Containing Emerging Epidemics: a Quantitative Comparison of Quarantine and Symptom Monitoring

Corey M Peak; Lauren M Childs; Yonatan H Grad; Caroline O Buckee

We find that the incremental benefit of quarantine over symptom monitoring is small for Ebola and SARS, but relatively large for influenza, whose short duration of infectiousness ( !"# ≈ 1-3 days) and some pre-symptomatic infectiousness ( !""#$% < 0) render symptom monitoring a generally ineffective intervention -particularly in settings with slow contact tracing ( !" >> 0) and symptom identification ( !" >> 0). For pandemic influenza strains (which are expected to have higher ! than the seasonal influenza strains shown here) or if circumstances arise such that MERS transmissibility increases substantially, quarantine may be necessary to achieve control (Fig 3B) . Note that CDC quarantine authorities do not extend to pertussis and hepatitis A, and these case studies were selected to demonstrate a broad range of natural histories and transmission routes, including bodily fluid, fecal-oral, and airborne, which will influence the contact networks . CC-BY-ND 4.0 International license is made available under a The copyright holder for this preprint (which was not peer-reviewed) is the author/funder. It . https://doi.org/10.1101/072652 doi: bioRxiv preprint and traceability of contacts. In general, we find that a reduction in the fraction of contacts who are ultimately traced will decrease the preference for quarantine over symptom monitoring, therefore supporting the previous findings that quarantine was inefficient for a respiratory disease like SARS (20).