PUBLIC RECORD OFFICE
Reference :-
ag IT CO. 885
22 PUBLIC RECORD OFFICE, LONDON ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
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for patients suffering from different infectious diseases and all buildings are very thoroughly screened. Mosquitoes are absent from the island on which the quarantine station for Panama is built.
The following figures relate to the quarantine transactions at the ports of Ancon-Panama and Colon-Cristobal during 1910:-
Number of vessels inspected and passed
Number of vessels fumigated
Number of Bills of Health viséd or issued
Number of crew and passengers inspected
Number of persons held in quarantine at the detention houses to complete
the incubation period of yellow fever and plague Number held on board vessels for the same purpose Number of immigrants rejected
New Orleans.-The accompanying map of the chief shipping routes in the Gulf of Mexico and the Caribbean Sea indicates the present importance of New Orleans in connexion with the spread of yellow fever, an importance which will doubtless be increased when the markets of the western coast of South America are brought into direct shipping communication with those of Louisiana and neighbouring States by way of the Panama Canal. The city is exposed to infec- tion from both the seaward and landward sides, and as regards the latter danger it is believed by responsible local officials that the chain of defence is unavoidably weak. Railway communication between the city and Central America is advancing rapidly, and even at present passengers from suspected places in Mexico can arrive in New Orleans within the incubation period of yellow fever. The city lies on the 30th degree of north latitude, and its climate is such that yellow fever can be epidemic during only the hotter months of the year; the average monthly tempera- ture in winter and spring does not rise above 55° and much lower temperatures than that are often recorded. This fortunate circumstance was in the past the only check upon the severe epidemics of yellow fever from which, during the first half of the 19th century, the city suffered every year. The beginning of a reduction in the frequency of those epidemics dates from 1859, and must be attributed during the early years to the absence of participation in foreign commerce as a result of the great civil war, and later to the gradual substitution of a rigid system of maritime quarantine and of a strict observance of the quarantine laws for the quite ineffective and almost entirely unobserved systems of earlier years. But the evolution of an effective quarantine system was of slow growth, and it was not until the early eighties that comparatively adequate arrangements were established. These arrangements, in addition to ensuring almost complete freedom from the risk of entry of yellow fever patients, included rules for the fumigation of ships by sulphur, and although the difficulties of carrying out the latter measure in the case of fruit vessels subsequently necessitated modifications which may have permitted the entry of infected mosquitoes, their general efficacy is shown by the following figures.
Since 1900 the only year in which a death from yellow fever has been recorded was 1905, when an epidemic which is said to have caused 3,403 cases and 437 deaths occurred. That epidemic afforded the first opportunity in a large American city of carrying out measures based upon the knowledge that the disease is spread by stegomyia mosquitoes, and in consequence has been much written about. Its present interest is chiefly that it brought to light the exceedingly primitive and dangerous conditions of the city, and provided a much-needed stimulus to sanitary effort and progress. Since its occurrence improvement has been more or less continuous, but the problem is very complex, and at the time of my visit in April, 1912, it appeared to me that its difficulties had been by no means entirely overcome.
The accompanying map, which shows the general arrangement and boundaries of the city, and the position of districts occupied chiefly by tenement houses, conveys some idea of the magnitude of the task with which the sanitary authorities have to deal. The municipality as a whole covers an area of 196 square miles, of which the city proper," containing about 80,000 houses, covers 36 square miles. In general the site has been reclaimed from swamps and flooded areas which were three or four feet below the level of the lakes and river by which the city is almost surrounded; and on the outskirts of what is called the "built-up section or improved area
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of the city, swamps, marshes, canals, and low jungle are still the chief features
of the landscape. The population of the city proper is estimated to be about
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380,000, of whom perhaps 100,000 are negroes. The remainder includes large numbers of French, Spaniards, and Italians, and it has been said of the Italians, as well as of the negro inhabitants, that they do not participate in the civic life of the community, but live in a manner which violates every sanitary rule. Among a population of this kind conditions are favourable for the concealment of disease, and any interference for sanitary purposes is usually much resented. The 1905 epidemic of yellow fever began near the wharves in the tenement districts where these people live, and for the reasons just given it is not surprising that it progressed for some time before its presence became known to the authorities, and that during its continuance it was necessary to seek the assistance of Italian physicians, interpreters, Catholic priests, and missionary sisters in the work of investigation of cases.
At the present time the sanitary affairs of the city are carried out by the following departments:
(1) A department of Public Works, charged with the cleaning of the streets and the removal and disposal of garbage. The latter is collected in carts and loaded into garbage boats by which it is dumped into the Mississippi River below the city limits.
(2) A Sewerage and Water Board charged with providing:
(i) A system of public sewers for the removal of night soil and domestic waste water. Work on this system, which comprises 375 miles of sewers and pipes, was begun in 1903, and is now almost com- plete, the old cesspools and vaults being abolished as house connections are made. The night soil from houses not connected with the public sewers is collected in barrels at the cost of the householder, and conveyed below the city limits by special "nuisance boats" and dumped in the Mississippi River in mid-
stream.
(ii) An adequate system of drainage for the removal of storm water. For this very difficult problem there are seven drainage pumps, the water being carried off in canals and pipes.
(iii) A filtered water-supply for the 80,000 houses in the city proper. This work was not begun until 1905, but is now said to be as complete as is possible in a growing city. An important result of the system will be the abolition of the large house cisterns which are such favourable breeding places for stegomyia mosquitoes; but at the time of my visit this necessary reform had been only partially accomplished. The water-supply is obtained from the Mississippi River and is filtered by mechanical precipitation and other means.
(3) A Municipal Board of Health created in 1898 with power "to establish, control and administer all matters of strictly and purely local sanita- tion," but for carrying out executive action it is dependent in great measure upon the various departments of the city government. It is organised in three departments, namely, sanitary, food inspection, and vital statistics. Anti-mosquito work is one of 'the duties of the sanitary department, and was commenced in earnest during the yellow fever epidemic of 1905. Unfortunately, during the last few years, owing to the exhaustion of the special fund which enabled a separate anti-mosquito staff to be maintained at an annual cost of 50,000 dollars, it has not been possible to carry on the work with the same thorough- ness as was the case between 1905 and 1908. In the biennial report for 1908-09 it is said that in 1909 the work was done by the city police, but that as divided authority in sanitary matters is never desirable," the city had provided for the resumption of the work in 1910 * a special force selected by the Board of Health and exclusively responsible to its executive officers for correct performance of duty." I have no knowledge of the plan adopted in 1911, and as regards 1912 I was informed that, owing to lack of funds, no campaign against mosquitoes was being carried on. During the time of my visit the temperature was not higher than between 42° and 50° F., and I saw no mosquitoes of any kind, but the President of the Louisiana State Board of Health, the British Consul-General, and other officials informed me that during the summer months they are exceedingly prevalent and troublesome. The common species were said to be
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