Quarantine

{{short description|Epidemiological intervention to prevent disease transmission}}
{{Other uses}}
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[[File:President Nixon welcomes the Apollo 11 astronauts aboard the U.S.S. Hornet.jpg|thumb|US President [[Richard Nixon]] greeting the [[Apollo 11]] astronauts in NASA's [[mobile quarantine facility]]]]

A '''quarantine''' is a restriction on the [[Freedom of movement|movement of people]], animals and goods which is intended to prevent the spread of [[disease]] or [[Pest (organism)|pests]]. It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a [[infection|communicable disease]], yet do not have a confirmed [[medical diagnosis]]. It is distinct from [[Isolation (health care)|medical isolation]], in which those confirmed to be infected with a communicable disease are isolated from the healthy population. Quarantine considerations are often one aspect of [[border control]].{{citation needed|date=June 2022}}

The concept of quarantine has been known since biblical times, and is known to have been practised through history in various places. Notable quarantines in modern history include the village of [[Eyam]] in 1665 during the [[bubonic plague]] outbreak in England; [[American Samoa|East Samoa]] during the [[Spanish flu|1918 flu pandemic]]; the [[Diphtheria]] outbreak during the [[1925 serum run to Nome]], the [[1972 Yugoslav smallpox outbreak]], the SARS pandemic, the Ebola pandemic and extensive quarantines applied throughout the world during the [[COVID-19 pandemic]] since 2020.

Ethical and practical considerations need to be considered when applying quarantine to people. Practice differs from country to country; in some countries, quarantine is just one of many measures governed by legislation relating to the broader concept of [[biosecurity]]; for example, [[biosecurity in Australia|Australian biosecurity]] is governed by the single overarching ''[[Biosecurity Act 2015]]''.

==Etymology and terminology==
The word ''quarantine'' comes from ''quarantena'' or ''quarantaine'', meaning "forty days", used in the [[Venetian language|Venetian]] language in the 14th and 15th centuries and also in France. The word is designated in the period during which all ships were required to be isolated before passengers and crew could go ashore during the [[Black Death]] plague.<ref>{{Citation |last=von Csefalvay |first=Chris |title=Modeling the control of infectious disease |date=2023 |url=https://linkinghub.elsevier.com/retrieve/pii/B9780323953894000153 |work=Computational Modeling of Infectious Disease |pages=173–215 |publisher=Elsevier |language=en |doi=10.1016/b978-0-32-395389-4.00015-3 |isbn=978-0-323-95389-4 |access-date=2023-03-02}}</ref> The ''quarantena'' followed the ''trentino'', or "thirty-day isolation" period, first imposed in 1347 in the [[Republic of Ragusa]], [[Dalmatia]] (modern [[Dubrovnik]] in Croatia).<ref name="JSM17"/><ref name="Eccles">{{cite book|editor1=Ronald Eccles|editor2=Olaf Weber|title=Common cold|url=https://archive.org/details/commoncoldbirkhu00eccl|url-access=limited|year=2009|publisher=Birkhäuser|location=Basel|isbn=978-3-7643-9894-1|pages=[https://archive.org/details/commoncoldbirkhu00eccl/page/n216 210]|edition=Online-Ausg.}}</ref><ref name="Mayer">{{cite web |first= Johanna |last= Mayer |title= The Origin Of The Word 'Quarantine' |date=4 September 2018 |url= https://www.sciencefriday.com/articles/the-origin-of-the-word-quarantine/ |access-date=17 March 2020 }}</ref><ref name="EID2013">{{cite journal|doi=10.3201/eid1902.ET1902| pmc=3559069 |title=Etymologia: Quarantine|journal=Emerging Infectious Diseases|year=2013|volume=19|issue=2|pages=263|doi-access=free}}</ref>

[[Merriam-Webster]] gives various meanings to the noun form, including "a period of 40 days", several relating to ships, "a state of enforced isolation", and as "a restriction on the [[Freedom of movement|movement of people]] and goods which is intended to prevent the spread of [[disease]] or [[Pest (organism)|pests]]". The word is also used as a verb.<ref>{{cite web|url=http://www.merriam-webster.com/dictionary/quarantine|title=quarantine: noun|website=Merriam-Wesbter| access-date=2 April 2020}}</ref>

Quarantine is distinct from [[Isolation (health care)|medical isolation]], in which those confirmed to be infected with a communicable disease are isolated from the healthy population.<ref name = "CDC">[https://www.cdc.gov/quarantine/ Quarantine and Isolation] ''Centers for Disease Control and Prevention, Quarantine and Isolation'', accessed 5 February 2020</ref>

Quarantine may be used interchangeably with ''[[Cordon sanitaire (medicine)|cordon sanitaire]]'', and although the terms are related, ''cordon sanitaire'' refers to the restriction of movement of people into or out of a defined geographic area, such as a community, in order to prevent an infection from spreading.<ref>{{cite journal|doi=10.18060/18963|title=From SARS to Ebola: Legal and Ethical Considerations for Modern Quarantine|year=2015|last1=Rothstein|first1=Mark A.|journal=Indiana Health Law Review|volume=12|pages=227–280|doi-access=free}}</ref>

==History==

===Ancient===
An early mention of isolation occurs in the [[Biblical]] [[book of Leviticus]], written in the 7th century BC or perhaps earlier, which describes the procedure for separating out people infected with the skin disease [[Tzaraath]]. The medical nature of this isolation is, however, disputed. As traditional exegesis (dated 700 CE) sees it as a punishment for trespassing one of several negative commandment, most notably [[Lashon hara|Evil Speech]].<ref>Leviticus Rabbah 17 3</ref> A more recent hypothesis postulates that the infected are required to isolate themselves in order to prevent spread of disease{{Citation needed|date=March 2021}} (although the Bible does not imply contagiousness of ''Tzaraath''):

{{blockquote|Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, "Unclean! Unclean!" As long as they have the disease they remain unclean. They must live alone; they must live outside the camp.<ref>{{Bibleverse|Leviticus|13:45–46|NIV}}</ref>{{Primary source inline|date=March 2020}}<ref>[https://www.sparknotes.com/lit/oldtestament/section5/page/3/ Bible: The Old Testament – Leviticus, Numbers & Deuteronomy] ''www.sparknotes.com'', ''...the Israelites' punishment for certain infractions is to isolate or expel the offending individual from the camp... ...Since uncleanness bars a person from approaching the sacred religious items, physical impurity places one farthest from the center of Israel...'' accessed 14 March 2020</ref>}}

Moses ordered that dwellings from which infected Jews had gone should be inspected before being occupied again, and that people recovering from contagious disease were not to be allowed to go abroad until examined.{{citation needed|date=March 2023}}<ref>{{Cite web |title=Leviticus 13:1-40 - NIV - The ... |url=https://www.christianity.com/bible/niv/leviticus/13-1-40 |access-date=2023-10-17 |website=www.christianity.com |language=en}}</ref>

===Medieval Islamic world===
A [[hadith]] attributed to the Islamic prophet Muhammad advised individuals present in a region with a plague outbreak to remain in place, and advised healthy individuals to avoid traveling there.<ref>{{cite web|author=Souleymane Bachir Diagne|title=Lessons from the Hadith of the Plague|url=https://news.columbia.edu/news/islam-lessons-hadith-plague|work=[[Columbia University]] News|date=23 April 2020|department=In Brief}}</ref> The Persian Muslim polymath [[Avicenna]] argued for controlling “the spread of diseases" in his medical encyclopedia The Canon [Al-Qanun] of Medicine, published in 1025. He also recommended quarantine for patients with infectious diseases, especially [[tuberculosis]].<ref>{{cite book|author=Roy J. Shephard|title=An Illustrated History of Health and Fitness, from Pre-History to our Post-Modern World|page=279|publisher=[[Springer Publishing|Springer]]}}</ref><ref>{{Cite web|title=Ibn Sina – Ancient Hero of Modern Pandemics| date=31 May 2022| url=https://blog.frontiersin.org/2022/05/31/ibn-sina-ancient-hero-of-modern-pandemics/}}</ref><ref>{{Cite web|url=https://www.aljazeera.com/opinions/2020/6/15/what-can-avicenna-teach-us-in-time-of-coronavirus|title=What can Avicenna teach us in time of Coronavirus?|first=Hamid|last=Dabashi|website=www.aljazeera.com}}</ref>

Since the sixteenth century, the Ottoman empire has isolated travellers coming from epidemic areas during the Bubonic plague. A quarantine involved isolating healthy travellers for a period of time so that it could be ascertained if they were sick or not.<ref>{{Cite web|url=https://muslimheritage.com/plague-and-contagion/|title=Plague and Contagion|date=24 August 2020}}</ref>

The mandatory quarantine of special groups of patients, including those with leprosy, started early in Islamic history.<ref>{{cite journal|author=Arthur Saniotis|title=Islamic Medicine and Evolutionary Medicine: A Comparative Analysis|quote="Islamic medicine heralded a disciplinary model which included quarantine, hospitals and systematic clinical training."|volume=44|issue=1|journal=Journal of the Islamic Medical Association of North America|year=2012|pages=44–1–8780|doi=10.5915/44-1-8780|pmid=23864992|pmc=3708639}}</ref> In the early 8th century the sixth [[Umayyad]] [[caliph]] [[Al-Walid I]] [[Leprosarium|segregated lepers]] from the general population, with some later sources crediting the caliph with opening a [[bimaristan|hospital]]. The separation of lepers from the general population was also practiced in the Moroccan city of Fez, where lepers were relocated to a cave system outside of the city. Dedicated leprosariums were built in the time of the Ottoman sultan [[Murad II]] in the 15th century, with some of the facilities operating for centuries.<ref>{{Cite book|last1=Dunlop|first1=D.M.|last2=Colin|first2=G.S.|last3=Şehsuvaroǧlu|first3=Bedi N.|chapter=Bīmāristān|editor-first=P.|editor-last=Bearman|editor-first2=Th.|editor-last2=Bianquis|editor-first3=C.E.|editor-last3=Bosworth|editor-first4=E.|editor-last4=van Donzel|editor-first5=W.P.|editor-last5=Heinrichs|title=Encyclopaedia of Islam, Second Edition|doi= 10.1163/1573-3912_islam_COM_0123|date=24 April 2012}}</ref>

===Medieval Europe===
The word "quarantine" originates from ''quarantena'', the Venetian language form, meaning "forty days".<ref name="origin"/><ref name="Mayer"/> This is due to the 40-day isolation of ships and people practised as a measure of disease prevention related to the [[Plague (disease)|plague]].<ref name="origin"/> Between 1348 and 1359, the [[Black Death]] wiped out an estimated 30% of Europe's population, and a significant percentage of Asia's population.<ref name="origin"/> Such a disaster led governments to establish measures of [[containment]] to handle recurrent epidemics.<ref name="origin"/> A document from 1377 states that before entering the city-state of [[Republic of Ragusa|Ragusa]] in [[Dalmatia]] (modern [[Dubrovnik]] in Croatia), newcomers had to spend 30 days (a ''trentine'') in a restricted place (originally nearby islands) waiting to see whether the symptoms of Black Death would develop.<ref name="origin">{{cite journal |author= Sehdev, Paul S. |year= 2002 |title= The Origin of Quarantine |journal= Clinical Infectious Diseases |volume= 35 |issue= 9 |pages= 1071–1072 |doi= 10.1086/344062 |pmid= 12398064|doi-access= free }}</ref> In 1448 the [[Venetian Senate]] prolonged the waiting period to 40 days, thus giving birth to the term "quarantine".<ref name="JSM17">The Journal of Sociologic Medicine – Volume 17</ref> The forty-day quarantine proved to be an effective formula for handling outbreaks of the plague. Dubrovnik was the first city in Europe to set up quarantine sites such as the [[Lazzarettos of Dubrovnik]] where arriving ship personnel were held for up to 40 days.<ref>{{cite web |agency=Associated Press |title=Croatia's Dubrovnik, Home to Ancient Quarantine Facilities |url=https://www.nytimes.com/aponline/2020/03/24/world/europe/ap-eu-virus-outbreak-first-quarantine.html |website=The New York Times |access-date=1 April 2020 |date=24 March 2020}}</ref> According to current estimates, the bubonic plague had a 37-day period from infection to death; therefore, the European quarantines would have been highly successful in determining the health of crews from potential trading and supply ships.<ref>Susan Scott and Christopher Duncan, ''Biology of Plagues: Evidence from Historical Populations,'' Cambridge, United Kingdom: Cambridge University Press, 2001</ref>

Other diseases lent themselves to the practice of quarantine before and after the devastation of the plague. Those affected by [[leprosy]] were historically isolated long-term from society, and attempts were made to check the spread of [[syphilis]] in northern Europe after 1492, the advent of [[yellow fever]] in Spain at the beginning of the 19th century, and the arrival of Asiatic [[cholera]] in 1831.{{citation needed|date=March 2023}}

[[Republic of Venice|Venice]] took the lead in measures to check the spread of plague, having appointed three guardians of public health in the first years of the Black Death (1348).<ref>{{cite journal|doi=10.21061/vtuhr.v2i0.16|title=A Brief History of Quarantine|year=2013|last1=Drews|first1=Kelly|journal=The Virginia Tech Undergraduate Historical Review|volume=2|doi-access=free|hdl=10919/90277|hdl-access=free}}</ref> The next record of preventive measures comes from [[Reggio Emilia|Reggio]]/[[Modena]] in 1374. Venice founded the first [[lazaret]] (on a small island adjoining the city) in 1403. In 1467 [[Genoa]] followed the example of Venice, and in 1476 the old leper hospital of [[Marseille]] was converted into a plague hospital. The great lazaret of Marseille, perhaps the most complete of its kind, was founded in 1526 on the island of [[Frioul archipelago|Pomègues]]. The practise at all the Mediterranean lazarets did not differ from the English procedure in the Levantine and North African trade. On the arrival of cholera in 1831 some new lazarets were set up at western ports; notably, a very extensive establishment near [[Bordeaux]]. Afterwards, they were used for other purposes.{{citation needed|date=March 2023}}

===Modern history===
[[File:Quarantine guardship Rhin 1830.jpg|thumb|right|The quarantine ship ''Rhin'', at large in [[Sheerness]]. Source: [[National Maritime Museum|National Maritime Museum of Greenwich, London]]]]
Epidemics of yellow fever ravaged urban communities in North America throughout the late-eighteenth and early-nineteenth centuries, the best-known examples being the [[1793 Philadelphia yellow fever epidemic]]<ref>{{cite book |last1=Powell |first1=J. H. |title=Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793 |date=2014 |publisher=University of Pennsylvania Press |id={{Project MUSE|32597|type=book}} |isbn=978-0-8122-9117-9 }}{{pn|date=October 2023}}</ref> and outbreaks in Georgia (1856) and Florida (1888).<ref>[http://bobarnebeck.com/history.html Arnebeck, Bob. "A Short History of Yellow Fever in the US". January 30, 2008; From ''Benjamin Rush, Yellow Fever and the Birth of Modern Medicine.''] ''bobarnebeck.com'', accessed 3 February 2020</ref> Cholera and smallpox epidemics continued throughout the nineteenth century, and plague epidemics affected Honolulu<ref>[http://www.slate.com/blogs/the_vault/2014/08/15/history_of_the_cordon_sanitaire_honolulu_hawaii_bubonic_plague_in_1899.html The Disastrous Cordon Sanitaire Used on Honolulu's Chinatown in 1900] ''www.slate.com'', accessed 3 February 2020</ref> and San Francisco from 1899 until 1901.<ref>[http://www.skubik.com/thesis%20summary.pdf Mark Skubik, "Public Health Politics and the San Francisco Plague Epidemic of 1900–1904,"] Doctoral Thesis, San Jose State University, 2002 ''www.skubik.com'', accessed 5 February 2020</ref> State governments generally relied on the ''[[Cordon sanitaire (medicine)|cordon sanitaire]]'' as a geographic quarantine measure to control the movement of people into and out of affected communities. During the [[Spanish flu|1918 influenza]] pandemic, some communities instituted [[protective sequestration]] (sometimes referred to as "reverse quarantine") to keep the infected from introducing influenza into healthy populations.<ref name="scholarcommons.usf.edu">[https://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=5386&context=etd Peter Oliver Okin, "The Yellow Flag of Quarantine: An Analysis of the Historical and Prospective Impacts of Socio-Legal Controls Over Contagion,"] Doctoral dissertation, University of South Florida, January 2012; p. 232, ''scholarcommons.usf.edu'', accessed 5 February 2020</ref>  Additionally, the nature of the influenza virus that caused the 1918 pandemic gave rise to a public awareness of the dichotomy between "crowd" and "home" diseases. Simply quarantining the sick in isolation was ineffective in halting the spread of the disease, and new quarantine standards that extended regulations to public spaces became increasingly more common.<ref>{{Cite journal |last=Tomes |first=Nancy |date=2010 |title="Destroyer and Teacher": Managing the Masses During the 1918–1919 Influenza Pandemic |journal=Public Health Reports |volume=125 |issue=Suppl 3 |pages=48–62 |doi=10.1177/00333549101250S308 |pmc=2862334 |pmid=20568568 }}</ref> Most Western countries implemented a range of containment strategies, including isolation, surveillance, and the closure of schools, churches, theatres, and public events.<ref>{{cite journal |last1=Martini |first1=Mariano |last2=Gazzaniga |first2=Valentina |last3=Bragazzi |first3=Nicola Luigi |last4=Barberis |first4=Ilaria |title=The Spanish Influenza Pandemic: a lesson from the history 100 years after 1918 |journal=Journal of Preventive Medicine and Hygiene |date=2 April 2019 |volume=60 |issue=1 |pages=E64–E67 |doi=10.15167/2421-4248/jpmh2019.60.1.1205 |pmid=31041413 |pmc=6477554 }}</ref>
[[File:Romania - Isolating a village whose inhabitants believe that doctors poison those suspected of cholera.jpg|thumb|upright|Isolating a village in [[Romania]] whose inhabitants believe that doctors poison those suspected of cholera (1911)]]

People were prevented from entering the [[Ashanti Empire]] at [[border checkpoints]] if they exhibited symptoms of smallpox. Those who discovered symptoms of the disease after entering Ashanti were quarantined in remote villages.<ref>{{cite journal | last=Maier| first=D. | title=Nineteenth-Century Asante Medical Practices| journal= Comparative Studies in Society and History| volume=21 | issue=1 | pages=63–81 | year=1979| jstor=178452| doi=10.1017/S0010417500012652 | pmid=11614369 | s2cid=19587869 }}</ref>  In the 1830s, both the [[Ottoman Empire]] and [[Egypt]] established new quarantine systems. In 1831, Mehmet Ali of Egypt founded the Quarantine Board in Alexandria. In 1838, the Ottoman government installed the Supreme Council of Health, including the Quarantine Administration, in Istanbul. These two institutions set up permanent quarantines throughout the eastern Mediterranean, based on the western Mediterranean quarantine model.<ref name="Hamed-Troyansky">{{Cite journal|last=Hamed-Troyansky|first=Vladimir|date=2021|title=Ottoman and Egyptian Quarantines and European Debates on Plague in the 1830s–1840s|journal=Past and Present|volume=253|pages=235–270|doi=10.1093/pastj/gtaa017}}</ref> For example, at the port of [[İzmir]], all ships and their cargo would be inspected and those suspected of carrying the plague would be towed to separate docks and their personnel housed in separate buildings for a determined period of time. In [[Thessaly]], along the Greek-Turkish border, all travellers entering and exiting the Ottoman Empire would be quarantined for 9–15 days. Upon appearance of the plague, the quarantine stations would be militarised and the [[Ottoman army]] would be involved in border control and [[disease monitoring]].<ref>{{cite book|title=Plague and Contagion in the Islamic Mediterranean|editor=Nukhet Varlik|author=Andrew Robarts|pages=236–7|publisher=Arc Humanities Press}}</ref>

====International conventions 1852–1927====
Since 1852, several conferences were held involving European powers, with a view to uniform action in keeping out infection from the East and preventing its spread within Europe. All but that of 1897 were concerned with [[cholera]]. No result came of those at Paris (1852), Constantinople (1866), Vienna (1874), and Rome (1885), but each of the subsequent ones doctrine of constructive infection of a ship as coming from a scheduled port, and an approximation to the principles advocated by the United Kingdom for many years. The principal countries which retained the old system at the time were Spain, Portugal, Turkey, Greece, and Russia (the British possessions at the time, Gibraltar, Malta, and Cyprus, being under the same influence). The aim of each international sanitary convention had been to bind the governments to a uniform minimum of preventive action, with further restrictions permissible to individual countries. The minimum specified by international conventions was very nearly the same as the British practice, which had been in turn adapted to continental opinion in the matter of the importation of rags.{{citation needed|date=March 2023}}

The Venice convention of 30 January 1892 dealt with cholera by the [[Suez Canal]] route; that of Dresden of 15 April 1893, with cholera within European countries; that of Paris of 3 April 1894, with cholera by the pilgrim traffic; and that of Venice, on 19 March 1897, was in connection with the outbreak of plague in the East, and the conference met to settle on an international basis the steps to be taken to prevent, if possible, its spread into Europe. An additional convention was signed in Paris on 3 December 1903.<ref>[http://www.fco.gov.uk/resources/en/pdf/treaties/TS1/1907/27 Text of the 1903 convention] British Foreign and Commonwealth Office, ''www.fco.gov.uk'' {{webarchive|url=https://web.archive.org/web/20120926134555/http://www.fco.gov.uk/resources/en/pdf/treaties/TS1/1907/27 |date=26 September 2012}}, accessed 5 February 2020</ref>

A multilateral international sanitary convention was concluded at Paris on 17 January 1912.<ref>Text in ''League of Nations Treaty Series'', vol. 4, pp. 282–413.</ref> This convention was most comprehensive and was designated to replace all previous conventions on that matter. It was signed by 40 countries, and consisted of 160 articles. Ratifications by 16 of the signatories were exchanged in Paris on 7 October 1920. Another multilateral convention was signed in Paris on 21 June 1926, to replace that of 1912. It was signed by 58 countries worldwide, and consisted of 172 articles.<ref>Text in ''League of Nations Treaty Series'', vol. 78, pp. 230–349.</ref>

In Latin America, a series of regional sanitary conventions were concluded. Such a convention was concluded in Rio de Janeiro on 12 June 1904. A sanitary convention between the governments of Argentina, Brazil, Paraguay, and Uruguay was concluded in Montevideo on 21 April 1914.<ref>Text in ''League of Nations Treaty Series'', vol. 5, pp. 394–441.</ref> The convention covers cases of [[Asiatic cholera]], [[Third plague pandemic|oriental plague]] and [[yellow fever]]. It was ratified by the Uruguayan government on 13 October 1914, by the Paraguayan government on 27 September 1917 and by the Brazilian government on 18 January 1921.

Sanitary conventions were also concluded between European states. A Soviet-Latvian sanitary convention was signed on 24 June 1922, for which ratifications were exchanged on 18 October 1923.<ref>Text in ''League of Nations Treaty Series'', vol. 38, pp. 10–55.</ref> A bilateral sanitary convention was concluded between the governments of Latvia and Poland on 7 July 1922, for which ratifications were exchanged on 7 April 1925.<ref>Text in ''League of Nations Treaty Series'', vol. 37, pp. 318–339.</ref> Another was concluded between the governments of Germany and Poland in Dresden on 18 December 1922, and entered into effect on 15 February 1923.<ref>Text in ''League of Nations Treaty Series'', vo. 34, pp. 302–313.</ref> Another one was signed between the governments of Poland and Romania on 20 December 1922. Ratifications were exchanged on 11 July 1923.<ref>Text in ''League of Nations Treaty Series'', vol. 18, pp. 104–119.</ref> The Polish government also concluded such a convention with the Soviet government on 7 February 1923, for which ratifications were exchanged on 8 January 1924.<ref>Text in ''League of Nations Treaty Series'', vol. 49, pp. 286–314.</ref> A sanitary convention was also concluded between the governments of Poland and Czechoslovakia on 5 September 1925, for which ratifications were exchanged on 22 October 1926.<ref>Text in ''League of Nations Treaty Series'', vol. 58, pp. 144–177.</ref> A convention was signed between the governments of Germany and Latvia on 9 July 1926, for which ratifications were exchanged on 6 July 1927.<ref>Text in ''League of Nations Treaty Series'', vol. 63, pp. 322–361.</ref>

In 1897, the [[incubation period]] for this disease was determined and this was to be adopted for administrative purposes. The incubation period was comparatively short, some three or four days. After much discussion ten days was accepted by a majority. The principle of [[disease notification]] was unanimously adopted. Each government had to notify other governments of the existence of plague within their jurisdictions and state the measures of prevention being carried out to prevent its spread. The area declared infected was limited to the district or village where the disease prevailed, and no locality was deemed to be infected because of the importation into it of a few cases of plague while there has been no spread. It was decided during the prevalence of plague, every country had the right to close its land borders to traffic. At the [[Red Sea]], it was decided after discussion a healthy vessel could pass through the Suez Canal and continue its voyage in the Mediterranean during the incubation period of the disease and that vessels passing through the Canal in quarantine might, subject to the use of the electric light, coal up in quarantine at Port Said by night or by day, and that passengers might embark in quarantine at that port. Infected vessels, if these carry a doctor and a disinfecting stove, have a right to navigate the Canal in quarantine and subject only to the landing of those who have plague.{{citation needed|date=March 2021}}

In the 20th and 21st centuries, people suspected of carrying infectious diseases have been quarantined, as in the cases of [[Andrew Speaker]] (multi-drug-resistant tuberculosis, 2007) and [[Kaci Hickox]] (Ebola, 2014). During the [[1957–58 influenza pandemic]] and the [[1968 flu pandemic]], several countries implemented measures to control spread of the disease. In addition, the [[World Health Organization]] applied a global influenza surveillance network.<ref>{{cite journal |last1=Tognotti |first1=Eugenia |title=Lessons from the History of Quarantine, from Plague to Influenza A |journal=Emerging Infectious Diseases |date=February 2013|volume=19 |issue=2 |pages=254–259 |doi=10.3201/eid1902.120312 |pmid=23343512 |pmc=3559034 }}</ref>

During the [[1994 plague in India]], many people were quarantined. Vessels and aircraft carrying passengers were fumigated.<ref>[https://web.archive.org/web/20160206192456/http://www.tm.mahidol.ac.th/seameo/2006_37_4/21-3658.pdf Review: Surat Plague of 1994 Re-examined] archived from ''www.tm.mahidol.ac.th'', accessed 22 November 2020</ref><ref>[https://www.montana.edu/historybug/yersiniaessays/godshen.html The Surat Plague and its Aftermath] ''www.montana.edu'', accessed 22 November 2020</ref>

In the [[SARS epidemic]], thousands of Chinese people were quarantined and checkpoints to take temperatures were set up.<ref>Yanzong Huang, "The SARS Epidemic and its Aftermath in China: A Political Persecutive", ''Learning from SARS: Preparing for the Next Disease Outbreak: Workshop Summary'', Washington (DC): National Academies Press (US), 2004.</ref>

Moving infected patients to [[isolation ward]]s and home-based self-quarantine of people potentially exposed was the main way the [[Western African Ebola virus epidemic]] was ended in 2016; members of the 8th [[World Health Organization|WHO]] Emergency Committee criticised international travel restrictions imposed during the epidemic as ineffective due to difficulty of enforcement, and counterproductive as they slowed down aid efforts.<ref>{{cite report|url=https://www.who.int/mediacentre/news/statements/2015/ihr-ebola-8th-meeting/en/|title=Statement on the 8th meeting of the IHR Emergency Committee regarding the Ebola outbreak in West Africa|publisher=WHO|access-date=9 June 2016|date=|archive-date=22 December 2015|archive-url=https://web.archive.org/web/20151222223327/http://www.who.int/mediacentre/news/statements/2015/ihr-ebola-8th-meeting/en/|url-status=dead}}</ref>

The [[People's Republic of China]] has employed mass quarantines – firstly of the city of [[Wuhan]] and subsequently of all of the [[Hubei]] province (population 55.5 million) – in the [[Coronavirus disease 2019|coronavirus disease 2019 pandemic]]. After a few weeks, the Italian government imposed [[2020 Italy lockdowns|lockdowns]] for the entire country (more than 60 million people) in an attempt to stop the [[COVID-19 pandemic in Italy|spread of the disease there]]. [[India]] quarantined itself from the world for a period of one month.<ref>{{Cite news|url=https://timesofindia.indiatimes.com/india/india-quarantines-itself-from-world-for-a-month-to-fight-coronavirus/articleshow/74584811.cms|title=Coronavirus update: India quarantines itself from world for a month to fight coronavirus |first1=Sushmi |last1=Dey |website=The Times of India|date=12 March 2020 |language=en|access-date=13 March 2020 }}</ref><ref>{{Cite web|url=https://www.researchdecoded.com/covid-19-quarantine-punishment-india/|title=Know the legal aspects of breaking Quarantine order|last=Gyan|date=27 March 2020|website=Research Decoded|language=en-US|access-date=29 March 2020|archive-date=28 March 2020|archive-url=https://web.archive.org/web/20200328063523/https://www.researchdecoded.com/covid-19-quarantine-punishment-india/|url-status=dead}}</ref> Most governments around the world restricted or advised against all non-essential travel to and from countries and areas affected by the outbreak.<ref name="AutoDW-50">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html |title=COVID-19 Information for Travel |date=11 February 2020 |work=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=25 February 2020}}</ref> By late 2020, the virus had already spread within communities in large parts of the world, with many not knowing where or how they were infected.<ref name="CDC-CD-transmission">{{cite web |title=Coronavirus Disease 2019 (COVID-19)—Transmission |url=https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=29 March 2020 |date=17 March 2020}}</ref><!-- Add lockdown dates to this paragraph -->

== Signals and flags ==
[[File:ICS Quebec.svg|thumb|The [[International maritime signal flags|signal flag]] "Quebec", also called the "Yellow Jack", is a simple yellow flag that was historically used to signal quarantine (it stands for '''Q'''), but in modern use indicates the opposite, as a signal of a ship free of disease that requests boarding and inspection.]]
Plain yellow, green, and even black flags have been used to symbolise disease in both ships and ports, with the colour yellow having a longer historical precedent, as a colour of marking for houses of infection, previous to its use as a maritime marking colour for disease. The former flag used for the purpose was the "Lima" ('''L''') flag, which is a mixture of yellow and black flags previously used. It is sometimes called the "yellow jack" but this was also a name for [[yellow fever]], which probably derives its common name from the flag, not the colour of the victims (cholera ships also used a yellow flag).<ref>{{cite journal|vauthors=Sehdev PS|title=The origin of quarantine|journal=[[Clinical Infectious Diseases]]|date=1 November 2002|volume=35|issue=9|pages=1071–2|doi=10.1086/344062|pmid=12398064|doi-access=free}}</ref> The plain [[yellow flag (contagion)|yellow flag]] ("Quebec" or '''Q''' in [[international maritime signal flags]]) probably derives its letter symbol for its initial use in ''quarantine'', but this flag in modern times indicates the opposite—a ship that 'requests free [[pratique]]', i.e. that declares itself free of quarantinable disease, and requests boarding and routine port inspection.<ref>[http://flagspot.net/flags/xf~q.html Quarantine Flag history] ''flagspot.net'', accessed 2 February 2020</ref>

Ships in quarantine today would fly either the Q flag alone, meaning "My vessel is 'healthy' and I request free pratique", or the double Q flag (QQ), meaning "I require health clearance".<ref>[https://msi.nga.mil/Publications/ICOS International Code of Signals, page 102.] ''msi.nga.mil'' {{Webarchive|url=https://web.archive.org/web/20200711064159/https://msi.nga.mil/Publications/ICOS |date=11 July 2020 }}</ref>

==Ethical and practical considerations==
The quarantining of people often raises questions of [[civil rights]], especially in cases of long confinement or segregation from society, such as that of [[Mary Mallon]] (also known as Typhoid Mary), a [[typhoid fever]] [[Asymptomatic carrier|carrier]] who was arrested and quarantined in 1907 and later spent the last 23 years and 7 months of her life in medical isolation at Riverside Hospital on [[North and South Brother Islands, New York City#North Brother Island|North Brother Island]].<ref>[http://broadstreetonline.org/2015/02/typhoid-mary-and-the-publics-right-to-health/ "Typhoid Mary and the Public's Right to Health,"] ''Broad Street Magazine,'' 16 February 2015, 12:37 pm</ref><ref>[http://time.com/3474945/politics-quarantines-typhoid-mary-ebola/ Mary Beth Keane, "The History of Quarantine Is the History of Discrimination,"] 6 October 2014 ''Time Magazine,'', accessed 5 February 2020</ref>

===The United Nations and the Siracusa Principles===
Guidance on when and how human rights can be restricted to prevent the spread of infectious disease is found in the [[Siracusa Principles]], a non-binding document developed by the [[Siracusa International Institute for Criminal Justice and Human Rights]] and adopted by the [[United Nations Economic and Social Council]] in 1984.<ref>[http://www.unhcr.org/refworld/docid/4672bc122.html United Nations Economic and Social Council UN Sub-Commission on Prevention of Discrimination and Protection of Minorities, "The Siracusa Principles on the limitation and derogation provisions in the International Covenant on Civil and Political Rights," Section I.A.12 UN Doc. E/CN.4/1985/4, Annex. Geneva, Switzerland: UNHCR; 1985.] ''www.unhcr.org'', accessed 5 February 2020</ref> The Siracusa Principles state that restrictions on human rights under the [[International Covenant on Civil and Political Rights]] must meet standards of legality, [[evidence-based practice|evidence-based necessity]], proportionality, and gradualism, noting that public health can be used as grounds for limiting certain rights if the state needs to take measures 'aimed at preventing disease or injury or providing care for the sick and injured.' Limitations on rights (such as quarantine) must be 'strictly necessary,' meaning that they must:
* respond to a pressing public or social need (health)
* [[Proportionality (law)|proportionately]] pursue a legitimate aim (prevent the spread of infectious disease)
* be the [[least restrictive means]] required for achieving the purpose of the limitation
* be provided for and carried out in accordance with the law
* be neither arbitrary nor discriminatory
* only limit rights that are within the jurisdiction of the state seeking to impose the limitation.<ref>{{Cite journal |pmc = 4463097|year = 2013|last1 = Todrys|first1 = K. W.|title = Failing Siracusa: Governments' obligations to find the least restrictive options for tuberculosis control|journal = Public Health Action|volume = 3|issue = 1|pages = 7–10|last2 = Howe|first2 = E.|last3 = Amon|first3 = J. J.|pmid = 26392987|doi = 10.5588/pha.12.0094}}</ref>

In addition, when quarantine is imposed, public health ethics specify that:
* all restrictive actions must be well-supported by data and [[scientific evidence]]
* all information must be made available to the public
* all actions must be explained clearly to those whose rights are restricted and to the public
* all actions must be subject to regular review and reconsideration.

Finally, the state is ethically obligated to guarantee that:
* infected people will not be threatened or abused
* [[basic needs]] such as food, water, medical care, and preventive care will be provided
* communication with loved ones and with caretakers will be permitted
* constraints on freedom will be applied equally, regardless of social considerations
* patients will be compensated fairly for economic and material losses, including salary.<ref>M. Pabst Battin, Leslie P. Francis, Jay A. Jacobson, ''The Patient as Victim and Vector: Ethics and Infectious Disease,'' Oxford University Press, 2009. {{ISBN|019533583X}}</ref>

===Psychological impact===
[[File:Bell System Flu Quarantine.png|thumb|High tech communication brings cheer and encouragement]]
Quarantine can have adverse psychological effects on the quarantined, including [[post-traumatic stress]], confusion, and anger. According to a "Rapid Review" published in [[The Lancet]] in response to the [[COVID-19 pandemic]], "Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable."<ref>{{cite journal|doi=10.1016/S0140-6736(20)30460-8|title=The psychological impact of quarantine and how to reduce it: Rapid review of the evidence|year=2020|last1=Brooks|first1=Samantha K.|last2=Webster|first2=Rebecca K.|last3=Smith|first3=Louise E.|last4=Woodland|first4=Lisa|last5=Wessely|first5=Simon|last6=Greenberg|first6=Neil|last7=Rubin|first7=Gideon James|journal=The Lancet|volume=395|issue=10227|pages=912–920|pmid=32112714|pmc=7158942|doi-access=free}}</ref> Although youngsters appear to be less vulnerable to [[COVID-19]], the side effects of the pandemic can be devastating. Quarantine from the pandemic led to an increase the prevalence of violence in the family, depression, anxiety, and post-traumatic stress disorder. Children and adolescents may be highly exposed to biopsychosocial stressors generated by the pandemic and once population's containment measures to reduce virus spread are required, they could be potentially affected by the disruption in daily life routine as a result of social isolation and their unseasoned ability to conceive and comprehend the short- and long-term consequences of this outbreak.<ref>{{cite journal |last1=Spinelli |first1=Maria |last2=Lionetti |first2=Francesca |last3=Pastore |first3=Massimiliano |last4=Fasolo |first4=Mirco |title=Parents' Stress and Children's Psychological Problems in Families Facing the COVID-19 Outbreak in Italy |journal=Frontiers in Psychology |date=3 July 2020 |volume=11 |page=1713 |doi=10.3389/fpsyg.2020.01713 |pmc=7350926 |pmid=32719646 |doi-access=free }}</ref><ref>{{cite journal |last1=Banerjee |first1=Debanjan |last2=Rai |first2=Mayank |title=Social isolation in Covid-19: The impact of loneliness |journal=The International Journal of Social Psychiatry |date=September 2020 |volume=66 |issue=6 |pages=525–527 |doi=10.1177/0020764020922269 |pmid=32349580 |pmc=7405628 }}</ref>

===Short-term quarantines, e.g. for decontamination===
Quarantine periods can be very short, such as in the case of a suspected [[anthrax]] attack, in which people are allowed to leave as soon as they shed their potentially contaminated garments and undergo a [[decontamination]] shower. For example, an article entitled "Daily News workers quarantined" describes a brief quarantine that lasted until people could be showered in a decontamination tent.<ref>{{cite news| url = https://www.ourmidland.com/news/article/Anthrax-scare-temporarily-closes-Midland-Daily-7020034.php| title = Kelly Nankervis: Anthrax scare temporarily closes Midland Daily News| newspaper = Midland Daily News| date = 26 April 2005}} ''Daily News/ www.ourmidland.com''</ref>

The February–March 2003 issue of ''HazMat Magazine'' suggests that people be "locked in a room until proper decon could be performed", in the event of "suspect anthrax".{{citation needed|date=November 2018}}

''[[The Standard-Times (New Bedford)|Standard-Times]]'' senior correspondent Steve Urbon (14 February 2003) describes such temporary quarantine powers:
{{blockquote|Civil rights activists in some cases have objected to people being rounded up, stripped and showered against their will. But Capt. Chmiel said local health authorities have "certain powers to quarantine people".<ref>{{cite journal|last1=Tognotti|first1=E.|title=Lessons from the history of quarantine, from plague to influenza A.|journal=Emerging Infectious Diseases|volume=19|issue=2|pages=254–259|doi=10.3201/eid1902.120312|pmid=23343512|pmc=3559034|year=2013}}</ref><ref>{{cite book|last1=Qureshi|first1=Adnan|title=Ebola Virus Disease: From Origin to Outbreak|date=2016|publisher=Academic Press|location=London|isbn=978-0-12-804230-4|page=62}}</ref>}}

The purpose of such quarantine-for-decontamination is to prevent the spread of contamination and to contain the contamination such that others are not put at risk from a person fleeing a scene where contamination is suspect. It can also be used to limit exposure, as well as eliminate a [[Vector (epidemiology)|vector]].<ref>{{Citation |last1=National Academies of Sciences |first1=Engineering |title=Implementing Quarantine to Reduce or Stop the Spread of a Contagious Disease |date=2020-07-14 |work=Evidence-Based Practice for Public Health Emergency Preparedness and Response |url=https://www.ncbi.nlm.nih.gov/books/NBK563999/ |access-date=2024-04-10 |publisher=National Academies Press (US) |language=en |last2=Division |first2=Health and Medicine |last3=Practice |first3=Board on Population Health and Public Health |last4=Policy |first4=Board on Health Sciences |last5=Response |first5=Committee on Evidence-Based Practices for Public Health Emergency Preparedness and |last6=Downey |first6=Autumn |last7=Brown |first7=Lisa |last8=Calonge |first8=Ned}}</ref>

New developments for quarantine include new concepts in quarantine vehicles such as the [[ambulance bus]], mobile hospitals, and lockdown/invacuation (inverse evacuation) procedures, as well as docking stations for an ambulance bus to dock to a facility under lockdown.<ref>{{cite journal |last1=Zhang |first1=Min-Xia |last2=Yan |first2=Hong-Fan |last3=Wu |first3=Jia-Yu |last4=Zheng |first4=Yu-Jun |title=Quarantine Vehicle Scheduling for Transferring High-Risk Individuals in Epidemic Areas |journal=International Journal of Environmental Research and Public Health |date=27 March 2020 |volume=17 |issue=7 |pages=2275 |doi=10.3390/ijerph17072275 |pmc=7177222 |pmid=32230995 |doi-access=free }}</ref>

==Standard quarantine practices in different countries==
{{Globalize|section|the English-speaking world|date=February 2020}}

===Australia===
{{further|Biosecurity in Australia}}
Biosecurity in Australia is governed by the ''[[Biosecurity Act 2015]]''. The [[Department of Agriculture, Water and the Environment]] (DAWE) is responsible for border inspection of products brought into Australia, and assesses the risks the products might harm Australian environment. No person, goods, and vessels are permitted into Australia without clearance from DAFF. Visitors are required to fill in the information card on arriving in Australia. Besides other risk factors, visitors are required to declare what food and products made of wood and other natural materials they have. Visitors who fail to do so may be subject to a fine of A$444, or may face criminal prosecution and be fined up to A$444,000 or imprisonment of up to 10 years.<ref>{{cite web |title=Travelling to Australia  |url=https://www.agriculture.gov.au/travelling/to-australia |website=Department of Agriculture, Fisheries and Forestry |access-date=25 July 2020}}</ref>

Australia has very strict quarantine standards. Quarantine in northern Australia is especially important because of its proximity to South-East Asia and the Pacific, which have many pests and diseases not present in Australia. For this reason, the region from Cairns to Broome—including the [[Torres Strait]]—is the focus for quarantine activities that protect all Australians.<ref>{{cite web |url=http://www.daff.gov.au/aqis/about/public-awareness |title=Public Awareness and Education |access-date=27 March 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130405091101/http://www.daff.gov.au/aqis/about/public-awareness |website=Department of Agriculture, Fisheries and Forestry |date= 29 Apr 2011  |archive-date=5 April 2013  }}</ref> As Australia has been geographically isolated from other major continents for millions of years, there is an endemically unique ecosystem free of several severe pests and diseases that are present in many parts of the world.<ref name="daff">{{cite web |url=http://www.daff.gov.au/biosecurity/quarantine|title=Quarantine in Australia |publisher=Department of Agriculture |date= 13 Dec 2013  |access-date=14 September 2014|archive-url=https://web.archive.org/web/20140713013953/http://daff.gov.au/biosecurity/quarantine|archive-date=13 July 2014|url-status=dead}}</ref> If other products are brought inside along with pests and diseases, it would damage the ecosystem seriously and add millions of costs in the local agricultural businesses.<ref name="australia">{{cite web|title=Australian Quarantine a shared responsibility: The Government response|url=http://www.agriculture.gov.au/biosecurity/australia/reports-pubs/nairn/govt-response|publisher=Australian Government|agency=Department of Primary Industries and Energy |website=DAFF |access-date=20 May 2016}}</ref>

===Canada===
There are three quarantine [[Acts of Parliament]] in Canada: ''Quarantine Act'' (humans), ''Health of Animals Act'' (animals), and ''Plant Protection Act'' (vegetations). The first legislation is enforced by the [[Canada Border Services Agency]] after a complete rewrite in 2005. The second and third legislations are enforced by the [[Canadian Food Inspection Agency]]. If a health emergency exists, the Governor in Council can prohibit importation of anything that it deems necessary under the ''Quarantine Act''.

Under the ''Quarantine Act'', all travellers must submit to screening and if they believe they might have come into contact with [[communicable disease]]s or [[Vector (epidemiology)|vectors]], they must disclose their whereabouts to a [[Border Services Officer]]. If the officer has reasonable grounds to believe that the traveller is or might have been infected with a communicable disease or refused to provide answers, a quarantine officer (QO) must be called and the person is to be isolated. If a person refuses to be isolated, any [[peace officer]] may arrest without warrant.

A QO who has reasonable grounds to believe that the traveller has or might have a communicable disease or is infested with vectors, after the medical examination of a traveller, can order him/her into treatment or measures to prevent the person from spreading the disease. QO can detain any traveller who refuses to comply with his/her orders or undergo health assessments as required by law.

Under the ''Health of Animals Act'' and ''Plant Protection Act'', inspectors can prohibit access to an infected area, dispose or treat any infected or suspected to be infected animals or plants. The Minister can order for compensation to be given if animals/plants were destroyed pursuant to these acts.

Each province also enacts its own quarantine/environmental health legislation.

===Hong Kong===
{{Wikisource|Prevention and Control of Disease Ordinance}}
Under the ''Prevention and Control of Disease Ordinance'' (HK Laws. Chap 599), a health officer may seize articles they believe to be infectious or containing infectious agents. All travellers, if requested, must submit themselves to a health officer. Failure to do so is against the law and is subject to arrest and prosecution.

The law allows for health officers who have reasonable grounds to detain, isolate, quarantine anyone or anything believed to be infected, and to restrict any articles from leaving a designated quarantine area. He/she may also order the Civil Aviation Department to prohibit the landing or leaving, embarking or disembarking of an aircraft. This power also extends to land, sea or air crossings.

Under the same ordinance, any police officer, health officer, member of the [[Civil Aid Service]], or member of the [[Auxiliary Medical Service]] can arrest a person who obstructs or escapes from detention.

===United Kingdom===
To reduce the risk of introducing [[rabies]] from continental Europe, the United Kingdom used to require that dogs, and most other animals introduced to the country, spend six months in quarantine at an [[Her Majesty's Customs and Excise|HM Customs and Excise]] pound; this policy was abolished in 2000 in favour of a scheme generally known as [[Pet Passports]], where animals can avoid quarantine if they have documentation showing they are up to date on their appropriate [[vaccine|vaccinations]].<ref>"[https://www.gov.uk/take-pet-abroad#countries-and-territories Bringing your pet dog, cat or ferret to the UK]", ''gov.uk'', accessed 27 January 2020.</ref>

====British maritime quarantine rules 1711–1896====
{{Infobox UK legislation
| short_title           = Quarantine Act 1710
| type                  = Act
| parliament            = Parliament of Great Britain
| long_title            = An Act to oblige Ships, coming from Places infected, more effectually to perform their Quarentine.
| year                  = 1710
| citation              = 9 Ann. c. 2
| introduced_commons    =
| introduced_lords      =
| territorial_extent    =
| royal_assent          = 23 December 1710
| commencement          =
| expiry_date           =
| repeal_date           =
| amends                =
| replaces              =
| amendments            =
| repealing_legislation =
| related_legislation   =
| status                =
| legislation_history   =
| theyworkforyou        =
| millbankhansard       =
| original_text         =
| revised_text          =
| use_new_UK-LEG        =
| UK-LEG_title          =
| collapsed             = yes
}}
The plague had disappeared from England for more than thirty years before the practice of quarantine against it was definitely established by the Quarantine Act 1710 (''[[9 Ann.]]'').<ref>{{cite book |url=https://archive.org/details/statutesatlargef04grea/page/420/ |title=Quarantine Act 1710 |last=Stuart |first=Anne |year=1710 |trans-title=9 Ann. Chapter II A.D. 1710 |series=The Statutes at Large : from Magna Charta, to the End of the Last Parliament, 1761 |location=London, Great Britain |via=Internet Archive |publisher=Mark Baskett, Henry Woodfall, and William Strahan |volume=IV |pages=420–421 |oclc=228755149}}</ref> The first act was called for due to fears that the plague might be imported from Poland and the [[Baltic Sea|Baltic]] [[Baltic region|region]]. The second act of 1721 was due to the prevalence of plague at [[Marseille]] and other places in [[Provence, France]]. It was renewed in 1733 after a new outbreak in [[continental Europe]], and again in 1743, due to an epidemic in [[Messina]]. In 1752 a rigorous quarantine clause was introduced into an act regulating trade with [[the Levant]], and various arbitrary orders were issued during the next twenty years to meet the supposed danger of infection from the Baltic region. Although no plague cases ever came to England during that period, the restrictions on traffic became more stringent, and in 1788 a very strict Quarantine Act was passed, with provisions affecting cargoes in particular. The act was revised in 1801 and 1805, and in 1823–24 an elaborate inquiry was followed by an act making quarantine only at discretion of the [[privy council]], which recognised yellow fever or other highly infectious diseases as calling for quarantine, along with plague. The threat of cholera in 1831 was the last occasion in England of the use of quarantine restrictions. Cholera affected every country in Europe, despite all efforts to keep it out. When cholera returned to England in 1849, 1853 and 1865–66, no attempt was made to seal the ports. In 1847 the privy council ordered all arrivals with a clean [[bill of health]] from the [[Black Sea]] and the Levant to be admitted, provided there had been no case of plague during the voyage, and afterwards the practice of quarantine was discontinued.<ref name=Booker>{{cite book |chapter-url=https://books.google.com/books?id=B7OoDQAAQBAJ&pg=PT5 |first=John |last=Booker |chapter=Maritime Quarantine: The British Experience, c.1650–1900 |title=The History of Medicine in Context |publisher=Routledge |year=2016 |isbn=978-1-351-91984-5 |access-date=6 February 2020 }}</ref>

After the passing of the first Quarantine Act (1710) the protective practices in England were haphazard and arbitrary. In 1721 two vessels carrying cotton goods from Cyprus, then affected by the plague, were ordered to be burned with their cargoes, the owners receiving an [[indemnity]]. By the clause in the Levant Trade Act of 1752, ships arriving in the United Kingdom with a "foul bill" (i.e. coming from a country where plague existed) had to return to the [[lazaret]]s of Malta, Venice, Messina, Livorno, Genoa, or Marseille, to complete a quarantine or to have their cargoes opened and aired. Since 1741 [[Stangate]] Creek (on the [[Medway]]) had been the quarantine station but it was available only for vessels with clean bills of health. In 1755 lazarets in the form of [[Hulk (ship type)|floating hulks]] were established in England for the first time, the cleansing of cargo (particularly by exposure to [[dew]]s) having been done previously on the ship's deck. No medical inspections were conducted, but control was the responsibility of the Officers of [[Customs|Royal Customs]] and quarantine. In 1780, when plague was in Poland, even vessels with grain from the Baltic region had to spend forty days in quarantine, and unpack and air their cargoes, but due to complaints mainly from [[Edinburgh]] and [[Leith]], an exception was made for grain after that date. About 1788 an order of the council required every ship liable to quarantine to hoist a [[yellow flag (contagion)|yellow flag]] in the daytime and show a light at the main topmast head at night, in case of meeting any vessel at sea, or upon arriving within four [[league (unit)|leagues]] of the coast of [[Great Britain]] or [[Ireland]], the [[Channel Islands]], or the [[Isle of Man]].<ref name=Booker/>

After 1800, ships from plague-affected countries (or with foul bills) were permitted to complete their quarantine in the Medway instead of at a Mediterranean port on the way, and an extensive lazaret was built on [[Chetney Hill]] near [[Chatham, Kent|Chatham]] (although it was later demolished). The use of floating hulks as lazarets continued as before. In 1800 two ships with [[hide (skin)|hides]] from [[Mogador]] in Morocco were ordered to be sunk with their cargoes at the [[Nore]], the owners receiving an indemnity. Animal hides were suspected of harbouring infections, along with a long list of other items, and these had to be exposed on the ship's deck for twenty-one days or less (six days for each instalment of the cargo), and then transported to the lazaret, where they were opened and aired for another forty days. The whole detention of the vessel was from sixty to sixty-five days, including the time for reshipment of her cargo. Pilots had to pass fifteen days on board a convalescent ship. From 1846 onwards the quarantine establishments in the United Kingdom were gradually reduced, while the last vestige of the British quarantine law was removed by the [[Public Health Act]] of 1896, which repealed the Quarantine Act of 1825 (with dependent clauses of other acts), and transferred from the privy council to the [[Local Government Board]] the powers to deal with ships arriving infected with yellow fever or plague. The powers to deal with cholera ships had been already transferred by the [[Public Health Act 1875]].<ref name=Booker/>

British regulations of 9 November 1896 applied to [[yellow fever]], [[Bubonic plague|plague]] and [[cholera]]. Officers of [[Her Majesty's Customs]], as well as of [[Her Majesty's Coastguard]] and the [[Board of Trade]] (for signalling), were empowered to take the initial steps. They certified in writing the master of a supposedly infected ship, and detained the vessel provisionally for not more than twelve hours, giving notice meanwhile to the [[Port authority|port sanitary authority]]. The medical officer of the port boarded the ship and examined every person in it. Every person found infected was taken to a hospital and quarantined under the orders of the medical officer, and the vessel remained under his orders. Every person suspected could be detained on board for 48 hours or removed to the hospital for a similar period. All others were free to land upon giving the addresses of their destinations to be sent to the respective local authorities, so that the dispersed passengers and crew could be kept individually under observation for a few days. The ship was then disinfected, dead bodies buried at sea, infected clothing, bedding, etc., destroyed or disinfected, and [[bilge-water]] and [[Sailing ballast|water-ballast]] pumped out at a suitable distance before the ship entered a dock or basin. Mail was subject to no detention. A stricken ship within 3 miles of the shore had to fly a yellow and black flag at the main mast from sunrise to sunset.<ref name=Booker/>

===United States===
In the United States, authority to quarantine people with infectious diseases is split between the state and federal governments. States (and [[Tribal sovereignty in the United States|tribal governments]] recognised by the federal government)<ref>[https://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html Legal Authorities for Isolation and Quarantine] 8 October 2014, ''Centers for Disease Control and Prevention'', accessed 6 February 2020</ref> have primary authority to quarantine people within their boundaries. Federal jurisdiction only applies to people moving across state or national borders, or people on federal property.<ref>[https://time.com/3516827/cdc-constitution-quarantine/ The CDC Has Less Power Than You Think, and Likes it That Way] 17 October 2014, Denver Nicks ''time.com'', accessed 6 February 2020</ref>

====Federal rules====
{{cleanup|reason=Summary of CDC quarantine regulations and powers only covers recent changes rather than explaining the whole body of regulations.|date=February 2020}}
Communicable diseases for which apprehension, detention, or conditional release of people are authorised must be specified in [[Executive Order]]s of the President.<ref>{{cite web|title=Regulations to control communicable diseases|url=http://www.gpo.gov/fdsys/pkg/USCODE-2013-title42/html/USCODE-2013-title42-chap6A-subchapII-partG-sec264.htm#264_1_target|website=gpo.gov|access-date=30 October 2014}}</ref>  As of 2014, these include Executive Orders 13295<ref>{{cite web| url = https://en.wikisource.org/wiki/Executive_Order_13295| title = Executive Order 13295}}</ref> 13375, and 13674; the latest executive order specifies the following infectious diseases: [[cholera]], [[diphtheria]], infectious [[tuberculosis]], [[plague (disease)|plague]], [[smallpox]], [[yellow fever]], [[viral haemorrhagic fevers]] ([[Lassa fever|Lassa]], [[Marburg virus|Marburg]], [[Ebola virus disease|Ebola]], [[Crimean–Congo hemorrhagic fever|Crimean-Congo]], [[Arenavirus|South American]], and others not yet isolated or named), [[severe acute respiratory syndrome]]s (SARS), and [[influenza]] from a novel or re-emergent source.<ref>{{cite web|title=Specific Laws and Regulations Governing the Control of Communicable Diseases|url=https://www.cdc.gov/quarantine/specificlawsregulations.html|website=cdc.gov|location=bottom of page, in "Executive Orders" paragraph|date=31 July 2014 |access-date= 4 March 2020}}</ref>

The [[Department of Health and Human Services]] is responsible for quarantine decisions, specifically the [[Centers for Disease Control and Prevention]]'s [[Division of Global Migration and Quarantine]]. As of 21 March 2017, [[Centers for Disease Control and Prevention]] (CDC) regulations specify:<ref>[https://www.cdc.gov/quarantine/final-rule-communicable-diseases.html Specific Laws and Regulations Governing the Control of Communicable Diseases] – Final Rule for Control of Communicable Diseases: Interstate and Foreign ''www.cdc.gov'', accessed 4 March 2020</ref>
* All [[Commercial aviation|commercial passenger flights]] must report deaths or illnesses to the CDC.
* Individuals must apply for a travel permit if they are under a Federal quarantine, isolation, or [[conditional release]] order.
* When an individual who is moving between U.S. states is "reasonably believed to be infected" with a quarantinable communicable disease in a "qualifying stage", the CDC may apprehend or examine that individual for potential infection.
* This includes new regulatory authority permitting the CDC Director to prohibit the importation of animals or products that pose a threat to public health.

The rules:
* Do not authorise compulsory medical testing, vaccination, or medical treatment without prior [[informed consent]].
* Require CDC to advise individuals subject to [[medical examination]]s that they will be conducted by an authorised health worker and with prior informed consent.
* Include strong [[due process]] protections for individuals subject to public health orders, including a right to counsel for [[indigent]] individuals.
* Limit to 72 hours the amount of time that an individual may be apprehended pending the issuance of a federal order for isolation, quarantine, or conditional release.

====US quarantine facilities====
{{update section|date=February 2020}} <!-- quarantine facilities have been operating for Wuhan coronavirus -->
The [[Division of Global Migration Health]] (DGMH) of the US [[Centers for Disease Control]] (CDC) operates small quarantine facilities at a number of US ports of entry. As of 2014, these included one land crossing (in [[El Paso, Texas]]) and 19 international airports.<ref>[https://www.cdc.gov/quarantine/QuarantineStationContactListFull.html Quarantine Station Contact List, Map, and Fact Sheets] (CDC)</ref><ref name=acrp2008>{{citation
|url=http://onlinepubs.trb.org/onlinepubs/acrp/acrp_rpt_005.pdf
|title=Quarantine Facilities for Arriving Air Travelers: Identification of Planning Needs and Costs
|series=TRB's Airport Cooperative Research Program (ACRP) Report 5
|year=2008
|first1=Hollis |last1=Stambaugh
|first2=Daryl  |last2=Sensenig
|first3=Rocco  |last3=Casagrande
|first4=Shania  |last4=Flagg
|first5=Bruce  |last5=Gerrity
|publisher=The National Academies Press
|doi=10.17226/13989
|isbn=978-0-309-09940-0
}}</ref><ref group=note>The 19 airports with quarantine facilities are in Anchorage, Atlanta, Boston, Chicago, Dallas/Ft. Worth, Detroit, Honolulu, Houston, Los Angeles, Miami, Minneapolis, New York City (JFK), Newark, Philadelphia, San Diego, San Francisco, San Juan, Seattle, and Washington, D.C. (Dulles).</ref>

Besides the [[port of entry]] where it is located, each station is also responsible for quarantining potentially infected travellers entering through any ports of entry in its assigned region. These facilities are fairly small; each one is operated by a few staff members and capable of accommodating 1–2 travellers for a short observation period.<ref name="acrp2008" /> Cost estimates for setting up a temporary larger facility, capable of accommodating 100 to 200 travellers for several weeks, have been published by the Airport Cooperative Research Program (ACRP) in 2008 of the [[Transportation Research Board]].<ref name="acrp2008" />

====US quarantine of imported goods====
The United States puts immediate quarantines on imported products if a contagious disease is identified and can be traced back to a certain shipment or product. All imports will also be quarantined if the disease appears in other countries.{{citation needed|date=February 2020}} According to Title [http://www.publichealthlaw.net/Resources/ResourcesPDFs/4quarantine.pdf 42 U.S.C. §§264 and 266] {{Webarchive|url=https://web.archive.org/web/20150924083040/http://www.publichealthlaw.net/Resources/ResourcesPDFs/4quarantine.pdf |date=24 September 2015 }}, these statutes provide the [[Secretary of Health and Human Services]] peacetime and wartime authority to control the movement of people into and within the United States to prevent the spread of communicable disease.
[[File:Columbia River Quarantine Station - Knappton Washington.jpg|thumb|The quarantine hospital building (lazaretto) at the historic Columbia River Quarantine Station near Knappton, Washington]]

====History of quarantine laws in the US====
[[File:PHSQuarentineStationNOLA1957.jpg|thumb|Public Health Service Quarantine Station, [[New Orleans]], [[Louisiana]], 1957]]
Quarantine law began in Colonial America in 1663, when in an attempt to curb an outbreak of [[smallpox]], the city of New York established a quarantine. In the 1730s, the city built a quarantine station on the [[Bedloe's Island]].<ref name="Lazaretto">{{cite web |url= http://www.ushistory.org/laz/history/index.htm |title=Lazaretto Quarantine Station, Tinicum Township, Delaware County, PA: History |access-date=24 April 2008 |publisher= [[ushistory.org]]}}</ref> The [[Philadelphia Lazaretto]] was the first quarantine hospital in the United States, built in 1799, in <!-- [[Essington, Pennsylvania|Essington]], --> [[Tinicum Township, Delaware County, Pennsylvania|Tinicum Township]], [[Delaware County, Pennsylvania|Delaware County]], Pennsylvania.<ref name="City">{{cite web |url= http://www.phila.gov/Health/Commissioner/History/ContagiousDiseaseControl.html | title=Contagious Disease Control, The Lazaretto | access-date=21 November 2007 |publisher=[[City of Philadelphia]] |archive-url = https://web.archive.org/web/20080508033044/http://www.phila.gov/Health/Commissioner/History/ContagiousDiseaseControl.html <!-- Bot retrieved archive --> |archive-date = 8 May 2008}}</ref> There are similar national landmarks such as the [[Columbia River Quarantine Station]], [[Swinburne Island]]  and [[Angel Island (California)#Angel Island Immigration Station|Angel Island]]. The [[Pest House (Concord, Massachusetts)|Pest House]] in [[Concord, Massachusetts]] was used as early as 1752 to quarantine those with cholera, tuberculosis and smallpox.

In early June 1832, during the cholera epidemic in New York, Governor [[Enos Throop]] called a special session of the Legislature for 21 June, to pass a Public Health Act by both Houses of the State Legislature. It included to a strict quarantine along the Upper and Lower New York-Canadian frontier. In addition, New York City Mayor Walter Browne established a quarantine against all peoples and products of Europe and Asia, which prohibited ships from approaching closer than 300 yards to the city, and all vehicles were ordered to stop 1.5 miles away.<ref>{{cite web| url = https://www.varsitytutors.com/earlyamerica/early-america-review/volume-4/the-1832-cholera-epidemic-part-2| title = G. William Beardslee, "The 1832 Cholera Epidemic – Part 2: 19th Century Responses to Cholerae Vibrio."| access-date = 6 March 2019| archive-date = 18 May 2015| archive-url = https://web.archive.org/web/20150518003717/http://www.earlyamerica.com/review/2000_fall/1832_cholera_part2.html| url-status = dead}}</ref>

The Immigrant Inspection Station on [[Ellis Island]], built in 1892, is often mistakenly assumed to have been a quarantine station, however its marine hospital ([[Ellis Island Immigrant Hospital]]) only qualified as a contagious disease facility to handle less virulent diseases like measles, [[trachoma]] and less advanced stages of tuberculosis and diphtheria; those affected by smallpox, yellow fever, cholera, leprosy or typhoid fever, could neither be received nor treated there.<ref>{{Cite journal|last=Yew|first=E.|date=June 1980|title=Medical inspection of immigrants at Ellis Island, 1891-1924.|journal=Bulletin of the New York Academy of Medicine|volume=56|issue=5|pages=488–510 |pmc=1805119|pmid=6991041}}</ref><ref>{{Cite journal|last=Birn|first=Anne-Emanuelle|date=1997|title=Six Seconds Per Eyelid: the medical inspection of immigrants at Ellis Island, 1892-1914|url=https://www.raco.cat/index.php/Dynamis/article/download/106118/165458|journal=DYNAMIS. Acta Hisp. Med. Sci. Hist.|volume=17|pages=289|pmid=11623552}}</ref>

[[Mary Mallon]] was quarantined in 1907 under the Greater New York Charter, Sections 1169–1170,<ref>Judith Walzer Leavitt, ''Typhoid Mary: Captive to the Public's Health,'' Beacon Press, 1996, p. 71. {{ISBN|0807021032}}</ref> which permitted the [[New York City Board of Health]] to "remove to a proper place…any person sick with any contagious, pestilential or infectious disease."<ref>[http://www.columbia.edu/cu/lweb/digital/collections/cul/texts/ldpd_6864674_000/index.html The Greater New York Charter as enacted in 1897] ''www.columbia.edu'', accessed 2 February 2020</ref>

During the [[1918 flu pandemic]], people were also quarantined. Most commonly suspect cases of infectious diseases are requested to voluntarily quarantine themselves, and Federal and local quarantine statutes only have been uncommonly invoked since then, including for a suspected [[smallpox]] case in 1963.<ref>{{cite news |title=Get In That Bubble, Boy! When can the government quarantine its citizens? |url=http://www.slate.com/articles/news_and_politics/explainer/2007/06/get_in_that_bubble_boy.html |quote= In fact, until this recent situation, the CDC hadn't issued such an order since 1963, when it quarantined a woman for smallpox exposure. Even during the SARS epidemic in 2003, officials relied mostly on voluntary isolation and quarantine. And the last large-scale quarantine in the U.S. took place during the Spanish flu epidemic of 1918–19. ... |newspaper=[[Slate magazine]] |date=1 June 2007 |access-date=30 September 2011 }}</ref>

The 1944 [[Public Health Service Act]] "to apprehend, detain, and examine certain infected persons who are peculiarly likely to cause the interstate spread of disease" clearly established the [[Federal government of the United States|federal government]]'s quarantine authority for the first time. It gave the [[United States Public Health Service]] responsibility for preventing the introduction, transmission and spread of communicable diseases from foreign countries into the United States, and expanded quarantine authority to include incoming aircraft.<ref name = "CDC"/> The act states that "...any individual reasonably believed to be infected with a communicable disease in a qualifying stage and...if found to be infected, may be detained for such time and in such manner as may be reasonably necessary."<ref>{{Cite journal |pmc = 1403520|year = 1994|title = Public Health Service Act, 1944|journal = Public Health Reports|volume = 109|issue = 4|pages = 468|pmid = 8041843}}</ref>

No federal quarantine orders were issued from 1963 until 2020, as American citizens were evacuated from China during the [[COVID-19 pandemic]].<ref>[https://abcnews.go.com/Health/wireStory/american-evacuated-china-wary-deadly-virus-68658460 U.S. evacuees 'relieved' about quarantine on military base] 1 February 2020, AMY TAXIN ''abcnews.go.com'', accessed 6 February 2020</ref>

===List of quarantine services in the world===
* [[Australian Quarantine and Inspection Service]]
* [[MAF Quarantine Service]], in the New Zealand
* [[Quarantine, Western Australia]]<ref>[https://web.archive.org/web/20070829025740/http://www.agric.wa.gov.au/quarantine.htm Western Australian Quarantine and Inspection Service] Archived from ''www.agric.wa.gov.au'', accessed 1 February 2020</ref>
* [[Samoa Quarantine Service]], in the [[West Samoa]]
* [[Racehorse & Equine Quarantine Services]], A company built & developed by Frankie Thevarasa [[Kuala Lumpur Malaysia]]
* [[Federal Service for Supervision of Consumer Rights Protection and Human Welfare]], a Federal Quarantine Service of the [[Government of Russia]].

==Notable quarantines==
===Eyam village, 1665 (plague)===
[[Eyam]] was a village in Britain that imposed a ''[[Cordon sanitaire (medicine)|cordon sanitaire]]'' on itself to stop the spread of the bubonic plague to other communities in 1665. The plague ran its course over 14 months and one account states that it killed at least 260 villagers.<ref>{{Cite book
| last= Clifford
| first= John G.
| title= Eyam Plague, 1665–1666
| publisher= J.G. Clifford
| year= 1989
| oclc= 57354126 }}</ref> The church in Eyam has a record of 273 individuals who were victims of the plague.<ref name="victims">{{Cite web|url=http://www.eyamplaguevillage.co.uk/index.php/eyam-plague/plague-victims|archive-url=https://web.archive.org/web/20120311041739/http://www.eyamplaguevillage.co.uk/index.php/eyam-plague/plague-victims|url-status=dead|title=List of plague victims|archive-date=11 March 2012}}</ref>

===Convict ship ''Surry'', Sydney Harbour, 1814 (typhoid)===
[[File:1814 07 30 Sydney Gazette Surry Quarantine.png|thumb|Quarantine of the convict ship [[Surry (1811 ship)|''Surry'']] on the North Shore of Sydney Harbour in 1814, the first quarantine in Australia]]

On 28 July 1814, the convict ship ''[[Surry (1811 ship)|Surry]]'' arrived in Sydney Harbour from England. Forty-six people had died of [[typhoid]] during the voyage, including 36 convicts, and the ship was placed in quarantine on the North Shore. Convicts were landed, and a camp was established in the immediate vicinity of what is now [[Jeffrey Street]] in [[Kirribilli]]. This was the first site in Australia to be used for quarantine purposes.<ref>{{cite news
|url= http://nla.gov.au/nla.news-page7203
|work= The Sydney Gazette and New South Wales Advertiser
|author= Secretary's Office, Sydney
|date= 10 September 1814
|title= Government Public Notice, Published by Authority
|page=2
|access-date=7 June 2010}}</ref>

==='Typhoid Mary' (US), 1907–1910 and 1915–1938===
[[Mary Mallon]] was a cook who was found to be a carrier of [[Salmonella enterica subsp. enterica]], the cause of [[typhoid fever]], and was forcibly isolated from 1907 to 1910. At least 53 cases of the infection were traced to her, and three deaths. Subsequently, she spent a further 23 years in isolation prior to her death in 1938. The presence of the bacteria in her gallbladder was confirmed on autopsy.<ref name="TyphoidMaryTSD">{{cite web|author=Dex and McCaff|url=http://www.straightdope.com/columns/read/1816/who-was-typhoid-mary |title=Who was Typhoid Mary?|website=The Straight Dope|date= 14 August 2000 |access-date= 5 March 2020}}</ref>

===East Samoa, 1918 (flu pandemic)===
During the [[1918 flu pandemic]], the then [[List of governors of American Samoa|Governor of]] [[American Samoa]], [[John Martin Poyer]], imposed a full [[protective sequestration]] of the islands from all incoming ships, successfully preventing influenza from infecting the population and thus achieving zero deaths within the territory.<ref name="scholarcommons.usf.edu"/> In contrast, the neighbouring [[Occupation of German Samoa|New Zealand-controlled]] [[Western Samoa Trust Territory|Western Samoa]] was among the hardest hit, with a 90% infection rate and over 20% of its adults dying from the disease. This failure by the New Zealand government to prevent and contain the Spanish Flu subsequently rekindled [[Mau movement|Samoan anti-colonial sentiments]] that led to its eventual independence.<ref>{{Cite web |title=Apia |url=https://www.mfat.govt.nz/en/about-us/mfat75/75-our-story/apia |access-date=2024-04-11 |website=www.mfat.govt.nz |language=en}}</ref>

===Gruinard Island, 1942–1990 (anthrax)===
In 1942, during [[World War II]], British forces tested out their biological weapons program on [[Gruinard Island]] and infected it with [[anthrax]]. Subsequently, a quarantine order was placed on the island. The quarantine was lifted in 1990,<ref>[http://news.bbc.co.uk/1/hi/scotland/1457035.stm Britain's 'Anthrax Island'], 25 July 2001 ''news.bbc.co.uk'', accessed 5 March 2020</ref> when the island was declared safe, and a flock of sheep was released onto the island.

===Apollo series space explorers, 1969–1971===
Between 24 July 1969 and 9 February 1971, the astronauts of [[Apollo 11]], [[Apollo 12]], and [[Apollo 14]], were quarantined (in each case for a total of 21 days) after returning to Earth, initially where they were recovered, and then were transferred to the [[Lunar Receiving Laboratory]], to prevent possible [[interplanetary contamination]] by microorganisms from the [[Moon]]. All lunar samples were also held in the [[Biosecurity|biosecure]] environment of the Lunar Receiving Laboratory for initial assay.<ref>{{Cite web |date=2021-10-13 |title=Building on a Mission: The Lunar Receiving Laboratory - NASA |url=https://www.nasa.gov/history/building-on-a-mission-the-lunar-receiving-laboratory/ |access-date=2024-04-11 |language=en-US}}</ref>

===Yugoslavia, 1972 (smallpox)===
The [[1972 Yugoslav smallpox outbreak]] was the final outbreak of [[smallpox]] in Europe. The [[World Health Organization]] fought the outbreak with extensive quarantine and a ''[[Cordon sanitaire (medicine)|cordon sanitaire]]'', and the government instituted [[martial law]].

===Case of Kaci Hickox' return to US, 2014 (Ebola)===
In 2014, [[Kaci Hickox]], a [[Doctors Without Borders]] nurse from Maine, legally battled 21-day quarantines imposed by the states of New Jersey and Maine after returning home from treating [[Ebola]] patients in [[Sierra Leone]].<ref>{{cite news|work=Huffington Post|url=http://www.huffingtonpost.com/2014/11/08/kacii-hickox-leaving-maine_n_6127146.html|agency=Reuters|title=Kaci Hickox, Nurse Who Fought Ebola Quarantine, To Leave Maine: Report|date=8 November 2014 }}</ref> "Hickox was sequestered in a medical tent for days because New Jersey announced new Ebola regulations the day she arrived. She eventually was allowed to travel to Maine, where the state sought to impose a 'voluntary quarantine' before trying and failing to create a buffer between her and others. A state judge rejected attempts to restrict her movements, saying she posed no threat as long as she wasn't demonstrating any symptoms of Ebola. Hickox said health care professionals like those at the U.S. Centers for Disease Control and Prevention – not politicians like New Jersey Gov. Chris Christie and Maine Gov. [[Paul LePage]] – should be in charge of making decisions that are grounded in science, not fear."<ref>[https://www.cbsnews.com/news/ebola-outbreak-maine-nurse-kaci-hickox-to-remain-advocate-against-quarantines/ Maine nurse to remain advocate against Ebola quarantines] 9 November 2014, ''CBSNews'', accessed 28 January 2020</ref>

===COVID-19 pandemic, 2020–2023===
[[File:Vermont COVID travel sign.jpg|thumb|A road sign at an exit on [[Interstate 91]] in [[Vermont]], photographed in November 2020.]]
During the [[COVID-19 pandemic]], multiple governmental actors enacted quarantines in an effort to curb the rapid spread of the virus. Quarantine-like restrictions on movement included [[curfews]] and restrictions variously described as [[stay-at-home orders]], shelter-in-place orders, shutdowns or [[lockdown#COVID-19 pandemic|lockdowns]].{{citation needed|date=July 2023}}

On 26 March 2020, 1.7 billion people worldwide were under some form of [[COVID-19 lockdowns|lockdown]],<ref>{{cite news |last1=Jones |first1=Sam |last2=Kassam |first2=Ashifa |title=Spain defends response to coronavirus as global cases exceed 500,000 |url=https://www.theguardian.com/world/2020/mar/26/spanish-coronavirus-deaths-slow-as-world-nears-500000-cases |work=The Guardian |date=26 March 2020}}</ref> which increased to 2.6 billion people two days later—around a third of the [[World population|world's population]].<ref>{{cite news |title=A third of the global population is on coronavirus lockdown — here's our constantly updated list of countries and restrictions |url=https://www.businessinsider.com/countries-on-lockdown-coronavirus-italy-2020-3 |work=Business Insider |date=28 March 2020}}</ref><ref>{{cite news |title=How to Lock Down 2.6 Billion People Without Killing the Economy |url=https://www.bloomberg.com/opinion/articles/2020-03-25/coronavirus-how-to-make-locking-down-2-6-billion-people-work |work=Bloomberg |date=25 March 2020}}</ref>

====Hubei====
{{further|COVID-19 lockdown in Hubei}}

In Hubei, the origin of the epidemic, a ''[[Cordon sanitaire (medicine)|cordon sanitaire]]'' was [[2020 Hubei lockdown|imposed on Wuhan]] and other major cities in China, affecting around 500 million people, which is unprecedented in scale in human history,<ref>[https://www.abc.net.au/news/2020-02-15/coronavirus-lockdown-in-china-6.5-per-cent-worlds-population/11968114 Coronavirus COVID-19 prompts China to lock down its megacities as the death toll climbs] ''ABC News'', 15 February 2020. Retrieved 26 February 2020.</ref> to limit the rate of spread of the disease. The 'lockdown' of Wuhan, and subsequently a wider-scale 'lockdown' throughout Hubei province, began on 23 January 2020. At this stage, the spread of the virus in mainland China was running at approximately 50% growth in cases per day. On 8 February, the daily rate of spread fell below 10%. {{citation needed|date=July 2023}}

====Italy====
{{further|COVID-19 pandemic in Italy|COVID-19 lockdown in Italy}}

As the outbreak spread there, beginning 22 February 2020, a ''cordon sanitaire'' was imposed on a group of at least 10 different municipalities in [[Northern Italy]], effectively quarantining more than 50,000 people.<ref>{{cite web|url=https://milano.repubblica.it/cronaca/2020/02/21/news/coronavirus_codogno_castiglione_d_adda_contagiati_misure_sicurezza-249154447/|title=Coronavirus, in dieci comuni lombardi: 50 mila persone costrette a restare in casa. Quarantena all'ospedale milanese di Baggio|date=21 February 2020|website=la Repubblica|language=it |trans-title=Coronavirus, in ten Lombard municipalities: 50 thousand people forced to stay at home. Quarantine at the Milanese hospital in Baggio|access-date=23 February 2020}}</ref><ref>{{cite web|url=https://www.ilsole24ore.com/art/coronavirus-chi-viola-quarantena-rischia-l-arresto-fino-tre-mesi-ACrcnLLB|title=Coronavirus, come funziona la quarantena e cosa rischia chi la viola (l'arresto)|language=it|trans-title=Coronavirus, how quarantine works and what threatens those who violate it (arrest)|website=Il Sole 24 ORE|date=22 February 2020 |access-date=4 March 2020}}</ref> This followed a second day when the declared detected cases leapt enormously (the period from 21 to 23 February saw daily increases of 567%, 295% and 90% respectively). A week later the rate of increase of cases in Italy was significantly reduced (the period from 29 February to 4 March saw daily increases of 27%, 50%, 20%, 23%, and 23%).

On 8 March 2020, a much wider region of Northern Italy was placed under quarantine restrictions, involving around 16 million people.<ref>[https://www.bbc.co.uk/programmes/w172wyjnjccvmqr Coronavirus: Authorities order the lockdown of northern Italy to try to halt the virus] 8 March 2020 ''www.bbc.co.uk/programmes (BBC World Service)'', accessed 10 March 2020</ref>  On the next day, the quarantine was extended to the whole of Italy, effective on 10 March 2020, placing roughly 60 million people under quarantine.<ref>[https://www.bbc.co.uk/news/world-europe-51810673 Coronavirus: Italy extends emergency measures nationwide] 10 March 2020 ''www.bbc.co.uk/news'', accessed 10 March 2020</ref>

A team of Chinese experts, together with some 31 tonnes of supplies, arrived in Rome on 13 March 2020 to help Italy fight the virus.<ref>[https://www.reuters.com/article/us-health-coronavirus-italy-respirators-idUSKBN2101IM China sends medical supplies, experts to help Italy battle coronavirus] 13 March 2020 ''www.reuters.com'' accessed 16 May 2020</ref>

On 22 March 2020, Russia sent nine Ilyushin 76 planes with expert virologists, epidemiologists, medical equipment, and pharmaceuticals in a humanitarian aid operation that Italian media dubbed "From Russia With Love".<ref>[https://formiche.net/2020/03/russia-putin-aiuti-mistero/ Dalla Russia con amore, Putin invia gli aiuti in Italia. Con un mistero…] {{Webarchive|url=https://web.archive.org/web/20200409051108/https://formiche.net/2020/03/russia-putin-aiuti-mistero/ |date=9 April 2020 }} ''(From Russia with love, Putin sends aid to Italy. With a mystery ...)'' Emanuele Rossi, ''formiche.net'', accessed 23 April 2020</ref><ref>[https://www.npr.org/sections/coronavirus-live-updates/2020/03/25/821345465/for-help-on-coronavirus-italy-turns-to-china-russia-and-cuba For Help On Coronavirus, Italy Turns To China, Russia And Cuba] 25 March 2020 ''www.npr.org'', accessed 23 April 2020</ref>

Eventually the lockdown was extended until 3 May, although starting from 14 April stationery shops, bookshops, and children clothing's shops were allowed to open.<ref>{{cite news |title=Italy extends lockdown until May 3rd despite pressure from business |url=https://www.thelocal.it/20200410/italy-set-to-extend-lockdown-until-early-may |access-date=11 April 2020 |work=The Local.it |date=10 April 2020}}</ref>

On 26 April 2020, the so-called "Phase 2" was announced, to start from 4 May. Movements across regions were still forbidden, while movements between municipalities were allowed only to visit relatives or for work and health reasons.<ref>[https://www.repubblica.it/politica/2020/04/26/news/coronavirus_riaperture_cabina_regia_governo_regioni-254928829/?ref=RHPPTP-BH-I254972764-C12-P3-S2.4-T1 Coronavirus, Fase 2: dal 4 maggio sì a incontri con familiari. Il 18 riapriranno i negozi, il primo giugno bar, ristoranti, parrucchieri e centri estetici], 26 April 2020 ''la Repubblica'', accessed 16 May 2020</ref> Moreover, closed factories could re-open, but schools, bars, restaurants, and barbers were still closed.<ref>[https://www.corriere.it/politica/20_aprile_27/coronavirus-nuovo-decreto-26-aprile-ecco-calendario-quello-che-si-potra-fare-fase-2-80508a10-8802-11ea-8a3a-5c7a635a608c.shtml Coronavirus, il nuovo decreto del 26 aprile: ecco il calendario di quello che si potrà fare nella "fase 2"], 27 April 2020 ''Corriere Della Sera'', accessed 16 May 2020</ref>

As at 4 May 2020, when new cases were running around 0.5%, ({{circa|1600}} persons) per day and consistently falling, it was expected that museums and retailers might reopen from 18 May, while hairdressers, bars and restaurants were expected to reopen fully on 1 June.<ref>[https://www.theguardian.com/world/2020/may/03/anger-as-italy-slowly-emerges-from-long-covid-19-lockdown Anger as Italy slowly emerges from long Covid-19 lockdown] 4 May 2020, ''www.theguardian.com'', accessed 16 May 2020</ref>

Regional lockdowns were subsequently imposed as further waves of the virus spread through the country.<ref>{{Cite news|date=2020-11-06|title=Coronavirus: Italy imposes regional lockdown as Europe battles surges|language=en-GB|work=BBC News|url=https://www.bbc.com/news/world-europe-54839429|access-date=2021-11-28}}</ref>

====Rest of Europe====
{{further|COVID-19 pandemic in Europe}}
[[File:Berg a DNV - 49655647492.jpg|thumb|[[COVID-19 pandemic in Slovakia|Slovakia]] closed borders to non-residents because of the [[coronavirus disease 2019]] pandemic.]]

As cases of the virus spread to and took hold in more European countries, many followed the earlier examples of China and Italy and began instituting policies of lockdown. Notable among these were [[COVID-19 pandemic in the Republic of Ireland|Ireland]] (where schools were closed in mid March for the rest of the month, and limits were set on sizes of meetings),<ref>{{Cite news|url=https://www.irishtimes.com/news/health/coronavirus-schools-colleges-and-childcare-facilities-in-ireland-to-shut-1.4200977|title=Coronavirus: Schools, colleges and childcare facilities in Ireland to shut|last1=Leahy|first1=Pat|last2=Cullen|first2=Paul|newspaper=The Irish Times|language=en|access-date=12 March 2020|last3=Lynch|first3=Suzanne|last4=Kelly|first4=Fiach}}</ref> [[COVID-19 pandemic in Spain|Spain]] (where a [[2020 Spain coronavirus lockdown|lockdown]] was announced on 14 March),<ref>{{cite news |last1=Jones |first1=Sam |title=Spain orders nationwide lockdown to battle coronavirus |url=https://www.theguardian.com/world/2020/mar/14/spain-government-set-to-order-nationwide-coronavirus-lockdown |work=The Guardian |date=14 March 2020 }}</ref> [[COVID-19 pandemic in the Czech Republic|Czech Republic]], [[COVID-19 pandemic in Norway|Norway]], [[COVID-19 pandemic in Denmark|Denmark]], [[COVID-19 pandemic in Iceland|Iceland]], [[COVID-19 pandemic in Poland|Poland]], [[COVID-19 pandemic in Turkey|Turkey]], and [[COVID-19 pandemic in France|France]], while the [[COVID-19 pandemic in the United Kingdom|United Kingdom]] noticeably lagged behind in adopting such measures.<ref>[https://www.bbc.co.uk/news/science-environment-51892402 Coronavirus: Some scientists say UK virus strategy is 'risking lives'] 14 March 2020, ''www.bbc.co.uk/news'', accessed 14 March 2020</ref>

As of 18 March 2020, more than 250 million people were in lockdown across Europe.<ref>{{cite news |last1=Henley |first1=Jon |last2=Oltermann |first2=Philip |title=Italy records its deadliest day of coronavirus outbreak with 475 deaths |url=https://www.theguardian.com/world/2020/mar/18/coronavirus-lockdown-eu-belgium-germany-adopt-measures |work=The Guardian |date=18 March 2020 }}</ref>

====Rest of the world====
{{further|Travel restrictions related to the COVID-19 pandemic}}

In the immediate context of the start of the pandemic in Wuhan, countries neighbouring or close to China adopted a cautious approach. For example, Sri Lanka, Macau, Hong Kong, Vietnam, Japan, and South Korea had all imposed some degree of lockdown by 19 February.<ref name=BBC_Lockdown>[https://www.bbc.co.uk/news/world-52103747 Coronavirus: The world in lockdown in maps and charts] 7 April 2020 ''www.bbc.co.uk'', accessed 19 April 2020</ref> As countries across the world reported escalating case numbers and deaths, more and more countries began to announce travel restrictions and lockdowns.<ref name=BBC_Lockdown/> Africa and Latin America were relatively delayed in the spread of the virus, but even on these continents, countries began to impose travel bans and lockdowns. Brazil and Mexico began lockdowns in late February and much of the rest of Latin America followed suit in early March.<ref name=BBC_Lockdown/> Much of Africa was on lockdown by the start of April.<ref name=BBC_Lockdown/> Kenya, for example, blocked certain international flights and subsequently placed a ban on 'global' meetings.<ref>[https://www.capitalfm.co.ke/news/2020/03/govt-imposes-month-long-ban-on-global-meetings-in-measures-to-avert-coronavirus-spread/ Kenya: Govt imposes month-long ban on global meetings in measures to avert coronavirus spread] ''www.capitalfm.co.ke'', accessed 15 March 2020</ref>

{{As of|2020|04|01|alt=As of 1 April 2020}}, more than 280&nbsp;million people, or about 86% of the population, were under some form of lockdown in the [[United States]],<ref>{{cite news |title=More than 85% of all Americans have been ordered to stay at home. This map shows which cities and states are under lockdown |url=https://www.businessinsider.com/us-map-stay-at-home-orders-lockdowns-2020-3 |work=Business Insider |date=1 April 2020}}</ref> 59 million people were in lockdown in [[South Africa]],<ref>{{cite news |last1=Chutel |first1=Lynsey |last2=Dahir |first2=Abdi Latif |title=With Most Coronavirus Cases in Africa, South Africa Locks Down |url=https://www.nytimes.com/2020/03/27/world/africa/south-africa-coronavirus.html |work=The New York Times|date=27 March 2020}}</ref> and 1.3 billion people were in [[2020 coronavirus lockdown in India|lockdown in India]].<ref>{{cite news |last1=Nair |first1=Supriya |title=For a billion Indians, lockdown has not prevented tragedy |url=https://www.theguardian.com/world/commentisfree/2020/mar/29/india-lockdown-tragedy-healthcare-coronavirus-starvation-mumbai |work=The Guardian |date=29 March 2020}}</ref><ref>{{cite news |title=Chaos and hunger amid India coronavirus lockdown |url=https://www.aljazeera.com/news/2020/03/chaos-hunger-india-coronavirus-lockdown-200327094522268.html |work=Al-Jazeera |date=27 March 2020}}</ref>

== Self-quarantine ==
{{further|Isolation (health care)#Self-isolation}}
'''''Self-quarantine''''' (or ''self-isolation'') is a popular term that emerged during the [[COVID-19 pandemic]], which spread to most countries in 2020. Citizens able to do so were encouraged to stay home to limit the spread of the [[Coronavirus disease 2019|disease]]. Health specialists advise that self-quarantine lasts 14 days. Two weeks gives the necessary time for them to determine whether or not they will become ill and become contagious to others.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-social-distancing-and-self-quarantine|title=Coronavirus, Social and Physical Distancing and Self-Quarantine|date=16 February 2022|website=www.hopkinsmedicine.org}}</ref><ref>{{Cite web|url=https://www.vcuhealth.org/news/what-does-it-mean-to-self-quarantine|title=What does it mean to self-quarantine? &#124; VCU Health|website=www.vcuhealth.org}}</ref>

==Other uses==
U.S. President [[John F. Kennedy]] euphemistically referred to the U.S. Navy's interdiction of shipping en route to Cuba during the [[Cuban Missile Crisis]] as a "quarantine" rather than a [[blockade]], because a quarantine is a legal act in peacetime, whereas a blockade is defined as an act of aggression under the [[U.N. Charter]].<ref>{{Cite web|url=http://www.nationalgeographic.org/thisday/oct22/kennedy-quarantines-cuba/|title=Kennedy 'Quarantines' Cuba|date=25 September 2014|website=National Geographic Society|language=en|access-date=20 November 2019}}</ref>

In computer science, "quarantining" describes putting files infected by [[computer virus]]es into a special directory, so as to eliminate the threat they pose, without irreversibly deleting them.<ref name="Mowbray2013">{{cite book |author=Thomas J. Mowbray |year=2013 |title=Cybersecurity: Managing Systems, Conducting Testing, and Investigating Intrusions |url=https://books.google.com/books?id=iXOAAQAAQBAJ&pg=PA72 |publisher=Wiley |page=72 |isbn=978-1-118-84965-1 |quote=Both antivirus and anti-spyware programs either quarantine or remove the malicious file. A quarantined file is temporarily disabled, usually by moving it to a sandboxed directory. An administrator may restore it.}}</ref>

The Spanish term for quarantine, ''(la) cuarentena'', refers also to the period of [[postpartum confinement]] in which a new mother and her baby are sheltered from the outside world.<ref>{{Cite web|url=https://slate.com/human-interest/2011/04/new-mom-traditions-from-around-the-world-cuarentena-and-doing-the-month.html|title=New-mom traditions from around the world: Cuarentena and "doing the month."|last=Tuhus-Dubrow|first=Rebecca|date=12 April 2011|website=Slate Magazine|language=en|access-date=20 November 2019}}</ref>

==See also==
* {{annotated link|Biosecurity}}
* {{annotated link|Epidemiology}}
* {{annotated link|Extra-Terrestrial Exposure Law}}
* {{annotated link|Infection control}}
* {{annotated link|Isolation (health care)}}
* {{annotated link|Lazaretto}}
* {{annotated link|Lytton Quarantine Station}}
* {{annotated link|Pest house}}
* {{annotated link|Protective sequestration}}
* {{annotated link|Quaranup}}, a former quarantine station in [[Albany, Western Australia]]
* {{annotated link|Social distancing}}

==Notes==
{{reflist|group=note}}

==References==
{{Reflist|30em}}

==Sources==
{{EB1911|wstitle=Quarantine}}

==Further reading==
* {{cite book |title=Quarantine!: East European Jewish Immigrants and the New York City Epidemics of 1892 |author=Howard Markel |publisher=Johns Hopkins University Press |year=1999 |isbn=978-0-8018-6180-2}}
* {{cite journal|doi=10.18060/18963|title=From SARS to Ebola: Legal and Ethical Considerations for Modern Quarantine|year=2015|last1=Rothstein|first1=Mark A.|journal=Indiana Health Law Review|volume=12|pages=227–280|doi-access=free}}
* {{cite journal|pmid=11624707|year=2000|last1=Frati|first1=P.|title=Quarantine, trade and health policies in Ragusa-Dubrovnik until the age of George Armmenius-Baglivi|journal=Medicina Nei Secoli|volume=12|issue=1|pages=103–27}}

==External links==
{{Commons category}}
{{Wiktionary}}
{{Scholia}}
* {{cite book|author=Ayliffe, Graham A. J.|author2=[[Mary P. English]]|url=http://assets.cambridge.org/052181/9350/sample/0521819350ws.pdf|title=Hospital infection, From Miasmas to MRSA|publisher=[[Cambridge University Press]]|year=2003}} – Hardback {{ISBN|0 521 81935 0}}; paperback {{ISBN|0 521 53178 0}}
* [https://wwwnc.cdc.gov/eid/articles/issue/11/2/table-of-contents Emerging Infectious Diseases – Contents, Volume 11, Number 2] {{Webarchive|url=https://web.archive.org/web/20200201084105/https://wwwnc.cdc.gov/eid/articles/issue/11/2/table-of-contents |date=1 February 2020 }}, February 2005
* [https://wwwnc.cdc.gov/eid/article/11/2/04-0190_article Quarantine for SARS, Taiwan] {{Webarchive|url=https://web.archive.org/web/20200201084054/https://wwwnc.cdc.gov/eid/article/11/2/04-0190_article |date=1 February 2020 }}, February 2005, ''wwwnc.cdc.gov''
* [https://www.pbs.org/wgbh/nova/typhoid/quarantine.html History of quarantine (from PBS NOVA)]
* {{cite web|author=Cole, Jared P.|url=https://fas.org/sgp/crs/misc/RL33201.pdf|title=Federal and State Quarantine and Isolation Authority|publisher=[[Congressional Research Service]]|date=9 October 2014}}

{{Public health}}

{{Authority control}}

[[Category:Quarantine| ]]
[[Category:Quarantine facilities]]
[[Category:Infectious diseases]]
[[Category:Prevention]]