52 m'laughlin. 



Even with perfect, daily disinfection of closets and places soiled with 

 fagcal matter, all chance of infection from bacilli carriers is not cut off, 

 because a bacilli carrier with his soiled fingers may infect the food or 

 drink of other persons. 



The prohibition of certain native foods, fruits, and vegetables was 

 necessary, not only because these substances were often infected or 

 dangerous of themselves, but they were also the substances carelessly 

 handled by dirty people of dirty habits, many of whom were undoubtedly 

 bacilli carriers, and they were the substances which were eaten without 

 sterilization by boiling or cooking, after such handling. 



It has been demonstrated this year that the perennial outbreaks of 

 cholera in Bilibid Prison are probably due to bacilli carriers. Upon the 

 appearance of cholera in Bilibid Prison this year, the writer gave orders 

 that stools of those who had anything to do with the preparation or 

 handling of food or drink be taken to be examined for cholera. Two 

 hundred and sixty-four samples were taken and of this number of ap- 

 parently healthy persons, 17 were found to be carrying the cholera 

 organisms in their intestines. To find out and isolate all the other bacilli 

 carriers would have involved an amount of work in stool examinations 

 alone which would have been impossible for the already overtaxed bac- 

 teriologists of the Biological Laboratory. 



Kesults were obtained by an order from the writer to compel washing 

 of the hands in disinfecting solution after stool and before eating. This 

 order was enforced and cases ceased to appear, although there were 

 doubtless many bacilli carriers in the 3,000 prisoners whose stools had 

 not been examined. 



THE SPREAD OP THE INEECTIOISr. 



The practice of taking stools had to be discontinued when the cases 

 increased to such an extent that it was no longer possible to do so. For 

 the .same reason, the house-to-house inspection areas had to be supplanted 

 by general house-to-house inspection of the whole city when the number 

 of infected houses — that is, houses in which cholera had appeared within 

 five days — reached 200. 



Failure to find cases of cholera early makes the suppression of the 

 disease difficult. Cases, even with the house-to-house inspection, are 

 sick from two to twenty-four hours before discovery. Upon discovery, 

 a quarantine guard is placed upon the house and inmates, and from this 

 point that particular focus is adequately cared for, but, in the hours 

 before discovery other individuals probably have been infected. 



When a Filipino falls ill, all the neighbors will, either through interest 

 or curiosity, crowd into the house. Upon discovery, or upon decision of 

 the householder or doctor, to report the case, these people promptly 

 scatter, go to their meals without washing their infected hands, eat their 

 rice with these same infected hands, and even carry with them from the 



