126 TROPICAL MEDICINE AND HYGIENE 



is a source of danger to the whole community. This 

 danger can, by energetic measures, be reduced to a 

 minimum. 



(1) All cases of fever must be at once reported and 

 inquired into. Any that are yellow fever must be at 

 once isolated. In a port where yellow fever is likely to 

 be introduced, the machinery for the registration, identi- 

 fication, and isolation of cases must be kept in working 

 order, and form a department or bureau that is at all 

 times available. 



(2) If there is a case of yellow fever the patient must 

 be removed to another room and placed inside a mos- 

 quito net, and kept there night and day till convalescent, 

 as the young mosquitoes feed both during the day and 

 night, and may become infected therefore at any time. 



(3) The room from which the patient has been re- 

 moved must be at once closed and all places where 

 mosquitoes can escape blocked. The room must then 

 be fumigated with burning sulphur ij lb., or pyrethrum 

 2 lb., to each 1,000 cu. ft. As soon as possible after the 

 fumigation the floor must be swept and the sweepings 

 at once burnt, as mosquitoes may revive after such a 

 fumigation. The attendants, those engaged in fumigation 

 or mosquito destruction, and any persons having business 

 in the house, must be protected by suitable clothing from 

 mosquitoes. 



(4) In adjoining houses every effort should be made 

 to destroy the mosquitoes, as some may have escaped 

 to them. If the case of yellow fever is detected early, 

 when these precautions are adopted there is frequently 

 no spread of the disease, because the mosquitoes, as in 

 malaria, are not capable of infecting human beings in 

 less than ten days after biting the patient. 



Where the first case is not detected early, and the 

 disease has spread, each case as it is reported must be 

 treated in the same manner as an original case. The 

 success of the measures depends on each case being 

 reported early, and a thoroughly efficient central bureau 

 is therefore essential. 



