﻿REAPPEARANCE OF PLAGUE IN THE PHILIPPINES AFTER AN 

 ABSENCE OF SIX YEARS ^ 



BRIEF DESCRIPTION OF THE OUTBREAK, THE METHODS USED TO COMBAT IT, 

 AND THE PROBABLE FACTORS IN ITS INTRODUCTION 



By Victor G. Heiser 

 {Director of Health for the Philippine Islands) 



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The Far Eastern Association of Tropical Medicine has been 

 a beneficent influence in disseminating useful sanitary informa- 

 tion among medical men of the Orient, and has been a great factor 

 in promoting friendly relationship between the countries from 

 which its membership is drawn. 



In choosing plague as a subject, we deal with a disease that 

 concerns all of us, because it is constantly present in some ports 

 of the Orient and is one that constantly threatens our frontiers. 

 The factors concerned in the transmission of the disease are now 

 so generally accepted that a study of the methods of pombating 

 plague in the different countries shows them to be very much the 

 same. 



Therefore, the purpose of this paper will be, in addition to a 

 brief description of the outbreak in the Philippine Islands, to 

 refer particularly to those features which have not been so 

 frequently mentioned in the literature of the disease. 



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

 rats, plague was again found in the Philippine Islands in man 

 on June 17, 1912. From the beginning of the outbreak up to 

 the present time, there have been in Manila 68 cases with 58 

 deaths, which gives a mortality of 85.3 per cent. At Iloilo, there 

 were 9 cases with 9 deaths. In view of the fact that Manila is 

 a city with a population of approximately 300,000 and is largely 

 built up with a poor type of wooden buildings, which furnish 

 ideal harboring places for rats, it would not have been strange 

 if there had been more cases. In fact, a much larger number 

 of cases could have been reasonably expected. On account of the 

 almost daily communication which Manila has with plague- 

 infected foreign ports which are within a few days' steaming 

 distance for the average vessel and since passengers, crew, ro- 

 dents, and vermin may arrive well within the incubation period 

 of the disease, it is remarkable that the Philippines should have 

 remained free from plague for so many years. This freedom 



^ Read at the third annual meeting of The Far Eastern Association of 

 Tropical Medicine held at Saigon, November, 1913. 



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