Europe and Canada and back again-the possibility of infecting others if he was not quarantined could arguably considered a valid reason for the quarantine.

A recent case of a more disturbing situation happened in South Africa in December 2007. 49 people were being held in a South African hospital for drug resistant TB (the details of the strain of TB have not been released). Again the treatment of these individuals appeared to be similar to the treatment of prison inmates, these patients-which is really what they are later escaped cutting through a perimeter fence. Of the 49 patients 26 returned, however 23 patients are still “on the loose”. These situations highlight the problems associated with the practice of quarantine.

Mario Raviglione, director of the WHO (World Health Organization) TB department indicated “it’s a last resort.” Arthur Caplan director of the Center for Bioethics at the University of Pennsylvania conveyed his sentiments “There are certain circumstances when public health trumps individual rights-when it comes to protecting lives.” Exacerbating this problem, is underdeveloped countries if they even have hospitals, lack the facilities to effectively treat possibly infectious patients. furthermore, the possiblity of a major outbreak in such a country would lead to problems of the feasibility of locking up thousands of individuals.

All experts and now policy makers are coming into line with the need for improvement in the use of quarantine in all countries, as Arthur Caplan notes…. “but you have to be careful. The purpose is to prevent spread of disease, not to punish people.”