"I'm not willing to stand here and let my civil rights be violated when it's not science-based."

Those were the recent words of nurse Kaci Hickox, who successfully fought Maine's 21-day home quarantine order last week after she returned from treating Ebola patients in Sierra Leone.

Hickox first made headlines last month after she was detained in a plastic isolation tent near the Newark airport and later transferred to Maine. The 33-year-old Hickox then defied Maine's stay-at-home quarantine orders and went on a bike ride, prompting a showdown of sorts. Hickox's defiance highlighted the science, fear, hysteria, and politics surrounding a disease that has no cure but just arrived to the United States—with four known cases nationwide—from Ebola-ravaged West Africa.

“We have been researching this disease for 38 years, since its first appearance in Africa. And we know how the infection is transmitted from person to person. And we know that it’s not transmitted from someone who is asymptomatic, as I am and many other aid workers will be when they return," Hickox, who worked for Doctors Without Borders, told Meet the Press Sunday.

Hickox's plight demonstrates the powers that health officials—from the federal level to every state—have when it comes to preventing infectious diseases. And because time is of the essence to stop an outbreak, officials don't need a court's authority to involuntarily confine someone. As New York attorney and CNN analyst Paul Callan described those powers, they're "as American as apple pie" and date on the books back to the 1872 battle against yellow fever.

In Texas, where Ebola-infected patient Thomas Duncan from Liberia was the first and only US patient to die last month, it's a "criminal penalty" for anybody who "refuses to perform or allow the performance" of quarantine measures. People close to Duncan were quarantined in Dallas and kept under police guard. Those quarantined included his girlfriend, two men, and a teenager. They were not allowed to touch anybody, including one another. Duncan was cremated and his belongings were incinerated, but even those ashes were caught in a legal limbo, amid a battle over what US state they'd be buried in.

Duncan died October 8 at Texas Health Presbyterian Hospital, infecting treating nurse Nina Pham, who recovered from the disease. Nevertheless, a climate of fear gripped the nation. Would the United States become West Africa—Guinea, Sierra Leone, and Liberia—for example, where some 5,000 people died in the latest outbreak, another 13,000 were infected, and no reliable cure is available?

History on repeat?

The quarantine concept isn't new by any means. In the past, an affected area within the US could be as small as a Washington state residence with diphtheria, as shown above, or it could be on a much greater scale. Ships with disease-laden passengers entering America were being quarantined as early as 1758 at the site today where the Statue of Liberty rests. And as many as 420 people reportedly died while being quarantined at Ellis Island between 1909-1911.

So the Hickox quarantine is a tiny affair relative to long-term US quarantines. For example, there was a wholesale quarantining of the Chinatown district in San Francisco more than a century ago. In 1900, the city erected a barbed-wire fence [PDF] around Chinatown after a Chinese laborer, suspected of having Bubonic plague, died. Wendy Mariner, a Boston University School of Public Health professor, said the quarantine was "struck down by the courts because it essentially quarantined the healthy with the sick" and was "highly discriminatory."

According to the National Park Service:

While the cause of death was still undetermined, a cordon was placed around Chinatown, and no Chinese American was allowed to leave the area bounded by California, Kearny, Broadway, and Stockton streets. This restricted the freedom of movement of people, some of whom were American citizens. It caused them many hardships, for they had difficulty in obtaining goods and services from people outside Chinatown. There was a shortage of food, and prices increased sharply. Chinese American businessmen faced a loss of income, and workers a loss of wages. Finally, after three and a half months, it was found that there were no cases of bubonic plague within Chinatown. This lengthy quarantine of Chinatown was motivated more by racist images of Chinese as carriers of disease than by actual evidence of the presence of bubonic plague.

The list goes on. That same year in Maui, Hawaii, "the Chinatown section of Kahului was burnt down leading to the end of detectable plague on Maui until 1931." Between 1917-18, quarantine was widely used in the United States during the influenza pandemic, which killed as many as 50 million globally and up to 675,000 in the United States.

In the 1920s, Mariner said, "there was sometimes isolation for somebody with sexually transmitted infections before there were antibiotics to treat them. But again, it was targeted largely at poor sex workers and some immigrants." And more recently in the 1980s and 1990s, she added, "a lot of treatment programs for tuberculosis lost funding and there was an influx of both HIV and TB—immigrants, homeless people, many who were mentally ill, or many who were on drugs and didn’t have any place to go, so they ended up being isolated in the hospital." California voters defeated a ballot measure in 1986 and again in 1988 amid the AIDS onslaught that sought to list AIDS as a communicable disease. And opponents said it was a veiled attempt toward quarantining those with AIDS while proponents claimed the disease was spread by insects and even casual contact with a public toilet seat.

Even within the last 10(ish) years, the Western world has used massive quarantines to fight disease. In 2003, some 15,000 people in Toronto, Canada, voluntarily separated themselves amid fears of SARS, a respiratory illness. "It was frightening because of the unknown," nurse Susan Sorrenti told local media last year, reflecting on the 10 years since.

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