YELLOW FEVER AND MOSQUITOES. 241 



Tlie washing of walls, lloors, ceilings and furniture with disinfectants is 

 unnecessary. 



3. As it has been demonstrated that yellow fever cannot be conveyed by 

 fomites, such as bedding, clothing, effects and baggage, they need not be sub- 

 jected to any special disinfection. Care should be taken, however, not to remove 

 them from the infected rooms until after formaldehyde fumigation, so that they 

 may not harbor infected mosquitoes. 



Medical officers taking care of yellow-fever patients need not be isolated; 

 they can attend other patients and associate with non-immunes with perfect 

 safety to the garrison. Nurses and attendants taking care of yellow fever 

 patients shall remain isolated, so as to avoid any possible danger of their con- 

 veying mosquitoes from patients to non-immunes. 



4. The infection of mosquitoes is most likely to occur during the first two or 

 three days of the disease. Ambulant cases, that is, patients not ill enough to 

 take to their beds and remaining unsuspected and vmprotected, are probably 

 those most responsible for the spread of the disease. It is therefore essential 

 that all fever cases should be at once isolated and so protected that no mos- 

 quitoes can possibly get access to them until the nature of the fever is positively 

 determined. 



Each post shall have a 'reception ward' for the admission of all fever cases 

 and an 'isolation ward' for the treatment of cases which prove to be yellow 

 fever. Each ward shall be made mosquito-proof by ware netting over doors and 

 windows, a ceiling of wire netting at a height of seven feet above the floor, and 

 mosquito bars over the beds. There should be no place in it where mosquitoes 

 can seek refuge, not readily accessible to the nurse. Both wards can be in the 

 same building, provided they are separated by a mosquito-tight partition. 



5. All persons coming from an infected locality to a post shall be kept 

 under careful observation until the completion of five days from the time of 

 possible infection, either in a special detention camp or in their own quarters; 

 in either case, their temperature should be taken twice a day during this period 

 of observation so that those who develop yellow-fever may be placed under treat- 

 ment at the very inception of the disease. 



6. Malarial fever, like yellow fever, is communicated by mosquito bites and 

 therefore is just as much of an infectious disease and requires the same meas- 

 ures of protection against mosquitoes. On the assirmption that mosquitoes re- 

 main in the vicinity of their breeding places, or never travel far, the prevalence 

 of malarial fever at a post would indicate want of proper care and diligence on 

 the part of the Surgeon and Commanding Officer in complying with General 

 Orders No. 6, Department of Cuba, 1900. 



7. Surgeons are again reminded of the absolute necessity, in all fever cases, 

 to keep, from the very beginning, a complete chart of pulse and temperature, 

 since such a chart is their best guide to a correct diagnosis and the proper treat- 

 ment. 



By Command of Major General Wood: 



H. L. SCOTT, 



Adjutant General. 



vol. lix. — 16 



