CO885-(20-21) — Page 642

PUBLIC RECORD OFFICE

Reference :-

TTTTT C.O.885

21 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

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little time he returned to Rio, leaving its continuation in the hands of Dr. João Pedroso B. de Albuquerque, who is now in charge of the arrangements, and who most courteously took me round and gave me every facility for seeing what was being done and the methods employed.

Dr. Pedroso, who is quite separate from the Municipal Sanitary Authorities, although they mutually assist each other, has with him 16 medical officers and a staff of inspec tors and fumigators, all of whom were brought up to Para.

7. Inspection of Tourn.--The town is divided into districts, every house in each being visited at least once a week.

Mosquito-breeding places are sought for and treated, and all tins, rubbish, &c., are collected and removed.

8. Cases of Yellow Ferer.-The assistance of the medical men in the town has been obtained and all cases which arouse any suspicion of yellow fever are at once reported. On a report being received, the patient is at once visited by Dr. Pedroso or one of his assistants and, even if only considered suspicious, is removed at once in a mosquito-proof conveyance to the mosquito-proof wards of a hospital either for observation or treatment, or both.

If the house in which a patient was taken ill be a good one, his room is made mosquito-proof at the expense of the Government, and he is allowed to remain in it. Immediately after removal the fumigating staff visits the house and fumigates both it and those buildings in the vicinity and special vigilance is exercised by the inspectors in that district for the next 15 days or more.

The mosquito-proof conveyance is after the style of a country hotel bus which has been rendered mosquito-proof. It is provided with seats on each side, but no arrangements

for patients lying down are made.

9. Results already obtained. Since the work was insti- tuted, there has been a very considerable diminution of the number of cases, as the following figures will show :—

In December, 55 cases were reported.

In January, 32 cases were reported.

In February (up to the 10th), 15 cases were reported—

of which 3 turned out to be yellow fever,

and 2 out of the 3 were from Manaos.

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upon

10. Precautions against Munaos. Manaos (which is 3-4 days' distance away and from which

Para looks about 10 steamers arrive weekly) as the great source of infection,

All steamers arriving at Para have to anchor at least 1,100 yards from the land and are then visited by the Port

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Medical Officer. If there are no sick, all passengers are allowed to land; but should there be the cases are at once seen, and if considered suspicious in any way, Dr. Pedroso informed and the ship visited by one of his assistants. The patient is then removed to the hospital for observation and treatment and the remaining passengers are allowed to land, but are under surveillance for 15 days or more.

No steamer from Manaos is allowed at the quay under any circumstances without being previously fumigated, although, if there is no sickness on board she may discharge into lighters at her anchorage in the river. If, however, yellow fever has been on board, fumigation is compulsory, whether she discharges or not.

11. Yellow Fever Hospital Wards. The hospital wards for yellow fever have been placed under the care of Dr. Pedroso and are visited daily or oftener, according to circumstances.

12. Burial of Yellow Fever Patients.-Patients who die from yellow fever are not buried in the usual cemeteries, but in a place apart by themselves.

13. Fumigation. Fumigation is done immediately a patient has been removed from his house. No objection is raised by the people; in fact, they and the other householders in the neighbourhood are glad to have it, and give the fumigators every facility.

The fumigating band, under the supervision of a medical officer, takes complete charge of the building as it stands. Articles which would be injured by the fumes are removed if possible, but if not, are adequately protected against their action. Metal work, clocks, &c., are removed. Pianos are wrapped in a large cloth and sheets of paper are pasted together over the cloth so as to totally exclude any fumes. Silk clothing, &c., is well shaken and shut up in a thoroughly clean wardrobe, which is sealed doors, windows, &c., are carefully sealed with paper." When up with paper. All openings, it is impossible to close all the cracks and crevices by means of paper, large cloths of grey baft are thrown over the building, roof, or space, and carefully fixed down to the walls or ground with long narrow strips of wood. outhouses are done in this way, and in some instances the roofs of ordinary buildings have to be similarly treated. Fumigation is carried out with sulphur or pyrethrum, the latter only when the former, which is considered the better, is inadmissible. The sulphur, with which a little nitre is mixed to make it burn better, is burnt in iron pans 6 inches to 7 inches in diameter and not more than 1 inch deep,

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