living specimens reached Khartoum, and were there offered
mosquito larvae, which they took readily. This, however, is
not conclusive proof that C. dispar feeds on mosquito larvae in
its wild state, as the specimens had been unfed for two days
when the larvae were given them, none being obtainable at
Khor Arbat.
" As these fish did not thrive in jars I wrote to Mr Maclntyre,
Acting Manager of the estate at Zeidab, belonging to the
Sudan Plantations Syndicate Ltd., asking him if he would
allow them to be placed in a gudwal on the Company's estate
for purposes of experiment. This he readily agreed to ; so that
on 19th September I took those that were still alive — about
seventy in number — to Zeidab, and the following morning
liberated them in a short length of gudwal which Mr Maclntyre
very kindly had filled with water. This gudwal is not used, at
present, for agricultural purposes, and the pipe connecting it
with the canal has been netted to prevent other fish gaining
access. This was done in order that the C. dispar might be
given every chance of establishing themselves before being
subjected to the possible ravages of other and larger fish.
" The specimens liberated at Zeidab were all immature, as it
was found that partially-grown fish withstood captivity better
than did adults.
" When full grown, C. dispar attains a length of 8 centimetres,
and in all stages appears to prefer shallow water.
" Should the gudwal in which these fish were liberated remain
free from mosquito larvae during the coming year, while similar
gudwals in the immediate vicinity serve as breeding-places for
these pests, I think sufficient proof of their value will have been
obtained to justify an effort being made on a larger scale to
establish C. dispar throughout all the gudwals on the Sudan
Plantations Syndicate Ltd.'s estate, and on other similar farms
where great difficulty is experienced in controlling mosquitos."
As regards legislation the following irrigation rules, imposed
540 THE CAMPAIGN AT KHARTOUM [Sect.
on all who take up land with a view to cultivation on a large
scale, may be quoted with advantage. They are of very great
importance both from the sanitar}' and the economic standpoint.
" I. Irrigation channels should be constructed on a higher
level than the surrounding land, so that when the flow of water
in them ceases they may drain dry.
"2. They should be constructed of such material and in such
a manner as to prevent leakage.
" 3. Their banks and beds should be kept in good repair, and
the beds even, to prevent the formation of pools.
"4. 'Dead ends' of irrigation channels should be reduced to
the smallest size compatible with efficiency, so that water will
not stagnate in them.
" 5. Vegetation should be periodically cleared out of the
channels.
" 6. Sluices should be constructed so that there is no leakage
to form stagnant puddles.
" 7. Where possible, fish should be introduced, and kept in
the main channels to destroy the larvae.
" 8. Lands where water is apt to stand should have proper
surface drainage.
" 9. Crops, such as sugar-cane, rice and others which require
to stand in water, should not be grown within half a mile of any
town or village.
" 10. If an engine or pump should happen to break down,
particular care should be taken to deal with stagnant pools, and
petroleum should be used when necessary.
"II. Cases of malarial fever, and any prevalence of mosquitos,
should be notified to the governor of the provinces by the
manager of the concession."
The above is a brief outline of the measures adopted and
the work accomplished. What has been the result? It is
difficult to give comparative statistics, as we do not know
how much malaria used to be locally acquired in Khartoum ;
but we do know that P. costalis used to be fairly common,
especially at certain times of the year ; while now it is wholly
absent during many months, and if it does invade the town
its breeding operations are usually quickly checked, it does
not multiply, and soon disappears. As a direct consequence
locally acquired malaria has become very rare. One cannot
54] RESULTS 541
wholly trust the notifications, but they afford considerable
indication of how matters stand, and, so far as Egyptian and
British troops are concerned, are trustworthy. Here, then,
are the locally acquired cases for the past few years.
Year Civil Egyptian British
population, military troops
Oct. to Sept. About 3,000 men (One battalion)
inclusive. most of them about 600 men
very susceptible changed annually,
to infection.
1904-05 Seven cases in all. Not stated according to population
attacked. Unsatisfactory notification.
1905-06 2(?) ? 8
1906-07 441
1907-08 210
1908-09 142
1909-10 2 ... 4
(to date)
(i6th January 1910)
It is very rare for a British official or European resident
to acquire malaria in Khartoum itself, while I should say that
owing to increased trade and communication more cases are
now imported than was previously the case. There can be
no doubt that if operations were suspended Khartoum would
speedily regain, if not its old evil notoriety, at least a certain
measure of the same. At the time of writing there is a good
deal of malaria in the neighbourhood of the town, i.e., in villages
a couple of miles to the north, in one part of Omdurman,
and at various places along the White Nile. Anophelines
now, as previously, are endeavouring to obtain a footing in
the town, and have been blown into it by the wind or brought
into it by boats. As a result, we have had a few cases, mostly
in British soldiers who were wont to wander out to the east
of their quarters towards a part of the river where there are
extensive sand-banks and many pools, some 2\ miles from
the centre of the city. Had operations not been in force I am
very certain that this year would have witnessed an epidemic ;
for conditions seem specially favourable to the propagation
of P. costalis at present, and, as stated, there is much malaria
542 THE CAMPAIGN AT KHARTOUM [Sect. 54
in the neighbourhood. A measure which has had good effects
is to put any dangerous area out of bounds for British troops.
One may conclude by stating that Khartoum is a favour-
able place for carrying Professor Ross's methods into effect ;
and that they have met with marked success, and doubtless
will continue to do so, provided the work is carried out con-
tinually, thoroughly, consistently and with intelligence, that
the influence of immigration is borne in mind, and that legisla-
tion provides for the control of irrigation and the regulation
of irrigated areas.
By Dr L. BOSTOCK
District Surgeon, Komatipoort, Transvaal
55. Malaria in South Africa. — British South Africa as a
whole does not suffer much from malaria. Along the east
coast, in Portuguese East Africa, Swaziland and Zululand, the
disease is common enough, and occasional outbreaks occur in
a few parts of the Cape Colony and Natal. A recent outbreak
in Durban assumed serious proportions.
In the Transvaal the disease is endemic in the Low Veldt, in
the east and north of the country ; and the type is severe, bilious,
remittent and haemoglobinuric forms being common. Owing
to paucity of population in these districts the disease attracted
little attention until the building of the Pretoria-Delagoa Bay
railway line, when the heavy death-rate forced the disease upon
the public notice. No effort was, however, made to combat the
disease until I was appointed District Surgeon here, and com-
menced to make representations to Government on the sub-
ject in 1903. The work was started in 1904, and immediately
its results were obvious in a greatly reduced sick-rate. The
Railways thereupon instructed me to make a fever survey of
the main line and the Barberton branch, and to make recom-
mendations for each station. I obtained the assistance of the
Government Entomologist, the late Mr C. B. Simpson, for this
survey, and our recommendations, being promptly carried out,
resulted in a considerable reduction of fever along the line.
543
544 MALARIA IN SOUTH AFRICA [Sect.
Every station and ganger's cottage from Komatipoort to
Waterval Onder was dealt with, local measures for mosquito
reduction carried out, and all railway quarters in the Low Veldt
made mosquito-proof We were compelled to rely chiefly on
the latter method of fever prevention, owing to the small
number of persons concerned, and the great amount of work
necessary to deal with the breeding-places along the Crocodile
River, which runs parallel to the line. All small breeding-
places in the immediate neighbourhood of the stations were
dealt with.
To the Central South African Railway belongs the credit of
first efforts to combat malaria in the Transvaal, and since 1905
the apathy of the public and the authorities has been gradually
overcome. The results obtained by the Central South African
Railway proved a powerful argument, and now the value of
anti-malarial measures is fully recognised by private residents
and the different Government departments who have officials
in this part of the Transvaal. Practically every private resident
in this town has now a mosquito-proof bedroom ; and in the
country many farmers have also adopted this precaution.
Mosquito-proof quarters are being provided for all police posts
in the Low Veldt, and also for the officials of the Government
Game Reserve, which lies north of the Crocodile River. The
Colonial Secretary's Department have now arranged to issue
free quinine in all fever districts in the Transvaal to all indigent
whites and all natives ; the Barberton municipality have lately
taken up the subject ; and a League has been founded for the
purpose of carrying on the anti-malarial campaign throughout
the district.
Anti- malaria methods employed at Komatipoort. — Anti-
malarial work was commenced at Komatipoort in 1904, the
cost being borne by the Central South African Railways. The
town is rather unfortunately situated, in the angle between the
Crocodile and the Komati Rivers. Along both rivers are
fe-,> -^
I. AN EXCELLENT TVl'E OF MOSQUITO-I'KOOK HOL'SE AS lUILT HY THE
TRANSVAAL GOVERNMENT.
The residence of Major Hamilton, Warden of the Sabi Government Game Reserve.
\'ie\vs of front and iiack of house.
A SHOOTING CAMP ON THE LOW" VELDT.
Portable folding mosquito-proof beds.
2. AN EXAMPLE OF ROUGH BUT EFITCIENT MOSQUITO PKOOFLNG IN THE VELDT.
A hut at Sabi Bridge, Game Reserve. Transvaal, fornierl}- occupied by the Warden,
Major Hamilton.
AN AFRICAN " RONDHAVliL," AS MOSQUITO-PKOOF SLKEPING-QUAKTF.RS.
3. AN l.\(.l-.MiH .1 lUKA.
A military block house, Ijought as it stood after the war, converted by addition
of door and \vindo.\s into a very comfortable niosiiuito-proof bedroom.
TWO-ROn.\rF.I1 WOOD AXn iron- house with MOSQUITO-I'ROOF vf.raxda.
As built by the C.S.A.R. for temporary quarters at the Sabi Uridj^e, Selali Railway.
Cost about ;/,i8o.
4. A GOOD EXAMl'l.E UF .MoSQUFro-l'Kool HuL'SF.
The Customs quarters, Komatipoort.
^fb^'"^
5. JOINT OFFICKS OF THE WlTWATEKSKANl) XATIVK LAIiOUK ASSOCIATION, AND THE
PORTUGUESE DEPARTMENT OF EMIGRATION AT RESSAXE GARCIA, PORTUGUESE
EAST AFRICA.
Natives receiving their passes tiirough tlie sliding window in the netting. (The tear
is in the photo film, not in the netting.)
55] KOMATIPOORT 545
backwaters, pools and inlets, with dense vegetation in parts,
and below the junction lie some acres of broken, rocky ground
holding innumerable small pools. The worst breeding-place
of Anophelines, however, was a swamp running parallel to the
railway and opposite the station. The swamp was fed by a
small spring and surface drainage, and by the waste water from
the pump and engine sheds. It consisted of about two acres
of ground only, but the whole of it was a network of small
pools amongst thick reeds and rank vegetation. Anopheline
mosquitos were breeding here in great abundance, and it was
decided to obliterate this swamp entirely. A brick and cement
drain was cut through the centre to carry off the water supply
which maintained it. The ground was cleared, all pools filled
in, and the surface evenly graded from each side down to the
drain to carry off the rainfall. The reclaimed ground was
planted with banana trees and eucalyptus, and absorption of
water by these has sufficed to keep the area perfectly dry,
and the former swamp is now, on a small scale, a town
plantation. Efficient treatment of the main rivers was im-
possible on the score of expense ; but the portions of them
within half a mile of the town were dealt with by filling
in some pools by rubble and cement, and, a mosquito
gang having been organised, larger pools were treated with
paraffin.
These methods proved in practice to be most satisfactory.
Only partial reduction of mosquitos had been attempted, but
it was subsequently found most difficult to discover any
specimens of Anophelines within the town area.
At the same time all railway servants' quarters were made
mosquito-proof, and the reduction of fever cases was marked
and immediate.
The following table is taken from a report on the subject
made to the General Manager of the Central South African
Railway in December 1905.
2 M
546
MALARIA IN SOUTH AFRICA
[Sect.
1903
1904
1905
212
396
55
230
341
42
277
405
43
281
320
33
207
192
60
40
20
175
61
10
209
80
63
3S
4
18
191
41
28
217
20
25
9
8 (to 7th Dec.)
Cases of malarial fever among Central South African
Railway employees — Komatipoort — Kaapmuiden section : —
January .
February
March
April
May
June
July
August
September
October .
November
December
The above figures are gross details, and represent each case
counted for every day of illness, that is, they are " days lost " by
the whole of the railway staff. The actual daily average of the
number of sick during March 1905 is i"38, against a similar
average for the same month in 1904 of i3"o6.
The work of proofing the quarters was begun in June 1904.
Portuguese East Africa. — With the exception of the town and
district of Lourenco Marques nothing has been undertaken, but
the Portuguese authorities have taken up the subject with great
energy in the town of Lourenco Marques, with the result that
the town, once extremely unhealthy, is now comparatively free
of the disease.
The Municipal Health Officer, Dr Amaral Leal, has con-
trolled the work, while the Government Entomologist, Mr
C. W. Howard, has carried out an investigation of the local
mosquito problem. Their methods have been the draining of
a swamp, which was the chief breeding-ground ; organisation
of anti - malarial sanitary measures ; appointment of special
sanitary inspectors, with power to inspect all houses and com-
pounds, and to enforce the carrying out of their instructions ;
the treatment of all breeding - places ; and the netting of
Government offices and quarters.^
^ In speaking of anti-malarial measures in Louren9o Marques, I should like to
put on record the great service rendered on this subject by A. W. Bayly, Esq. , the
55] SOUTH AFRICAN MOSQUITOS 547
All offices and quarters on the Portuguese railway between
Komatipoort and Lourenco Marques are now mosquito-proof.
Mosquitos. — The following is a list of the mosquitos which
are prevalent in this Colony. The larger number of them were
collected at Nelspruit in the season of 1904- 1905.
Anophelina.
Nyssorhynchus pretorietisis. Pyretophorus cincrcus.
Myzorhynchus mauritianus. Do. nianhalli.
Do. maculipalpis. Do. costalis.
CULICINA.
Culex bostocki. Culex transvaleiisis.
Culex sitnpsoni. Culex 7nmuius.
Culex theileri. Culex bifoliata.
Culex hirsutipalpis. Culex salisbrunensis.
Culex fatigans. Stegomyia fasciata.
Culex tigripes. Stegomyia simpsoni.
In addition to these there are a dozen other species of rare
genera, which as far as we know as yet are of but little or
no economic importance. In the early part of the season the
commonest Anopheles mosquito at Nelspruit is P. cinereus,
and later in the season N. mmirilianus and N. maculipalpis.
The former is much more abundant than the latter, especially
in March and April, It seems that the abundance of these
last two mosquitos is quite parallel with the abundance of
fever. While all of these may carry fever, the two latter are,
in our opinion, the most important agents of transmission.
Stegomyia fasciata is by far the most abundant mosquito in
the Low Veldt. It is followed by C. simpsoni, C. hirsutipalpis,
and S. simpsoni in order of abundance. — From Bostock and
Simpson [1905].
I have obtained from Mr Howard, the Chief of the Ento-
mological Section of the Agricultural Department, Lourenco
Marques, the attached report on the Anophelines for the Province
of Mozambique.
proprietor and editor of the Lourenco Marques Guardian. He was among the first
householders in the town to make his house mosquito-proof, and has spared no trouble
to extend a knowledge of the subject by constant references to it in his paper.
548
MALARIA IN SOUTH AFRICA
[Sect. 55
Report by C. W. HOWARD, Esq., B.A., F.E.S.
Chief of the Entomological Section, Department of Agriculture
for Mozambique
Distribution of Anophelines in Mozambique
In my collections in Lourengo Marques District, Gazaland,
and about the Zambesia, I have taken several Anophelines.
The commonest is Pyretophorus costalis. It seems to be
distributed all along the coast, and is without doubt the
principal carrier of malaria. I have always found it wherever
I found people suffering from malaria. It is very abundant
in the flats about Lourenco Marques, breeding even in the
brackish marches along the shores of the bay. Careful notes
were made of this mosquito last season, and it was found
that its increase and decrease almost exactly coincided with
the rise and fall of malaria cases in town. They seem to
hibernate over the dry season, in such places as grass huts
and stables, although, if favourable places exist, they ma}'-
breed throughout the year in sheltered localities. This, how-
ever, seems to be the exception. The same mosquito is also
very abundant along the Zambesia and about Quelimane.
Another Anopheline fairly common on the coast is Alyzor-
hynchus niauritianus. I have taken this on the Limpopo and
Maputo rivers, but not about Lourenco Marques. It frequents
houses in company with P. costalis, but not in such large
numbers.
NyssorJiynchiis pretoriensis also occurs along the coast. My
specimens seem to have been taken from Lourenco Marques
District.
An apparently new species of Anopheles also occurs here, and
is now being named by Mr Knab of Washington.
Of mosquitos other than Anophelines our commonest species
along the coast are : —
Stegomyia calopus Mey., our com-
monestmosquitonexttoCy^^//^a«J^
Scutomyia sugens Wied.
Stegomyia sitnpsoni Theob.
Culex luteolateralis Theob.
Culex univittatus Theob.
Grabhainia durbanensis Theob.
Culex transvaalensis Theob.
Taeniorhynchus aurites Theob.
Matisonia uniformis Theob.
Culex theileri Theob.
Culex fatigans Wied. Common
everywhere.
Culex thalassius Theob.
Eretmapodites n. sp.
Heptaphlebomyia simplex Theob.
By p. MURISON, M.D., B.Sc, D.P.H.
Medical Officer of Health, Durban
56. Epidemic of Malaria in Durban, 1905-1907. — Malaria
broke out in Durban during January 1905, and the number
of cases rapidly increased until the cooler autumn weather
set in. The following table shows the monthly notifications : —
Summer. Autumn. Winter.
January. February. March. April. May. June. July.
12 85 612 1,084 1,877 497 135
Some parts of Zululand are so unhealthy from the presence
of malaria that they are uninhabitable.
In Durban, malaria has been a compulsorily notifiable
infectious disease since 1902, and as a result an average of
seventy cases were notified per annum, as existing in the
borough. All these cases were found on enquiry to have
contracted the disease elsewhere, and had come to Durban
to recuperate.
No definite information, either from professional or lay
persons, can be obtained to show that malaria had ever existed
as a local infection within the borough of Durban previous
to 1905. Within a fortnight of the 1905 outbreak every medical
man in Durban had recognised many cases.
The borough of Durban consists somewhat roughly of a
triangle, one side being bounded by the Indian Ocean, another
by the waters of Durban Bay, and the base is formed by a
range of low hills, in extent about 6 miles, which stretches
from one end of the borough to the other. From the base
of these hills to the water's edge there is a plain, being about
549
550 EPIDEMIC OF MALARIA IN DURBAN [Sect.
i^ miles in greatest width, and probably averaging about 15
feet above high-water mark. All classes of houses are to be
found on this plain.
Chiefly along the base of these hills, this flat area is at
its lowest level, and contains many swampy areas, some of
quite small size, others extending to scores of acres.
The slope of the hills (Berea) extend to, roughly, about a
mile from the plain to their summit, and on this gradual rising
ground have been erected dwellings of all classes.
The notifications received during the first few months
distinctly localised malaria into many areas, and these were
found to be always in close proximity to swampy or water-
logged lands.
When malaria broke out, I decided to rigidly follow the
teachings of Professor Ronald Ross, and this has been adhered
to throughout.
It was recognised from the beginning that in order to cope
with the disease both temporary and permanent measures were
necessary.
The permanent improvements were to consist of such work
as (i) The drainage of surface and water-logged and swampy
areas. The cutting of new watercourses and the extension
of old ones. (2) The filling in of swampy areas, pools, etc.,
and the levelling and grading of land to enable stormwater
to flow towards some drain or watercourse. Such measures
naturally removed for all time the pools and swamps necessary
for the larvae stage of mosquito development. Since 1905
the borough has expended on this class of work approximately
^80,000.
The temporary measures consisted of the formation of a
mosquito brigade, whose work was to consist of dealing
immediately with all pools or areas of swampy lands which
were the habitat of mosquito larvae by means of larvicides
such as paraffin and disinfectants.
We discovered that the crudest and cheapest disinfectants
56] MEASURES ADOPTED 551
were the best for larvae destruction, and we used disinfectants
where pools were shallow, or where reeds existed in considerable
numbers. We found it not only cheaper but more efficient
to use disinfectant under such circumstances. One part of
disinfectant to five thousand parts of estimated water in the
pool was found to be effectual. Paraffin was used where pools
were deep, and where an unbroken film could be formed.
Many substances were tried as larvicides, and some
mechanical ingenuity was shown by those in charge of the
work in endeavouring to improve the process of application
of the larvicides.
As permanent improvements are carried out, the area of
temporary measures was naturally reduced, and it may be
stated that the only part of the borough of Durban requiring
any temporary measures now is practically confined to that
part known as the Eastern Vlei.
It was also recognised that the education of the inhabitants
of the borough regarding the natural history of malaria was
a necessary auxiliary aid in the work of prevention. We
believed that a much more whole - hearted assistance would
be more readily obtained if some facts regarding the disease
were freely spread about so that the rationale of the work
and the orders required to be carried out by householders
were more clearly understood and appreciated. Hand - bills
dealing with malaria prevention were left at all houses in which
cases of malaria had been notified to exist, and in some areas
these hand-bills were left at every house. Lectures and magic
lantern demonstrations were given by me to societies, institu-
tions, schools, etc. ; and I feel sure these lectures and demonstra-
tions were a potent agent for good in our campaign.
The mosquito brigade consisted of two Europeans and about
fifty Indians. Every swampy part where larvae could breed
out being treated every ten days or thereby, so as to render