703 



a national health administrator. If a person requires vaccination in 

 the interest of public health and refuses the vaccination, he may be 

 isolated for a period up to foui-teen days.*'^ Ships, aircraft, trains, and 

 road vehicles are also subject to disinsecting or disinfection, depend- 

 ing on circumstances at the port of arrival. Further health measures 

 may be applied to any vehicle as determined by conditions on board 

 during the voyage or which exist at the time of medical examination 

 bv the port health authority. 



■"The United States' part of the WHO epidemiological intelligence 

 network is operated by the Public Health Service Center for Disease 

 Control in Atlanta, Georgia. The Center also serves as the Interna- 

 tional Influenza Center of the Americas and the Arborvirus Center for 

 the Western Hemisphere; it is also the International Center for 

 Shigellosis (a form of dysentery). 



To implement the International Health Regulations and to protect 

 the United States from the importation of disease from abroad, the 

 Public Health Service spends about $10 million annually and checks 

 about 140 million international travelers arriving at some 400 differ- 

 ent points of entry. The Public Health Service also maintains physi- 

 cians on duty in more than 30 nations in order to examine an average 

 of 250,000 applicants per year for visas to the United States. 



CURRENT PR0BLE3IS OF EPIDEMIC CONTROL 



Perhaps the main problem in implementing the International Health 

 Regiilations is a tendency on the part of some governments not to report 

 diseases for fear of restrictive action that would affect trade and 

 travel.*^ This problem came to the fore recently when WHO reported 

 the presence of cholera in Guinea without awaiting notification of the 

 serious outbreak there from the Guinea Health Ministry. WHO's 

 notification of 2,000 cases and 60 deaths from cholera in Guinea came 

 as it was completing its preparations for an emergency anticholera 

 training program for African countries. The present epidemic (which 

 began nearly a decade ago) has penetrated south of the Sahara where 

 cholera had not been seen for more than a century.*^ WHO had earlier 

 provided technical assistance for use in Conakry, the capitol of Guinea, 

 when the government reported 230 cases of an unidentified illness 

 which had already caused 27 deaths.** 



The outcome of WHO's report of the nature and extent of cholera in 

 Guinea were (1) a threat from the Guinea Government to withdraw 

 from WHO in protest to the report *^ and (2) "no further news" from 

 Guinea as of September 8, 1970, when the first WHO notification oc- 

 curred concerning 2,000 cases of cholera there.*^ Notifications have been 

 received from Dubai [one of the Trucial States], Israel, Lebanon, 

 Libya, and the U.S.S.R. ; however, Iran and the United Arab Republic 

 have repeatedly denied the presence of cholera.*^ As the Medical 

 Tnhune states, "it seems clear that the haziness surrounding the exact 

 locations outside the officially notified areas where cholera has appeared 



" IWH. Chaptpr IV. napp 24. 



« WHO Chronicle (World Health Orsanization. June 1970). page 262. 



"Medical Tribnne (September 21. 1970). page 3. 



♦•Medical Tribune (Sentemher 7. 19701. pR?p 1. 



** Medical Tribune (September 21. 1970). page 3. 



« The Lancet (September 12. 1970) , page 578. 



" Ibid. 



