“While the Angel of Death rides on the fumes of the iron scow, and infected airs are wafted to our shores from the anchorage, we shall have no security against these annual visitations of pestilence.” Dr. Anderson: Harper’s Weekly, 1858
Quarantine. The word is medieval yet futuristic, biblical as well as a harbinger of end-of-the-world doomsday scenarios. According to the BBC, the cases of Ebola since the start of the outbreak in March now stands at 7,780 in Sierra Leone, 7,719 in Liberia, and 2,283 in Guinea. The virus has killed more than 6,300 people. In recent months, public health officials have struggled with how to isolate people who may have been exposed to Ebola while still preserving individual rights and freedoms; governors in New York and New Jersey imposed 21-day quarantines on health care workers returning from the Ebola-stricken countries of West Africa. The New England Journal of Medicine has called these quarantines “not scientifically based” and “unfair and unwise.” Below is a timeline of unusual facts associated with the history of quarantines.
10. The Middle Ages
The formal system of quarantine began in the 14th century as a “state of enforced isolation” to protect coastal cities from plague epidemics. During the height of the Black Death, ships arriving in Venice were required to sit at anchor for 40 days before passengers and crew could go ashore. The word quarantine comes from the Italian words, quaranta giorni, which means forty days. Nevertheless, as early as the writing of the Old Testament, informal rules existed for isolating lepers.
9. Leper Colonies
Scholars believe the earliest account of leprosy appears in an Egyptian Papyrus written around 1550 B.C. In Europe, leprosy first appeared in the records of ancient Greece after Alexander the Great’s army returned from India. Throughout history, the disease has been feared and misunderstood, often believed to be a hereditary curse or a punishment from God. In Europe during the Middle Ages, lepers had to wear special clothing and ring bells to warn people that they were approaching. By 1200, there were 19,000 leprosariums in Europe, many of which functioned like self-contained towns complete with specially minted currencies.
8. The Lazaretto
The Lazaretto, an 18th century building on the bank of the Delaware in Essington, Pa, is the oldest surviving quarantine hospital in the United States. Named after St. Lazarus, the patron saint of lepers, the building was once the official quarantine facility for the port of Philadelphia; its history is tied to the yellow fever epidemic that ravaged the city in 1793, nearly wiping out the country’s fledgling democracy (it killed one of out five people). According to Dr. Robert Hicks, director of the Mutter Museum and Historical Medical Library at the College of Physicians in Philadelphia, “When yellow fever struck, the consequences were absolutely horrific. When people began vomiting up their stomach lining, the black vomit, that was the real lethal calling card that it had arrived.”
7. The Cholera Epidemic
Between 1831 and 1832, nearly 30,000 people in Britain died in a cholera epidemic. In June 1832, a New York mandate said that no ship can approach within 300 yards of any dock if the captain suspects that cholera is aboard. However, the disease wasn’t contained and killed nearly 3,500 people in New York before the epidemic ended in September. The catastrophe led to the first international sanitary conference in Paris, with the goal to make quarantine an international cooperative effort.
6. Typhoid Mary
Marry Mallon, better known as Typhoid Mary, is believed to have infected at least 53 people –three of whom died -with typhoid fever over the course of her career as a New York City cook. Marry Mallon is the first person in the U.S. identified as an asymptomatic carrier of the pathogen associated with typhoid fever. She was twice forcibly quarantined. After her second arrest in 1915, in which she started a major outbreak at Sloane Hospital for Women (25 infected, two dead), Mallon was isolated at Riverside Hospital. She spent 24-years in quarantine and in 1938, at age 69, died of pneumonia.
5. Venereal Diseases
In the early 20th century, venereal diseases were a serious problem for the U.S. military. According to a Harvard University study “The Syphilis Epidemic and its Relation to AIDS,” 13 percent of all Americans drafted by Uncle Sam for WWII tested positive for syphilis or gonorrhea. At the time, the moral stigma associated with venereal diseases was intense, and it was widely believed the transmission of these diseases occurred when one engaged in sex acts outside of traditional marriage. In other words, prostitution was to blame for venereal diseases.
In 1918, in an effort to dismantle the prostitution trade, U.S. Congress passed the Chamberlain-Kahn Act, which granted the military $1 million to be used in a civilian quarantine and isolation fund. The highly unconstitutional Act aimed to quarantine prostitutes and promiscuous women and girls. It’s estimated nearly 30,000 women were held in federal detention centers as a result of the program.
4. The Apollo 11 Mission
On July 24, 1969, the astronauts in the first manned lunar mission splashed to earth aboard the Command Module Columbia just before dawn local time. The recovery mission took place in the Pacific Ocean, where the three-man Apollo 11 crew was airlifted to safety. NASA, fearing the lunar surface may be wrought with pathogens (or dangerous, Triffid-like spores) took a cue from the science fiction playbook and isolated the astronauts for 21 days, first in a Mobile Quarantine Facility and later at the Lunar Receiving Laboratory at the Manned Spacecraft Center.
3. Cuban “Health Resorts”
In 1986, Cuba treated the first cases of HIV/AIDS by enforcing compulsory and indefinite quarantines for citizens who tested positive for HIV. The Los Angeles Times first reported on these “health resorts” in 1988, when a U.S. delegation visiting a sanatorium described it as “pleasant but frightening.” Despite achieving the lowest rate of HIV infection and the highest level of AIDS treatment in the Caribbean, Cuban policies aimed at stopping the spread of the disease were internationally condemned as violations of human rights. The “health spas” were quickly dubbed concentration camps. In 1989, Cuba changed its health care system, allowing patients to leave the sanatoriums for long stretches of time. By 1993, citizens with HIV could choose to live at home after completing an eight-week education program at a sanatorium.
The introduction of antibiotics and vaccinations made large-scale quarantines a thing of the past by the mid-20th century. Nevertheless, the threat of bioterrorism and newly emergent diseases like SARS and Ebola resurrected the age-old custom, causing many people, including doctors, nurses, travelers, and the federal government, to publicly debate the success of border security, travel bans, and medical quarantines. However, officials credit the use of quarantines and isolation with forestalling the SARS outbreak (severe acute respiratory syndrome) that began in Asia and Canada in 2003. President George W. Bush added SAARs to the list of the CDC’s quarantinable diseases in April 2003.
1. Quarantinable Diseases
According to the CDC, the list of quarantinable diseases contained in an Executive Order of the President include the following: cholera, plague, diphtheria, infectious tuberculosis, smallpox, yellow fever, viral hemorrhagic fevers (Marburg, Ebola, and Congo-Crimean), and severe acute respiratory syndromes. While illnesses such as measles, mumps, rubella, and chicken pox are not on the CDC’s list of quarantinable diseases, they can pose a serious health risk to the public.