Quarantine Has A History, Laws And Current Events

July 28, 2021 at 7:36 p.m.


After almost 80 years, I can still recall the ”Quarantine” sign that was posted on our house in Ohio the result of my brother’s bout with scarlet fever. This was a requirement at that time for patients with certain infectious diseases, a medical and governmental practice with a long history.    

According to Geoff Manaugh and Nicola Twilley in their informative new book “Until Proven Safe,”  the practice of quarantine, as we know it, began during the 14th century in an effort to protect coastal cities in Europe from the bubonic plague — the notorious Black Death.  

Epidemics began to ravage large parts of Europe afflicting seaports in the Mediterranean following the arrival of infected ships and their crews from Asia. Ships arriving in Venice from infected ports were required to sit at anchor for 40 days before landing. This practice, called quarantine, was derived from the Italian words quaranta giorni, which mean 40 days.

Early American Quarantine

When the United States was first established, little was done to prevent the importation of infectious diseases. Protection against imported diseases fell under local and state jurisdiction. Individual municipalities enacted a variety of quarantine regulations for arriving vessels.

State and local governments made sporadic attempts to impose quarantine requirements. Continued outbreaks of yellow fever finally prompted Congress to pass federal quarantine legislation in 1878. This legislation, while not conflicting with states’ rights, paved the way for federal involvement in quarantine activities.

Late 19th Century

Outbreaks of cholera from passenger ships arriving from Europe prompted a reinterpretation of the law in 1892 to provide the federal government more authority in imposing quarantine requirements.

The following year, Congress passed legislation that further clarified the federal role in quarantine activities. As local authorities came to realize the benefits of federal involvement, local quarantine stations were gradually turned over to the federal government.

Additional federal facilities were built and the number of staff was increased to provide better coverage. The quarantine system was fully nationalized by 1921 when administration of the last quarantine station was transferred to the federal government.

Under its delegated authority, the Division of Global Migration and Quarantine is empowered to detain, medically examine or conditionally release individuals and wildlife suspected of carrying a communicable disease.

The 21st Century

The Ebola scare in the U.S. repeated a typical response — demands for quarantine. In January 2017, the Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) issued final regulations on its authority to issue Federal Quarantine Orders. These regulations rely heavily on confining persons who may or may not be ill, raising serious questions about federal commitment to due process protections as well as the scope of statutory authority to impose quarantine.

As the Supreme Court has stated in United States v. Salerno, “liberty is the norm, and detention prior to trial or without trial is the carefully limited exception.”

Unconstrained use of quarantines undermines both the rule of law and public confidence in government decisions in times of crisis. The purpose is to respect human rights while encouraging public trust and cooperation to minimize harm both essential requirements for controlling an epidemic.

New federal quarantine regulations were issued on Jan. 19, 2017, the day before the inauguration of President Trump, the Department of Health and Human Services (HHS), with its Centers for Disease Control and Prevention (CDC), promulgated final rules amending the regulations governing domestic and foreign quarantine.

Though the terms quarantine and isolation are often used interchangeably, they are distinct concepts. Isolation refers to the confinement of individuals known to be infected with a contagious infection during its period of communicability, whereas quarantine restricts the movements of persons who have been exposed or potentially exposed to a contagious disease during the period of its communicability.

In reality, these regulations appear to be a direct response to criticism of the CDC during the 2014 Ebola scare. Much of the public blamed the CDC for failing to prevent any Ebola case from arising within U.S. borders.  

The CDC did issue guidelines for quarantine, but it has no legal authority to require states to implement them, and many states ignored the guidelines, using their own, often more restrictive and inconsistent measures. The backlash against the CDC came in spite of the fact that the agency is typically charged not with delivering services, but with data collection and providing technical assistance, research and laboratory services to the states.  

The new regulations grant broad quarantine authority to the CDC. They empower the CDC director to authorize the “apprehension, medical examination, quarantine, isolation, or conditional release of any individual for the purpose of preventing the introduction, transmission, and spread of quarantinable communicable diseases, as specified by Executive Order.” This applies to those who arrive in the United States, those who may move interstate, and to some whose movements remain intrastate.

Final Thoughts

 Quarantines,  the most effective remedies used more than seven centuries, are still being used to stop or curtail the current pandemic of COVID-19.  By April 2020, over 20% of the world’s population had been quarantined in some fashion either locked down or self isolated.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected].  



After almost 80 years, I can still recall the ”Quarantine” sign that was posted on our house in Ohio the result of my brother’s bout with scarlet fever. This was a requirement at that time for patients with certain infectious diseases, a medical and governmental practice with a long history.    

According to Geoff Manaugh and Nicola Twilley in their informative new book “Until Proven Safe,”  the practice of quarantine, as we know it, began during the 14th century in an effort to protect coastal cities in Europe from the bubonic plague — the notorious Black Death.  

Epidemics began to ravage large parts of Europe afflicting seaports in the Mediterranean following the arrival of infected ships and their crews from Asia. Ships arriving in Venice from infected ports were required to sit at anchor for 40 days before landing. This practice, called quarantine, was derived from the Italian words quaranta giorni, which mean 40 days.

Early American Quarantine

When the United States was first established, little was done to prevent the importation of infectious diseases. Protection against imported diseases fell under local and state jurisdiction. Individual municipalities enacted a variety of quarantine regulations for arriving vessels.

State and local governments made sporadic attempts to impose quarantine requirements. Continued outbreaks of yellow fever finally prompted Congress to pass federal quarantine legislation in 1878. This legislation, while not conflicting with states’ rights, paved the way for federal involvement in quarantine activities.

Late 19th Century

Outbreaks of cholera from passenger ships arriving from Europe prompted a reinterpretation of the law in 1892 to provide the federal government more authority in imposing quarantine requirements.

The following year, Congress passed legislation that further clarified the federal role in quarantine activities. As local authorities came to realize the benefits of federal involvement, local quarantine stations were gradually turned over to the federal government.

Additional federal facilities were built and the number of staff was increased to provide better coverage. The quarantine system was fully nationalized by 1921 when administration of the last quarantine station was transferred to the federal government.

Under its delegated authority, the Division of Global Migration and Quarantine is empowered to detain, medically examine or conditionally release individuals and wildlife suspected of carrying a communicable disease.

The 21st Century

The Ebola scare in the U.S. repeated a typical response — demands for quarantine. In January 2017, the Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) issued final regulations on its authority to issue Federal Quarantine Orders. These regulations rely heavily on confining persons who may or may not be ill, raising serious questions about federal commitment to due process protections as well as the scope of statutory authority to impose quarantine.

As the Supreme Court has stated in United States v. Salerno, “liberty is the norm, and detention prior to trial or without trial is the carefully limited exception.”

Unconstrained use of quarantines undermines both the rule of law and public confidence in government decisions in times of crisis. The purpose is to respect human rights while encouraging public trust and cooperation to minimize harm both essential requirements for controlling an epidemic.

New federal quarantine regulations were issued on Jan. 19, 2017, the day before the inauguration of President Trump, the Department of Health and Human Services (HHS), with its Centers for Disease Control and Prevention (CDC), promulgated final rules amending the regulations governing domestic and foreign quarantine.

Though the terms quarantine and isolation are often used interchangeably, they are distinct concepts. Isolation refers to the confinement of individuals known to be infected with a contagious infection during its period of communicability, whereas quarantine restricts the movements of persons who have been exposed or potentially exposed to a contagious disease during the period of its communicability.

In reality, these regulations appear to be a direct response to criticism of the CDC during the 2014 Ebola scare. Much of the public blamed the CDC for failing to prevent any Ebola case from arising within U.S. borders.  

The CDC did issue guidelines for quarantine, but it has no legal authority to require states to implement them, and many states ignored the guidelines, using their own, often more restrictive and inconsistent measures. The backlash against the CDC came in spite of the fact that the agency is typically charged not with delivering services, but with data collection and providing technical assistance, research and laboratory services to the states.  

The new regulations grant broad quarantine authority to the CDC. They empower the CDC director to authorize the “apprehension, medical examination, quarantine, isolation, or conditional release of any individual for the purpose of preventing the introduction, transmission, and spread of quarantinable communicable diseases, as specified by Executive Order.” This applies to those who arrive in the United States, those who may move interstate, and to some whose movements remain intrastate.

Final Thoughts

 Quarantines,  the most effective remedies used more than seven centuries, are still being used to stop or curtail the current pandemic of COVID-19.  By April 2020, over 20% of the world’s population had been quarantined in some fashion either locked down or self isolated.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected].  



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