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The Suez Canal is ranked among the most significant engineering feats in human history. Besides its geopolitical and economic impact, however, the Canal became a subject of sanitary concern right from the beginning of its operation in 1869, which coincided with the fourth pandemic of cholera. Sanitary efforts during the 19th century focused on humans and merchandise distributed through the Canal in the frame of the theories of contagion and contamination. Contact with Asia via maritime trade routes entailed increased possibilities of dangerous pathogens and infectious diseases invading the Mediterranean and – by extension – Europe, as evidenced by the cholera and plague epidemics in Egypt. The sanitary significance of the Suez Canal was further demonstrated in the early 20th century when the cholera biotype El Tor was discovered in the Sinai Peninsula. After the Second World War the health systems evolved by incorporating all guidelines of the World Health Organization, whereas special provisions were established for pilgrims traveling to Mecca. The Suez Canal continues to serve as one of the most important global commercial hubs of the 21st century. Accordingly, health security remains a global priority, while strict adherence to international health regulations and epidemiological monitoring represent key elements in safeguarding health in the Mediterranean region.

The Suez Canal under Quarantine: Sanitary History of the Mediterranean Gateway (19th–21st centuries)