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Flying the Quarantine flag

THE FORGOTTEN OF ELLIS ISLAND
Deaths in Quarantine, 1909-1911

 

A Word to Ship Captains About Quarantine

An Open Letter to Ship Captains

by L.E. Cofer, Assistant Surgeon General
Chief, Division of Foreign and Insular Quarantine
of the Bureau of the Public Health and Marine-Hospital Service
Public Health Bulletin No. 55, July, 1912
Part 1 of 3


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There are very few people who would run the risk of plague or yellow fever infection just to save a vessel from being quarantined. No one feels sorry for the expense and trouble put upon the captain and owners of a vessel because of plague or yellow fever being on board. Everyone says "Quarantine it!" and Congress, which represents the will of the people, appropriates a sum of money every year to prevent vessels from infecting ports. Some people object to quarantine, but no one wants it abolished. Why? Because everyone has a horror of catching plague, cholera, yellow fever, smallpox, jail fever, or leprosy. When a person catches any one of these diseases even his friends consider him loathsome (and so he is) , and the first thing they say is, "Take him at once to the pesthouse." People have been saying this since biblical times, they are saying it now, and they will keep on saying it. So quarantine is here to stay, and it costs money to operate it, and so far as vessels are concerned, it costs money to run against it. So what is to be done? Well, it is up to you captains of vessels. You can avoid much of the trouble and expense of quarantine for yourselves and also for your owners by following the suggestions made in this little pamphlet. In fact, the whole story is really told in this little table:

Rats carry plague, mosquitoes carry yellow fever
Plague and yellow fever cause quarantine
Quarantine means expense
Ship captains, destroy your rats and mosquitoes,
and not only save your owners' money,
but save lives

It does not cost any money to catch these diseases, and with a little trouble and expense they can be dodged, but once they infect a ship it costs both time and money to get rid of them, and, what is still more important, these diseases kill captains, crew, and passengers.

When these diseases appear in ports the expense falls rather evenly on the citizens or taxpayers, but in the case of vessels the owners are the losers. Shipowners are commencing to see this and the time is fast coming when a captain will be tried for letting his vessel become infected with quarantinable diseases and punished if the fault be his neglect to take the precautions which he could have taken to prevent infection. It may not be an everlasting disgrace for a captain to run a vessel ashore — this accident frequently happens, through no fault of the captain — but it does not help the captain in any event. People usually remember it.

It not infrequently happens that a vessel carrying valuable cargo and passengers is fumigated and dead rats are found by the hundreds.

Bubonic Plague

Now, is not this a reflection upon the captain? — f not, it is a reflection upon the owners. It is evidence that they are willing to risk the cargo being damaged by the rats. They may be exposing the crew and passengers to a rat disease known as rat plague, which disease man can easily catch from the rat, and then it is known as human plague — bubonic plague, pneumonia plague, and quick-death plague. A description will be given of a rat sick with plague and then will follow a description of the same disease in a man who has contracted the disease from a rat.

When a rat becomes sick with plague his coat becomes rough and he refuses food. Ordinarily rats are afraid of people and will run away from them, but when they have plague they become restless, want help, and they come to man — at least it appears so, for rats in plague-infected vessels are frequently found dead upon the decks and in places where rats seldom go — in fact, prior to their death, rats have been reported as staggering about the decks and cabins. But they do not always do this; on the contrary, in most instances they do not. They simply die in localities on the vessel at varying distances from their nests. But that a rat, even after he has caught the plague and during this period of restless wandering, can walk from a wharf to a vessel or from a vessel to a wharf there is no doubt, and in this way may be explained the old saying "where ships go, the plague goes."

After a rat becomes sick with plague he dies in from 1 to 3 days, falling upon his side and having fits just before death. As soon as his body begins to get cool the rat fleas begin to leave and seek another warm body — either another rat or a man. The largest vessel is, after all, a small inclosure and everything and every person is at close quarters, and it is small wonder that after the rat has died away from his nesting place, usually above decks, his fleas very quickly find some person to fasten on to. As a matter of fact, they do, and the person in turn gets the plague. If the body of the rat lies in some out-of-the-way place and is not soon discovered and burned up, flies, roaches, and various insects may feed for awhile upon his body and then crawl onto the ship's food, whether it be in the ship's galley, pantries, or on the dining table. It may be depended upon that if there is a plague rat in a vessel he will soon give the disease to a few other rats, who in turn will give it either to the passengers and crew or else by escaping from the vessel at the next port give it to the rats in that port, who in turn will give it to the inhabitants.

Now as to what happens when a person catches plague from a rat. A man has plague in three ways, first, with swellings under his arms and in his groins, bubonic plague. Second, with the fatal lung disease, known as lung fever or pneumonia plague, and, third, the quick black death, or what doctors call septicĉmic plague. In this last form the patient is poisoned with plague so rapidly that he dies before the swellings or the "buboes" in his groins appear. After a person catches plague a certain length of time must pass before the person is actually taken sick. This is known as the period of incubation. It is usually seven days. This is the reason persons who have been exposed to plague are quarantined for seven days.

Occasionally when a person has contracted plague he can feel it coming on — he is "tired out," chilly, giddy, has no appetite, and his legs ache. Usually it does not give such signals, but starts in with high fever, headache, leg ache, dizziness, and weakness, and a feeling of wanting to drop down even in the street and go to sleep. There is a haggard look about the face; eyes bloodshot, sunken, and staring, and the face has a look of horror and dread or fear. If the patient can walk at all he staggers like a drunken man. The patient also gets "out of his head" — picks at bed clothes. Inside of 24 hours the groin swellings appear or else the swellings appear under the arms — in the arm pits. The swellings or buboes are in size from that of a walnut to a goose egg and they are boggy and painful. The patient will pull away at the very slightest touch of the hand.

These swellings or buboes continue to enlarge and soften and after a few days, if they are not opened, they will burst and foul-smelling pus will pour out.

Hemorrhages (oozing of blood) frequently occur under the skin in various portions of the body. In this way dark purplish spots are seen which caused the disease bubonic plague to be called the "black death."

Death may occur at any time, although it usually occurs between the third and fifth day.

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