THE DISEASE-CARRIER PROBLEM IN THE PHILIPPINE 
ISLANDS 
By Dr. CoNcHA BRILLANTES 
INTRODUCTION 
From the viewpoint of the epidemiologist, a carrier is of 
more concern than a frank case of a disease. This should be 
quite obvious; for the latter, being easily recognized, even by the 
laity, usually comes under official notice either through the re- 
port of a physician, a neighbor, or a member of the family, or 
comes to the attention of a house-to-house inspector. On the 
other hand, carriers may be recognized by a laboratory exam- 
ination only. This is a task of some difficulty and not a little 
uncertainty, because the taking of specimens is subject to op- 
position on the part of the public, who consider the act a vio- 
lation of their personal rights; besides which, they fear the 
hospitalization or sanitary isolation consequent on a positive 
finding. Furthermore, the person may be a real carrier, but the 
laboratory may fail to detect the organisms because of error in 
the taking or transportation of the specimen, delayed examina- 
tion, etc. 
A carrier is a hidden focus of infection for other persons and 
a menace to himself—a focus which, unless discovered by the 
laboratory, the sanitarian cannot control. His detection and 
control therefore constitute one of the most important problems 
in the suppression of disease in which carriers play a part. 
So far as I have been able to ascertain, carriers were first 
discovered in connection with cholera. For some time Koch 
held the view that man is the “real bearer and reproducer of the 
cholera organism.” Many isolated epidemics could be explained 
only on the assumption that completely healthy persons, or those 
not noticeably diseased, had introduced the organisms. This 
assumption was first confirmed by W. P. Dunbar in the winter 
epidemic in Hamburg in 1892-93 when, by the use of the pep- 
tone culture medium, he found the cholera vibrio in the stools 
of no less than twenty-eight healthy persons, who had never 
had cholera nor the slightest diarrhea. 
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