( l * 7 ) 
I hese letters show that reliance must be placed upon the medical men to 
notify to the health authorities the first suspicious cases, and that consultation is 
essential. 1 
It sometimes happens, however, and examples have occurred this year, that 
rumour, or a sanitary inspector, directs attention to a suspicious case in some 
pm t ol the town, usually amongst the poor ; there may, for instance, be a direct 
attempt at concealment. Under these circumstances the Health Officer should 
have power of entry into the house. 
Concealment of Cases . — A concealed case is a very serious danger, as it 
may lead to the infection of mosquitoes which may communicate the disease to 
surrounding houses over a considerable area. I do not gather from examination 
ol the 1 ublic Health Ordinance, Belize, 1894- that there is any clause covering 
a case of this kind. At the period when the Ordinance was framed, the role 
which mosquitoes played in dissemination of disease was not known ; now, 
however, that their share is well understood, it would, in my opinion, be most 
advisable to make an Ordinance to prevent the form of nuisance arising from 
the concealment of a case of Yellow fever. 
By Ordinance 63 of the Public Health Ordinance, Belize, 1894, the 
Central Board may make rules when necessary for the prevention and 
mitigation of infectious and epidemic disease (1) for the disinfection of houses, 
and (2) for house to house visitation. This latter has had to be resorted to 
in the case of New Orleans, and the results proved at once its great utility. 
I therefore recommend that the Board frame such rules as will enable the 
Medical Officer or his assistants to make a house-to-house inspection to be 
ready should the occasion arise. 
2. — Provision for Isolation Hospital. 
I he yellow fever this year found the majority of towns totally unprovided 
for the reception of Yellow- fever cases. Schools and dilapidated houses had to 
be carefully screened and converted into isolation hospitals. New Orleans is now 
about to erect a suitable permanent isolation hospital for infectious cases, having 
had, however, to incur the expense of two emergency hospitals this summer. 
A town of the size and importance of Belize should make provision for 
the reception of cases of plague, Yellow fever, or small-pox. A very small 
and simple hospital, carefully screened, would suffice, accommodation beino- 
made for twelve cases altogether. Experience demonstrates that it is impossible 
to obtain complete isolation amongst the poorer classes. It would be 
necessary, in order to make it effective, to place a sentry at the door of the 
sick room. Cases occurring amongst the poor should at once be removed 
under bars to the isolation hospital, and the medical men of the district might 
advantageously co-operate in bringing this about. 3 The same arguments 
against the cost of maintenance, such as the infrequency of use, may be 
employed here as well as in the case of expense in administering quarantine. 
1 In Havana it is obligatory, under penalty, for a physician to report at once all cases of a 
suspicious character , “Suspicious of Yellow Fever” is added to the notifiable list of fevers. 
- There is often a prejudice amongst the poor against hospitals, and it is of great importance 
for the educated to show, by example, that the best place for the treatment and cure of Yellow fever 
is in the Special Hospital. 
o 
