SUPPRESSION OF CHOLERA IN MANILA, 51 



used for general disinfection of lower floors, out-houses, patios, stables, 

 and closets in both strong and light material districts. 



Two factors, more than any others, make difBcult the suppression of 

 cholera in Manila — (1) the existence of bacilli carriers and bad closet 

 facilities or none at all; (2) failure to find cases in the early stages of 

 the disease. 



The presence of bacilli carriers makes necessary the safe disposal or dis- 

 infection of the dejecta of the entire population. 



The exjDerience of the writer in the recent epidemic points to the fact 

 that the most important role in the transmission of cholera is played by the 

 bacilli carrier. 



If a bacilli carrier is a person of cleanly habits, and if he is in posses- 

 sion and makes use of proper closet facilities, he is practically harmless. 

 But on the other hand, a bacilli carrier of filthy habits, who has no closet 

 facilities, or refuses to avail himself of the public closets furnished him, 

 is the greatest menace to the public health which can possibly exist, so far 

 as cholera is concerned. The demonstration of the fact that over 7 per 

 cent of apparently healthy individuals in the Meisic and Tondo districts 

 were bacilli carriers, cou.pled with the insanitary closets of Meisic dis- 

 trict and the absence of or failure to use public closets in the nipa districts, 

 will go far toward explaining the dissemination of cholera in Manila this 

 year. 



Every effort was made to discover promptly light cases of the disease 

 and bacilli carriers. When a case of cholera was found, the house was 

 quarantined until the removal of the patient and until the disinfection 

 had been completed. The stools of the other inmates were taken for the 

 purpose of discovering bacilli carriers. These, if found, were sent to 

 the San Lazaro Hospital and there detained until the vibrios disappeared 

 from their stools. A house-to-house inspection was made of a large area, 

 having the infected house for a center. This was done daily for five 

 days. 



The following tables show the number of apparently healthy persons 

 examined by the Biological Laboratory of the Bureau of Science for 

 cholera bacilli, and laow many were really carrying the bacilli : 



Bilibid Prison. 



Number of persons examined 264 



Number found positive 17 



Percentage found positive G.44 



City of Manila (exclusive of all hospitals and Bilibid Prison). 



Number of persons examined 37(5 



Number found positive 27 



Number found negative but containing vibrios other 



than cholera 46 

 Percentage found positive 7.18 

 Percentage found negative but containing other vib- 

 rios than cholera 12.23 



