An overview of infectious disease containment strategies throughout history
Historically, human civilizations have contained infectious diseases by isolation and confinement of the sick persons. As the knowledge of epidemiology expanded and we started to understand that even the apparently healthy but exposed individuals may harbor and spread disease, the concept of quarantine started taking shape. These strategies helped in containing the spread of diseases even before the understating of microorganisms and the era of antibiotics. And they continue to be useful in modern times when emerging and remerging diseases outpace the development of effective management strategies.
Isolation of the sick for containing the spread of disease has biblical mentions for Leprosy. Even when microbes and specific treatments were not known, containment was possible by simply ensuring that the sick don’t mingle with the healthy. This however led to stigmatization and social ostracization of the lepers. Similarly, isolation has been practiced since ancient times for cases of “fever with rashes”.
Quarantine has its origin from the Italian word “quarantena” which means forty days. This originated in the fourteenth century Venice from the practice of segregating the sailors for a period of forty days before allowing them ashore in an effort to prevent the epidemic of the bubonic plague. This followed from the practice of 30-day segregation of inbound sailors practiced in the erstwhile Republic of Ragusa, now known as Dubrovnik in Croatia, which was called as “trenteno”.
Quarantine and isolation are complex, controversial and coercive public health strategies and should be used only after carefully analyzing the benefits and harm to the public that a quarantine or isolation may place on individuals.