Select Page

Quarantine: Keeping contagions at bay with an ancient tradition to control the spread of illness

By Leslie S. Leighton, Visiting Lecturer of History, Georgia State University

The recent global spread of a deadly coronavirus originating in Wuhan, China, has led world leaders to invoke an ancient tradition to control the spread of illness: quarantine.

The practice is first recorded in the Old Testament where several verses mandate isolation for those with leprosy. Ancient civilizations relied on isolating the sick, well before the actual microbial causes of disease were known. In times when treatments for illnesses were rare and public health measures few, physicians and lay leaders, beginning as early as the ancient Greeks, turned to quarantine to contain a scourge.

In January, Chinese authorities attempted to lock down millions of residents of Wuhan and the surrounding area, to try to keep the new coronavirus from spreading outward. The country’s neighbors are closing borders, airlines are canceling flights, and nations are advising their citizens against traveling to China, a modern instance of the old impulse to restrict people’s movements in order to stop disease transmission. U.S. authorities are holding travelers returning from China in isolation for two weeks as an effort to halt coronavirus’ spread. Always at the center of the policy of quarantine is the tension between individual civil liberties and protection of the public at risk.

Keeping contagion at bay

The meaning of quarantine has evolved from its original definition “as the detention and segregation of subjects suspected to carry a contagious disease.” Now it represents a period of isolation for persons or animals with a contagious disease – or who may have been exposed but aren’t yet sick. Although in the past it may have been a self-imposed or voluntary separation from society, in more recent times quarantine has come to represent a compulsory action enforced by health authorities.

Leprosy, mentioned in both Old and New testaments, is the first documented disease for which quarantine was imposed. In the Middle Ages, leper colonies, administered by the Catholic Church, sprung up throughout the world. Although the causative agent of leprosy – the bacterium Mycobacterium leprae – was not discovered until 1873, its disfiguring and incurable nature made civilizations wrongly believe it was easily spread.

The plague of the 14th century gave rise to the modern concept of quarantine. The Black Death first appeared in Europe in 1347. Over the course of four years, it would kill between 40 million and 50 million people in Europe and somewhere between 75 million and 200 million worldwide.

In 1377, the seaport in Ragusa, modern day Dubrovnik, issued a “trentina” – derived from the Italian word for 30 (trenta). Ships traveling from areas with high rates of plague were required to stay offshore for 30 days before docking. Anyone onboard who was healthy at the end of the waiting period was presumed unlikely to spread the infection and allowed onshore.

Thirty was eventually extended to 40 days, giving rise to the term quarantine, from the Italian word for 40 (quaranta). It was in Ragusa that the first law to enforce the act of quarantine was implemented.

Over time, variations in the nature and regulation of quarantine emerged. Port officials asked travelers to certify they hadn’t been to areas with severe disease outbreaks, before allowing them to enter. In the 19th century, quarantine was abused for political and economic reasons, leading to the call for international conferences to standardize quarantine practices. Cholera epidemics throughout the early 19th century made clear the lack of any uniformity of policy.

Imported to America

The United States has also had its share of epidemics, beginning in 1793, with the outbreak of yellow fever in Philadelphia. A series of further disease outbreaks led Congress in 1878 to pass laws that mandated involvement of the federal government in quarantine. The arrival of cholera to the United States, in 1892, prompted even greater regulation.

Perhaps the best known example of quarantine in American history, pitting an individual’s civil liberties against public protection, is the story of Mary Mallon, aka “Typhoid Mary.” An asymptomatic carrier of typhoid fever in the early 20th century, she never felt sick but nevertheless spread the disease to families for whom she worked as a cook.

Officials quarantined Mary on North Brother Island in New York City. Released after three years, she promised never to cook for anyone again. Breaking her vow and continuing to spread the disease, she was returned to North Brother Island, where she remained for the remainder of her life in isolation.

More recently, in 2007, public health officials quarantined a 31-year-old Atlanta attorney, Andrew Speaker, who was infected with a drug-resistant form of tuberculosis. His case grabbed international attention when he traveled to Europe, despite knowing he had and could spread this form of TB. Fearing quarantine in Italy, he returned to the United States, where he was apprehended by federal authorities and quarantined at a medical center in Denver, where he also received treatment. Following release, deemed no longer contagious, he was required to report to local health officials five days a week through the end of his treatment.

Quarantine today continues as a public health measure to limit the spread of contagious disease, including not just coronavirus, but Ebola, flu and SARS. Its stigma has largely been removed by emphasizing not only the benefits of quarantine to society, by removing contagious individuals from the general population, but also the benefit of treatment to those who are ill.

In the United States, where the Constitution guarantees personal rights, it’s a serious decision to restrict an individual’s freedom of travel and compel medical treatment. And quarantine is not an ironclad way to prevent the spread of disease. But it can be a useful tool for public health officials working to stop the spread of a contagious disease.

Support evidence-based journalism with a tax-deductible donation today, make a contribution to The Conversation.

  1. Milwaukee Hope: A hometown meme series designed to inspire optimism during the coronavirus crisis
  2. Dear America: I know how scared you are, I’m scared too
  3. Heroes of Hope: How to find healing and happiness when life is surrounded by havoc
  4. A Political Plan B: DNC organizers prepare contingency options for Milwaukee’s July Convention
  5. Coronavirus pours cold water on Olympic flame as Tokyo Games get postponed to 2021
  6. Milwaukee rolls out “drive-up” option for early voting to eliminate risk of COVID-19 exposure
  7. Hey, Milwaukee, you are not on vacation. Take the stay-at-home order seriously
  8. COVID-19 social media campaign launches in Milwaukee with best practices for staying healthy
  9. Coalition of Milwaukee philanthropies partner to coordinate local resources in response to COVID-19
  10. Fleeing the Coronavirus: The dangers for individuals and everyone they encounter along the journey
  11. Milwaukee County seeks donations of Personal Protective Equipment for COVID-19 frontline workers
  12. Medical gear from postponed charitable clinic to distributed first responders statewide
  13. The Great Apprehension: How to help kids relax as the pandemic upends everyday life
  14. The Myth of Youth: How children can be infected with coronavirus and transmit it to others
  15. Jonathan Brostoff: On COVID-19 and Wisconsin’s future “After the Storm”
  16. Reggie Jackson: The impact of racism is the “Other Coronavirus Crisis” for People of Color
  17. How to have a healthy conversation about the coronavirus with someone who is misinformed
  18. Mass transit in a time of need: MCTS to suspend fare collection for bus rides from March 28
  19. Fighting the Coronavirus: Why the U.S. military should deploy as a humanitarian aid force
  20. The Inconvenience of COVID-19: Understanding the shared national sacrifice for a greater good
  21. Kevin Abing: Milwaukee mobilized every resource possible in 1918 to combat the Spanish Flu epidemic
  22. Greatest Pandemic in History: Common misconceptions about the global influenza of 1918
  23. Month-long “Safer at Home” order urges Wisconsin residents to make sacrifices and work together
  24. Masks and the Microbe Menace: A misperception that safety measures shield risky activities from danger
  25. Not a Lockdown: Milwaukee implements “Stay At Home” directive in order to save lives
  26. Safer At Home: Wisconsin orders statewide closure of non-essential businesses to contain COVID-19
  27. Frontline nurses treating coronavirus victims condemn Trump’s racist rhetoric and cruelty
  28. PrideFest 2020 postponement due to COVID-19 foreshadows disruption of summer festival season
  29. Reggie Jackson: The COVID-19 pandemic lays bare the absolute moral corruption of our society
  30. Health Official condemns Senator Ron Johnson’s false equivalency between traffic accidents and COVID-19
  31. The disappointment that comes when a pandemic cancels the freedom to party
  32. Vulnerable Populations: Infection rates and mortality from COVID-19 expected to hit the homeless hard
  33. Connecting without the human touch: How to cope with the side effects of social distancing
  34. Flattening the Curve: How to slow fear from spreading faster than COVID-19
  35. Sorry, We’re Closed: The signs and sights of solitude as Milwaukee digs in to fight COVID-19
  36. Being Positive during a Pandemic: 5 tips for getting through the coronavirus as a better person
  37. COVID-19 Mutual Aid: Confronting coronavirus conditions with community instead of consternation
  38. One of Wisconsin’s first two COVID-19 Deaths confirmed in Ozaukee County
  39. Price of our Pandemic: The bill for MAGA has come due and it is time to pay up
  40. The same people who believed COVID-19 was a hoax should now buy the homeopathic cure forsythia
  41. When plagues followed bad leadership: Greek tragedy of Oedipus Tyrannos is a lesson for Trump on COVID-19
  42. Wisconsin residents reminded to take precautions against COVID-19 scams and price gouging
  43. MCTS encourages riders to limit non-essential bus travel to help prevent spread of COVID-19
  44. The supply and demand of COVID-19: Predicted infection rates would overwhelm Milwaukee hospitals
  45. Wisconsin passengers under coronavirus quarantine aboard Grand Princess cruise ship return home safely
  46. Milwaukee Municipalities issue emergency orders closing bars and restaurants to protect public health
  47. Governor Tony Evers signs statewide order prohibiting mass gatherings of more than 50 People
  48. Teaching amid Coronavirus: What to expect from educational institutions as classes move online
  49. Wisconsin mandates closure of all K-12 Schools until early April to prevent spreading of COVID-19
  50. Closure of school cafeterias due to coronavirus puts poorest children at risk of missing nutritious meals
  51. Stop hoarding the Charmin: Why people are panic buying toilet paper when there is an abundant supply
  52. The social burden of Consumerism: Shopping carts are not overflowing with compassion
  53. Social Distancing: Think of it as “Elbow Room” for your health in the age of contagious pathogens
  54. City’s Health Department urges Milwaukee residents to avoid non-essential travel
  55. Milwaukee County Sheriff’s Office outlines COVID-19 protocols for protecting individuals in custody
  56. Coronavirus Hits Home: Milwaukee confirms first case of COVID-19 within the city
  57. Impact of COVID-19 sinks in for Milwaukee Bucks fans after NBA suspends remainder of season
  58. Governor Tony Evers declares public health emergency for Wisconsin in response to COVID-19
  59. A cauldron for infectious disease: Spread of COVID-19 inevitable in overcrowded ICE detention centers
  60. From SARS to Avian Influenza: A witness to history reflects on the first epidemics of the 21st-century
  61. Public health officials face challenges in distinguishing COVID-19 from seasonal influenza
  62. Plain old soap and water: Why hand-washing is still the best way to prevent illness
  63. Coronavirus Update: Milwaukee outlines preparations and precautions for dealing with COVID-19
For medical information, guidance, and resources, please visit the CDC’s COVID-19 information page or the Wisconsin Department of Health Services. All editorial content published by Milwaukee Independent related to the coronavirus can be found at mkeind.com/COVID19
Our mission of transformative journalism means that we are editorially independent. Our staff determines what is important news to report on, and in what voice to speak on issues. No one influences our opinion, and no one edits our editors. We are free from commercial bias and are not influenced by corporate interests, political affiliations, or a public preferences that rewards clicks with revenue. As an influential publication that provides Milwaukee with quality journalism, we depend on public support to fulfill our purpose. Our award-winning photojournalism, columns, interviews, and features have helped to achieve a range of positive social impact that enriches our community. Please join our effort by entrusting us with your contribution. Your Support Matters - Donate Now

About The Author

The Conversation

The Conversation US is a nonprofit media outlet, producing independent articles that are authored by academics and edited by professional. This feature is published under the terms of their Creative Commons license.