Two important developments occurred during the last half of the nineteenth century. An understanding of the cause and transmission of contagious disease occurred due to research leading to the germ theory. Government assumed increasing responsibility for the protection of the community from contagious diseases with legislation that established provincial and municipal Boards of Health.
Throughout the nineteenth century, the citizens of Kingston lived with the fear of both endemic and epidemic contagious diseases. These included a range of infections such as cholera, typhoid fever, diphtheria, scarlet fever and tuberculosis. Although the cause and transmission of these contagious diseases was understood by the end of the nineteenth century, little in the way of specific treatment was available.
Thus the community, in response to recommendations of the Board of Health, developed during the latter years of the nineteenth century and the first half of the twentieth century an extensive network of facilities and procedures to assure quarantine and isolation. These initiatives, which included isolation hospitals, home isolation, and sanatoria for tuberculosis, protected the community and assured optimal care.
However in recent years, it has been become apparent that this is not so. New diseases such as variants of the flu virus as demonstrated by the SARS epidemic, nosocomial infections in hospitals and the re-emergence of old diseases such as drug resistant tuberculosis continue to challenge our society.
Quarantine and isolation are again requirements. These requirements are best achieved by public education rather than legislation. Are we doing enough regarding public education to assure consent for the increasing requirements to protect the community from these emerging and re-emerging contagious diseases?