Sand Island was known as Quarantine Island during the nineteenth century when it was used to quarantine ships believed to hold contagious diseases. One such was the plague.

The plague is caused by bacteria; it is usually spread by fleas. These bugs pick up the germs when they bite infected animals like rats and mice. (WebMD)

They then pass it to the next animal or person they bite. You can also catch the plague directly from infected animals or people.

Bubonic plague is the most common type. It causes buboes, which are very swollen and painful lymph nodes under the arms, in the neck, or in the groin. Without treatment, the bacteria can spread to other parts of the body. (WebMD)

The bubonic plague is a bacterial disease that can kill an infected victim within three to seven days. Symptoms include red spots on the skin that later turn black, bloody vomit and decaying skin.

The first recorded incidence of this disease in Hawai‘i occurred at the close of the nineteenth century with the diagnosis of bubonic plague affecting Yon Chong, a Chinese bookkeeper in the old Chinatown section of Honolulu, who became ill on December 9, 1899.

The Board of Health, after a special meeting on December 12, 1899, announced the presence of the Bubonic Plague in the city, following an autopsy of the first victim.

The “Black Death,” or Bubonic Plague, had struck Honolulu.

Its presence caused pause in the opening months of 1900 and was on everybody’s mind, with good reason; the same disease had decimated a third of the world’s population during the fourteenth century.

Schools were closed, and Chinatown, with its 7,000 inhabitants, was placed under quarantine. In hopes of containing plague only within Honolulu, the Board of Health (BOH) closed the port of Honolulu to both incoming and outgoing vessels.

All foreign ships already docked at the wharf were ordered to move the vessels away from the dock and grease all mooring lines and attach funnel (rat-guard) on each mooring line anchored to the shore.

From the onset, three human cases of plague were recorded in the official BOH records. Later examination of other case records showed that in actuality two earlier cases were misdiagnosed and were therefore unrecorded as plague.

Inasmuch as no further human cases of plague were detected following the initial episode, the BOH (possibly because of economic pressure) lifted the quarantine of Chinatown and Honolulu Harbor on December 19, 1899, a dramatic error in judgment, as was later evidenced.

On December 24, 1899, only five days following the lifted quarantine, the plague epidemic in Honolulu erupted in full force with additional cases occurring at the end of the year.

In a matter of 19 days, a total of 12 cases of plague were diagnosed, leading to 11 fatalities.

On December 30, 1899, the BOH, with recommendations from a special commission, as well as from resolutions from the Medical Society and private citizens, chose fire as the final method of plague.

As more people fell victim to the Black Death, on January 20, 1900, the Board of Health conducted “sanitary” fires to prevent further spread of the disease.

Because of the size of the area, the entire fire department, with all four of its engines, was on the scene. The fire was ignited at 9 am and all went well for the first hour … until the wind shifted.

One fire, started between Kaumakapili Church and Nu‘uanu Avenue, blazed out of control, due to the change in wind. The fire burned uncontrollably for 17 days, ravaging most of Chinatown. People trying to flee were beat back by citizens and guards into the quarantine district.

The extent of the fire and the estimates of the area ranged from 38-65 acres. The fire caused the destruction of all premises bounded by Kukui Street, River Street, Queen Street (presently Ala Moana Boulevard) and Nu‘uanu Avenue.

No lives were lost in the fire, but 4,000 people were left homeless, without food and with little of anything else.

Following the Chinatown fire of January 20, 1900, cases of plague on O‘ahu began to appear in other previously uninfected areas, and spread as far off as Waialua.

The spread of plague on O‘ahu was traced to the railroad linking Honolulu with the plantation towns of Aiea, Waipahu and Waialua.

The spread of bubonic plague to the neighbor islands from Honolulu was quite rapid following the unfortunate lifting of the quarantine on December 19, 1899 of Honolulu Harbor.

The Honolulu epidemic was not halted until March 31, 1900, during which time a total of 71 cases of plague were diagnosed, leading to 61 deaths.

During this re-emergence of plague, the port of Honolulu was again quarantined, until the official reopening on April 30, 1900.

Because the fire displaced the residential population of Chinatown, as the area was rebuilt, the Chinese only rebuilt their businesses in the neighborhood – not their homes.

The last recorded case of plague on O‘ahu (a rodent case) was recorded from Aiea in 1910 after which time it has never been found again.

(Lots of good info and images for this summary came from: “A Brief History of Bubonic Plague in Hawai‘i,” DLNR and ChinatownHonolulu-org.)

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