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which call regularly. The population is estimated at 3,500, of which one-third 
are Spanish, and the remainder Carib. There are some thirty Europeans 
and Americans. There is an English and an American Consul. There is 
no government medical officer nor local medical practitioner. Dr. I eters, 
the representative of the United States Public Health and Marine Hospital 
Service, is, however, recognised as a medical adviser by the Guatemalans, and 
his directions are to a certain extent followed. 1 he town appears to be well 
placed on the slope of a hill. The water supply is derived from cisterns 
and springs. I examined a considerable number of the lots, and found that 
in addition to the large wooden vats attached to the larger houses, barrels were 
everywhere present as in other coast towns. P roni my examination of the 
larvae and mosquitoes, which I found, I am of opinion that the Stegomyia 
fasciata is here, as elsewhere, the common water receptacle mosquito. 1 he 
larvte were present in large numbers. During and since the recent epidemic, 
some oiling has been done, but, owing to the frequent rains, this is not 
effective, and the better remedy of screening has not been attempted so far. 
There appears to be little attempt at sanitary supervision, and the town is 
not equal in this respect to the coast towns in British Honduras. 
The Recent Yellow Fever Epidemic. 
The last epidemic in Livingston, as in Belize, was in 1891, some cases 
are stated, however, to have occurred in 1892. 
The first case in the recent epidemic occurred on 4th June and died on 
the 9th, and altogether there appears to have been some 45 cases and 
18 deaths. The death rate amongst new residents was very high and 
largely confined to them. Dr. Peters reports a case on the 9th October, 
that is, 70 days after the last case. 
The outbreak in Livingston is locally traced to Belize, the infection, 
either in the person of an infected native from Belize, or as infected 
Stegomyias, starting, it is supposed, in or near the wharf. It appears, how- 
ever, to me, that it must of necessity be very difficult to attribute the outbreak 
to Belize in the north in preference to Puerto Cortes or Colon in the south. 
Fever was declared at Puerto Cortes at about the same time as at Belize, 
but the epidemic has been much more severe in Puerto Cortes, therefore the 
volume of infection in all probability at the time of declaring the outbreaks 
in both places would have been much greater in Cortes than in Belize. In 
addition. Puerto Cortes is about 56 miles from Livingston, Belize being 
108 miles, but there is more traffic between Livingston and Belize. We also 
know that from Puerto Cortes a passenger, the Rev. Mr. Harvey, who was 
placed in quarantine on arrival in Belize, developed Yellow fever very shortly 
after arrival, and he must have been clearly infected in Puerto Cortes. If 
the infection in Livingston was due to Belize, the infection must have 
been carried there by a sick native or by Stegomyias , and we know that the 
latter method of conveyance by small open boats is difficult, although not 
impossible, It is, however, remarkable that the outbreak in Livingston 
followed at an interval of some 12 days, the outbreaks (as officially notified) 
