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Isolation vs. quarantine vs. cohorting vs. surveillance

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Dr KK Aggarwal    16 February 2020

  1. Isolationis used to separate ill persons with a communicable disease from healthy individuals. The movement of ill persons under isolation is restricted in order to help stop the spread of certain diseases. Hospitals use isolation for patients with infectious tuberculosis. More often, isolation is required for airborne infections and precautions. MDR patients require strict isolation.
  2. Quarantineis used to separate and restrict the movement of well persons who have possibly been exposed to a communicable disease in order to see if they become sick. These people may have been exposed to a disease and do not know it, or they may have the disease but are asymptomatic. Quarantine can help limit the spread of a communicable disease.  
  3. Cohorting is used when patients are infected with the same pathogen. This interrupts the spread of infections. Examples are contagious disease hospitals.
  4. Community surveillance includes hospital and home-based surveillance. Example is Kerala tackling Nipah and COVID-19.  
  5. Cohorting of infected patients should not be combined with quarantine of healthy people.

Quarantine and isolation are linked to incubation period, mode of transmission, symptoms and the capacity of local government structures or health facilities to ensure that the needs of those kept separate are met.

In low- and middle-income countries, the capacity to individually isolate patients in health facilities are limited and patients with communicable diseases are often cohorted together away from the general patient population.

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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