Most of the news about how to fight an outbreak of Avian flu should it start to spread have been discussions on drugs and Influenza shots.

Today, however, the NYTimes brings up an older method to stop the spread of disease: Old fashioned quarantine.

Such ideas are not new: The book Pox Americana describes how Washington first used quarantine then used innoculation of smallpox on new recruits to guard his army against smallpox outbreaks, a policy that probably saved the US Army. (In constrast, the British recruited runaway slaves to fight; when smallpox broke out, the mortality was huge, and as a result, the British lost thousands of local American recruits).

Similarly, SARS spread was slowed by isolation and by screening Asian travelers for fever.

The next epidemic may or may not be Avian flu, and may or may not be terror related. History shows however that in times when people travel, disease will spread. Rome probably fell when Egytian malaria became endemic in nearby swamps, killing young children, and epidemics like Justinian’s plague brought in with soldiers from Iran was probably the final blow. Similarly, the cross African highway and the presence of many French speaking Haitians working in the Congo and the custom of men working in cities but having spouses keep their farms going at home probably had more to do with the HIV epidemic spreading than other factors.

Yet the idea of quarantine will come directly in conflict with western ideas of freedom.

Ironically, the Cuban expertise in HIV, where Cuban soldiers who contracted HIV while working as mercenaries in Angola, were essentially placed in isolation camps, could have saved thousands of lives.

Hopefully, by the time that an epidemic will require isolation and quarantine, there will be a Democratic president. For just as “only Nixon could go to China”, similarly, only a Democratic president will be able to impose such a drastic cutback in civil rights in order to protect the country against the next infectious disease epidemic.


Nancy Reyes is a retired physician living in the Philippines. Her webpage is FInest Kind Clinic and Fishmarket

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