﻿580 
  ANNUAL 
  REPORT 
  SMITHSONIAN 
  INSTITUTION, 
  1943 
  

  

  in 
  the 
  mucosa. 
  The 
  liver 
  was 
  yellow 
  and 
  friable 
  and 
  the 
  kidneys 
  large 
  

   and 
  congested. 
  There 
  were 
  no 
  histological 
  examinations. 
  

  

  No 
  further 
  cases 
  suspicious 
  of 
  yellow 
  fever 
  were 
  reported. 
  It 
  was 
  

   decided 
  to 
  make 
  a 
  thorough 
  study 
  of 
  the 
  situation 
  in 
  the 
  forested 
  

   hinterland 
  of 
  the 
  Golfo 
  Dulce 
  region 
  on 
  the 
  Pacific 
  slope, 
  inland 
  from 
  

   the 
  place 
  in 
  which 
  the 
  second 
  case 
  had 
  occurred. 
  

  

  The 
  investigation 
  was 
  considered 
  especially 
  necessary 
  as 
  the 
  previous 
  

   investigation 
  in 
  Costa 
  Rica 
  had 
  been 
  confined 
  largely 
  to 
  urban 
  com- 
  

   munities 
  and 
  had 
  not 
  reached 
  the 
  forested 
  regions. 
  In 
  the 
  original 
  

   immunity 
  survey 
  of 
  Costa 
  Rica 
  190 
  blood 
  specimens 
  were 
  collected 
  by 
  

   Dr. 
  D. 
  M. 
  Molloy 
  from 
  1932 
  to 
  1934 
  in 
  the 
  cities 
  of 
  San 
  Jose, 
  Alajuela, 
  

   Liberia, 
  Puntarenas, 
  and 
  Puerto 
  Limon 
  and 
  sent 
  for 
  examination 
  to 
  

   the 
  laboratories 
  of 
  the 
  International 
  Health 
  Division 
  of 
  The 
  Rocke- 
  

   feller 
  Foundation 
  in 
  New 
  York. 
  The 
  results 
  were 
  included 
  in 
  the 
  re- 
  

   port 
  published 
  by 
  Sawyer, 
  Bauer, 
  and 
  Whitman 
  (1937). 
  There 
  were 
  

   no 
  immunes 
  among 
  the 
  115 
  persons 
  bled 
  who 
  were 
  under 
  20 
  years 
  of 
  

   age, 
  while 
  there 
  were 
  18 
  among 
  the 
  75 
  older 
  persons. 
  Among 
  the 
  coun- 
  

   tries 
  of 
  Central 
  America, 
  Costa 
  Rica 
  and 
  Panama 
  stood 
  out 
  in 
  the 
  

   published 
  report 
  as 
  the 
  only 
  ones 
  in 
  which 
  immunes 
  were 
  not 
  found 
  

   in 
  the 
  age 
  group 
  15 
  to 
  19 
  years. 
  

  

  Realizing 
  the 
  significance 
  of 
  the 
  reports 
  of 
  suspected 
  yellow 
  fever, 
  

   Dr. 
  Peiia 
  Chavarria, 
  then 
  Secretary 
  of 
  Public 
  Health 
  and 
  Welfare 
  for 
  

   Costa 
  Rica, 
  and 
  Dr. 
  Henry 
  W. 
  Kumm, 
  of 
  the 
  International 
  Health 
  

   Division, 
  made 
  a 
  field 
  investigation 
  in 
  January 
  1939 
  and 
  collected 
  133 
  

   blood 
  specimens 
  from 
  three 
  Boruca 
  Indian 
  communities 
  in 
  the 
  region 
  

   in 
  which 
  the 
  deaths 
  had 
  occurred. 
  These 
  villages 
  were 
  Potrero 
  

   Grande, 
  Boruca, 
  and 
  Palmar. 
  They 
  are 
  located 
  in 
  or 
  near 
  extensive 
  

   tracts 
  of 
  virgin 
  forest 
  at 
  elevations 
  of 
  800 
  feet, 
  2,000 
  feet, 
  and 
  100 
  feet, 
  

   respectively. 
  Specimens 
  were 
  taken 
  only 
  from 
  persons 
  who 
  had 
  al- 
  

   ways 
  lived 
  in 
  the 
  same 
  locality 
  and 
  this 
  restriction 
  prevented 
  obtain- 
  

   ing 
  more 
  than 
  19 
  specimens 
  from 
  males 
  over 
  15 
  years 
  of 
  age. 
  The 
  in- 
  

   habitants 
  were 
  principally 
  Indian, 
  although 
  some 
  of 
  the 
  blood 
  donors 
  

   were 
  mestizos. 
  Some 
  of 
  the 
  older 
  Indians 
  stated 
  that 
  they 
  had 
  often 
  

   seen 
  severe 
  cases 
  of 
  fever, 
  some 
  of 
  which 
  were 
  fatal 
  in 
  a 
  few 
  days 
  and 
  

   were 
  characterized 
  by 
  jaundice 
  and 
  black 
  vomit. 
  No 
  evidence 
  of 
  ma- 
  

   laria 
  was 
  found 
  in 
  Boruca, 
  but 
  the 
  disease 
  was 
  quite 
  prevalent 
  in 
  Pal- 
  

   mar. 
  As 
  in 
  the 
  case 
  of 
  the 
  other 
  investigations 
  here 
  reported, 
  the 
  

   specimens 
  were 
  sent 
  to 
  the 
  laboratories 
  of 
  the 
  International 
  Health 
  

   Division 
  for 
  examination. 
  No 
  evidence 
  of 
  immunity 
  was 
  obtained 
  in 
  

   any 
  of 
  the 
  tests. 
  The 
  results 
  are 
  included 
  in 
  table 
  1. 
  The 
  locations 
  

   in 
  which 
  blood 
  specimens 
  were 
  collected 
  are 
  shown 
  in 
  figure 
  1. 
  

  

  Although 
  the 
  investigation 
  seemed 
  adequately 
  to 
  rule 
  out 
  the 
  pres- 
  

   ence 
  of 
  yellow 
  fever 
  in 
  the 
  region 
  in 
  which 
  the 
  suspect 
  cases 
  had 
  oc- 
  

   curred, 
  it 
  was 
  deemed 
  advisable 
  to 
  make 
  similar 
  inquiries 
  in 
  other 
  

   representative 
  forested 
  regions 
  of 
  Costa 
  Rica. 
  In 
  the 
  following 
  year 
  

  

  