CHAPTER I.
YELLOW FEVER—INDIA'S FUTURE DANGER.
Section 1.
1. The Malaria Conference held in Bombay on
November 10th and 17th, 1911, resolved that:—
" In view of the possibility of the importation of Yellow Fever in
India, the Conference suggests the advisibility of a careful Stegomyia
Survey and the education of the public in the matter of the destruction
of domestic mosquitoes."
In accordance with this resolution the enquiry was started in Karachi, as
well as in other important ports of India having a large Eastern trade,—to
prevent the Yellow Fever from getting an entrance through them.
2. Major E. E. Gordon Tucker, I. M. S., in a paper " Yellow Fever—
India's F0uture Danger " read before the British Medical Association in June
1910 brought it prominently to notice, that the presence of Stegomyia Fasciata
in a sea-port with trade communications with the East is a very serious
matter. The essential facts in the epidemiology of Yellow Fever are,
that it is a disease of sea-ports and especially affects shipping, by means
of which it is conveyed to temperate climates at a great distance from the
endemic areas. It affects the low-lying and insanitary areas of cities. It is
a disease of warm climates, and latitude 22° North and South of the Equator
roughly covers its area of maximum intensity—the key to the whole problem
of epidemiology being the extra-corporeal host of the virus—Stegomyia
Fasciata:—
" Considering ' the gross roads of the Pacific' of the future, Hono-
lulu is the centre of the hemisphere which includes American continents,
Japan, China and Malay Peninsula, Australia and New Zealand; and it is
the central point of the direct route between Panama and Hongkong.
It is hard to prognosticate as regards the direct trade between the endemic
ports of Yellow Fever and India. India has of late been importing large
quantities of sugar, which may in time come from Jamaica.
" The species S. Fasciata is widely distributed in the regions with
which we are particularly concerned. As regards India, we have two of
the three factors which permit Yellow Fever epidemics—(1) The
S. Fasciata in abundance and (2) a complete non-immune population. The
incubation period of Yellow Fever extends from 36 hours to 4 or 5 days.
Another 3 days must be added to this when the diagnosis is doubtful.
A case of Yellow Fever on a tramp steamer escaping detection will infect
the Stegomyia on board, in whom the virus takes another 12 to 14 days
to mature. So that in a period of 17 days, when the ordinary tramp
steamer is approaching the Hawaiian group of islands, the virus will have
matured in the mosquitoes and these can infect for 50 days after ingesting
the virus. The S. Fasciata can make herself at home on steamers prefer-
ring warm spots such as cook's galley and engine room or in the hold
containing cargoes of sugar. Efficient inspection at Hanolulu will no
doubt be a great protection to Hongkong and Shanghai; but the trade for
Borneo and the adjacent islands and Malay Straits may utilize ports of
call rather near the Equator, such as Christmas Island, where the inspection
may not be so efficient."
YELLOW FEVER.
Section 2.
1. An acute specific, very fatal febrile disease, occurring within a
peculiarly limited geographical area and is charac-
terised by a definite course consisting of an initial
stage of a Sthenic nature rapidly followed by such evidences of blood destructions
as black vomit, albuminuria, and jaundice.
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