Hyderabad:At a time when more than half of the world population has been forcibly put in a de facto quarantine in a bid to contain the spread of coronavirus disease which has affected millions and claimed thousands of lives, let’s take a look at the origins, purpose and the expanse of this practise or mechanism being touted as the only way to combat COVID-19 until a vaccine is developed.
In the list of diseases that may require quarantine, issued by the Centers for Disease Control and Prevention, the Severe Acute Respiratory Syndrome that can go on to become pandemic has been recently added to the existing ones — cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever and viral hemorrhagic fever. It shows that quarantine is a medically accepted mode to reduce community transmission.
Quarantine is considered to be the oldest mechanism to reduce the rapid spread of contagious diseases. Since ancient times, societies have practised isolation, and imposed a ban on travel or transport and resorted to maritime quarantine of persons.
From ‘Trentino’ to quarantine
The first law on medical isolation was passed by the Great Council in 1377 when the plague was rapidly ruining European countries. Detention for medical reasons was justified and disobedience made a punishable offence. The law prescribed isolation for 30 days, called a ‘trentino’. Subsequently, many countries adopted similar laws to protect people. When the duration of isolation was enhanced to 40 days, the name also changed to ‘quarantine’ by adopting the Latin 'quadraginta', which referred to 40-day detention placed on ships.
Quarantine has since been treated as the cornerstone of a coordinated disease-control strategy, including isolation, sanitary cordons, bills of health issued to ships, fumigation, disinfection, and regulation of groups of persons who were believed to be responsible for spreading the infection.
Some early examples
Bubonic plague in Venice (1370)
The so-called Black Death killed 20 million Europeans in the 14th century. So Venice, a major trade port, grew nervous. If a ship was suspected of harbouring plague, it had to wait 40 days before any passengers or goods could come ashore. Venice built a hospital/quarantine centre on an island off its coast, where sailors from plague-infested ships were sent either to get better or, more likely, to die. This 40-day waiting period became known as quarantinario,from theItalian word for 40.
Yellow fever in Philadelphia (1793)
Almost 5,000 people died over the course of two years, about a tenth of the city's population. Thousands fled for the countryside, and at the height of the epidemic, when nearly 100 people were dying every day, the city government collapsed. The best-known cure at the time was to "bleed" patients of infected blood and give them wine — and a popular theory on stopping the disease was to quarantine sailors at the Lazaretto, a hospital outside the city. But the disease is spread through mosquitoes, so quarantine was not as effective as the cold snap that eventually killed the infected insects.
Typhus in New York (1892)
In 1892, a boat carrying many Russian Jewish immigrants arrived at Ellis Island. Passengers in steerage class had developed such bad cases of body lice that the harbour inspector declared he had "never seen a more bedraggled group," according to medical historian Howard Markel. Lice led to typhus, but by the time that disease was discovered, the passengers had spread out to boarding houses and family homes across New York's Lower East Side. At least 70 were rounded up and quarantined in tents on North Brother Island in the East River.
Bubonic plague in San Francisco (1900)
City authorities strung rope and barbed wire around a 12-square-block section of Chinatown (after allowing all Caucasian residents to leave). The cause: fear of bubonic plague, after a Chinese immigrant was found dead in a hotel basement. The quarantine was lifted after a few days, but not before countless Chinese labourers had lost their jobs.