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Michigan-CDC study supports value of social restrictions during influenza pandemics

ANN ARBOR, Mich. Although physicians have imposed quarantine orders since at least 1374, when the Port of Venice officially isolated foreigners and shippers for 40 days to keep out infectious scourges, there has been no definitive evidence that public health measures like quarantining the sick and isolating people after exposure to ill people would save lives during an influenza pandemic.

Until now.

In a study published in the Aug. 8 Journal of the American Medical Association, a team of University of Michigan medical historians and epidemiologists from the federal Centers for Disease Control and Prevention say that social restrictions allowed 43 U.S. cities to save thousands of lives during the Spanish influenza pandemic of 1918-1919.

Although these urban communities had neither effective vaccines nor antiviral medicines, they were able to organize and execute a suite of classic public health measures called non-pharmaceutical interventions or NPIs before the pandemic gained full force.

The new study finds that cities whose NPIs were sustained and layered with multiple tactics had the best outcomes. In addition to quarantine and isolation, the NPIs examined in this study were school closures and cancellation of public gatherings.

Public health is everyones responsibility. In a world faced by the threat of newly emerging and re-emerging infectious diseases, it is critical to determine if costly and potentially socially harsh NPI measures can save lives and reduce the numbers of those infected, says lead author Howard Markel, M.D., Ph.D., the George E. Wantz Distinguished Professor of the History of Medicine, professor of pediatrics and communicable diseases, and director of the U-M Center for the History of Medicine. Now we know the answer is yes.

Markel adds that in todays world, implementing these measures in a layered, sustained fashion would also provide a cushion of time for the development an
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Contact: Mary Beth Reilly
reillymb@umich.edu
734-764-2220
University of Michigan Health System
7-Aug-2007


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