The first designated hospital in North Carolina was built in 1846-1847 on Portsmouth Island. Although not a designated quarantine facility, it often fulfilled that purpose.
|Architect's Sketch of the Porstmouth Hospital|
As Dr. Martin Rozear wrote in 1991, "The [19th century] lightering and coasting trade [in North Carolina] brought another element to this busy, lucrative scene; sick seamen. They came from abroad, as well as from interior towns, with scurvy, smallpox, dysentery, fractures, infected wounds, venereal disease, insanity, yellow fever, ague, and miasmas. (They rarely lived long enough to have strokes, heart attacks, and cancer.)
"Being unfit for duty (many posed potential quarantine problems for their ships at the next port of call), these sick sailors were 'dumped' on the island more or less to fend for themselves. Generally poor, filthy, and graceless, they made a sorry sight and were a major problem for the islanders. Care, such as it was for these wretches, was provided in homes, haphazardly. There was no physician within 40 miles of Portsmouth until 1828."
Thus it was that Portsmouth Island acquired a Marine Hospital in 1846-1847. The building burned to the ground in 1894.
Ocracoke Island experienced at least one episode of quarantine, as evidenced by this sentence in The Croatan Courier, February 10, 1939, about a Mr. Chambers who worked for the North Carolina Beach Erosion Control Project: "Well, it seems that the quarantine has been lifted somewhat at Ocracoke...[and] Chambers is making his trips as usual (of course his trips weren't interrupted by a little outreak of the measles and a few restrictions)."
This must have been a quarantine authorized by the national government since the quarantine system was fully nationalized by 1921 when administration of the last local quarantine station was transferred to the U.S. government (https://www.cdc.gov/quarantine/historyquarantine.html).
I am not aware of any later quarantines on Ocracoke Island.
This month's Ocracoke Newsletter is about Old Christmas in Rodanthe. You can read it here: https://www.villagecraftsmen.com/old-christmas-rodanthe/.