Lecturer: Abdirahman Moalim Hassan

(BScN, Master of Health service Mgt , Candidate PhD of Nursing

Science )

Cabdirahman05@gmail.com

252615218180

LECTURER ONE: LECTURE ONE

Health Quarantine And Regulation

LECTURE ONE
 Introduction
Isolation and quarantine help protect the public by preventing
exposure to people who have or may have a contagious disease.

Quarantine and isolation are both public health tools that

involve physical separation and quarantine of infected
individuals to prevent disease spread and for protecting the
general public health.

Isolation is used for symptomatic individuals, while quarantine

is for asymptomatic individuals.
The decision for quarantine should be based on best available
evidence rather than being driven by fear or political
motivation.

In general, to order a quarantine, the disease in question must

be transmitted from person to person and it must occur before
symptom onset.

Once symptoms occur, a person would be isolated rather

quarantined.

The disease must also have high mortality and morbidity rate.
• Quarantine may be defined as the limitation or
segregation(Sepration) of human beings or other living
creatures, who may have come, either hypothetically or
actually, into contact with transmissible pathologies, until
the moment when it is considered certain that they no
longer constitute a health risk.
• The term and the concept of quarantine are profoundly
rooted in culture and world health procedures, and have
periodically recalled peak interest in the course of
epidemics.

• In the past the concept of quarantine was used to refer to

the period of isolation of people alone, whereas in more
recent times it has come to be applied to animals and
things as well (Gensini et al., 2004).
• Quarantine has been implemented in many
different ways in the course of Western history,
undergoing periods in which it was highly
considered and periods in which it was relatively
neglected.
• In Europe and North America, during the last decades of
the twentieth century, quarantine was substantially
unrecognized, given that the great achievements of
modern medicine, from effective vaccines to powerful
antibiotics, generated, in the general public but
sometimes in health systems and operators too, the false
impression that the battle against infectious diseases
could be considered won.
• The recent, worldwide realities of ‘new’ transmissible
pathologies, including the severe acute respiratory
syndrome (SARS) and the avian influenza, have provided
evidence of the fact that human beings are still engaged in a
struggle against pathogen agents.

• Avian influenza refers to the disease caused by infection

with avian (bird) influenza (flu) Type A viruses. These viruses
occur naturally among wild aquatic birds worldwide and can
infect domestic poultry and other bird and animal
species. Avian flu viruses do not normally infect humans.
• Furthermore, in the case of an epidemiological
emergency, the collaboration of the majority of the
population in health measures planned by the
government would be limited, largely because the
majority of the interviewed people did not know what
quarantine is, what it is for, and what it exactly entails.
 History of quarantine
The word quarantine comes from the Italian word,
‘quarantena’, which means ‘forty days’. 

According to the Centers for Disease Control and

Prevention (CDC), this was the first recorded example of
quarantine as we know it today. 
One of the most widespread pandemics before
coronavirus, the flu pandemic of 1918, also saw
many efforts made towards enforcing quarantine
and isolation.

Public gatherings were forbidden and people were

asked to stay at home, though it proved difficult to
enforce these measures on a wide scale.
Similar, more recent examples include
the 1799 outbreak of yellow fever in Philadelphia in
the USA. 

The government quarantined hundreds of

sailors(seaman) in a hospital just outside of the city
in an attempt to stop the spread. However, the
fever comes from mosquitos so it was the cold
winter which finally saw the outbreak end. 
 History of Quarantine
The Middle Ages

• The practice of quarantine, began during the 14th

century in an effort to protect coastal cities from plague
epidemics.

• This practice, called quarantine, was derived from the

Italian words quaranta giorni which mean 40 days.
 What Is Quarantine?
According to the Centers for Disease Control and
Prevention (CDC), quarantine is the “separation and
restriction of movement of persons, who, while not yet ill,
have been exposed to an infectious agent and therefore
may become infectious.”

Quarantine is effective in preventing the spread of a

contagious illness and can be carried out voluntarily or
ordered by government public health authorities.
 A quarantine
• A quarantine is a restriction on the movement of people,
animals and goods which is intended to prevent the
spread of disease or pests.

• A pest is any animal or plant harmful to humans or

human concerns.
• The term is particularly used for creatures that damage
crops, livestock, and forestry or cause a nuisance to
people, especially in their homes.
 QUARANTINABLE
DISEASES
Quarantinable diseases include the viral haemorrhagic
fevers (VHF) (Lassa fever; Ebola haemorrhagie fever,
Marburg disease, Crimean-Congo haemorrhagic fever;
Argentinian haemorrhagic fever; Bolivian haemorrhagic
fever), cholera, plague, typhus (epidemic) and yellow fever.
• Diphtheria

• Infectious tuberculosis

• Smallpox

• Viral hemorrhagic fevers (like Ebola)

• Severe Acute Respiratory Syndrome (SARS, MERS, COVID-

19)

• Flu that can cause a pandemic

 State, Local, and Tribal Law
• States have police power functions to protect the health,
safety, and welfare of persons within their borders.

• To control the spread of disease within their borders,

states have laws to enforce the use of isolation and
quarantine.
• These laws can vary from state to state and can be 
specific or broad.

• In some states, local health authorities implement state

law.

• In most states, breaking a quarantine order is a criminal

misdemeanor.
• Tribes also have police power authority to take actions
that promote the health, safety, and welfare of their own
tribal members.

• Tribal health authorities may enforce their own isolation

and quarantine laws within tribal lands, if such laws exist.
 Purpose and scope

The purpose and scope of these Regulations are to prevent,

protect against, control and provide a public health response to
the international spread of disease in ways that are
commensurate with and restricted to public health risks, and
which avoid unnecessary interference with international traffic
and trade.
 Principles
1. The implementation of these Regulations shall be with
full respect for the dignity, human rights and fundamental
freedoms of persons.
2. The implementation of these Regulations shall be guided
by the Charter and the Constitution of the World Health
Organization.
3. The implementation of these Regulations shall be guided
by the goal of their universal application for the protection
of all people of the world from the international spread of
disease.
4. States have, in accordance with the Charter and the
principles of international law, the independent right to
legislate and to implement legislation in fulfillment of their
health policies.

In doing so they should uphold the purpose of these

Regulations.
 Common terms
Disease: means an illness or medical condition, irrespective of
origin or source, that presents or could present significant
harm to humans.

Decontamination: means a procedure whereby health

measures are taken to eliminate an infectious or toxic agent or
matter on a human or animal body surface, in or on a product
prepared for consumption or on other inanimate objects,
including conveyances, that may constitute a public health risk.
Cargo: means goods carried on a transportation or in a
container.

Competent authority: means an authority responsible for

the implementation and application of health measures
under these Regulations.

affected area: means a geographical location specifically for

which health measures have been recommended by WHO
under these Regulations.
Conveyance: means an aircraft, ship, train, road vehicle or other
means of transport on an international voyage(trip).

conveyance operator: means a natural or legal person in charge of a

conveyance or their agent.

Crew: means persons on board a conveyance who are not passengers.

Disinfection: means the procedure whereby health measures are

taken to control or kill infectious agents on a human or animal body
surface or in or on baggage, cargo, containers, conveyances, goods
and delivery or post by direct exposure to chemical or physical agents.
Goods: mean tangible products, including animals and
plants, transported on an international voyage, including
for utilization on board a conveyance.

health measure: means procedures applied to prevent the

spread of disease or contamination; a health measure does
not include law enforcement or security measures.

ill person: means an individual suffering from or affected

with a physical ailment that may pose a public health risk.
Infection: means the entry and development or
multiplication of an infectious agent in the body of humans
and animals that may constitute a public health risk.

Inspection: means the examination, by the competent

authority or under its supervision, of areas,
baggage(suitcases, trunks, and personal belongings of
travelers), containers, conveyances, facilities, goods or
postal parcels, including relevant data and documentation,
to determine if a public health risk exists.
international traffic: means the movement of persons,
baggage, cargo, containers, conveyances, goods or postal
parcels across an international border, including
international trade.
Medical examination: means the preliminary assessment
of a person by an authorized health worker or by a person
under the direct supervision of the competent authority, to
determine the person’s health status and potential public
health risk to others, and may include the inspection of
health documents, and a physical examination when
justified by the circumstances of the individual case.
Reservoir: means an animal, plant or substance in which an
infectious agent normally lives and whose presence may
constitute a public health risk.

scientific evidence: means information furnishing a level of

proof based on the established and accepted methods of
science.
Surveillance: means the systematic ongoing collection,
collation and analysis of data for public health purposes and
the timely dissemination of public health information for
assessment and public health response as necessary.

Suspect: means those persons, baggage, cargo, containers,

conveyances, goods or postal parcels considered by a State
Party as having been exposed, or possibly exposed, to a
public health risk and that could be a possible source of
spread of disease.
Verification: means the provision of information by a State
Party to WHO confirming the status of an event within the
territory or territories of that State Party.
The end
Thanks