CEBU INSTITUTE OF MEDICINE

WRITTEN OUTPUT ON ISOLATION

Submitted by:
Tibay, Eris John F.
Clinical Junior Clerk

Submitted to:
Dr. Karen Batoctoy
Director of Junior Clerkship Program
 Isolation, as defined by Merriam-Webster dictionary, means “a shutting away or keeping
apart from others”.1 In a more clinical sense, CDC defines isolation as “separating sick people
with a contagious disease from people who are not sick”.2 As we have witnessed from the past
couple years at the peak of the COVID-19 pandemic, isolation is one way to curb the spread of
illnesses. This is also another way to protect people from being infected by the patient that they
are taking care of.

According to the CDC, there are 2 tiers of precautions to be put in place to prevent
transmission of infectious agents: Standard Precautions and Transmission-Based Precautions.3
Standard Precautions are to be applied in all patients in all healthcare settings, regardless of
etiology of illness. Transmission-Based Precautions are for patients with known infectious
agents which require additional control measures to control the spread of infection, and this is
further subdivided into 3 categories: Contact Precautions, Droplet Precautions and Airborne
Precautions.

Certain infectious diseases require an infected patient to be isolated for a certain amount
of time so as to mitigate the spread of the disease. Some viral diseases can be pinpointed as
culprits. As was previously mentioned, COVID-19 is one of them, with the WHO recommending
a self-isolation of 10 days from symptom onset, plus 3 days after symptoms disappear.4
Influenza A (H1N1) is also included, with the CDC recommending anyone aged 18 or greater
with fever or cough to stay at home for 24 hours after fever is gone.5 Bird flu or Avian Influenza
(H5N1) also requires isolation with infection control precautions, including isolation, continuing
in an adult patient for 7 days after resolution of fever and 21 days after onset of illness for
children younger than 12 years.6 Another viral illness requiring isolation is Severe Acute
Respiratory Syndrome (SARS), caused by a coronavirus, with isolation recommended for 10
days after the resolution of fever, provided respiratory symptoms were absent or improving.7

Some bacterial illnesses also require patients to be isolated for a few days. Diphtheria,
caused by Corynebacterium diphtheriae, is one such infection, with patients infected put on
isolation until the organism is eliminated as evidenced by negative cultures of two samples
obtained at least 24 hours apart after completion of antimicrobial therapy, according to CDC.8
Tuberculosis, caused by Mycobacterium tuberculosis, also requires isolation. According to the
CPG guidelines by the DOH, isolation is done especially if the patient is infectious. Also,
patients living with HIV or with other forms of immunosuppression, should be physically
separated from those with suspected or confirmed infectious TB. Patients that are MDR or
XDR-TB, or people suspected of having drug-resistant TB should be separated or isolated from
other patients, including other TB patients.9 Pertussis, caused by Bordetella pertussis, also
requires isolation, with the CDC recommending isolation for 21 days from the onset of cough, or
until 5 days after the start of effective antimicrobial therapy for symptomatic patients.10

Isolation helps prevent the spread of disease to the public. Hence, if one is infected with
a potentially infectious disease, one should practice self-isolation and avoid public contact as
much as possible. After all, the concept of isolation is just one of the ways that public health is
maintained.
REFERENCES

1. Definition of ISOLATION. Merriam-webster.com. Accessed May 18, 2023.

https://www.merriam-webster.com/dictionary/isolation
2. Quarantine and isolation:: The rise of multiple borders. In: China and the Cholera
Pandemic. University of Pittsburgh Press; 2021:111-142.
3. Precautions. Cdc.gov. Published July 22, 2019. Accessed May 18, 2023.
https://www.cdc.gov/infectioncontrol/guidelines/isolation/precautions.html
4. Advice for the public on COVID-19 – World Health Organization. Who.int. Accessed May
18, 2023.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
5. Influenza Season Triage Algorithm for Adults (Older than 18 Years of Age) With
Influenza-Like Illness.; 2009.
6. Interim Guidelines for Avian Influenza Case Management. WHO; 2007.
7. SARS. Cdc.gov. Published March 20, 2023. Accessed May 18, 2023.
https://www.cdc.gov/sars/quarantine/fs-isolation.html
8. Diphtheria - Vaccine Preventable Diseases surveillance Manual. Cdc.gov. Published
April 26, 2023. Accessed May 18, 2023.
https://www.cdc.gov/vaccines/pubs/surv-manual/chpt01-dip.html
9. Clinical practice guidelines for the diagnosis, treatment, prevention and control of
tuberculosis in adult Filipinos. Psmid.org. Accessed May 18, 2023.
https://www.psmid.org/wp-content/uploads/2020/03/CPG-TB-2016.pdf
10. Pertussis. Cdc.gov. Published January 13, 2023. Accessed May 18, 2023.
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/selected-infections/
pertussis.html