PUBLIC RECORD OFFICE
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יזוןון
Reference :-
C.O. 885
22 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE COPYRIGHT PHOTOGRAPH-NOT TO BE REPRODUCED PHOTOGRAPHIC-
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In addition to the above regular lines a few foreign sailing vessels bring general merchandise from Europe, coal from Australia, and nitrates from South American ports, and some small American sailing vessels are engaged in carrying lumber and other freight between Hawaii and the mainland.
Quarantine arrangements.-The chief risk of infection to Honolulu is from ports in Mexico and South America, and the following occurrence related to me by Dr. Pratt, Chief Health and Sanitary Officer of the Territorial Government, illustrates forcibly that the risk is a real one. On the 23rd of October, 1910, the steamship Hong Kong Maru," of the Toyo Kisen Kaisha Line, arrived at Honolulu from Manzanillo, having on board a Chinaman who was found to be suffering from yellow fever. Orders were given that the ship should be anchored outside the harbour, a police guard from the quarantine station was placed on board to prevent the landing of any of the passengers and crew, and she was fumigated to destroy mosquitoes. On the 27th it was necessary to change one of the members of the guard, but the man who was relieved, instead of returning to the quarantine station, went to his home. The next morning he was absent from roll call, and it was found that he was lying ill in a small house near the beach. His illness was diagnosed as yellow fever, and he was at once taken to the quarantine camp. The hut where he had stayed was in a hamlet of 48 small wooden houses on an isolated piece of ground. All the houses were immediately evacuated and guards were stationed to prevent anyone entering the area. The windows and doors of the houses being left open, all the surrounding bush for a distance of 150 feet from every dwelling was then thoroughly cleared with the object of driving into the empty houses any mosquitoes that might be sheltering in it. The houses were then sealed and fumigated three times at intervals of twenty-four hours, 10 lbs. of sulphur being used for every 1,000 cubic feet of space. Meanwhile, a heavy barbed-wire fence was erected round the area, and for 90 days after the last fumigation no one was allowed inside it. All these measures were completed in eight days, and it was believed that if any mosquitoes in the area had bitten the infected patient they were killed before a sufficient time had elapsed for them to become infective. The ship was again thoroughly fumigated, and, after being detained for a further period equal to the incubation period of the disease, was allowed to proceed. No other case occurred on her or in the town.
If the facts are as stated their explanation may be that the infected mosquito which had got on board at Manzanillo and caused one case during the 10 or 11 days required for the voyage to Honolulu, had bitten the second man while he was assisting in the operations of fumigation.
The occurrence indicates that Honolulu is in danger from the importation of infected mosquitoes as well as of patients, and since December, 1910, all vessels from places where mosquitoes are known to be prevalent have been fumigated before being permitted to enter the port. For these and all other measures connected with the procedure necessary to prevent the entry of communicable diseases, the United States Government is responsible, and they maintain a well-equipped quarantine station conducted by officers of the Public Health and Marine Hospital Service. It is situated on an artificial island of about 40 acres in area, and is connected by a slipway with an isolated wharf to which ships requiring disinfection can be moored, and on which there are disinfecting sheds, apparatus and other arrangements such that passengers, crew and their effects can be quickly and efficiently dealt with and afterwards conveyed to the quarantine station without contact with the harbour or town. On the island itself every potential breeding place of mosquitoes has been done away with, and although it is possible that mosquitoes from the town might reach the island (towards which the prevailing winds blow) every building upon it is efficiently screened against their entry. The houses and appurtenances are sufficient for the proper handling at one time of 30 sick persons, 100 first-class cabin passengers, 300 second-class passengers, 600 emigrants, and 1,600 troops. The station is equipped with excellent water-supply and water-carriage sewerage systems, electric light and telephone plant, steam laundry, disinfecting aparatus, crematorium, hospital, dispensary, detention rooms, and bacteriological laboratory, all the buildings being kept in a state of perfect order and preparedness.
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Japanese and Chinese Ports-From Honolulu towards the countries in eastern hemisphere the trade. routes are northward to Japan or southward to New Zealand and Australia, the northward being the route for ships bound for Hong Kong. Yokohama, the first port of call, is 3,379 miles from Honolulu, and the journey in a full-powered steamship occupies about ten days. Kobe, the next port of call, is 350 miles further, and
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Nagasaki, by way of the Inland Sea, another 388. I visited those three ports and the city of Tokyo between the 7th and 14th of February. They lie between the 32nd and 35th degrees of north latitude, and although the occurrence of outbursts of yellow fever in them during the summer months would not be surprising, the severe cold of winter would certainly prevent the disease from becoming endemic. I have only the scantiest information to record regarding conditions in these ports. The season of my visit was not suitable for ascertaining by personal observation the species and prevalence of mosquitoes, for the temperature even at midday was not higher than 45° F., and strong cold winds prevailed; and although I was enabled, through the kindness of the Consuls-General of Great Britain and the United States, to interview at Yokohama the chief Japanese port and sanitary authorities and the Medical Officer of the United States Public Health Service, who is attached to the American Consulate, and at Tokyo the staff of the Imperial Bacteriological Institute, I did not learn more than that stegomyia mosquitoes are thought to be among those that are troublesome in the summer, but that no special investigation had been made. So far as I could ascertain, the increased danger of the entry of yellow fever into Japan, as a result of the construction of the Panama Canal, had not as yet engaged the attention of the Japanese authorities in the port of Yokohama, but they were greatly interested in the steps taken by the Government of India in the matter, and it appeared to me possible that my visit might lead to the consideration of special precautions.
From the appended copy of the present quarantine laws of the Imperial Govern- ment it will be seen that for preventing the entry of infectious diseases into Japan reliance is at present placed upon the sanitary inspection of ships (except junks, fishing boats, and the like), which arrive at the seven ports of Yokohama, Kobe, Nagasaki, Moji, Shimonoseki, Wakamatsu, and Kuchinotsa. Infected or suspected vessels arriving at other ports are required by the local police authorities to proceed to one of the ports, where a proper inspection can be undertaken. The periods of detention in quarantine are ten days for plague and five days for cholera and yellow fever. Arrangements at the quarantine stations are apparently adapted for the reception of the sick only. So far as I could ascertain there were no arrangements to meet the possibility that it might be necessary to evacuate a ship infected with yellow fever and to destroy the mosquitoes on board.
Shanghai. On February 5th, during a stay of a few hours at this port, I took the opportunity to consult Dr. Stanley, the Medical Adviser and Bacteriologist to the Municipality. He informed me that the possible introduction of yellow fever after the opening of the Panama Canal had been considered by the authorities, and I understood that special regulations to guard against it were contemplated. The species of mosquitoes present in the city during the summer were said to be stegomyia fasciata, anopheles simensia, culex fatigans, and armigeres rentralis, but among some mounted examples that were shown to me I found one specimen of stegomyia scutellaris, but none of fasciata, and this raised a doubt in Dr. Stanley's mind as to whether stegomyia fasciata really occurs or not. At the time of my visit the weather was too cold for the problem to be settled by personal observation, but I note that the annual report which has appeared since my departure contains a list of mosquitoes which, while including scutellaris, does not mention fasciata. A special anti- mosquito staff is employed from the beginning of April to the middle of October each year. Except during the summer months the climate is not favourable to mosquitoes, and it is possible that a winter and spring campaign, having for its object the destruction of the insects in their hibernating stages, might be useful.
Hong Kong lies slightly above the 22nd degree of north latitude, and during more than six months of the year its climate is favourable to the existence of yellow fever. Nearly 5,000 ocean-going vessels enter its port annually, and it is the centre of an immense trade in sugar, opium, flour, rice, oil, cotton, tea, silks, salt, and other produce. The Colony includes (a) the city of Victoria, which has a frontage to the sea of nearly five miles on the northern shore of the island of Hong Kong. It contains about 10,000 houses, of which all, except about 950, are occupied by Chinese, of whom there are 180,000 in the city. Most of the houses are of three or four stories, and in many of them the sub-division of the upper floors into cubicles greatly increases the difficulties connected with their sanitation. (b) The harbour between the city and the mainland. It varies in width from about a quarter of a mile in the Lyemun pass, on the east, to more than three miles on the west. It is the home
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