Quarantine

QUARANTINE (from the Italian quaranta--forty), a preventive measure that arose in the 14th century in Italy to prevent the importation of the plague, which was uncontrollably spreading throughout Europe at that time. For this purpose, all people and goods arriving by ships from infected areas were not allowed ashore for 40 days. Initially, the word Q. itself denoted precisely this period. In the 15th century, in places designated for observation of quarantined ships, various auxiliary institutions began to be created, and among them—first and foremost, lazarets for the sick and suspicious. Gradually, the word Q. came to be applied to these institutions, and this name began to denote not the period, but the territory itself on which measures against the importation of plague were carried out. The rapid development of international trade relations in the early 19th century led to the importation into Europe and the spread on its territory of new diseases: first yellow fever, and then cholera. The result of this was the application of quarantine measures to these two infections, and Q. became a method for preventing the importation of "foreign" infections in general. However, the ineffectiveness of quarantine measures in many cases, along with their severity, restrictiveness, and harshness, eventually forced the major states of Europe to adopt the path of international regulation, the form of which was international sanitary conferences and, as a result of them, corresponding conventions (see). In the work of all conferences, there was a consistent trend toward replacing the crude empirical methods of old Q. with rationally justified measures based on scientific knowledge. As early as the 1903 International Paris Conference, a firm path was taken toward replacing Q. in the former sense of the word with sanitary observation measures, among which observation and medical observation (see), along with isolation of the sick (see), disinfection (see), etc., are only individual methods for preventing the importation of infection, applied within strictly scientifically justified limits. At the same time, even the name Q. as applied to corresponding institutions began to be formally replaced by the term "medical observation stations and points." Nevertheless, the term Q. continues to be retained in practice in many cases, although with significantly changed content.-A modern quarantine institution must have all technical means for preventive measures, i.e., an isolation ward for those who have fallen ill, premises for observation of healthy persons, a transit bath with a disinfection installation, a sanitary-bacteriological laboratory, technical means for disinfection, disinsection, and deratization of ships, etc. According to international conventions, each state on the coast of every sea forming its border must have at least one fully equipped medical observation station (see Medical observation stations, floor plan of the premises of the Feodosia sea medical observation station). The most stable system of Q. proved to be in relation to pilgrims in a number of eastern countries, with their mass detention for a more or less long period. Thus, in the Red Sea to the present time, there are a number of quarantine stations, examples of which can be Gabbari near Alexandria, El-Tor on the Sinai Peninsula, Q. on Kamaran Island in Hejaz. This last Q. was founded by the Turks in 1882; in 1915 Kamaran was captured by England, which reopened a station here in 1919. In the first 7 years of its operation, this Q., which could simultaneously accommodate 4,000 pilgrims, passed through 60-70 thousand people per year. This system in relation to eastern countries found its formal expression until recently in the so-called "quarantine regime of the East," which, although abolished after persistent struggle by the international sanitary conference of 1926, nevertheless left its traces in the form of special mentions of sanitary measures in the ports of the Persian Gulf, in the existence of the Sanitary Sea and Quarantine Council in Alexandria, mostly consisting of representatives of European powers.-Much smaller a role was played and less application was had compared to maritime Q. by land Q. The extreme difficulty of their implementation, given their great restrictiveness for the population, was the main reason for this. Nevertheless, some application of land Q. on railroads may occur. Thus, even at the last conference of 1926, which generally rejected the system of observation (i.e., quarantine) on land borders, on behalf of the British and French governments it was stated that "they have organized quarantine stations at Ma'an (Palestine) and Der'a (Syria) on the Hejaz railway."-Another type of land Q. was represented by the system of so-called cordoning off of foci, mostly plague, which posed a danger to the rest of the country; in this case, the entire country adopts quarantine measures with respect to this focus. Examples of the application of Q. of this kind can serve as epidemics of pulmonary plague in Odessa in 1837, in Vetlyanka in 1879, in Harbin in 1910-11, etc. At present, this system is not applied. Mention should also be made of quarantine-type measures applied by some countries with respect to certain infectious diseases not included among the five infections that are the subject of international agreements. Most often this is achieved by countries occupying an island position with respect to the main reservoir of one infection or another. To this category of Q. can be included, for example, attempts to prevent the importation of pandemic influenza in 1918-19, applied in Australia, New Zealand, and other places, measures applied by England and Australia against the importation of rabies, restriction of entry of patients with trachoma into America, measures against the importation of anthrax with animal raw materials, carried out in a number of countries, etc. Finally, to the category of Q. belong the so-called local, or house Q., when some institution of a closed or semi-closed type, for example, a place of detention, a children's home, a medical institution, a school, etc., takes quarantine measures to prevent the importation of one infection or another into its environment. Various methods of sanitary treatment of newly arriving persons in such an institution, their examination for bacillary carriage, keeping them under special observation for the period of possible INCUBATION, etc., can serve this purpose.

L. Gromashevsky. Quarantine in Veterinary Medicine. In veterinary-sanitary affairs, quarantine (K.) does not imply any specific institution, but rather a complex of measures for protecting the country from the introduction of contagious or epizootic animal diseases from abroad, or for stopping these diseases that have arisen within the country. In the Veterinary Statute of the RSFSR, the word 'quarantine' does not appear; it states: 1) about 'protective-quarantine zones both on the state border and internally', 2) about 'quarantine checkpoints or quarantine-protective lines in infected points or unfavorable areas' and finally 3) about 'isolation (quarantining) of animals with the application of veterinary supervision, during which time the animals must be kept in separate premises or places, and it is forbidden to lead them to common pastures, to common watering places, and generally beyond the limits of these premises or places, access to them by other animals or outsiders, their slaughter for meat and other purposes without prior examination and permission from the responsible veterinarian'.-The first two types of quarantine have a territorial character, while the latter relates to specific animals and does not exclude the presence on the same territory of other animals that are not under veterinary supervision, but only under 'veterinary observation, during which time these animals are kept under ordinary conditions, and only their sale and slaughter for meat without examination and permission from a veterinarian are forbidden'. Among the measures provided for in the Veterinary Statute for application within the country in the fight against various contagious diseases depending on their nature, certain measures definitely pursue quarantine objectives: 'Prohibition of the removal and export of animals susceptible to infection and of raw products obtained from such animals from an infected point and areas declared unfavorable for contagious disease without special permission from the responsible veterinarian'.^:-'Prohibition of bringing into the limits of an infected point or unfavorable area animals susceptible to the disease that has appeared, as well as travel on such animals and driving them'.-'Prohibition of releasing pigs, cats, dogs, birds and other small domestic animals, although not susceptible to this particular disease, but capable of spreading the infection'.- 'Restriction of access for people to infected farms and prohibition of persons having contact with contagious animals and objects from coming into contact with animals susceptible to infection without prior disinfection of their hands, feet, clothing, footwear as directed by the veterinarian'.-'Prohibition of export from infected points or unfavorable areas of raw animal products, bulky and other feeds that may serve as a source of spread of infection without permission from the responsible veterinarian'.-'Prohibition of sale of prepared for human consumption and for animal feed milk and all kinds of other food products from diseased and suspicious of contagious disease animals without prior disinfection of these products'. In cases of detection of diseases common to animals and humans (zoonoses), the following of the above-mentioned quarantine measures are applied. In case of anthrax in unfavorable points and areas, prohibition of entry and exit of animals susceptible to anthrax, as well as travel and driving of such animals; prohibition of export of raw animal products and feeds.-In tuberculosis, animals without signs of general emaciation and without lesions of the udder, but recognized as diseased or suspicious of disease, are isolated and remain under veterinary supervision, and milk from them can be used for human and animal consumption only after prior disinfection; animals suspected of infection are kept under veterinary observation.-In glanders, horses, donkeys, mules, and mules suspicious of disease are left under veterinary supervision, and those suspected of infection are kept under veterinary observation until the nature of the disease is determined.-In foot-and-mouth disease in infected points and unfavorable areas, in addition to the measures mentioned for anthrax, isolation with veterinary supervision, restriction of access for people, prohibition of release of small domestic animals, prohibition of sale of dairy products are applied.-In rabies, animals suspicious of disease are as a rule killed; but they may be subjected to isolation with veterinary supervision until the nature of the disease is clarified. Animals (except dogs and cats) bitten by rabid animals may be subjected to preventive vaccinations under veterinary supervision. For dogs and cats suspected of being bitten by rabid animals, isolation for a specified period is permitted. Within the limits of an unfavorable area, all dogs must be kept on a leash or in muzzles. In the interests of protecting the RSFSR from the introduction of contagious and epizootic animal diseases from foreign countries where veterinary supervision is completely absent or poorly organized, animals delivered from them may be admitted after undergoing quarantine observation at the border, and raw animal products - while observing special rules. For this purpose, 'protective-quarantine zones' are established along such borders, served by border guard organs and veterinary personnel. The work of the latter is concentrated in special 'protective-quarantine points', representing installations of a specific type. They must contain: fenced places, bases, sheds, etc. for quarantined animals; equipment for disinfection of raw animal products; places for burying or burning carcasses, raw animal products and feeds; premises for owners of animals, conductors, and drovers; premises for veterinary personnel to examine animals and raw animal products, to perform necropsy and research of carcasses, to produce preventive, therapeutic and diagnostic vaccinations. Arriving at these transit points, batches of animals that are healthy with respect to contagious diseases and provided with appropriate foreign veterinary certificates about preventive vaccinations administered to them are nevertheless detained for 3 days for mass thermometry, malleinization of horses and tuberculinization of cattle. Without the mentioned certificates, animals are left under quarantine observation for 7-10 days. Before release into the country, healthy animals are branded or provided with a seal on metal wire.-In case of detection of contagious diseases in animals arriving from abroad at the moment of their arrival at the protective-quarantine point or during the preliminary three-day test, protective measures are applied to the entire unfavorable batch according to precisely developed instructions for each form of disease separately. These measures include: slaughter on the spot with destruction of the carcass, dispatch to the nearest slaughterhouse, immediate return abroad, preventive vaccinations to still healthy animals of this batch, keeping the batch in quarantine for various, more or less prolonged periods after the last case of death or recovery.-In transport veterinary-sanitary sections on railway, water and land routes of communication, having the purpose of 'preventing the spread of contagious diseases by commercial-industrial livestock, guaranteeing veterinary-sanitary well-being during their movement, protecting public health from contagious-epizootic diseases common to humans and animals', 'quarantine bases' must be present for isolating contagious animals discovered on transport. A. Vladimirov.