Of TB, smallpox and old New York quarantine centres

North Brother Island, found within the middle of East River in New York City has a fascinating history. It houses the ruins of a 19th century solution to infectious diseases in the urban environment: an old quarantine centre, the last of it's kind in the US. See the Daily Mail article here for pictures.

Before it's closure in 1963, Riverside hospital as it was known, saw to the care of those infected with the likes of smallpox, tuberculosis, leprosy and typhoid. In fact, it first gained notoriaty after caring for one of the more infamous of Irish women, a cook known as Typhoid Mary. Now nearly half a decade after shutting down, a local historian has been given rare access to document what a difference fifty years makes.

Cities in general were always a hotbed of disease and no more so than New York city, which was a major centre of immigration during the turn of the century. The rationale for buildings like these was in direct response to the dangers that some infections pose to the population if left unchecked. 

The likes of some viral and bacterial diseases rely upon close contact between hosts in order to survive and persist within the population. But what is good for the microbe isn't necessarily good for us and in many cases can result in major fatalities. Take for example smallpox: nearly two weeks after initially being infected the virus erupts out of your body in the form pus-(and virus)-filled lesions covering every region of your skin resulting in at least a 30% fatality rate.

At the end of the 1800's we had little vaccines or antibiotics at our disposal, sadly we would have to wait until 1928 for Alexander Fleming to discover penicillin. Although a vaccine against smallpox was available at the time, many countries where people were emigrating from failed to protect their population and places like cities served only to amplify these public health disasters. We thus only relied on rest and isolation to stem the tide of epidemics and this is where houses like this came in. 

Leper colonies, sanitaria and smallpox hospitals like the one on the East River can basically be considered one and the same. To stop dangerous disease from spreading, remove those infected from the population, keep them there and if you can afford it: treat them and if not, wait until they're OK or have died. This was reality in the days before antibiotics and vaccines, but it could easily come back into fashion if the microbes have anything to say.

North & South Brother islands, N

Institutions like these gradually became non-viable with the development of cheap drugs that could specifically target and kill bacteria, such as those that cause typhoid and tuberculosis. Increased availability of these antibiotics, vaccines and the generally superior healthcare at the time led to the widespread closure of these specialised quarantine centres. But as some bacteria become increasingly resistant to our best medicinal efforts (see the totally drug resistant tuberculosis), will we have to reinstate these buildings in the near future?