92 PREVENTIVE AND REMEDIAL WORK AGAINST MOSQUITOES. 



(2) That this was due directly to the works carried out, and not to a general dying 

 out of malaria in the district, is clearly shown by figures pointing out that while 

 malaria has practically ceased to exist in the areas treated, it has actually increased 

 to a considerable extent in other parts of the district where antimalarial measures have 

 not been undertaken. 



The fact that the statistics for 1905 are even more favorable than those for 1902 is 

 very strong evidence in favor of the permanent nature of the improvement carried out. 



If, as it is hoped, malaria has been permanently stamped out from Klang and Port 

 Swettenham by works undertaken in 1901, our experience in the Malay States should 

 be of value to those responsible for the health of communities similarly situated in 

 many other parts of the world. 



THE WORK IN HABANA DURING THE AMERICAN OCCUPATION, 1901-2. 



One of the most striking examples of clean, efficient antimosquito 

 work is that done by the American troops in Habana at the close of 

 the Spanish war, under the direction of the Army Medical Corps 

 and under the especial direction of Col. W. C. Gorgas, U. S. Army. 

 In the statements which follow, Colonel Gorgas' s published writings 

 have been freely used. 



Yellow fever had been endemic in Habana for more than 150 

 years, and Habana was the source of infection for the rest of Cuba. 

 Other towns in Cuba could have rid themselves of the disease if they 

 had not been constantly reinfected from Habana. By ordinary 

 sanitary measures of cleanliness, improved drainage, and similar 

 means, the death rate of the city was improved from 1898 to 1902 

 from 100 per thousand to 22 per thousand, but these measures had 

 no effect upon yellow fever, this disease increasing as the nonimmune 

 population increased, and in 1900 in fact there was a severe epidemic. 



Aedes calopus was established as the carrier of the fever early in 

 1901, and then antimosquito measures were immediately begun. 

 Against adult mosquitos no general measures were attempted, 

 although screening and fumigation were carried out in . quarters 

 occupied by yellow fever patients or that had been occupied by yellow 

 fever patients. It was found that calopus bred principally in the 

 rain-water collections in the city itself; that Culex quinquefasciatus 

 bred everywhere, and that Anopheles argyritarsis bred principally in 

 the suburbs in pools and puddles well protected with grass. Two 

 mosquito brigades were started — one to take care of calopus and the 

 other Anopheles. 



The work of the so-called "Stegomyia brigade" was confined to 

 the built-up portions of the city. The city was divided into about 

 thirty districts, and to each district an inspector and two laborers 

 were assigned, each district containing about a thousand houses. 

 The mayor of Habana issued an order requiring all collections of 

 water to be so covered that mosquitoes could not have access, a fine 

 being imposed in cases where the order was not obeyed. The water 

 supplied Habana was very hard, and it was customary for every 



