www.ncbi.nlm.nih.gov/pmc/articles/PMC1891118/]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891118/[/url]
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Καραντίνα - ιστορικά στοιχεία και προέλευση του όρου:[/size]
Quarantine is an ancient concept. It can be traced back to the efforts to control the Black Death in 14th century Italy. Initially, the period of detention was 30 days — the trentino. This was later modified to 40 days — the quarantino — perhaps because this matched the 40 days of Lent.
Quarantine measures were “harsh and stupid” and were based on “gross ignorance” and “fear”. The unmarked graves on Grosse-Île in the St. Lawrence River bear stark witness to the folly of quarantine.
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Τι αναφέρει το Control of Communicable Disease Manual:[/size]
Quarantine has a very limited role in modern public health practice. The Control of Communicable Disease Manual provides an authoritative summary of control measures for more than 150 infectious diseases of public health concern. For the vast majority of these diseases, the manual dismisses quarantine with the curt phrase “not applicable” and
recommends modified quarantine for only 6 diseases. For example, it recommends that children who have not been immunized against mumps be excluded from school during an outbreak. The manual recommends absolute quarantine in only 2 circumstances: people exposed to pneumonic plague who refuse chemoprophylaxis and people who are louse infested and have been exposed to typhus fever. The manual does not recommend any quarantine measures for influenza, smallpox or SARS, and it
does not recommend mass quarantine for any disease in any circumstances.
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Παράγοντες που καθιστούν αποτελεσματική μια καραντίνα:[/size]
For quarantine to be effective, 3 conditions must be met. First,
the disease must be efficiently transmissible in its incubation period or very early in its symptomatic stage. Case isolation, not quarantine, is appropriate for diseases that are spread only during symptomatic illness. Quarantine will be ineffective for diseases that can be spread by people with only asymptomatic illness. Second,
it must be possible and practical to identify all, or virtually all, people incubating the infection. Third,
infected people must comply with the conditions of the quarantine.
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Κόστη μιας καραντίνας:[/size]
Quarantine has substantial costs. These can include
diversion of scarce resources, augmentation of public fears and intolerances, provocation of civil disobedience and infringement of human rights.
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Η περίπτωση του Τορόντο κατά την πανδημία του SARS:[/size]
Mass absolute quarantine was used as a control measure by public health authorities in the outbreak of SARS in Toronto in 2003.
Quarantine was adopted early in the outbreak, when little was known about the disease, and was unnecessary because SARS was not highly infectious during its incubation period or its early symptomatic stage. SARS quarantine was ineffective because compliance was poor — no higher than 57% and possibly much lower. The costs, in terms of wasted resources and public anxiety and intolerance, were substantial. Travel advisories for SARS, a form of modified quarantine, were also unnecessary.
SARS was, in fact, rapidly eradicated by effective isolation of cases in hospitals.
