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PUBLIC RECORD OFFICE
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PUBLIC RECORD OFFICE, LONDON
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identified with inquiries into sleeping sickness, was entrusted with the organiza- tion of the scheme, and his subordinates were instructed to specially inquire into the distribution of the tsetse and of other biting flies; to note the spread of the disease; and to encourage the natives, as far as possible, to adopt such preventive measures as might be practicable. In view of the bearing of these investigations on the interests of the Sudan, a grant of £1,000 towards expenses was made by the Egyptian Government. The six officers were distributed in the various districts of the Protectorate, and their observations have been of considerable value. sina palpalis have been found in large numbers in the interior of Usoga, on the banks of rivers and in swamps; also on the shores of Lakes Albert and Albert Edward. There are not many rivers on the banks of which tsetse flies are not found in abundance, and almost the whole length of the Nile, in its course through Uganda, is badly infested.
Glos-
19. Great Mortality. It appears from such statistics as are available that the mortality from sleeping sickness has been on the following scale :—
The
In 1900 there were 8,430 deaths; 1901, 10,384; in 1902, 24,035; in 1903, 30,441; in 1904, 11,251; and during 1905, 8,003. This total of 92,544, however, only repre- sents the loss of life during six years in the kingdom of Uganda alone. mortality in Usoga, where statistics have not been available, has probably been quite as great, if not greater, and, if we also include the deaths that have occurred from sleeping sickness in Unyoro and the Nile district, it may be taken that the total mortality from this scourge in this Protectorate during the last five years has considerably exceeded 200,000. The total population of the affected districts at the outbreak of the disease probably did not exceed 300,000.
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21. Depopulation of the Sesse Islands. The decrease in the number of deaths in the kingdom of Uganda since 1903 is not believed to be due to any diminution in the virulence of the disease, but simply to the reduction of possible victims in the affected areas. The natives have been almost completely wiped out everywhere along the lake shore, and in the islands the mortality has been even more appalling. Buvuma, for instance, which, a few years ago, was one of the most thickly populated and prosperous of all the islands, counted over 30,000 inhabitants. There are now barely 14,000. Some of the Sesse group have lost every soul, while in others a few moribund natives, crawling about in the last stages of the disease, are all that are left to represent a once teeming population. It might have been expected that, even though the negroes showed inability to grasp the theory of the transmission of the disease by the agency of insects, the undeniable deadliness of the countries immediately bordering on the lake shore would have induced them to flee from the stricken land and to have sought, in the healthier districts inland, a refuge from An extraordinary.fatalism, the pestilence that was slaying them by thousands. however, seems to have paralysed the natives, and, while deploring the sadness of their fate, they appear to have accepted death almost with apathy, and to have preferred to perish in their old surroundings rather than migrate to countries where the conditions of life might possibly be uncongenial.
22. Arrival of Professor Koch.-Professor Koch, who arrived in Uganda some weeks ago, and who is actively prosecuting his researches on one of the islands of the Sesse group, is of opinion that nearly every soul now remaining in the islands is infected, and that, unless some therapeutic remedy be discovered, all must assuredly die within a year or two. He is now experimenting with the use of atoxyl in large and repeated doses, and when I saw him, three weeks ago, was inclined to be hopeful of success. Natives suffering from sleeping sickness are flocking to him in hundreds, and he and his assistants are being worked to the limits of their endurance. It is needless to say that this Administration has offered Professor Koch help in every direction possible, and I am glad to add that our officers on the Extended Investigation Commission are working in perfect har- mony with their German colleagues. Dr. Hodges has noted the effect of atoxyl on Professor Koch's patients, and is sanguine as to the results. He points out, however, that, in view of the protracted duration of the disease and the variety of its phases, some years must elapse before any cure may be considered as permanent.
23. Résumé of results of Investigations. The investigations which have been carried out during the last five years have resulted in the collection of a certain
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amount of information concerning sleeping sickness which may, I think, be broadly summed up as follows :---
(1) That, prior to the outbreak of the disease, tsetse flies were quite as abun- dant in Uganda as they are now, but that no ill effects seemed to attend their bites. (2) That the disease, generally speaking, is now almost always transmitted from a sick person to a healthy one by the bite of a tsetse fly (Glossina palpalis).
(3) That sleeping sickness may, in some cases, be transmitted from an infected animal, but that the risk from such a source is almost nil.
(4) That the presence of even a single diseased person, in a locality infested by tsetse flies, may entail the infection of the whole community.
(5) That the disease, so far, appears to be incurable.
(6) That a tsetse fly is able to retain the power of infection for a limited period. Some experts give a limit of two days, others fourteen, while others consider the limit to be undefined.
(7) That a more or less extended period elapses between the bite of an infected fly and the appearance of the characteristic signs of the disease.
(8) That there are no authenticated instances of the transmission of the disease from sick persons to healthy ones in districts where the tsetse fly is not found. (9) That the tsetse fly is nearly always found in the near neighbourhood of fresh water where the vegetation is luxuriant and shade abundant. That they are only found where those conditions exist, and that the infested belt is a narrow one. (10) That the flies quickly abandon places where, through the clearing of vegetation, the conditions favoured by them are removed.
24. If the foregoing deductions are correct the tsetse seems to be the indispensable link in the chain of infection, and it would therefore appear that We should only by its elimination can the spread of the disease be checked. consequently either remove all tsetse flies from infected areas all infected persons from fly-infested regions.
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or else withdraw
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29. It is to be feared that, in many places, the mischief has already been done. In the Wadelai district, for instance, the mortality has been terrible, and it is estimated that over 2,000 persons have died within the last eighteen months in a comparatively small area. In Unyoro there are now believed to be many hundreds of cases, while in the districts bordering on the Mpologoma, in the Mount Elgon district, thousands have died.
6900
SIR,
No. 69.
MALAY STATES.
IMPERIAL BUREAU OF ENTOMOLOGY to COLONIAL OFFICE. (Received 12th February, 1916.)
[Answered by No. 70.]
Imperial Bureau of Entomology,
British Museum (Natural History),
Cromwell Road, London, S. W., 11th February, 1916.
WITH reference to the investigation into the mosquito-fauna of the principal ports in the Far East now being carried out by Dr. A. T. Stanton, of the Institute for Medical Research, Kuala Lumpur, I have the honour to report that I have just received a communication from that gentleman in which he points out that it is useless for him to continue his journey to the Chinese and Japanese ports at this time of the year, for, owing to the cold weather, no mosquitoes are likely to be present.
Dr. Stanton suggests that the examination of the ports referred to might be postponed until next year, when he is coming home on leave, and he would make arrangements to come to Europe via Japan and America. I venture to recommend that this proposal should be adopted, for it would be the means of saving a con- siderable amount of expense as compared with the cost of a special visit this
2.