Abstract

The quarantine of suspected cases and isolation of individuals with symptoms are two of the primary public health control measures for combating the spread of a communicable emerging or re-emerging disease. Implementing these measures, however, can inflict significant socio-economic and psychological costs. This paper presents a deterministic compartmental model for assessing the single and combined impact of quarantine and isolation to contain an epidemic. Comparisons are made with a mass vaccination program. The model is simulated using parameters for influenza-type diseases such as SARS. The study shows that even for an epidemic in which asymptomatic transmission does not occur, the quarantine of asymptomatically-infected individuals can be more effective than only isolating individuals with symptoms, if the associated reproductive number is high enough. For the case where asymptomatic transmission occurs, it is shown that isolation is more effective for a disease with a small basic reproduction number and transmission coefficient of asymptomatically-infected individuals. If asymptomatic individuals transmit at a rate that is at least 20% that of symptomatic individuals, quarantine is always more effective. The study further shows that the reduction in disease burden obtained from a combined quarantine and isolation program can be comparable to that obtained by a vaccination program, if the former is implemented quickly enough after the onset of the outbreak. If the implementation of such a quarantine/isolation program is delayed, however, even for a short while, its effectiveness decreases rapidly.

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