THE OUTBREAK OF PLAGUE IN MANILA DURING 1912 



THE INSIDIOUS BEGINNING, WITH A DISCUSSION OF PROBABLE FACTORS 

 CONCERNED IN ITS INTRODUCTION ^ 



By Victor G. Heiser' 



(From the Bureau of Health, Manila, P. I.) 



One map 



After an absence of six years in human beings, and five years 

 among rats, plague was again found in the Philippine Islands 

 on June 19, 1912. On account of the almost daily communica- 

 tion which Manila has with badly plague-infected foreign ports 

 which are within a few days' steaming distance for the average 

 vessel, and since, therefore, passengers, crews, rodents, and 

 vermin may arrive well within the incubation period of the 

 disease, it seems remarkable that the Philippines should have 

 remained free from plague for so many years. During this 

 period, plague has been detected from time to time, among 

 human beings upon incoming vessels, but such infections were 

 invariably intercepted at quarantine. All vessels plying between 

 the Philippines and Oriental ports have been fumigated with 

 sulphur, at not greater than six-month intervals, to destroy 

 rodents and vermin. 



In view of the fact that we are still in the midst of the out- 

 break, this paper will be confined strictly to a statement of 

 fact, as it is not believed to be advisable, at this time, to attempt 

 to draw any conclusions. 



CHARACTER OF PLAGUE AT QUARANTINE 



A most insidious form of plague was encountered at Manila 

 last spring. On April 6, a death was reported on the steamer 

 Zafiro which had arrived the day previous from Hongkong, and 



' Read before the Ninth Annual Meeting of the Philippine Islands 

 Medical Association, held in Manila from November 4-7, 1912. 



' Passed assistant surgeon. United States Public Health and Marine- 

 Hospital Service; Director of Health for the Philippine Islands; and 

 professor of hygiene, College of Medicine and Surgery, University of the 

 Philippines. 



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