PUBLIC RECORD OFFICE
Reference :-
C.O. 885
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9 PUBLIC RECORD OFFICE, LONDON
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3. A real danger exists of the introduction of sleeping sickness into this region by means of porters and others coming from the Congo Free State.
4. Owing to the non-existence of the "Glossina Palpalis" on the borders of the French Congo and on the Anglo-Egyptian White Nile, the danger of introduction of this disease from Uganda and the French Congo at present is less great.
5. With improved facilities of communication with those districts the danger will be proportionately increased.
6. I am informed from Belgian sources that the cases reported from the Lado Enclave and the Wadelai District have been introduced from the interior of the Congo State.
7. As regards "Nagana" (mule and cattle tsetse fly disease) this malady is practically endemic amongst animals allowed to remain in the neighbourhood of rivers of the Bahr-el-Ghazal, west of Rumbek. The country between Rumbek and Shambe', Bor and Mvolo is singularly free fron this pest, as well as that north of Chak Chak.
8. Should it again be found necessary to send large numbers of transport animals to the Southern Bahr-el-Ghazal, I strongly recommend the Shambe-Rumbek- Mvolo road being used, the "Glossina Morsitans" variety of tsetse fly being far less commonly met with there than on the roads previously selected.
Khartoum,
July 14, 1906.
G. DANSEY-BROWNING,
Major, R.A.M.C.
NOTE by the Director of Wellcome Research Laboratories. Apart from the special purpose for which it was detailed the expedition, con- ducted by Major Dansey-Browning, has done useful work in several directions. A large number of biting diptera were secured by him and sent to the laboratories. They have been most carefully mounted and were in excellent condition. Amongst these were many tsetse flies, both "Glossina Morsitans" and "Glossina Palpalis together with their pupae. Careful notes as to habitat were sent with these flies thus enhancing the value of the collection. Certain filth-carrying diptere were also secured, and Major Dansey-Browning has been the first to send in specimens of the Congo floor maggot.
In addition, a large number of blood films were made and forwarded for examination. These were derived from man, various animals, birds, and reptiles, and in several instances have been found to contain interesting parasites.
Useful notes and suggestions regarding animal trypanosomiasis were also forth- coming, while Major Browning succeeded in interesting Bimbashi Vaughan in the whole subject of blood examinations, and as a result a large number of films have been sent from the Bahr-el-Ghazal.
There can, therefore, be no doubt that the laboratories, which supplied a good deal of the necessary scientific equipment, have benefited very considerably from Major Browning's mission.
ANDREW BALFOUR, M.D.,
Director of Laboratories.
Major Dansey-Browning's expedition has been of considerable interest, in that it supplies good and reliable data on which action can be taken. In reading the progress reports and final conclusions the following facts are elicited :-
1. The tsetse fly "Glossina Palpalis," the carrier of "Sleeping Sickness," is found to be in considerable numbers in the Bahr-el-Ghazal, but, from his observa- tions, its distribution is mainly confined to the country south of 6° latitude north.
2. The "Glossina Palpalis," found in this region, is at present apparently not infected by the organism of human trypanosomiasis.
3. From his personal observation, and from the examination of a large number of the inhabitants in the region where the "Glossina Palpalis" exists, and from
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enquiries amongst the inhabitants, he considers that sleeping sickness has not pre- viously been known, nor does it at present exist, in this area so that the Bahr-el- Ghazal may be described as an uninfected area."
From the above facts the following conclusions are drawn:—
1. In the southern districts of the Bahr-el-Ghazal, owing to the undoubted presence of the "Glossina Palpalis," a real and active danger exists of the introduc- tion of sleeping sickness into this region from the infected districts of the Congo Free State.
2. On the borders of the French Congo and on the left bank of the Anglo- Egyptian White Nile, the danger of its introduction is less-the presence of the fly in these regions not having been yet noted.
3. With improved facilities of communication and opening up of trade routes with the Congo Free State, the danger of the introduction of the disease into the Bahr-el-Ghazal will be proportionately increased.
4. As regards "Nagana" (mule and cattle tsetse fly disease), the disease is practically endemic amongst animals allowed to remain in the neighbourhood of rivers west of Rumbek.
Seeing that the introduction of "Sleeping Sickness" into the Bahr-el-Ghazal—- owing to its proximity to the infected areas in the Congo Free State-is now a real and pressing danger, the adoption of preventive measures must be considered. I would draw attention to a most interesting and valuable report by the late Dr. Dutton and Dr. Todd, issued by the Liverpool School of Tropical Medicine, Memoir XVIII., in which the preventive measures are fully discussed.
The disease is still rapidly spreading in the Congo basin-experience has shown that "Sleeping Sickness" follows the main lines of human communication, and can thus be carried into a region where the individuals. The disease can be quickly carried from place to place, but it spreads Glossina Palpalis" exists by infected slowly from an infected centre. The imposition of absolute quarantine in a region like the Bahr-el-Ghazal is practically an impossibility, but a system of strict super- vision and inspection at certain posts on the main lines of communication would undoubtedly lessen the liability of its introduction and the spread of the disease in an uninfected area.
Trypanosomiasis may exist in a native, although to all intents and purposes healthy and doing active work; and it is by the supervision of such seemingly healthy, but none the less infected persons, we must strive to prevent the introduc- tion of the disease.
The practical results of the observations of Drs. Dutton and Todd show that every negro with enlarged glands must be considered-until the contrary is shown -to be a case of trypanosomiasis. The glands of the neck are specially affected in this disease; consequently, in cervical gland palpation, we have a ready means of detecting the possibility of the existence of the disease in natives, and by super- vision and inspection of natives at certain posts on lines of traffic, a method for its early detection.
The conclusions of Drs. Dutton and Todd are as follows:-
1. The enormous spread and great increase of "Sleeping Sickness" in the Congo Basin during recent years has been due in a great measure to the increase in travel following the opening of the country.
2. Cases of trypanosomiasis, though apparently healthy, may be detected by their enlarged glands.
3. Good results may be expected from the serious application of quarantine measures, dependent for their efficiency upon cervical gland palpation.
The measures which they advise and which are already being initiated in the Congo Free State are:-
1. The establishment of posts of inspection along the main roads to prevent the entrance of infected persons into uninfected districts, and
2. The removal of infected persons from posts in uninfected districts to places already infected.
To apply the above measures effectively, all Government officials, sheikhs, and employers of labour in the districts liable to infection should be impressed with the great significance of enlarged cervical glands amongst natives, and an organised system of supervision and inspection of all natives in such districts be instituted.