Containment strategy

A containment strategy means attempting to prevent spread of disease (usually infectious) by:

• Case-finding:
  • Detecting imported infections into a community
  • Detecting first generation transmissions
• Preventive measures
  • That break chains of transmission
  • Prevent outbreaks
  • Theses include:
    • Vigorous contact tracing
    • Treatment
    • Immunisation
    • Quarantine
    • Quarantine of contacts.

For highly infectious disease with only moderate or low mortality and morbidity it may be far better to use the term "delaying strategy" as containment implies that it is reasonably possible to mobilise the resources and for society and individuals to accept the costs implicate for the disease in hand to prevent general transmission to the population.

Examples

Containment likely to be successful:

• Tuberculosis
• Smallpox
• Food contamination
• Water contamination
• Transmission mostly confined to restricted settings
  • SARS

Containment unlikely to be successful

• Viruses transmitted by respiratory and apparently clean fomite route
  • Influenza
    • But note successful containment of 1976 Swine flu outbreak (A/New Jersey/76 influenza) at a military base in USA which had the severe consequence that the vaccine prepared to cover this strain caused morbidity when not needed. Accordingly containment is appropriate for influenza either when a new strain is first detected in an isolated community or the actual virus has a low R^o as is the case to date with avian influenza H5N1 and suspected to be the case with the Fort Dix 1976 swine flu^[1]. Indeed the Fort Dix experience lead to the present phase 4 pandemic plan that was unable to be implemented with A(H1N1)v .
• Any disease where community transmission is established and no effective treatment preventative or otherwise exists
  • Common cold

References