Last time we looked at the origins of quarantine and the development of lazarets – quarantine stations for maritime travellers, normally on isolated islands, where ships could be permanently at anchor for the period of the quarantine. The next major development in the rudimentary attempts to protect public health was the introduction of bills of health.
The vibrant trading centre that was Venice was the first place to develop an effective system of maritime cordon. Once news of an outbreak of plague in the eastern Mediterranean reached Venice, boats suspected of carrying plague or of having originated from or called in at a plague spot were signalled by a flag which would be spotted by lookouts perched up on the tower of San Marco.
The captain would then be transferred from the ship into a life boat and rowed ashore to the health magistrate’s office. The captain would be kept in an enclosure and be required to speak through a window, ensuring that he was at what was considered a safe distance from the Venetian official, The captain would then be required to furnish proof of the health of the crew and passengers on his vessel and provide information about the origin of its cargo. If there were suspicions of disease on the ship, the captain was ordered to go to the nearby lazaret on the island of Santa Maria di Nazareth in the Venetian lagoon for the requisite period. This system was soon adopted by other Italian ports.
The first quarantine regulations did not come into force in England until 1663 when ships were confined in the Thames estuary if they were suspected of carrying plague-infected crew or passengers. In 1683 the French port of Marseille introduced legislation allowing the authorities to quarantine and disinfect anyone suspected of having the plague.
Across the pond the first steps towards a quarantine policy were taken in the 1680s when the connection between the arrival of new ships and fresh outbreaks of smallpox. So great was the fear of smallpox in some of the colonies that the health authorities began to order mandatory home isolation, even though the revolutionary public healthcare initiative of inoculation against the disease was in place.
Yellow fever was another eighteenth century peril. Quarantine legislation, which until 1796 in the United States was the responsibility of individual states, was passed by port cities to deal with the threat of the disease from the West Indies. On the European side of the Atlantic quarantine measures were introduced in 1720 to deal with a yellow fever epidemic which broke out in Marseille and swept across Europe.
The threat of plague and epidemic was ever-present and to combat it, as well as developing quarantine and isolation techniques, authorities built up information networks which alerted ports and cities of a potential outbreak. After all, forewarned is forearmed!
Next, the 19th century threat of cholera.