occasion in England of the use of quarantine restrictions. Cholera affected every country in Europe despite all efforts to keep it out. When cholera returned to England in 1849, 1853 and 1865–66, no attempt was made to seal the ports. In 1847 the privy council ordered all arrivals with a clean bill of health from the Black Sea and the Levant to be admitted, provided there had been no case of plague during the voyage and afterwards, the practice of quarantine was discontinued. In modern maritime law, biosecurity measures for arriving vessels centre around 'pratique', a licence from border control officials permitting a ship to enter port on assurance from the captain that the vessel is free from contagious disease. The clearance granted is commonly referred to as 'free pratique'. A ship can signal a request for 'pratique' by flying a solid yellow square-shaped flag. This yellow flag is the Q flag in the set of international maritime signal flags. In the event that 'free pratique' is not granted, a vessel will be held in quarantine according to biosecurity rules prevailing at the port of entry until a border control officer inspects the vessel. During the COVID-19 pandemic, a controversy arose as to who granted pratique to the Ruby Princess. A related concept is the 'bill of health', a document issued by officials of a port of departure indicating to the officials of the port of arrival whether it is likely that the ship is carrying a contagious disease, either literally on board as fomites or via its crewmen or passengers. As defined in a consul's handbook from 1879: Another category of biosecurity measures adopted by border control organisations is mandatory vaccination. As a result of the prevalence of Yellow Fever across much of the African continent, a significant portion of countries in the region require arriving passengers to present an International Certificate of Vaccination or Prophylaxis (Carte Jaune) certifying that they have received the Yellow Fever vaccine. A variety of other countries require travellers who have visited areas where Yellow Fever is endemic to present a certificate in order to clear border checkpoints as a means of preventing the spread of the disease. Prior to the emergence of COVID-19, Yellow Fever was the primary human disease subjected to de facto vaccine passport measures by border control authorities around the world. Similar measures are in place with regard to Polio