screened. The entrance to the room is to be through double doors (air lock) 
provided for the purpose, the original door, if there was one, having been 
removed. The portable screens and doors used for the purpose may be made 
with wire gauze or bobinette, the standard minimum gauge of 18 meshes to the 
inch either way being used. Employing mosquito nets alone, or, as at Belize, 
portable screened chambers, is not sufficient. The presumption being that as the 
majority of infected mosquitoes are in the patient’s room it is essential that both 
their egress from the chamber and the entrance of fresh ones be prevented. 
If screening cannot be carried out in the patient’s room, or there is reason 
to believe that the double doors will be left open or the screens to the windows 
interfered with, then, without hesitation, the patient should be removed in the 
screened ambulance to the isolation hospital, otherwise the patient becomes a 
source of infection in the district. 1 
4. Sealing and Fumigating. 
Preparation for fumigation should have started with the screening. Not 
only the sick chamber, but very possibly also other rooms in the house harbour 
infected specimens of the Slegomyia. The rule of procedure should, however, 
be absolute, and that is, that the entire house must be fumigated, with the 
exception of the patient’s room, which is screened. Incomplete and imperfect 
fumigation are the principal reasons of not being able more promptly to 
suppress yellow fever. The recent epidemic is, unfortunately, evidence of this. 
Houses in tropical countries have often numerous large openings, and it is 
contended that it would be difficult to seal them, or halls, stores or markets 
without elaborate and expensive wooden framing. As a matter of fact, and 
proved this year in numerous instances in New Orleans, an intelligent work- 
man can in an incredibly short time paper over a whole archway, hall, or even 
court (Figs. 25 and 26). By the use of a few supporting laths, and with stout 
and thin paper, the very large openings can be completely sealed. The stout 
paper necessary for covering large openings can usually be procured locally 
and at once. Paper cut in rolls three inches wide is exceedingly useful for 
pasting along the cracks, but would be required to be ordered and to be kept 
in stock. In an emergency, however, strips of newspaper could readily be 
cut. Although it is recommended to seal the rooms from the inside, I think 
there is an advantage in sealing windows, &c., from the outside, in order 
not to disturb any mosquitoes which may be present. If there are any fire- 
places or other holes they will require to be sealed from the inside. The 
doorway is left open till the last to introduce the fumigating materials and to 
light up ; when this has been done the door is brought to and sealed, and 
the time noted in a book kept for the purpose. The Medical Officer or the 
Chief Superintendent should personally examine to see that the sealing is 
carried out effectively. A small open chink admitting light is sufficient to 
attract mosquitoes to it, they then make their escape. Halls, water-closets, 
or outhouses must not be forgotten. 
Considerable objection amongst the poorer classes is usually taken to the 
disturbance of their homes and their displacement by the fumigation. No 
1 Under Section 3 of Ordinance 14, 1902, Belize, there are the necessary powers for carrying 
this out. 
