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cyanic gas has been satisfactorily substituted in several special instances.

Other vessels from ports included in the provisions of this circular which make Porto Rican ports only as ports of call are prohibited from docking but are allowed to transact business while at anchor in the bay, provided precautions are taken to prevent rats being carried ashore.

Vessels coming within the requirements of fumigation at sixmonth intervals are fumigated at San Juan or at the United States port, as may be convenient.

Fumigation of cargo.-The fumigation of cargo for rats, which was put in force during 1913, has been continued. At San Juan hydrocyanic gas is used; at Ponce and Mayaguez, sulphur dioxide gas.

The method of fumigating this cargo inaugurated during the past fiscal year has been continued with very satisfactory results to both quarantine officials and importers. Full details of the method, including the experiments to determine its efficiency, have been made the subject of an article sent to the bureau for publication by Asst. Surg. Carl Michel.

Special yellow-fever measures. For some years the ports of Venezuela have been considered to be endemic centers of yellow fever, and vessels from those ports were held in quarantine at Porto Rican ports, being allowed to transact business under certain restrictions while anchored in the bay. Nonimmune passengers were detained to complete the six-day period of observation. Reliable information having been received which gave good grounds for believing Venezuela, except possibly the port of Maracaibo, to be free from yellow fever, recommendation was made that these special restrictions be removed, except in the case of vessels from Maracaibo. Upon bureau approval of the recommendations the restrictions were recently removed.

Outgoing plague quarantine.-After the eradication of plague in Porto Rico, the outgoing quarantine restrictions were modified on different occasions until at present the measures are fumigation of vessels for the destruction of rats every six months, and the use of rat guards on the lines when vessels are moored alongside piers.

Bills of health.-Bills of health are issued by service officers at Porto Rican ports to all vessels destined to ports in the United States. Smallpox. The smallpox epidemic mentioned in the report of the past fiscal year continued into the present year, but within a short time had ceased to be epidemic. Occasional cases have been reported from various points in Porto Rico throughout the fiscal year. Quarantine restrictions at United States ports on account of smallpox in Porto Rico were removed August 10.

Poliomyelitis.-During the epidemic of poliomyelitis in New York, there was great fear in Porto Rico that the disease would be carried to Porto Rico. To prevent this, if possible, the chief quarantine officer and the director of sanitation of Porto Rico inaugurated a system of inspection of passengers from New York.

The quarantine officers boarded incoming vessels; inspected passengers especially children under 15 years of age; verified their certificates of residence, etc. The destination of the passenger in

Porto Rico was noted on a copy of the passenger list, which was turned over to the director of sanitation. The director of sanitation, through the health officers of the various towns and districts, was able to have passengers under daily observation during the incubation period of the disease and was prepared to immediately isollate any case that might have occurred. No case was found either at the primary or at the secondary inspection and these measures were discontinued upon the cessation of the epidemic in New York. Measles. A severe epidemic of measles began in San Juan in February and continued in epidemic form till April, and later spread to many towns in the island, assuming epidemic proportions in some places. The number of cases was variously estimated, but amounted to several thousand, and the epidemic was marked by a high infant mortality.

Leprosy.-Leprosy is endemic in Porto Rico, but the cases are not very numerous. Lepers are isolated on Cabras Island, at the entrance of San Juan Bay, as soon as the diagnosis is positively made. At present there are 34 patients so segregated.

Disease on vessels.-But one vessel arrived with quarantinable disease on board-the Spanish steamer Montevideo with a case of smallpox from the Canary Islands. During the fiscal year the following nonquarantinable diseases were found on arriving vessels: Malaria, three cases; typhoid fever; lymphadenitis of gland of groin, chronic; bronchitis, acute; indigestion, acute; and valvular disease of heart (mitral insufficiency); one case each.

PLAGUE ERADICATION

No human or rodent has been reported in Porto Rico during the year.

The laboratory examination of rodents has been continued by the sanitation service of the insular government. The weekly statements from July 1, 1916, to June 29, 1917, show 5,636 rats, 707 mice, and 4 mongoose examined, with negative results. The majority of these rodents were caught in San Juan and the suburbs of Puerta de Tierra and Santurce.

STATION REPAIRS AND IMPROVEMENTS

The needs of the station for water have been so greatly increased that the well and spring which formerly supplied sufficient water were found inadequate, especially during a prolonged dry season. To provide an adequate supply a 3-inch water main has been installed connecting with the city water system.

Gas mains have been laid to the station buildings and gas is now used for fuel, resulting in a saving over the use of coal.

A portion of the roof of the brick and cement reservoir, a construction dating back about 150 years, fell in, and the entire roof was found to be weakened and was rebuilt of concrete.

The buildings constructed in 1913 required extensive repairs including reconstruction of a large portion of the disinfecting building. The brick of the wall exposed to the rain were of such a poor quality and had dissolved to such an extent as to threaten to fall. 18643°-17- -10

The galvanized-iron roofs of these buildings had always leaked and various expedients failed to stop the leaking. New tile roofs have now been substituted which give every satisfaction.

The roadway to the mainland has been regraded and resurfaced, and repairs and improvements have been carried out on the grounds. Contracts have already been let for a steel flagpole to replace the present wooden pole, and for an iron gate in place of the wooden gate which closes the land approach. Contracts have also been let for repairs and painting of various buildings.

OTHER OPERATIONS.

Other operations at this port have been routine matters, such as marine-hospital relief, medical inspection of seamen, medical inspection of aliens, etc., which are given in the statistical table under their proper headings.

At the request of the Commissioner of Immigration, medical attendance was given to the German sailors interned at that port after the declaration of war until their transfer to New York.

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Total number of days passengers in quarantine_

Cases of sickness (nonquarantinable) occurring among passengers in quarantine_.

1,768

18

Number of vessels arriving with quarantinable disease on board (smallpox)

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1 Cases of sickness were: Lymphadenitis of glands of groin, chronic, 1; typhoid fever, 1; bronchitis, acute, 1; indigestion, acute, 1; valvular disease of heart (mitral insufficiency), 1; tertian malarial fever, 3.

2 None.

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PROGRESO, MEXICO.

Acting Asst. Surg. H. E. Gimler reports that during the period April 1 to June 30 there cleared from Progreso for ports in the United States some 48 vessels, of which 34 were fumigated prior to sailing.

Every effort has been made to facilitate the dispatch of ships to United States ports and to overcome the difficulties existing in this port, due to the fact that all ships are dispatched in an open roadstead, where work is very much interfered with by weather conditions.

The acquaintance of the Mexican health authorities both in Progreso and Merida has been cultivated in order to obtain information concerning the general health conditions and especially the existence of yellow fever in Progreso, Merida, and the interior of Yucatan. The policy of the Mexican authorities has been adverse to the publication of the existence of yellow fever, in order to prevent the imposition of quarantine measures at ports in the United States. The local government, through the agency of the Reguladora Hemp Co., operates a steamship line to the port of New Orleans which is called the Compania de Navigacion del Sureste."

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Up to the present date no cases of yellow fever have been reported in this district, excepting one case, which occurred in the town of Peto, Yucatan, on June 23. However, it is to be expected that more cases of yellow fever will develop in the near future, due to the immigration into this district of about 6,000 laborers from the high country around Mexico City during the last three months.

SHANGHAI, CHINA.

Temporary Acting Asst. Surg. John Overton reports as follows: During the fiscal year ending June 30, 1917, the Public Health work of this office shows a very decided increase in all but two phases. Disinfection of vessels for destruction of rates, fleas, etc., has been done as heretofore by the Shanghai Disinfecting Co., which has a very modern and efficient plant.

In the great majority of cases this was done by sulphur generated by burning in small iron pots. In a few instances the sulphur was generated in the plant of the disinfecting boat and pumped in; in 5 instances carbon dioxide was used to disinfect the holds and sulphur gas for the forecastles, the last method being used in loaded vessels where sulphur might have injuriously affected cargo. As in previous year there were 307 large lighters fumigated twice; these lighters are registered, and vessels loaded for the States are required to use only them if they expect to get a clean bill of health. There were also fumigated 84 small native lighters for use to carry cargo destined to American or Philippine ports.

No vaccination certificates were issued because there were so few cases of smallpox at this place that it was not necessary to insist upon this precaution. There were no cases of suspected quarantinable diseases which require any attention. One case of suspected beriberi was detained and kept in hospital for treatment. All shipping orders and manifests of cargo destined for an American port require signature of the officer on duty here, and articles requiring certificates as to

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