193 
THE PREVENTION OF DENGUE FEVER 
BY 
E. H. ROSS, M.R.C.S.Eng.. L.R.CP.Lond. 
MF-DICAl OFFICER OF HEAI.TH, PORT SAID; PUBI.IC HF.AI.TH INSPECTOR, SfF.Z CANA].; 
EGYPTIAN PUBLIC HEAI.TH DEPARTMENT 
{Received 25 March, 1908) 
Eg^^pt has always been subject to periodical epidemics of dengue 
or dandy fever. In some of the towns the disease seems to be 
endemic, but sudden outbursts occur which spread all over the 
country. The disease presents the same characteristics as in other 
parts of the world and rarely gives rise to much difficulty in diagnosis. 
During epidemics the classical symptoms are very evident, including 
the pains, the apyretic period, and the rashes, which are sufficient to 
differentiate it from influenza. When pandemics of the disease occur 
in Egypt every town is invariably attacked, and few people escape. 
The death-rate, however, is very small as noticed elsewhere, though 
the debility and cardiac depression following an attack occasionally 
account for the sudden deaths of a few individuals who before were 
healthy. Since the discovery of the means of the transmission of 
malarial fevers it has been suggested by various writers that dengue 
fever is also conveyed from the sick to the liealthy by the mosquito. 
Apparently Graham, of Beyrout, was the first to bring forward strong 
evidence of this,^ and he named Culex fatigans Wied; as the 
culprit. Since that date further and conclusive evidence has been 
brought forward to support this statement.- 
Dengue fever used to be very prevalent in Port Said, as in other 
parts of Egypt, up to the year 1905. An epidemic of the disease 
occurred in the town during the summer of 1904, and in the spring of 
^905- This epidemic was pari of an infection of all the towns of 
and was most severe. The hospitals were full of cases, and 
patients actually contracted the disease in them. In Port Said 
almost everyone suffered from an attack, and the place was regarded 
