It’s been more than a hundred years, so a lot has changed. Medical science is much more advanced. The world is a more interconnected place. But there are some important parallels between now and then. In some respects—the fear of travelers carrying the disease, the intense criticism of public health authorities—things haven’t changed much at all.
Asiatic cholera was spread by body fluids—especially the copious diarrhea it produced to the point of dehydrating a grown man in a matter of hours. Indeed, to the nineteenth-century American, cholera was every bit as scary, deadly, and disgusting as Ebola fever is today. The cholera of 1892 had already decimated much of India, the Middle East, Asia, and Eastern Europe and shut down the port of Hamburg, the largest in the world. By August 30, New York City, the world’s second largest port, began to receive its first cholera victims, mostly impoverished Russian Jewish immigrants.
It’s probably true, for example, that in 1892 the 20-day quarantine helped by reducing the flow of immigrants and the overwhelming workload of medical inspection. But the quarantine also caused collateral damage—starting with the scapegoating of all Eastern European immigrants. Meanwhile, those of us who have studied the outbreak have concluded that it was not the quarantine that deserves most of the credit for containing the disease. It should go instead to public health officials in New York City and to the federal government. They worked aggressively to ensure that the water supply was not tainted with the cholera microbe—and used case tracing and isolation of the ill to keep the disease from spreading.
And then thanks to Dr. Pollock who linked us to a story in the Washington Post enumerating what we do and, more importantly, don't know about Ebola. One concern is whether or not a person could carry the Ebola virus without showing symptoms, and thus be a carrier of the disease like Typhoid Mary back in NYC in the 19th century. Fortunately, the answer seems to be no, although of course we don't know for sure. The evidence suggests that if you have the disease your viral load is very low until you start to show symptoms. The implication is that if you have the virus but have no symptoms, your are unlikely to spread the disease. Of course, that doesn't mean it can't happen, and that uncertainty is what feeds fear...