So we had (yet) another dwarf contract the plague at Nutscaves. A learning experience ensued: he'd been assigned new shoes within the last two years, but his shoes had just rotted off, apparently moments before the illness kicked in. He contracted the blood plague, but the case was mild and he survived.
Previously I hadn't thought shoes would rot off so quickly. Perhaps it happened because we'd been doing a lot of long-range hauling recently--or he'd been assigned some slightly worn shoes to begin with. Each year I had been assigning ten new dwarves to wear shoes, assuming this would keep up with wear and not aggravate too many dwarves with "Enforced Dressing" (wherein I draft them into the military and make them stand around until their whole "squad" manages to get dressed. There are a lot of bumblers in my fortress and this takes a long time. There are tons of whines and complaints about hunger and thirst to accompany the process.) Each year I also check the condition of all currently assigned shoes, and decide whether to replace them.
After that dwarf contracted the plague, I did an extra check for glove-and-shoe wear, six months before the next one was due. I discovered a lot of other shoes had rotted off of other dwarves as well, much faster than expected! And so Nutscaves spent the late summer/early autumn of the year 266 doing nothing but reassigning shoes and gloves, to prevent more plague. It was a painstaking task on the part of Armok, and had to be done sloppily for speed (to prevent more plague contraction). Many dwarves are now walking around very upset as a result. We're in a precarious situation because of it. If anybody comes down with the plague and dies, or if there's a construction accident soon, we're already sitting on the precipice of a tantrum spiral.
Nutscaves is an unusual fortress. It has survived multiple strains and outbreaks of the worst type of highly contagious, deadly necrotic blood plague. It also has highly contaminated living and work spaces that can't be cleaned up safely. Many citizens also became infected with plague in less well-quarantined times, and they occasionally fall ill with recurrences of it. And yet, we have a population of about 155 dwarves, with 30 of them buck-naked children and infants. We have had only one plague death, and one other dwarf falling ill with plague and recovering, in the last few years.
Potentially, at any moment, if Armok stopped employing our strict quarantine procedures, then most of the population could fall ill and die. This fort has survived sixteen years so far, and Armok's procedures have evolved over time to prevent infection as much as possible within reason. Armok is currently using a set of procedures which seem quite effective in preventing the spread of plague. They're not 100% effective, but this quarantine procedure shows that a badly contaminated fort is not necessarily doomed. If I had started out with these procedures, the fort might never have become infected at all.
Following are Armok's current quarantine procedures, evolved over 16 years at Nutscaves.