title: Osler and the infected letter.
abstract: The spread of infectious agents through the mail has concerned public health officials for 5 centuries. The dissemination of anthrax spores in the US mail in 2001 was a recent example. In 1901, two medical journals reported outbreaks of smallpox presumably introduced by letters contaminated with variola viruses. The stability and infectivity of the smallpox virus are reviewed from both a historical (anecdotal) perspective and modern virologic studies. Bubonic plague was the contagious disease that led to quarantines as early as the 14th century in port cities in southern Europe. Later, smallpox, cholera, typhus, and yellow fever were recognized as also warranting quarantine measures. Initially, attempts were made to decontaminate all goods imported from pestilential areas, particularly mail. Disinfection of mail was largely abandoned in the early 20th century with newer knowledge about the spread and stability of these 5 infectious agents.
authors.affiliation: Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky School of Medicine, Lexington, Kentucky 40536-0298, USA. cambros@uky.edu
authors.forename: Charles T
authors.initials: CT
authors.lastname: Ambrose
mesh_terms: D015709:Correspondence as Topic / Q000266:history*; D004203:Disinfection / Q000266:history; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049691:History, Medieval; D006801:Humans; D011177:Postal Service; D011790:Quarantine / Q000266:history*; D012899:Smallpox / Q000266:history* / Q000517:prevention & control; D012901:Variola virus / Q000502:physiology