QUARANTINE (Fr. quarantaine, a

See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period of

See also:

• FORTY

forty days 1)  , a term originally applied to the old sanitary preventive system of detention of ships and men,. unlading of cargo in lazarets, fumigation of susceptible articles, &c., which was practised at seaports on account of the plague, in connexion with the Levantine trade . It is now a thing of the past in the United Kingdom and in the majority of other states . But, in common usage, the same word is applied to the sanitary rules and regulations which are the modern substitutes for quarantine . The plague was the only disease for which quarantine was practised (not to mention the earlier isolation of lepers, and the attempts to check the invasion of syphilis in northern Europe about 1490) down to the advent of yellow fever in Spain at the beginning of the 19th century, and the arrival of Asiatic cholera in 1831 . Venice took the lead in measures to check the spread of plague, having appointed three guardians of the public health in the first years of the Black Death (1348) . The next record of preventive measures comes from Reggio in Modena in 1374 . The first lazaret was founded by Venice in 1403, on a small island adjoining the city; in 1467 Genoa followed the example of Venice; and in 1476 the old leper hospital of Marseilles was converted into a plague hospital—the great lazaret of that city, perhaps the most complete of its kind, having been founded in 1526 on the island of Pomegue . The practice at all the Mediterranean lazarets was not different from the English procedure in the Levantine and North-African trade . On the approach of cholera in 1831 some new lazarets were set up at western ports, notably a very extensive establishment near Bordeaux, afterwards turned to another use . The plague had disappeared from England, never to return, for more than thirty years before the practice of quarantine against it was definitely established by an act of Parliament of Queen Anne's reign (1710) . The first act was called for, owing to an alarm lest plague should be imported from Poland and the Baltic; the second act of 1721 was due to the disastrous pre-valence of plague at Marseilles and other places in Provence; it was renewed in 1733 owing to a fresh outbreak of the malady on the continent of Europe, and again in 1743 owing to the disastrous epidemic at Messina . In 1752 a rigorous quarantine clause was introduced into an act regulating the Levantine trade; and various arbitrary orders were issued during the next twenty years to meet the supposed danger of infection from the Baltic .

Although no plague cases ever came to England all those years, the restrictions on

traffic became more amd more stringent (following the movements of medical dogma), and in 1788 a very oppressive Quarantine Act was passed, with provisions affecting cargoes in particular . The first year of the 19th century marked the turning-point in quarantine legislation; a parliamentary committee sat on the practice, and a more reasonable act arose on their report . In 1805 there was another new act, and in 1823–24 again an elaborate inquiry followed by an act making the quarantine only at discretion of the privy council, and at the same time recognizing yellow fever " or other highly infectious disorder " as calling for quarantine measures along 1 The strict sense of the term is also preserved in the " widows' quarantine," the right of a widow to remain in the principal house belonging to her husband for forty days after his death . with plague . The steady approach of cholera in 1831 was the I from the privy council to the Local Government Board the last occasion in England of a thoroughgoing resort to quarantine powers to deal with ships arriving infected with yellow fever or restrictions . The pestilence invaded every country of Europe plague, the powers to deal with cholera ships having been despite all efforts to keep it out . In England the experiment already transferred by the Public Health Act of 1875 . of hermetically sealing the ports was not seriously tried when The existing British regulations are those of 9th November 1896; cholera returned in 1849, 1853 and 1865-66 . In 1847 the privy they apply to yellow fever, plague and cholera . Officers of the council ordered all arrivals with clean bills from the Black Sea Customs, as well as of Coast Guard and Board of Trade (for signalling), and the Levant to be admitted to free pratique, provided there are empowered to take the initial steps . They certify in writing the master of a supposed infected ship, and detain the vessel pro- had been no case of plague during the voyage; and therewith visionally for not more than twelve hours, giving notice meanwhile the last remnant of the once formidable quarantine practice to the port sanitary authority . The medical officer of the port against plague may be said to have disappeared. boards the ship and examines every person in it .

Every person pro-For a number of years after the passing of the first Quarantine found infected is certified of the fact, removed to a hospital pro- vided (if his

condition allow), and kept under the orders of the Act (1710) the protective practices in England were of the most medical officer . If the sick cannot be removed, the vessel remains haphazard and arbitrary kind . In 1721 two vessels laden with under his orders . Every person suspected (owing to his or her cotton goods, &c., from Cyprus, then a seat of plague, were immediate attendance on the sick) may be detained on board ordered to be burned with their cargoes, the owners receiving forty-eight hours, or removed to the hospital for a like period. z indemnity. y B the clause in the Levant Trade Act All others are free to land on giving the addresses of their destina- £ 3,93 as Y tions to be sent to the respective local authorities, so that the of 1752 vessels for the United Kingdom with a foul bill (i.e. dispersed passengers and crew may be kept individually under coming from a country where plague existed) had to repair to observation for a few days . The ship is disinfected, dead bodies the lazarets of Malta, Venice, Messina, Leghorn, Genoa or buried at sea, infected clothing, bedding, &c., destroyed or disinfected, and bilge-water and water-ballast (subject to exceptions) pumped Marseilles, to perform their quarantine or to have their cargoes out at a suitable distance before the ship enters a dock or basin . " sufficiently opened and aired." Since 1741 Stangate Creek Mails are subject to no detention . A stricken ship within 3 miles (on the Medway) had been made the quarantine station at of the shore must fly at the main a yellow and black flag borne home; but it would appear from the above clause that it was quarterly from sunrise to sunset . available only for vessels with clean bills . In 1755 lazarets in International Conventions.—Since 1852 several conferences the form of floating hulks were established in England for the have been held between delegates of the Powers, with a view to first time, the cleansing of cargo (particularly by exposure to uniform action in keeping out infection from the East and pre-dews) having been done previously on the ship's deck . There venting its spread within Europe; all but that of 1897 were was no medical inspection employed, but the whole routine left occupied with cholera . No result came of those at Paris 1852, to the officers of customs and quarantine . In 1780, when plague Constantinople 1866, Vienna 1874, and Rome 1885, but each of was in Poland, even vessels with grain from the Baltic had to lie the subsequent ones has been followed by an international forty days in quarantine, and unpack and air the sacks; but convention on the part of nearly one-half of the Powers repreowing to remonstrances, which came chiefly from Edinburgh sented .

The

general effect has been an abandonment of the and Leith, grain was from that date declared to be a " non- high quarantine doctrine of " constructive infection " of a ship susceptible article." About 1788 an order of council required as coming from a scheduled port, and an approximation to the every ship liable to quarantine, in case of meeting any vessel principles advocated by Great Britain for many years . The at sea, or within four leagues of the coast of Great Britain or principal States which retain the old system are Spain, Portugal, Ireland, to hoist a yellow flag in the daytime and show a light Turkey, Greece and Russia (the British possessions Gibraltar, at the maintopmast head at night, under a penalty of £zoo . Malta and Cyprus being under the same influence) . The aim After 'Soo, ships from plague-countries (or with foul bills) were of each international sanitary convention has been to bind the enabled to perform their quarantine on arrival in the Medway Powers to a uniform minimum of preventive action, with further instead of taking a Mediterranean port on the way for that restrictions permissible to individual States . The minimum is purpose; and about the same time an extensive lazaret was now very nearly the same as the British practice, which has been built on Chetney Hill near Chatham at an expense of £170,000, in turn adapted to continental opinion in the matter of the which was almost at once condemned owing to its marshy importation of rags . foundations, and the materials sold for £' 5,000 . The use of The Venice convention of 1892 was on cholera by the Suez Canal floating hulks as lazarets continued as before . In 'boo two route; that of Dresden, 1893, on cholera within European countries; ships with hides from Mogador (Morocco) were ordered to be that of Paris, 1894, on cholera by the pilgrim traffic; and that of sunk with their cargoes at the Nore, the owners receiving £15,000 . Venice, in 1899, was in connexion with the outbreak of plague in About this period it was merchandise that was chiefly suspected: the East, and the conference met to settle on an international basis Per Y susP the steps to be taken to prevent, if possible, its spread into Europe . there was a long schedule of " susceptible articles," and these One of the first points to be dealt with in 1897 was to settle the were first exposed on the ship's deck for twenty-one days or incubation period for this disease, and the period to be adopted less (six days for each instalment of the cargo), and then trans- for administrative purposes . It was admitted that the incubation ported to the lazaret, where they were opened and aired forty th ee or four days. leAftero mpuch tdi cuss on ten days was accepted days more . The whole detention of the vessel was from sixty to by a very large majority .

The. principle of notification was sixty-five days, including the time for reshipment of her cargo. unanimously adopted . Each Government is to notify to other Pilots had to pass fifteen days on board a " convalescent ship." Governments the existence of plague within their several jurisdic- tions, expenses may be estimated from one or two examples . In tions, and at the same time

state the measures of prevention which Y are being carried out to prevent its diffusion . The area deemed to 182o the " Asia," 763 tons, arrived in the Medway with a foul bill be infected is limited to the actual district or village where the from Alexandria, laden with linseed; her freight was £1475 disease prevails, and no locality is deemed to be infected merely and her quarantine dues £610 . The same year the " Pilato," because of the importation into it of a few cases of plague while tons, making the same voyage, paid £200 quarantine dues tions has been no diffusion of the malady . As regards the precau-495 ons to be taken on land frontiers, it was decided that during the on a freight of £1060 . In 1823 the expenses of the quarantine prevalence of plague every country had the inherent right to close service (at various ports) were £26,090, and the dues paid by its land frontiers against traffic . As regards the Red Sea, it was shipping (nearly all with clean bills) £22,000 . A return for the decided after discussion that a healthy vessel may pass through United Kingdom and colonies in 1849 showed, among other the Suez Canal, and continue its voyage in the Mediterranean during the period of incubation of the disease the prevention of which is details, that the expenses of the lazaret at Malta for ten years in question . It was also agreed that vessels passing through the from 1839 to 1848 had been £53,553 . From 1846 onwards the Canal in quarantine might, subject to the use of the electric light, establishments in the United Kingdom were gradually reduced, coal in quarantine at Port Said by night as well as by day, and that while• the last vestige of the British quarantine law was removed passengers might embark in quarantine at that port . Infected the Public Health Act 1896, which repealed the Quarantine vessels, if these carry a doctor and are provided with a disinfecting by PBa Q stove, have a right to navigate the Canal in quarantine, subject Act 1825 (with dependent clauses of other acts), and transferred only to the landing of those who are suffering from plague, and of such persons as have been in actual contact with the sick or with infected articles, together with the disinfection of the infected compartment of the vessel .

Passing on to the conclusions dealing with regulations to be imposed " in Europe," the following are the

chief points to be noted:—As regards measures to be adopted at ports of arrival, the conclusions of the Dresden convention were as far as practicable adhered to . In the case of healthy vessels, i.e. those on board of which there is no illness, though they have sailed from an infected port, it was decided that they should at once have free pratique, but at the option of the local authority certain measures of disinfection of soiled articles may be required . For suspected vessels, viz. those on board of which there has been plague, but no fresh case within twelve days, some limited processes of disinfection, &c., as defined, having been complied with, it is recommended that the crew and passengers should be subject to surveillance for a period of ten days from the date of the arrival of the vessel . In the case of infected vessels, viz. those on which plague is actually present, or on which that disease has occurred ten days before arrival, the sick are to be landed and isolated, and the remainder of those on board are to be subjected, at the discretion of the local authority, to " observation " or " surveillance " for a period not exceeding ten days from the date of the occurrence of the last case of plague . In this convention the terms " observation " and " surveillance " are for the first time clearly defined; the definition as to the latter stating that under that system passengers are not to be isolated, but are to be allowed at once to proceed to their homes, where they can remain under medical supervision so long as may be deemed necessary by the local authority . The results of this conference indicated a great advance on the part of the nationalities represented towards a liberal and truly scientific conception of the means to be adopted by their respective Governments for the prevention and control of infective diseases .