Isolation & Quarantine Measures in Response to a Smallpox Emergency

Community Response

Level 1

At a minimum, a smallpox outbreak would result in travel alerts and information being released so that the community is aware of the situation and can make their own decision about how to manage their risk by controlling their own movements within the community (e.g. some people may decide themselves not to go to places where there are lots of people). Level 1 activities would include:

  1. Travel alerts and information
  2. Press releases
  3. Interagency partner notifications
  4. Self-restriction of movements

Level 2

Would include those activities implemented in Level 1 plus the issuance of travel advisories to those outside the community to avoid the area if possible. There would be a recommendation against those from the community traveling outside the area unnecessarily, but it would not be a forced restriction. In addition, public health authorities could also restrict large public gatherings and the temporary closure of unessential public places. Level 2 activities would include:

  1. All of Level 1 activities
  2. Travel advisories
  3. Recommendation against elective travel
  4. Suspension of large public gatherings
  5. Closing of public places

Level 3

Response would include all previous measures, but would actively restrict all travel to avoid the further spread of infection (e.g. closure of airports, bus stations, train stations, etc.). Level 3 activities include:

  1. Level 2 activities
  2. Restriction of travel (air, rail, water, motor vehicle and pedestrian)

Level 4

The institution of the highest level of quarantine, level 4 activities, would mean the complete cut-off of an area from the outside (i.e. institution of “Cordon Sanitaire”), with mass vaccination and treatment taking place within the area. Level 4 activities include:

  1. Level 3 activities
  2. “Cordon Sanitaire”
  3. Community-wide interventions (e.g., mass vaccination and treatment) 
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