( 6 7 ) 
Bluefields is a fruit port of 2,500 inhabitants and is 534 miles distant 
from Belize. No cases of Yellow fever have been reported. 
Grey town (San Jos^ del Norte) is at the mouth of the proposed 
Nicaraguan Interoceanic canal. It is not a fruit port and no Yellow fever 
has been reported. Yellow fever, however, was present in the interior. 
COSTA RICA. 
Port : Port Limon. 
Port Limon dates its origin from the opening of the nearly finished 
Interoceanic Railroad, connecting, when completed, Port Limon on the Atlantic 
with Punta Arenas on the Pacific, via San Jos£. The total distance is 276 
kilometres. 
It is a very considerable fruit port, fruit being exported to England as 
well as to the United States. It is 644 miles by steam from Belize. No 
Yellow fever has been reported in 1905. 
PANAMA. 
Ports : Bocas del Toro, Colon, and Panama. 
The total population of the Isthmian Canal Zone is 39,684, including 
Colon and Panama. Traffic has followed the construction of the Interoceanic 
Railroad, vast numbers of labourers were congregated together in the days of 
the old Panama Canal, and, as is the rule when non-immunes are massed in 
places where Yellow fever is endemic, the latter soon becomes epidemic. 
At the present time the United States Panama Commission have some 
1,100 employes in the Canal Zone. In April, 1905, a small outbreak of 
nine cases of Yellow fever occurred in Colon and Panama, resulting in three 
deaths, and altogether from July 1st, 1904, to April 30th, 1905, 66 cases had 
occurred on the Isthmus, including nine deaths, amongst the 9,100 employes 
of the Commission. 
The total number of deaths from diseases for the first year amongst the 
Commission employes amounted to 12, which gives an annual rate of I5’82 per 
thousand. The French in their first year had a death rate of 66'8o per thousand 
amongst the employes.* Plague has recently been reported. 
We have every reason to believe that the United States Sanitary Authorities 
on the Isthmus will succeed in preventing Yellow fever attacking or spreading 
amongst the workmen in their charge, and that they will achieve, under very 
difficult circumstances, one of the greatest triumphs of sanitation in modern 
times. 
Colon and Panama. — The Atlantic and Pacific terminals of the Interoceanic 
Railroad are separated by a distance of 47 miles. The distance of Panama from 
Colon being so short, it is evident that cases of Yellow fever in the former town 
will cause much suspicion to be attached to arrivals from Colon at times, even when 
there may not be Yellow fever at that port. 
* Col. Gorgas’ Report of the Department of Health of the Isthmian Canal Commission for 
April, 1905. 
