INTERNATIONAL QUARANTINE

Moderator: Presented by,

Mrs. Mamta Neha Rai
Assistant Professor
M.Sc. Nursing Second year
College of Nursing
College of Nursing
AIIMS, Jodhpur
 INTRODUCTION
• International Health also called ‘geographic medicine’ or ‘global health’, is a
field of health care, usually with emphasis towards public health dealing with
health across regio.nal and/or international boundaries.
• Quarantine is a restriction on the movement of people and goods which are
intended to prevent the spread of disease or pests. It is often used in
connection to disease and illness, preventing the movement of those who may
have been exposed to a communicable disease, but do not have a confirmed
medical diagnosis.
 CONCEPT OF QUARANTINE
• The concept of quarantine has been known since biblical times
and is known to have been practiced through history in various
places. Notable quarantines in modern history include that of the
village of Eyam in 1665 during the bubonic plague outbreak in
England; East Samoa during the 1918 flu pandemic; the 1972
Yugoslav smallpox outbreak, and extensive quarantines applied
throughout the world during the COVID-19 pandemic in 2020.
 DEFINITION
• Quarantine has been defined as the ‘the limitation of freedom of movement of

such well persons or domestic animals exposed to communicable disease for a

period of time not longer than the longest usual incubation period of disease,

in such manner as to prevent effective contact with those not so exposed’.

• Quarantine measures are also ‘applied by a health authority to a ship, an

aircraft, a train, road vehicle, and other means of transport or container, to

prevent the spread of disease, reservoirs of disease or vectors of disease’

 CONT..
Quarantine may comprise

1. Absolute quarantine: as defined above

2. Modified quarantine: e.g. a selective partial limitation of freedom of movement, such as

exclusion of children from school, and

3. Segregation: which has been defined as ‘the separation for special consideration, control

of observation of some part of a group of persons (or domestic animals) from the others to

facilitate control of communicable disease, e.g. removal of susuceptible children to homes

of immune persons’
CONT..
Quarantine represents a range of possible interventions that could be
applied at the level of the individual, small group, or community.
Quarantine may be used for:

• Individuals with close contact (e.g., household contact) to a known

case.
• Small groups with close contact (e.g., co-workers, health care workers
with unprotected exposure) to a case.
 CONT..
• Larger groups with an unspecified extent of exposures (e.g., social groups,
persons in congregate settings, passengers on airplanes) to a case.
• Communities in which the extent of exposure for individuals is unknown but
interventions are needed to control potential population exposures by increasing
social distance and limiting interactions and movement within a community.
• Local law enforcement enforces State issued quarantine/isolation orders
TYPES OF QUARANTINE INCLUDE

Home Quarantine
CONT..

1. Home quarantine: Quarantine at home is most suitable for

contacts that have a home environment in which their basic
needs can be met and where the protection of unexposed
household members is feasible.
CONT..

2. Quarantine in community facilities:

• Contacts who do not have an appropriate home environment for

quarantine or contacts who do not wish to be quarantined at

home may be quarantined in specific facilities (motels, nursing

homes, apartments, etc.) designated for this purpose.

CONT..

3. Work Quarantine:

• This applies to health care workers or other essential personnel who

have been exposed to cases and who may need to continue working

(with appropriate infection control precautions) but who are quarantined

either at home or in a designated facility during off-duty hours

 ISOLATION

• Isolation is defined as the physical separation and confinement of an individual,

group of individuals, or individuals present within a geographic area that are
infected with a communicable disease or are contaminated, in order to prevent or
limit the transmission of the disease to the general public.

Types of Isolation include:

• Home Isolation

• Isolation in a community facility

• Hospital Isolation
CONT..
• In contrast to isolation, quarantine applies to restrictions on the
healthy contacts of an infectious disease. Quarantine which was
once a popular method of disease control has now declined in
popularity. With better techniques of early diagnosis and
treatment, quarantine, as a method of disease control, has
become outdated. It has been replaced by surveillance
 TERMINOLOGY AND ETYMOLOGY

• The word quarantine comes from quarantena, meaning "forty days",

used in 14th–15th-century Venetian and designating the period that
all ships were required to be isolated before passengers and crew
could go ashore during the Black Death plague epidemic; it followed
the trentino, or thirty-day isolation period, first imposed in 1347 in
the Republic of Ragusa, Dalmatia (modern Dubrovnik in Croatia).
 CONT..

• Quarantine may be used interchangeably with cordon sanitaire, and

although the terms are related, cordon sanitaire refers to the
restriction of movement of people into or out of a defined geographic
area, such as a community, in order to prevent an infection from
spreading.
SIGNALS AND FLAGS

• Plain yellow, green, and even black flags have been used to symbolize disease in
both ships and ports, with the color yellow having a long historical precedent, as
a color of marking for houses of infection, previous to its use as a maritime
marking color for the disease.

• Ships in Quarantine today would fly either the Q flag alone (meaning ‘My vessel
is “healthy” and I request free pratique‘or the double Q flag (QQ) (meaning ‘I
require health clearance‘).
ETHICAL AND PRACTICAL CONSIDERATIONS

• The quarantining of people often raises questions of civil rights,

especially in cases of long confinement or segregation from
society, such as that of Mary Mallon (also known as Typhoid
Mary), a typhoid fever carrier who was arrested and quarantined in
1907 and later spent the last 23 years and 7 months of her life in
medical isolation at Riverside Hospital on North Brother Island.
 The United Nations and the Siracusa Principles
• The Siracusa Principles state that restrictions on human rights under the
International Covenant on
• Civil and Political Rights must meet standards of legality,

• 'aimed at preventing disease or injury or providing care for the sick and
injured.'
• Limitations on rights (such as quarantine) must be 'strictly necessary,' meaning
that they must:
CONT..
• Respond to a pressing public or social need (health)
• Proportionately pursue a legitimate aim (prevent the spread of infectious disease)
• Be the least restrictive means required for achieving the purpose of the limitation
• Be provided for and carried out in accordance with the law
• Be neither arbitrary nor discriminatory
• Only limit rights that are within the jurisdiction of the state seeking to impose the
limitation.
 CONT…
In addition, when quarantine is imposed, public health ethics specify that:
• All restrictive actions must be well-supported by data and scientific
evidence
• All information must be made available to the public
• All actions must be explained clearly to those whose rights are
restricted and to the public
• All actions must be subject to regular review and reconsideration.
 CONT..
Finally, the state is ethically obligated to offer certain guarantees:

• Infected people will not be threatened or abused.

• Basic needs such as food, water, medical care, and preventive care will be provided.

• Communication with loved ones and with caretakers will be permitted.

• Constraints on freedom will be applied equally, regardless of social considerations.

• Patients will be compensated fairly for economic and material losses, including salary.
 List of quarantine services in the world
• Australian Quarantine and Inspection Service

• MAF Quarantine Service, in the New Zealand

• Quarantine, Western Australia

• Samoa Quarantine Service, in the West Samoa

• Racehorse & Equine Quarantine Services, A company built & developed by Frankie

Thevarasa Kuala Lumpur Malaysia

• Federal Service for Supervision of Consumer Rights Protection and Human Welfare,

a Federal Quarantine Service of the Government of Russia.

 NOTABLE QUARANTINES
• Eyam village, 1665 (plague): Eyam was a village in Britain
that imposed a cordon sanitaire on itself to stop the spread of
the bubonic plague to other communities in 1665. The plague
ran its course over 14 months and one account states that it
killed at least 260 villagers. The church in Eyam has a record of
273 individuals who were victims of the plague.
• Convict ship Surry, Sydney Harbour, 1814 (typhoid): On 28
July 1814, the convict ship Surry arrived in Sydney Harbour
from England. Forty-six people had died of typhoid during the
voyage, including 36 convicts, and the ship was placed in
quarantine on the North Shore. Convicts were landed, and a
camp was established in the immediate vicinity of what is now
Jeffrey Street in Kirribilli. This was the first site in Australia to
be used for quarantine purposes.
• 'Typhoid Mary' (US), 1907–1910 and 1915–1938: Mary Mallon was a

cook who was found to be a carrier of Salmonella enterica subsp.

enterica, the cause of typhoid fever, and was forcibly isolated from 1907

to 1910. At least 53 cases of the infection were traced to her, and three

deaths. Subsequently, she spent a further 23 years in isolation prior to

her death in 1938. The presence of the bacteria in her gallbladder was

confirmed on autopsy
• East Samoa, 1918 (flu pandemic): During the 1918 flu pandemic, the then

Governor of American Samoa, John Martin Poyer, imposed a full protective

sequestration of the islands from all incoming ships, successfully preventing

influenza from infecting the population and thus achieving zero deaths within the

territory. In contrast, the neighboring New Zealand-controlled Western Samoa

was among the hardest hit, with a 90% infection rate and over 20% of its adults

dying from the disease. This failure by the New Zealand government to prevent

and contain the Spanish Flu subsequently rekindled Samoan anti-colonial

sentiments that led to its eventual independence.

• Gruinard Island, 1942–1990 (anthrax): In 1942, during
World War II, British forces tested out their biological weapons
program on Gruinard Island and infected it with anthrax.
Subsequently, a quarantine order was placed on the island. The
quarantine was lifted in 1990, when the island was declared
safe, and a flock of sheep were released onto the island.
• Apollo series space explorers, 1969–1971: Between 24 July 1969
and 9 February 1971, the astronauts of Apollo 11, Apollo 12, and
Apollo 14, were quarantined (in each case for a total of 21 days)
after returning to Earth, initially where they were recovered, and
then were transferred to the Lunar Receiving Laboratory, to prevent
possible interplanetary contamination by microorganisms from the
Moon. All lunar samples were also held in the biosecure
environment of the Lunar Receiving Laboratory for initial assay.
• Yugoslavia, 1972 (smallpox): The 1972 Yugoslav smallpox
outbreak was the final outbreak of smallpox in Europe. The
World Health Organization fought the outbreak with extensive
quarantine and a cordon sanitaire, and the government
instituted martial law.
• Case of Kaci Hickox' return to US, 2014 (Ebola): In 2014, Kaci

Hickox, a Doctors Without Borders nurse from Maine, legally battled 21-

day quarantines imposed by the states of New Jersey and Maine after

returning home from treating Ebola patients in Sierra Leone. "Hickox was

sequestered in a medical tent for days because New Jersey announced

new Ebola regulations the day she arrived. She eventually was allowed to

travel to Maine, where the state sought to impose a 'voluntary quarantine'

before trying and failing to create a buffer between her and others.
• COVID-19 pandemic, 2020–present: During the COVID-19
pandemic, multiple governmental actors enacted quarantines in
an effort to curb the rapid spread of the virus. On 26 March, 1.7
billion people worldwide were under some form of lockdown,
which increased to 2.6 billion people two days later—around a
third of the world's population.
• Hubei: In Hubei, the origin of the epidemic, a cordon sanitaire was
imposed on Wuhan and other major cities in China, affecting around
500 million people, which is unprecedented in scale in human history,
to limit the rate of spread of the disease. The 'lockdown' of Wuhan, and
subsequently a wider-scale 'lockdown' throughout Hubei province,
began on 23 January 2020. At this stage, the spread of the virus in
mainland China was running at approximately 50% growth in cases per
day. On 8 February, the daily rate of spread fell below 10%.
 QUARANTINABLE DISEASES
• Cholera: In the nineteenth century and in the first quarter of the twentieth, cholera
has spread several times in pandemics from the areas where it is endemic into
Europe, North Africa and North America, and eastward into China and the
Philippines. For more than thirty years, however, Europe, America, Australia, and
Africa (except Egypt) have been completely free from the disease.
• The endemic foci proper are considered to be the deltaic region of the Ganges and
Brahmaputra, together with some less important foci in the same part of the world.
• Typhus: Louse-borne typhus used to be the inevitable companion of war
and other social disorganization. But in the Second World War, though
there were some important outbreaks, typhus never got out of hand.

• This was not because the infective micro-organism was less virulent or
because conditions were initially unfavorable to the louse, but because it
was controlled by the more efficient sanitary measures enforced by armies
and civil authorities; by antilouse dusting techniques, which became more
effective when DDT came into use, and by the degree of protection given
by anti-typhus vaccination.
• Plague: Plague was responsible for one of the most disastrous of the
known pandemics, the Black Death, which disorganized human society
in the fourteenth century.

• Plague has been frequent in China both in coastal areas and in the
interior and rat-caused plague has been entrenched in parts of South
China, as well as in the north-west of the country. In India particularly,
plague was a major cause of human mortality at the beginning of the
century but has steadily decreased in recent years.
• Relapsing Fever Louse-borne relapsing fever is perhaps the least

well-known of the quarantinable diseases. Its incidence fell off rapidly

after the Second World War; it disappeared from Europe in 1949, and

in recent years it appears to have been confined to a few foci.

• But because sporadic cases persist in some areas of Africa and Asia

and because it can become epidemic if the conditions are favorable, it

was included in the International Sanitary Regulations in 1951.

• Smallpox: Smallpox has been known throughout history, in all
regions, climates and peoples. Vaccination has changed the course
of the disease in many countries but it still persists in others. The
importance of smallpox is much decreased now that the severe
type is confined to certain endemic areas of the globe; but the
endemic foci still persist.
• Yellow Fever: An important point in the epidemiology of yellow

fever is that it is found in tropical Africa and America, but is absent

from Asia where conditions seem favorable for it and where potential

vectors are present. Yellow fever has occasionally invaded Europe

and North America, but never Asia. The reason for this is unknown

and the possibility that yellow fever might spread to Asia is one of the

chief considerations in present international quarantine practice.

ACTIVITIES IN INDIA FOR QUARANTIABLE DISEASES

• Polio Vaccination: It is heartening to note that India has not reported

any Polio case due to wild poliovirus since 13th January, 2011.
However, the poliovirus continues to circulate in the three polio
endemic countries, namely Afghanistan Pakistan and Nigeria, as well as
some erstwhile polio free countries with recent importations of
poliovirus such as Somalia, Kenya, Syria and Ethiopia. This has
aggravated the risk of importation of the poliovirus into India.
• The government of India, in order to minimize the risk of polio virus importation
into India, has decided the travelers to or from the seven countries mentioned above
need to be vaccinated within a period four weeks to one year before the date of the
travel.
• IMMIGRATION: To check that all the passengers going to seven countries from
India should have Polio Vaccination Certificate with them issued between four
weeks before (but not more than one year before) the date of departure. The training
has been provided to the staff of Immigration for the screening of the passengers.
• THE VACCINATION: Provided to the passengers visiting Polio
Endemic/Affected countries. (NO FEE – NO DOCUMENT NEEDED)
 MIDDLE EAST RESPIRATORY SYNDROME
CORONAVIRUS (MERS-COV)

• Middle East respiratory syndrome (MERS) is a viral respiratory

disease caused by a novel coronavirus (MERS‐CoV) that was
first identified in Saudi Arabia in 2012.
• Coronaviruses are a large family of viruses that can cause
diseases ranging from the common cold to Severe Acute
Respiratory Syndrome (SARS).
• Symptoms
• Ranges from no symptoms (asymptomatic) or mild respiratory
symptoms to severe acute respiratory disease and death.
• fever, cough and shortness of breath. Pneumonia is a common
finding, but not always present.
• Diarrhoea
• Prevention and treatment: No vaccine or specific treatment is
currently available. Treatment is supportive and based on the
patient’s clinical condition.
• Travel: WHO does not recommend the application of any travel
or trade restrictions or entry screening related to MERS-CoV.
 ZIKA VIRUS INFECTION
• Zika virus disease is caused by a virus transmitted by
Aedes mosquitoes.
• Persons with Zika virus disease usually have a mild fever,
joint pain, skin rash (exanthema) and conjunctivitis.
These symptoms are mild and normally last for 2-7 days.

• Signs and Symptoms: Fever, headache, skin rashes,

conjunctivitis, muscle and joint pain
• Preventive Measures
• Union Ministry of Health and Family Welfare has advised to
defer all non-essential travel to affected countries.
• Women should essentially avoid travel to affected countries
(especially during pregnancy).
• All pregnant women who have travelled to any affected*
country during pregnancy period or two weeks prior to
becoming pregnant should consult their doctor and undergo
regular ante-natal check-up.
• In case the travel cannot be deferred, follow strict Personal
Protective Measures against mosquito bites.
• Treatment
• No vaccine or medications are available to prevent or treat Zika infections.
• Any traveler, who, after visiting the affected countries develops above
mentioned symptoms within 14 days of arrival in India, should visit nearest
hospital facility.

• Symptomatic treatment:
• Take plenty of rest.
• Drink fluids to prevent dehydration.
• Take medicine such as acetaminophen to relieve fever and pain.
• Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs),
like ibuprofen and naproxen.
• Consult your doctor.
 EBOLA VIRUS DISEASE
• Ebola Virus Disease (formerly known as Ebola Hemorrhagic
Fever) is a Severe, often fatal illness, with a death of up to 90%.
The illness affects humans and non-human primates (monkeys,
gorillas and chimpanzees).

• As on 18th May 2014, the Ministry of Health (MOH) of Guinea

has reported a cumulative total of 253 clinical cases of Ebola Virus
Disease (EVD), including 176 deaths.
• Transmission: Ebola is introduced into the human population
through close contact with the blood, secretions, organs or other
bodily fluids of infected animals, chimpanzee, gorilla, fruit bats,
monkeys, forest antelopes and porcupines.
• The virus can be transmitted through semen of affected person up to
7 weeks after recovery from illness.
• Health-care workers have frequently been infected while treating
patients with suspected or confirmed EVD. Till 28th August, 2014
around 240 health care workers have died
 All Countries
WHO Recommendations
• No general ban on international travel or trade
• Provide relevant information to
– Travelers to Ebola affected areas: with information on minimizing
risks
– General public: Ebola outbreak and measures to reduce risk of
potential exposure
• Prepare to detect, investigate and manage cases
 Country Situation
• No case of EVD till date
• Regular monitoring from Highest level (HFM, Sec (H), DGHS
and JMG)
• Surveillance both at POEs and inside country
• Preparedness of Health facilities, Laboratories
• Strengthening infection control practices
• Training of manpower
• Risk assessment
• Involvement of non-govt. Health sector (IMA etc.)
 MoHFW Initiatives
• Advisories: MOCA, MEA, MHA
– For travelers: families staying and travelers visiting, those returning
– Airlines crew
– Immigration officials
– APHO/PHO/Ground crossing staff
• Manpower strengthening: MOs, SN, HI
• Orientation training
• Health cards
• Display of Health Alert
• Back-up support: hospitals & Labs
 Screening Process
• Use of Health card
• Categorization of travellers
– Low: those who have only H/o travel to EVD affected countries
– Medium: those who have H/o contact and
– High risk: who have H/o travel and/ or with signs and symptoms of EVD
• Low risk to be given advisory for monitoring their Health for next 30 days
• Referral of travellers with medium risk to IDSP
• Referral of travellers with High risk to identified quarantine/isolation facility
for testing and treatment
• Enlisting and referral of contacts of Medium and high risk
• Special risk groups : Army, MEA feed-back, Medical staff, others
YELLOW FEVER VACCINATION & QUARANTINE
• Passengers travelling to and from YF endemic countries (countries
where Yellow Fever disease is persisting) are required to be in
possession of a “VALID YELLOW FEVER VACCINATION
CERTIFICATE” issued by authorized and designated vaccination
centers in India.

• As required the certificate is treated as “INVALID” in the absence of

(details as per YF Certificate). Incidentally this job of checking of Valid
YF Certificate in possession of such passengers travelling from / through
any of these YF endemic countries is done by the Immigration Officers.
• Vaccination Procedure
• The vaccine beneficiary moves in following direction

• Flow of vaccine Beneficiary

• Registration counter → waiting area → Injection Room →

Observation Room
• Yellow Fever Vaccination received in India is valid only if it is
received from Govt. of India recognized centers only.
• 10 PERSONS ARE REQUIRED IN THE LAST BATCH (As
the vaccine available vial is of 10 dose each & it is opened only
when 10 person are available)
• FEE - RS.300/- FOR ONE VACCINE, fixed by Govt. of India
from time to time.
• Mandatory Requirement – Original Passport
• There has to be gap of four weeks between two different live
vaccines.
 DISEASE IMMUNIZATION

1. Cholera Two types of safe and effective oral cholera vaccine currently available. Given orally in two doses
between seven days and six weeks apart.

2. Plague Given subcutaneously or intramuscularly in 2 doses at an interval of 7 to 14 days. Immunity starts 5

to 7 days after inoculation and lasts for about 6 months.

3. Typhoid Fever Two vaccines are available for prevention of typhoid. Typhoid polysaccharides vaccine is inject able
given subcutaneously or intramuscularly. One dose is required. Confers protection after 7 days. The
other is oral typ21 a vaccine, administered on 1,3 and 5 th day. Protective immunity achieved 7 days
after 3rd dose.

4. Influenza Inactivated vaccine is widely used. Two adequately spaced doses (1.0 ml each) of an aqueous or
saline vaccine are recommended for primary immunization, although one dose may be given when
an epidemic is threatened. The immunity lasts for about 3 to 6 months. Oil-adjuvant vaccine gives
immunity of longer duration, but they tend to produce unpleasant local reaction.

5. Yellow Fever The dose of the vaccine (17D vaccine) is 0.5 ml given subcutaneously. Immunity begins 10-12 days
after vaccination, and extends up to 10 years.
 CURRENT UPDATES FOR COVID – 19
• According to MoHFW Guidelines for international arrivals (in
supersession of guidelines issued on the subject dated 24th May 2020) (to
be operational from 00.01 Hrs, 8th August 2020)
Before Planning for Travel:
• All travelers should submit self-declaration form on the online portal
(www.newdelhiairport.in) at least 72 hours before the scheduled travel.
• They should also give an undertaking on the portal that they would
undergo mandatory quarantine for 14 days i.e. 7 days paid institutional
quarantine at their own cost, followed by 7 days isolation at home with
self-monitoring of health.
• Only for compelling reasons/ cases of human distress such as
pregnancy, death in family, serious illness and parent(s) with
children of the age of 10 years or below, home quarantine may
be permitted for 14 days.

• If they wish to seek such exemption under para (iii) above, they
shall apply to the online portal (www.newdelhiairport.in) at
least 72 hours before boarding. The decision taken by the
government as communicated on the online portal will be final.
• Travelers may also seek exemption from institutional
quarantine by submitting a negative RTPCR test report on
arrival. This test should have been conducted within 96 hrs
prior to undertaking the journey.

• The test report should be uploaded on the portal for

consideration. Each passenger shall also submit a declaration
with respect to authenticity of the report and will be liable for
criminal prosecution, if found otherwise. The test report could
also be produced upon arrival at the point of entry airport in
India.
 Before Boarding
• Dos and Don'ts shall be provided along with ticket to the travelers by
the agencies concerned.
• All passengers shall be advised to download Arogya Setu app on their
mobile devices.
• At the time of boarding the flight/ ship, only asymptomatic travelers
will be allowed to board after thermal screening.
• Passengers arriving through the land borders will also have to
undergo the same protocol as above, and only those who are
asymptomatic will be enabled to cross the border into India.
• Suitable precautionary measures such as environmental
sanitation and disinfection shall be ensured at the airports.
• During boarding and at the airports, all possible measures to
ensure social distancing to be ensured.
 During Travel
• Travelers who had not filled in self-declaration form on the portal shall fill the
same in duplicate in the flight/ship and a copy of the same will be given to
Health and Immigration officials present at the airport/ seaport/ Land port.
• Alternatively, such travelers may submit self-declaration form on the online
portal at arriving airport/ seaport/ Land port as per the directions of the
concerned authorities, if such facility is available.
• Suitable announcement about COVID-19 including
precautionary measures to be followed shall be made at
airports/port and in flights/ships and during transit.

• While on board the flight/ ship, required precautions such as

wearing of masks, environmental hygiene, respiratory hygiene,
hand hygiene etc. are to be observed by airline/ ship staff, crew
and all passengers.
 On arrival
• De-boarding should be done ensuring social distancing.

• Thermal screening would be carried out in respect of all the passengers by the Health
officials present at the airport/ seaport/ Land port. The self-declaration form filled online
shall be shown (or a copy of physical self-declaration form to be submitted) to the airport
health staff.

• The passengers found to be symptomatic during screening shall be immediately isolated

and taken to medical facility as per health protocol.
• Post thermal screening, the passengers who have been exempted from institutional quarantine
(decision as indicated on the online portal in advance) will show the same to the respective
State Counters on their cell phones/other mode before being allowed home quarantine for 14
days.

• The remaining passengers shall be taken to suitable institutional quarantine facilities, to be

arranged by the respective State/ UT Governments.

• These passengers shall be kept under institutional quarantine for a minimum period of 7 days.
They shall be tested as per ICMR protocol available at
https://www.mohfw.gov.in/pdf/Revisedtestingguidelines.pdf
• If they test positive, they shall be assessed clinically.
– If they are assessed as asymptomatic / pre-symptomatic/ very mild
cases, they will be allowed home isolation or isolated in the Covid
Care Centre (both public & private facilities) as appropriate.
– Those having mild/ moderate/ severe symptoms will be admitted to
dedicated Covid Health facilities and managed accordingly.
• If found negative, they shall be advised to further isolate
themselves at home and self-monitor their health for 7 days.
• vii. In case, any symptoms develop they shall inform the
district surveillance officer or the state/national call center
(1075).

• NOTE: States can develop their own protocol with regards

to quarantine and isolation as per their assessment post
arrival of passengers in the state concerned
 CONCLUSION AND SUMMARY
• To conclude, Quarantine is a restriction on the movement of
people and goods which are intended to prevent the spread of
disease or pests. It is often used in connection to disease and
illness, preventing the movement of those who may have been
exposed to a communicable disease, but do not have a
confirmed medical diagnosis. It is distinct from medical
isolation, in which those confirmed to be infected with a
communicable disease are isolated from the healthy population.
Quarantine considerations are often one aspect of border control.
 REFERENCES
• Centers for Disease Control and Prevention, Quarantine and Isolation, accessed 10 september 2020 https://www.cdc.gov/quarantine/ 

• Wikipedia. The free encyclopedia https://en.wikipedia.org/wiki/Quarantine

• "Coronavirus Disease 2019 (COVID-19)—Transmission". U.S. Centers for Disease Control and Prevention (CDC). 17 March 2020.

Retrieved 10 September 2020.

• Park. K. Preventive and social medicine. 25th ed. Jabalpur: Banarsidas Bhanot; 2019.

• Kishore J. National health programmes of India. 13 th ed. New Delhi: Century Publications; 2014.

• International Health Regulations (2005) 3 rded https://www.who.int/ihr/publications/9789241580496/en/

• Directorate general of health services ministry of health & family welfare

government of India https://dghs.gov.in/content/1480_1_phih.aspx 

• Government of India Ministry of Health & Family Welfare Directorate General of Health Services

https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf