When Britain and the United States began to respond to outbreaks of disease in the 19th century they developed two distinct systems of disease control. While not polar opposites, Britain focused primarily on sanitation, whereas the United States adopted policies of quarantine. Utilizing the approach of path dependency I argue that this divergence can be partly explained by the timing of disease control formation in each country. As Britain formed its system of disease control earlier, during the 1840s, it was influenced by a miasmatic understanding of disease (the belief that disease is caused by noxious gases that emanate from filthy environments), while as the United States formed its disease control system later, around the end of the 1870s, it was more influenced by new ideas about contagion and the rise of germ theory. Once formed, the public health system of each country began to travel down divergent historical paths; Britain came to connect disease control to the social problems of the working classes (e.g. poverty, working conditions, overcrowding) while the United States developed a militaristic approach that, at times, used quite coercive measures to isolate the contagious bodies of the sick. The origins of public health formation in each country helped shape the overall development of disease control in Britain and the United States over the long‐term.