Case Identification and Contact Tracing

Francis, John G.; Francis, Leslie P.

Identifying cases of contagious disease and following any chains of transmission from them is a mainstay of public health efforts to stop disease spread. This method of surveillance is ineffective, however, if people cannot be found or refuse to reveal contacts. It also declines in efficacy as disease spreads widely in a community or is transmitted in ways such as aerolisization that may make it difficult to recognize that contacts have occurred. This chapter considers the ethics of contact tracing, arguing that the method has far too often been associated with moral condemnation of behaviours such as non-marital sex or with stigmatization of groups. The chapter then explores how contact tracing can be combined with treatment and other support to facilitate warranted trust in the use of this traditional surveillance method.