SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS.

Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913.

SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS-Contd. Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913-Continued.

SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS-Contd

Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913-Continued.

IN INSULAR POSSESSIONS.

HAWAII.

Examination of Rats and Mongoose.

Rats and mongoose have been examined in Hawaii as follows: Honolulu, week ended October 11, 1913, 458; Hilo, week ended September 27, 1913, 10,858; week ended October 4, 1913, 2,790. No plague-infected animal was found.

PHILIPPINE ISLANDS.

Cholera-Cholera Carriers Manila.

During the week ended September 20, 1913, 3 cases of cholera with 1 death were notified at Manila.

On September 14, 1913, a case of cholera was found in the person of a Filipino carpenter who worked with a large group of men at the corner of Calles Padre Faura and Taft, and who lived on Calle Nueva, near Calle San Andres, both of which addresses are in the residential section of the city and a number of miles from the last case, which occurred at Caloocan. (See Public Health Reports, Oct. 10, 1913, p. 2093.) No connection could be traced between the cases, nor have any cases of cholera occurred in the group of men among whom the carpenter worked. Seven persons who were supposed to be contacts at his house were examined, and two vibrio carriers were found, the organism being identical with that of Koch with the exception that it failed to agglutinate with cholera serum.

On September 16 a case occurred in the person of an American who lived in Pasay under native conditions. Pasay is several miles from where the above case occurred. This man was an employee of the Quartermaster's Department of the Army and was alleged to have been a sufferer from nephritis. He died on September 17. The autopsy revealed the typical findings of cholera and in addition a nephritis which may have been present before cholera was contracted. The laboratory findings were positive. Five contacts were examined and all of them were negative for cholera organisms and vibrios.

The third case was in an African-Filipino child that applied at the Philippine General Hospital for treatment for dysentery. On stool examinations being made, Koch's vibrios were found. The case was removed to the San Lazaro Cholera Hospital. Two contacts examined were found negative for cholera organisms and vibrios.

During the week ended September 27, 1913, 3 cases of cholera with 1 death were notified in Manila. The disease occurred in widely separated sections of the city.

Plague-Plague Rats-Manila.

During the week ended September 27, 1913, a fatal case of plague occurred in Manila in the person of an American, editor of the Manila Daily Bulletin. In view of the completeness with which the origin of the infection in this case was traced, and its significance, the following details may be of interest:

On September 6 a plague rat was found in the block adjacent to that in which the offices of the Manila Daily Bulletin are located. On September 19 the editor was admitted to a local general hospital. On September 20 a preliminary diagnosis of plague was made and he was immediately transferred to the San Lazaro Plague Hospital, where he died on September 22. In carrying out the routine insecticidal measures in the offices of the Manila Daily Bulletin a mummified rat was found in the desk of the late editor. There were also a number of live fleas, one of which was identified as Pulex cheopis. Microscopical slides prepared from the ground-up flea showed bipolar staining organisms similar to those of plague. The rat was also ground up, and inoculations made from it into healthy laboratory rats produced in them typical cases of plague, which terminated fatally. A culture made from one of the buboes of the patient and inoculated into a guinea pig resulted in a positive case of plague, which also terminated fatally.

The facts that the mummified rat found in the desk must have been dead for a period of at least two weeks and that live fleas which contained plague bacilli were associated with it furnish strong proof that plague might be introduced into a country without either the importation of human or rat cases of plague and that fleas might be alone concerned. In this instance the possibility remains, however, that the fleas might have been carried into the desk by plague rats which either died elsewhere or subsequently recovered.

On the first floor of the building in which the offices of the Daily Bulletin are located are a large grocery warehouse and a restaurant, and in the cleaning up which followed 4 dead rats were found in these premises. The cause of death in these rats could not be definitely ascertained.

It is interesting to note, however, that on September 20 a Chinaman employed in the warehouse died, and that the attending physician certified the cause of death as pulmonary tuberculosis after an illness of four months. Subsequently it was learned that the Chinaman had been ill only one day. The body was ordered exhumed by the bureau of health on September 22, and it was definitely ascertained that