CO885-(21-23) — Page 136

PUBLIC RECORD OFFICE

Reference :-

C.O. 885

22 PUBLIC RECORD OFFICE, LONDON

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

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anopheles maculipennis, stegomyia fasciata, and various calicines [culicides] The prevalence of stegomyia fasciata must, of course, have been greatly reduced by the work of abolishing and screening cisterns which followed the introduction of the water-supply, but at the time of my visit many favourable breeding places for the species still remained, and one cannot but regard with anxiety the cessation of the special measures. As a rule the houses in the better parts of the city are carefully screened, but this is not the rule in the areas where an epidemic is most likely to occur, and at the hotel where I stayed the manner of screening was not such as would have prevented the entry of mosquitoes.

Quarantine arrangements are supervised by the Federal Government, and the rules for the treatment of ships are, in general, similar to those adopted in the Canal zone, but all ships from suspected ports are fumigated throughout before being permitted to proceed up the river, and in the case of infected ships the period of detention after fumigation is seven days instead of six. The quarantine station. at which all ships proceeding to New Orleans must stop, is situated at the mouth of the Mississippi, 90 miles below the port. The following sketch* indicates the arrangement and uses of the different buildings. The station is on an uninhabited area of land, and is free from mosquitoes, but for greater safety all the buildings are thoroughly screened. The station is provided with a disinfecting apparatus on a tug as well as with the movable apparatus on shore.

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Guayaquil.-Yellow fever has been endemic in some of the seaports of Ecuador many years, and the danger of its spread from that country is a constant source of anxiety to the officials of the Panama Canal zone. Heavy expenses incurred during the political troubles in which the country is frequently involved have strained its financial resources, and adequate sanitary public works are almost non-existent. The available records of the occurrence of yellow fever refer only to Guayaquil (which is the principal seaport) and neighbouring places along the railway, and they are not, I think, sufficiently accurate to be given in detail. They show, however, that the disease has been endemic for a long time and that, while cases occur as a rule in every month of the year, the disease is most prevalent during the rainy months from December to April. Any unusual immigration of non- immunes at once causes a rise in the number of cases, and in Guayaquil this occurred markedly in December, 1911, and January, 1912, when revolutionary troubles brought many non-immune soldiers into the district. The troubles were such that no record was kept during that period, but during February there were recorded 98 new cases and 43 deaths, and during March 96 new cases and 36 deaths. Cases and deaths were also recorded in those months at Duran, Taguachi, Milagro, Naranjito, Huigra, and Naranjal.

The distribution of the disease in Guayaquil during the last three years is shown on the accompanying map.* The city is situated on low-lying land between the river Guayas and an arm of the sea or salt-water creek known as the Estero Salado, and considerable areas in its neighbourhood are covered with brackish water. The climate is equable, the daily average temperature being about 76° F. with a range between 72° in the morning, 80° at mid-day, and 79° in the evening. In 1910 the highest monthly temperatures were in February and March, when the average figures were 72° in the inorning, 84° at mid-day, and 81° in the evening. As a rule no rain falls from the beginning of May until the end of November, but the remaining months are very wet. The population numbers about 80,000, and is housed for the most part in water-logged situations among ponds, marshes, stagnant water-courses, and open ditches.

The houses of the poorer classes are usually constructed of split bamboos and are raised on piles. A few main streets near the water-front are laid with large smooth stones, "but in many places the stones have become loose and worn away, so that large pools and ruts full of water are numerous: the remaining roads, being entirely unmade," are grass-grown and deep with mud; and down the middle of them there are surface ditches full of stagnant water. A portion of the city is provided with a water-supply and sewerage system, but the water is turned on for only a few hours each day, and during that time the inhabitants collect as much as they can in cisterns, barrels, large water-jars and other receptacles.

At the time of my visit in April, mosquitoes were exceedingly prevalent, cellia albimana and stegomyia fasciata being particularly abundant. The hotel at which

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I stayed was partially screened, but on the first day I caught ten specimens of stegomyia fasciata in my bedroom, and many specimens every day afterwards. I also caught adults of this species in the offices of the British and American Consulates and in shops and houses of private citizens. They were also present in the wards of the yellow fever lazaretto, although it is situated on the outskirts of the town and is well screened.

Through the kindness of Senor Dr. Cornejo Gomez, Director of the Sanitary Service at Guayaquil, I had an opportunity, in company with Senor Dr. Mino, Senor Dr. Pareja, and others, of studying the sanitary organisation at work in the city, and the measures that are being taken in the attempt to eradicate plague and yellow fever. These measures are fully described in the official publication which accompanies this report, and it is not necessary for me to recapitulate them here. What is being done is doubtless as much as can be accomplished with the money and means available, but the conditions of the city are exceedingly favourable to the breeding of mosquitoes and to the spread of yellow fever, and it appeared to me that in the absence of complete arrangements for water-supply, sewerage, paving, and draining, any efforts towards the eradication of mosquitoes would be futile. Negotiations for a loan of fifty million francs for those very necessary purposes have been under consideration for some years, but revolutionary troubles and changes of government have delayed their completion, and at the time of my visit there appeared little prospect that a radical advancement in sanitation would occur in the near future.

The arrangements by which an attempt is made to prevent the spread of yellow fever to the Canal zone by ships visiting the port have already been described. but those arrangements do not apply to ships trading with the ports of other countries than the United States, and such ships usually lie in the river opposite the wharves and frequently become infected.

Honolulu.--The protection of the East from yellow fever is dependent in great measure upon the protection of the ports of call in various islands which lie on the route of ships crossing the Pacific Ocean from the endemic area. An examination of the map which accompanies this section will show that among such ports Honolulu, in the Hawaiian Islands, is chiefly to be considered. It is situated at latitude 21° 30' north of the Equator, on the island of Oahu--the second largest of the eight inhabited islands in the Hawaiian group-and, as a result of the development of the natural resources of the islands and because it is used as a port of call by trans- Pacific ships, is rapidly becoming a place of considerable commercial importance. About nine-tenths of the whole trade is with the United States, and practically all the exports (which are chiefly sugar and coffee) go to that country.

Local conditions in Honolulu are all the year round favourable to the existence and spread of yellow fever. The climate is remarkably equable, being represented as regards temperature by maxima and minima in the hottest and coolest months respectively of 85° and 65° in August and 80° and 55° in February, and as regards rain by a total fall of about 20 inches, which is distributed over every month of the year, but is greatest from November to April. Secondly, the population of about 52,000 is entirely non-immune to yellow fever, and is composed largely of Japanese, pure and part Hawaiian, Portuguese, Chinese, Spaniards, Porto Ricans, Koreans, and Filipinos, many of whom live in low and insanitary buildings or overcrowded tenement houses in areas where the sanitary conditions leave much to be desired, and where, as a rule, the owners carry out improvements only when forced to do so. Thirdly, although the town has modern arrangements of water-supply, sewage disposal, drainage, and paving of the streets, conditions, both natural and artificial, are favourable to the breeding of mosquitoes. It will be seen from the following plan* of the city that it extends for a considerable distance parallel to the sea, but is very narrow, and the various sections are separated from one another by tortuous streams, large areas of unreclaimed swamp, and flat land, on which there are many ponds, irrigated rice fields and taro patches. Most of these are actual, and all of them are potential, breeding grounds of mosquitoes. In this connexion I may note that, according to Dr. Van Dine, the islands of Hawaii were entirely free fron mosquitoes of any kind until 1826, when they were introduced by the sailing ship Wellington" from San Blas, in Mexico, and that up to the present only three species have been found in the islands, namely, stegomyia fasciata, stegomyia scutellaris, and culex fatigans. Systematic search for anophelines has been made by entomologists and medical men without their having been found. It is perhaps

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