Protective sequestration

Protective sequestration is a public health term that refers to measures taken to protect a small, defined, and still-healthy population from an epidemic (or pandemic) before the infection reaches that population.

Given the extraordinary nature of these measures, they should be considered, if at all, only under exceptional circumstances:

The term “protective sequestration” was coined by Howard Markel and his colleagues, in their paper that described the successes and failures of several communities in the United States in their attempts to shield themselves from the 1918-1920 so-called “Spanish Influenza” pandemic during the second wave of that pandemic (September–December 1918).[1]

The term “protective sequestration” avoids the use of the word quarantine, which, in public health, refers to the voluntary or enforced detention of a person who, because of actual or possible contact with a person carrying an infectious agent, may have acquired that agent and be capable of passing it along to others. The duration of the quarantine period is determined by the incubation period of the infection, i.e., the time between acquisition of the infectious agent and the development of signs or symptoms of the illness caused by that agent.

During the 1918 flu pandemic, factors that contributed to the rare successes of protective sequestration were the following:

An advantage of protective sequestration is that it shields selected people from infection and possibly buys them time for the development and distribution of drugs or vaccine. A disadvantage, apart from its elitism and social and economic cost, is that those sequestered have no opportunity to develop naturally-acquired immunity to the infectious agent through contact with it, and, therefore, they remain susceptible to the agent during subsequent waves of the epidemic or pandemic.

References

  1. See Howard Markel, Alexandra M. Stern, J. Alexander Navarro, Joseph R. Michalsen, Arnold S. Monto, and Cleto DiGiovanni, Jr., “Nonpharmaceutical Influenza Mitigation Strategies, US Communities, 1918-1920 Pandemic,” Emerging Infectious Diseases, vol. 12, no. 12 [December 2006]; available at http://www.cdc.gov/ncidod/eid/vol12no12/06-0506.htm.
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