Quantifying the Risk and Cost of Active Monitoring for Infectious Diseases

Nicholas G Reich; Justin Lessler; Jay K Varma; Neil M Vora

In some settings, active monitoring could serve as an alternative to quarantine, which involves both monitoring and severe restrictions on movement. In countries at low risk for Ebola, quarantine raised many ethical 7 . CC-BY-NC-ND 4.0 International license is made available under a The copyright holder for this preprint (which was not peer-reviewed) is the author/funder.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/10.1101/156497 doi: bioRxiv preprint issues during the West Africa Ebola outbreak.(24) CDC's Ebola active monitoring recommendations were therefore a critical cornerstone of the public health response in the United States that strived to balance the concerns from a diverse set of stakeholders without unnecessarily restricting individual liberties.(2) Active monitoring has since been applied by DOHMH for an individual at risk for another acute viral illness, Lassa fever. However, for diseases in which asymptomatic persons may transmit infection -such as influenza or measles-detection of the cases based on active monitoring of symptomology might not be soon enough to prevent secondary transmission. As such, for these diseases, quarantine might be a more appropriate public health measure.