DENGUE IN INDO-CHINA. 31 



mosquitoes. As in malaria and yellow fever, a patient is not himself 

 infectious, but it is necessary to protect him against the bites of 

 mosquitoes and to destroy these insects in the neighborhood. 



The line of conduct particularly on a boat is clear. The patients 

 should be isolated and put in rooms protected by wire gauze or landed in 

 a place where contagious agents are lacking. The collections of water on 

 board, as well as the bilge water, should be drained, and the boat later 

 disinfected by means of Clayton gas. This will kill all vermin and 

 insects. A boat infected by dengue should be put in quarantine and 

 anchored far from the shore and from other boats. It is evident that a 

 disease with such a great epidemicity, and which may have a death rate 

 of 2.12 per cent warrants strict regulations. Although quarantine means 

 an economic loss, the disorganization and cessation of work in a com- 

 munity caused by even a slight epidemic of dengue is still more detri- 

 mental; moreover, as the incubation period of the disease is not more 

 than four days (Ashburn and Craig), quarantine need not be prolonged 

 over this time, after the boat is disinfected. 



CONCLUSIONS. 



(1) The dengue of the Manche is related to other forms of dengue in 

 Indo- China. 



(2) It was distinguished by the absence of an eruption, a mortality of 

 2.12 per cent and the absolute immunity of the Annamese as compared 

 with the extreme susceptibility of the Europeans. 



(3) Endemo-epidemic areas of dengue exist in Indo-China, the best 

 known and most important area being that of Saigon. 



(4) The epidemic of the Manche again confirms the mosquito trans- 

 mission theory; therefore, prophylactic measures should be directed 

 against mosquitoes. 



LITEEATURE. 



(1) Ashburn P. M., and Craig, Charles F. Experimental investigations regard- 



ing the etiology of dengue fever with a general consideration of the 

 disease. This Journal, Sec. B. (1907), 2, 93. 



( 2 ) de Brun. Maladies des pays chauds, Paris, 1 , chap. 4. 



(3) van der Burg, C. L. Handbuch der Tropenkrankheiten herausgegeben von 



Dr. Carl Mense, Das Dengue Fieber, Leipzig (1905), 11. 



(4) Cazmian. Quelques considerations sur une epidemic de dengue & bord du 



"Kersaint" (Saigon, juillet-aout-september-1905) . Arch. mid. nav. (1906), 

 85, 241. 



(5) Cotholendy. Relation de I'gpidemie de dengue qui a rggn6 a St. Denis 



(Reunion) pendant les mois de ffivrier, mars, avril, et mai, 1873. Ibid. 

 (1873). 



(6) Graham, H. (Beyrouth.) The dengue: a study of its pathology and mode 



of propagation. Journ. trap. Med. & Hyg. (1903), 6, 209. 



