PLAGUE IN PERU. The number of cases of plague in Peru has been as follows during the calendar year 1915: From the monthly official reports are taken the following data showing the number of cases of plague which occurred in the Departments of Peru during the months of 1915: Departments. Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec. The number of cases of plague during the year has been little more than half of that for the preceding year, and was the lowest number since the appearance of plague in Peru. However, the decrease in cases can not be regarded as an indication of improved conditions with respect to the plague. It has not been the result of efficient sanitation measures but it is probably due to change in natural conditions. Smallpox at Callao and Lima has decreased very much but is working havoc in the interior of the country. In December of 1915, one case of yellow fever from Guayaquil died at Lima in the special lazaretto for that disease. Officially, the case was not accepted as yellow fever. Several cases of leprosy exist at Lima among the Chinese and Japanese. The Peruvian Government intends to send them to their own countries. The newspapers at Lima announce that in Iquitos and the low Amazon Department there exist many cases of leprosy. The deaths during the year at Callao have been distributed as follows: Typhoid fever___ Malaria Erysipelas Smallpox Measles Scarlet fever_. 18 1 27 The death rate in Callao was 40.77 per thousand during the calendar year 1915. GUANTANAMO BAY, CUBA. Acting Asst. Surg. R. Spear reports as follows: The duties of the public health officer at this station consist in inspecting incoming vessels and issuing bills of health to departing vessels. As the naval station is not an open port the only ships that come here other than naval vessels are the ships from the Ward Line which bring supplies from New York. There is a quarantine camp at Caracoles Point equipped for handling infectious cases. This camp is primarily for use of the fleet, but can be used for infectious cases that may develop on the station. During the past year two cases of smallpox were successfully treated at this place. The quarantine station lacks a disinfecting plant, and there are no facilities for disinfecting ships. The common diseases in the eastern end of Cuba among the natives are hookworm infections, malaria, and tuberculosis. In about 1,500 stool examinations among the natives from different localities eastward from Santiago, including both coasts, over 50 per cent have been found to be infected with hookworm. Ascaris and trichocephalus infections are also very common. Some very severe malarial infections have been seen among the natives. Asst. Surg. C. R. Baker, United States Navy, has examined the blood of 188 in this vicinity. Sixty-two per cent were positive for malaria, 48 per cent of which were of the estivo-autumnal variety. Malaria in this locality most frequently assumes a quiescent form and does very little apparent damage. There are a number of lepers in the eastern end of Cuba. No attempt at segregation is made. GUAYAQUIL, ECUADOR. Passed Asst. Surg. Herman B. Parker reports as follows: Maritime quarantine.-During the fiscal year 64 bills of health were issued to vessels bound to United States territory. Of these, 43 were bound to the Canal Zone and 21 to other ports in the United States. During this period there were inspected 3,865 crew, 1,158 cabin passengers, and 834 steerage passengers. The following is a summary of the quarantine transactions for the Number of steerage passengers inspected__ Number of cabin passengers for United States ports_ 3, 865 1, 158 834 591 210 Anchorage. During the fiscal year all vessels entering Guayaquil anchored in front of the city. This, owing to cases of yellow fever, was considered as objectionable, and in order to insure greater security ships were sent down the river and there completely fumigated with sulphur prior to the embarkation of passengers and sailing. Vessels bound for San Francisco via Mexican ports or direct were inspected and passed, and the quarantine officer at the port of destination so informed. Vessels bound for New York through the Panama Canal were treated as though bound for the Canal Zone; while those vessels bound for New York via the Straits of Magellan were inspected and passed, owing to the necessity of fumigation in the southern coast ports and at the first port of entry in the United States. Cargo.--The principal cargo from Quayaquil is cacao. During the fiscal year nearly 1,000,000 quintals were shipped. İn former years almost all the cacao was shipped to Europe and thence a small proportion to the United States; while this year, owing to war conditions, the most of it was first shipped to a United States port. This is not a dangerous cargo as regards plague, owing to the method of fermentation prior to shipment. During the fiscal year hides were subjected to the usual arsenic treatment before shipment, and received in addition a sulphur fumigation after having been placed on board the vessel. Wool is becoming annually a larger product of commerce of Ecuador and, while it is known that anthrax does not prevail, the methods of storing in Guayaquil have not met with approval on account of the existence of plague, and shippers were notified that unless greater precautions were taken in the erection of satisfactory bodegas outside of the plague zone the shipment of wool would be prohibited. The usual consular certificates, countersigned in this office, are required for hides, lana de ceiba, cotton, and wool. Plague and yellow fever on outgoing ships.-As far as can be ascertained neither of these diseases appeared on outgoing ships during the fiscal year, and notwithstanding the monthly increase in these diseases during the year no cases were reported on ships in the harbor. Bubonic plague.-In the annual report of 1914 it was mentioned that bubonic plague had not yet invaded the altitudes of the Andes, but this year the disease has passed over an altitude of 12,000 feet and appeared in the subtropical town of Ambato, which has an altitude of 7,000 feet. There were reported in this town 42 cases and 18 deaths. Rodents, including guinea pigs, are quite numerous in this town. In these small interior towns guinea pigs are a favorite article of food, and each house keeps its supply in about the same manner that they keep chickens. They also serve as household pets, which increases the danger from this disease. Strenuous efforts have been made to eliminate these foci in order to prevent the ingress of the disease into Quito, the capital of the Republic. Appended is a table of the disease for the calendar year 1915 and the first six months of 1916. Dysentery.-Amebic dysentery still exists almost as an epidemic in the coast and interior towns of the Republic. The general use of emetine has done much in curing these cases, and the consequences of this disease, especially abscess of the liver, are seen less frequently. Bacillary dysentery still exists sporadically, but the use of serum has reduced the mortality. Typhoid fever.-During the year a severe epidemic of typhoid fever occurred in Guayaquil, indirectly caused by the excavation of streets for installation of water supply. It was found in this work that many of the old supply pipes in the town were porous as the result of oxidation, but were more or less protected by the surrounding clay soil. This resulted in the contamination of the water supply of the town during the period of negative pressure in the pipes. Vaccination, however, was generally used, and at the present time only sporadic cases occur. Tuberculosis.-Tuberculosis still contributes largely to the death rate and high mortality of the city. Sanitation of Guayaquil.-During the fiscal year a new distribution system for the water supply has been completed, and work has well advanced on the reservoir. Surveys have been made of the various water sources, and, as soon as the economic conditions permit, this most important work will be completed. Malarial fever.-Owing to the great diminution in the rainfall during the past rainy season, malarial fevers have not prevailed to the same extent as in former years. Uncinariasis.-The service representative was the first to recognize and report in Ecuador a disease that exists so widely and is so well known. In the beginning of the work thymol was used as the standard remedy. During the past year oil of chenopodium has been used with far more efficient results than with thymol. Every effort is made to educate the ranch owners as to the nature of the disease and the simple methods that are necessary for its extermination. Leprosy. This disease is less frequently seen on the streets this year. During the past two years the bacteriological diagnosis has been made in 13 cases, and, as a matter of interest, several of these cases have been treated with the resorcin-chaulmoogra oil mixture, recommended in the Philippines, and in two cases, both young subjects, with marked amelioration of the symptoms. Yellow fever.-During the calendar year of 1915 there was a notable diminution in the number of cases of yellow fever in Ecuador. These cases were so rare and infrequent that for a long time the existence of the disease was seriously doubted. An opportunity, however, was offered to see an autopsy, and the existence of the disease was confirmed as a result of the post-mortem examination. During the year also an almost entire absence of the stegomyia mosquito was noted. This was largely due to an efficient mosquito campaign. With the advent of the year 1916, owing to a scarcity of funds, the campaign was discontinued with an almost immediate recrudescence of the disease in epidemic form. From the 1st of January until June 30, 1916, there were reported in Guayaquil 133 new cases, of which 46 recovered and 78 died. This mortality indicates that only the more serious cases came under observation of the health department. Appended is a table giving the existence of the disease as reported during the periods mentioned. 63887°-H. Doc. 1493, 64-2——12 Yellow fever in Ecuador during the first six months of 1916. Plague in Ecuador during the first six months of 1916. HABANA, CUBA. Acting Asst. Surg. Richard Wilson reports as follows: SUMMARY OF TRANSACTIONS. The work of this office in brief was as follows: Bills of health were issued to 1,827 vessels bound for the United States and its dependencies. This is an increase of 209 over the last fiscal year. This gives an average of a little more than 152 vessels a month, an increase in the monthly average of 17 vessels. Of the 1,827 vessels receiving bills of health, 1,040 were inspected, because they were going direct to the United States or its dependencies. On the vessels inspected the number in the crews was 60,806, and the number of passengers was 37,313. Certificates of vaccination were issued to 101 passengers for the Canal Zone and Panama, who asked for them. No other health certificates were issued during the year, except late in June, 1916, when restrictions were placed on passengers from Mexico. As this was begun at the end of the fiscal year, only seven certificates were issued in the time that this report covers. Fumigation of vessels for the purpose of killing rats was practiced throughout the fiscal year. Fumigations done in Habana are divided into two classes: First, vessels fumigated by the service. This includes all vessels going direct to the United States. Second, vessels fumigated by the Cuban authorities under the supervision of the service. These are vessels going to the United States via Cuban ports. In the last-named class the service fumigator is sent on board, and if he sees that the vessel is fumigated according to the |