Maine plan considers quarantine options

Mask use for public transportation

The section on community-based containment measures in Maine's pandemic flu plan includes the following information on possible strategies that may be employed by the state:

Isolating influenza cases separates them from healthy persons and restricts their movement, thereby preventing transmission to others. It also allows for the focused delivery of specialized health care to ill people. Quarantining persons who may have been exposed to influenza, but who are not ill, is intended to identify those at greatest risk for developing influenza and to prevent transmission to others. Quarantine allows for the monitoring of symptoms and the institution of appropriate isolation procedures as soon as symptoms are detected. In this way, quarantine reduces both the period of risk of transmission and the number of persons potentially exposed.

Isolation and quarantine are optimally performed on a voluntary basis, although different levels of government (local, state, federal) have the basic legal authority to compel mandatory isolation and quarantine of people and communities to protect the public's health. At the federal level, the U.S. Secretary of Health and Human Services has the statutory responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the United States. Within the State of Maine, authority to mandate involuntary quarantine and isolation is granted to the director of the Bureau of Health.

Following the 2003 severe acute respiratory syndrome (SARS) epidemic, many countries adopted community-based strategies to control the spread of SARS-CoV. These strategies also could be considered for use during a large-scale influenza outbreak: requiring fever screening before entry into schools, work sites, and public buildings; requiring face masks in certain settings (e.g., on public transportation systems); establishing fever hotlines and referral services for concerned citizens; and implementing widespread environmental disinfection strategies. A variety of quarantine strategies also may be considered, including:

  1. Disseminate information (in appropriate languages) on restrictions in the quarantine zone (e.g., print/broadcast media, posters, leaflets, fliers, door-to-door).
  2. Disseminate information on quarantine rationale, procedures, and restrictions to neighboring zones/communities.
  3. Restrict mass transit as necessary.
  4. Restrict access routes.
  5. Minimize movements into quarantined areas by use of monitoring checkpoints, curfews, travel permits, health certificates.
  6. Establish cooperative arrangement with neighboring zones/communities to prevent movement into or out of quarantine zone.
  7. Clearly define who may enter quarantine zone.
  8. Ensure that enforcement is maintained; this may require fines, penalties, barricades, and visible signs of boundary enforcement.
  9. Discontinue isolation/quarantine measures, maintenance of designated facilities, and enforcement measures at the conclusion of three incubation periods after the last reported case.