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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2009

Open Access 01-12-2009 | Research article

Quarantine for pandemic influenza control at the borders of small island nations

Authors: Hiroshi Nishiura, Nick Wilson, Michael G Baker

Published in: BMC Infectious Diseases | Issue 1/2009

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Abstract

Background

Although border quarantine is included in many influenza pandemic plans, detailed guidelines have yet to be formulated, including considerations for the optimal quarantine length. Motivated by the situation of small island nations, which will probably experience the introduction of pandemic influenza via just one airport, we examined the potential effectiveness of quarantine as a border control measure.

Methods

Analysing the detailed epidemiologic characteristics of influenza, the effectiveness of quarantine at the borders of islands was modelled as the relative reduction of the risk of releasing infectious individuals into the community, explicitly accounting for the presence of asymptomatic infected individuals. The potential benefit of adding the use of rapid diagnostic testing to the quarantine process was also considered.

Results

We predict that 95% and 99% effectiveness in preventing the release of infectious individuals into the community could be achieved with quarantine periods of longer than 4.7 and 8.6 days, respectively. If rapid diagnostic testing is combined with quarantine, the lengths of quarantine to achieve 95% and 99% effectiveness could be shortened to 2.6 and 5.7 days, respectively. Sensitivity analysis revealed that quarantine alone for 8.7 days or quarantine for 5.7 days combined with using rapid diagnostic testing could prevent secondary transmissions caused by the released infectious individuals for a plausible range of prevalence at the source country (up to 10%) and for a modest number of incoming travellers (up to 8000 individuals).

Conclusion

Quarantine at the borders of island nations could contribute substantially to preventing the arrival of pandemic influenza (or at least delaying the arrival date). For small island nations we recommend consideration of quarantine alone for 9 days or quarantine for 6 days combined with using rapid diagnostic testing (if available).
Appendix
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Metadata
Title
Quarantine for pandemic influenza control at the borders of small island nations
Authors
Hiroshi Nishiura
Nick Wilson
Michael G Baker
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2009
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-9-27

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