Old plagues in the jet age. International aspects of present and future control of communicable disease.

Abstract

The observation that some of the most deadly diseases of the past could in one way or another be transmitted either by man or through goods transported by ships is an ancient one.During the fourteenth century pandemic of plague (as early as 1348 in Venice, 1377 in Ragusa, and 1383 in Marseilles) ships, crews.travellers, and cargoes were being detained for 40 days: hence " quarantine," from the Italian word meaning "forty."In the absence of scientific knowledge these quarantine measures were quite naturally arbitrary.They also varied from country to country.The nineteenth century, the period of the great pandemics of cholera, saw the first attempt at international arrangements to deal with them and similar diseases.A conference convened in Paris in 1851-the first-prepared a sanitary code which never came into force.A series of conferences followed, equally unable to reach an agreement.After the discoveries of Pasteur, Koch, and Findlay, a better scientific basis was available, and the turn of the century saw the foundation, in 1902, of the Pan American Sanitary Bureau, the adoption in 1903 of a convention in Paris, and the establish- ment in 1907 of the Office International d'Hygiine Publique, generally known as the " Paris Office," which led to the 1920-6 convention, completed in 1933 by a sanitary convention for aerial navigation.In 1944 the conventions were revised under the aegis of U.N.R.R.A.The aim of the conventions was to prevent the diffusion of five so-called pestilential diseases- cholera, plague, yellow fever, smallpox, and typhus-without unduly disturbing international traffic, by defining permissible quarantine measures, imposing vaccination for international travellers, disinfection and deratting of ships, aircraft, and goods, and establishing a network of mutual information.There was still a great deal of confusion.A number of con- ventions, some of them completely obsolete, were simultaneously in force, none of them binding on all countries.In 1946 the constitution of W.H.O.gave that body authority to adopt international regulations, and one of the first tasks of the new organization, while still in its interim stage, was to prepare international sanitary regulations to replace the quarantine conventions of the past.Experts from all parts of the world were involved, and under the chairmanship of Dr. M. T. Morgan a special committee considered the text of the International Sanitary Regulations that were eventually adopted by the World Health Assembly in May 1951.Air Travel At this time air traffic was of small volume-there were fewer than four million passengers on international scheduled air services in 1948.In 1949 an aircraft still carried only 20 to 40 passengers.The speed was also moderate: in 1946

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