THE PHILIPPINE 
JOURNAL OF SCIENCE 
B. TROPICAL MEDICINE 
Vou. X JANUARY, 1915 No. 1 
CHOLERA CARRIERS IN RELATION TO CHOLERA CONTROL? 
By HE. L. Munson 
(Major, Medical Corps, United States Army. Advisor to the 
Bureau of Health) 
In the recent cholera outbreak in Manila and in Bilibid 
Prison a very high percentage of carriers in persons not cholera 
suspects was early discovered. The number of both carriers 
and cases was showing a steady increase, and there were a 
number of recurrent cases developing in groups found to have 
a high carrier index. It was then decided to depart from pre- 
vious ideas, and to regard actual cases merely as symptomatic 
of a wider spread and more dangerous concealed infection. 
The dangerous nature of frank cases of cholera with diar- 
rhoea, vomiting, and collapse is well recognized by the people, 
and such cases would be avoided, reported, isolated, and followed 
by disinfection of their environment. But the carriers were 
unsuspected sources of infection who were scattering it broad- 
east through the public latrines, handling and preparing food 
and drink for public consumption, and admitted as welcome 
guests into homes and social entertainments. To avoid a dan- 
ger, it must first be known where it exists. 
Special effort, therefore, was made to seek out and isolate 
the carriers, who were presumably the chief factors in spread- 
ing the infection. It was recognized that the task would be 
one of too great magnitude to include all the inhabitants of 
the entire city, nor was this thought necessary in practice; so, 
after a few special surveys to determine the degree of preva- 
lence of infection, the work of carrier detection was limited to 
contacts with cholera cases, to persons living in a vicinity in 
which several cases had occurred, and to persons engaged in 
the handling of food and drink in hotels, restaurants, bottled- 
*Read at the annual meeting of the Philippine Islands Medical. Associa- 
tion, Manila, November 4—7, 1914. 
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