Severe Acute Respiratory Syndrome: Did Quarantine Help?

York Central Hospital, Richmond Hill, Ontario Correspondence and reprints: Dr Richard Schabas, York Central Hospital, 10 Trench Street, Richmond Hill, Ontario, L4C 4Z3. Telephone 905-883-1212 ext 312, fax 905-883-2455, e-mail rschabas@yorkcentral.on.ca Quarantine, the isolation of asymptomatic individuals who are thought to be incubating infection, was a prominent control strategy used in the recent severe acute respiratory syndrome (SARS) outbreaks. A recent report about the public health efforts to control SARS in Toronto concluded that in future outbreaks “for every case of SARS, health authorities should expect to quarantine up to 100 contacts” (1). This is a remarkable conclusion. It is one thing to resort to an unproven intervention in the crisis posed by a novel disease threat; however, it is quite another to recommend the continued use of this intervention after the dust has settled and we know, or should know, a great deal more about the problem at hand. Mass quarantine for disease control was essentially abandoned last century. Does it deserve a second look? An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control: