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It is worthy to note the words of Sir John Simon, who as Medical Officer of the
Privy Council in 1875 wrote the following condemnation of the quarantine system:—
"A quarantine which is ineffective is a mere irrational derangement of commerce,
and a quarantine of the kind which ensures success is more easily imagined than
realised. Only in proportion as a community lives apart from the great highways
and emporia of commerce or is ready and able to treat its commerce as a subordinate
interest—only in such proportion can quarantine be made effectual for protecting it."
This view was not accepted on the Continent, and in spite of a number of International
Conferences it was not until the Venice Conference of 1892 that the European
powers accepted the British principle that measures against the importation of
infectious diseases should be based on the health conditions on board the ship rather
than those existing in the port of departure.
The next year a conference was held in Dresden and a Convention was drawn up.
This Convention was ratified by Great Britain with the priviso that persons who
appeared well at the time of disembarkation, might be kept under surveillance at
their destinations rather than be detained under observation in the port of arrival.
Further International Sanitary Conventions were held in 1903 in Paris and in
1907 in Rome, and the latter Convention saw the constitution of the Office International
d'Hygiene Publique with headquarters in Paris which, until the present day, has
continued to collect and distribute epidemiological information; to issue reports
and recommendations on matters of international public health interest; has drawn
up the International Conventions of 1912 and 1926, and recently the International
Sanitary Convention for Aerial Navigation.
In this country power to detain ships remained in the hands of the Customs
Officers until 1871, which saw the foundation of the Local Government Board. In
1872-3 the Board constituted Port Sanitary Authorities. Further powers were given
to the Board by the Public Health Acts of 1873, 1896 and 1904.
The International Sanitary Convention of 1912 was not put into into operation
owing to the war. After the war it was decided to revise this Convention, and so far
as this country was concerned the gap was filled by the introduction of the Port
Sanitary Authorities (Infectious Diseases) Regulations, 1920; but after the International
Sanitary Convention of 1926 these and previous Regulations were repealed
by the issuing of the Port Sanitary Regulations, 1933, which prescribe uniform action
throughout the ports of the British Isles in dealing with the control of both the major
and minor infectious diseases.
The foregoing has been introduced into this paper mainly to show how severe
were the restrictions of the old quarantine system, and how slowly they were discarded
in spite of their failure.
In the United Kingdom surveillance has been found to be an effective and practical
measure, owing to the facts that the country is divided into comparatively small
sanitary areas, each with its Medical Officer of Health; that means of communication
are rapid and easy, and members of the population have, for the most part, a sense
of their obligations to the community.
The success of this system of surveillance depends very largely upon the accuracy
and rapidity with which the names and addresses of passengers and crew are forwarded
to the medical officers of health of their districts of destination.
In London vessels from the Far East usually arrive on a Friday, and as it is on
such vessels that the major infectious diseases are most likely to be found, speed in
notification becomes an important factor in order to avoid delay over the week-end.
Bearing this in mind a system has been evolved in the Port of London by which
the minimum amount of work has been combined with the maximum amount of
efficiency.
Nowadays through either the aforementioned Office International d'Hygiene
Publique, the Ministry of Health, the Press or the shipowners themselves, advance
information is usually received of the occurrence of serious infectious disease on
board ship, and as ships run to a schedule it is possible to know exactly when a particular
vessel will arrive.