When Germs Travel

March 22, 2004
Markel (Quarantine!
), a professor of the history of medicine at the University of Michigan and a practicing physician, argues that quarantines in the U.S. and other restrictive measures (such as mandatory kerosene baths at the Texas-Mexico border in 1917 to kill typhus-carrying lice) are based more on xenophobia than science. An outbreak of bubonic plague in San Francisco's Chinatown in 1900, for example, resulted in a complete cordon sanitaire around the district; the city's white merchants, however, could move freely within and outside of the area. Similarly in the early 1900s, trachoma, an infectious eye disease that was common throughout the U.S., became associated with Jewish immigrants from Eastern Europe. More recently, Haitian refugees in the 1980s were stigmatized as carriers of HIV, the virus that causes AIDS. Markel argues that though quarantines of immigrant populations may have lessened the chance of major epidemics during the early 1900s, such measures unfairly punish people for being poor and sick. And nowhere is this more important than in developing countries, where rates of tuberculosis, cholera, malaria, AIDS and other deadly diseases are highest. As increased travel continues to shrink distances and bring people together, germs will also travel more easily; the prevalence of infectious disease, therefore, is no longer a merely local issue. As Markel warns in this informative and important book, we must work to prevent and treat infectious diseases throughout the entire world because "in public health terms, every city is a 'sister city' with every other metropolis on earth." Agents, Glen Hartley and Lynn Chu.