YELLOW FEVER PROPHYLAXIS IN NEW ORLEANS 51 



e 



diagnosis had commenced to be realised, is more accurate than thi 

 estimated figure on the 22nd July, and that in reality the rise was 

 more gradual from a much higher figure than 20 on the 22nd. 



From the 1 2th July, when two very suspicious cases were privately 

 reported, up to August the 4th, the local authorities dealt with the 

 situation with increasing vigour. First, there were the measures 

 undertaken by the State and Municipal Health Authorities. In spite 

 of their efforts, however, the fever gained. Then on July the 22nd 

 the campaign was taken up by the medical and citizens' Ward organi- 

 sations working together with the local Health Authorities, and early 

 notification and fumigation was universally advocated. On August 

 2nd, the screening of cisterns was made compulsory, and between 

 60,000 and 70,000 cisterns were screened in the course of a few days. 

 This wise measure, however, would not produce an immediate effect 

 in reducing the number of cases, for by this time the volume of 

 infected mosquitoes in the houses would be very great ; its effect 

 would be seen later when the mosquitoes infected prior to the 

 Ordinance having been killed by the repeated fumigations, there 

 would be no fresh supplies of mosquitoes to take the place of those 

 which were destroyed. As one would expect, therefore, the fever 

 still increased, and on August the 4th it was decided to ask the 

 Public Health and Marine Hospital Service to continue and perfect 

 the campaign against the fever. On the 12th the fever reached its 

 maximum point of 105, on the 17th the numbers were 74 and from 

 this date onwards there was an absolutely steady fall into the first 

 week in October, when the drop became more accentuated and two 

 or three cases were reported on the average daily. It is clear that 

 by August the 12th, the prophylactic measures, including early notifi- 

 cation, isolation, fumigation, and cistern screening had begun to tell 

 in no unmistakable manner, and that the Public Health and Marine 

 Hospital Service Officers by most strenuous efforts and the exercise 

 of the greatest vigilance and precision had made the occurrence of 

 a subsequent recrudescence impossible. In three weeks time from 

 the first official notification the fever was held absolutely under control, 

 and was thenceforward week by week steadily driven back. There 

 can be no doubt that the rigid control of the situation which com- 

 menced to be exercised after the 4th, was the great factor in pre- 

 venting fresh outbreaks. The Chart is a splendid example of what 



