One joke told many times in the emergency room goes something like this:
ER doc to patient: “Sir, you seem to be pretty sick – headache, low fever, chills, malaise, nausea, aches all over – could be a number of things. We’re thinking you might even have GASH – our acronym for gonorrhea, syphilis, AIDS and hepatitis. Could be one; could be all. We’re not sure.”
Patient: “That sounds pretty serious, what are we going to do?”
Doc: “Until we get your test results and given the uncertainty, we’ll admit you to the hospital and place you on a pancake and flounder diet.”
Patient: “I can understand coming into the hospital, but what’s this about the pancake and flounder diet?”
Doc: “Well, that’s about all we can slide under your door.”
Is the this a quarantine? No. Since the person already is sick and symptomatic, it’s isolation.
Quarantines have been a subject in the media for months. They are imposed on people who have, or may have, been exposed to contagious diseases. Similarly, exposure to some hazardous materials might result in quarantine. The word itself derives from the Italian quaranta (or the French quarante) for 40 – the duration ships from infected ports were required to sit at anchor before landing, centuries ago. If 21 days quarantine for Ebola sounds bad, how about 40?
A classic example of quarantine was applied in the early Apollo moon landings: Apollo 11, 12 and 14. Not only were the astronauts – healthy and symptom-free – placed in quarantine, but also lunar specimens and other materials returned from the moon’s surface. There was serious debate whether microbes could exist in essentially a zero-atmosphere environment, subject to severe temperature changes and bombarded for hundreds of million of years by solar and cosmic radiation.
The duration from entering the Mobile Quarantine Facility – a converted, sealed, wheel-less, Airstream trailer aboard a ship – to exiting the Lunar Receiving Laboratory was 21 days. Caution (and quarantine) prevailed in the LRL until Apollo 15, when quarantine, proven unnecessary, was discontinued.
Typhoid Mary, a recognized typhoid carrier who was apparently never sick, infected dozens. A handful died. She is probably the record holder for quarantines – from 1907 to 1910, and again from 1915 to 1938. Today, a “discussion” about public interest and safety versus her civil rights would likely be moot – thanks to sanitation, immunization and antibiotics.
The U.S. Centers for Disease Control and Prevention’s list for quarantinable diseases includes cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, SARS and viral hemorrhagic fevers, of which Ebola is one. Federal regulations generally trump those state and local.
If I’m ever offered pancakes and flounder, I’ll flee to the wilderness in an Airstream trailer – provisioned for 21 days.
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.