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the year. One hundred and fifty-two vessels were inspected and a
total of 2,980 passengers and 8,673 members of crews examined.

Presidio {Tex.) quarofntine. — Acting Asst. Surg. W. C. Moore in
charge.

This is one of the smaller border stations transferred from the
control of the Texas State quarantine service to the Public Health
Service on September 1 in accordance with arrangements for the
sole control of all border quarantine by the service. Whereas for-
merly there was merely an inspection station, office space has now
been provided and additional facilities for inspection and treatment
of incoming travelers when ilecessary. Special attention has been
paid to the prevention of the introduction of smallpox. With this
object in view, 5,090 persons were vaccinated. On various occasions
service representatives have assisted the local health authorities,
both city and county, in measures for the control of local epidemics
of nonquarantinable diseases, such as diphtheria and scarlet fever.
Travelers from the interior of Mexico numbered 373 and local
travelers inspected numbered 4,679.

In addition to the quarantine function, service representatives
made medical examination of arriving aliens for immigration pur-
poses.

Providence {B. I.) quarantine. — Surg. H. G. Ebert, in charge.

During the year 83 vessels were boarded for quarantine inspec-
tion as follows: Steamers, 66; sailing vessels, 10; and barges, 7*
Two steamers were remanded to New York quarantine on account
of smallpox among the passengers, the detention facilities at this
station not being sufficient for the number of persons (244 crew and
1,760 passengers) on those ships.

A total of 4,017 crew and 13,538 passengers subject to quarantine
inspection arrived and 3,773 crew and 11,778 passengers were in-
spected and passed. The remainder went to New York as above
stated, 244 crew and 1,760 passengers.

Communicable diseases not quarantinable under the regulations
were reported to the local health authorities as follows : Measles, 10
cases; chicken pox, 1 case. One case of fever was sent to the hos-



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PUBLIC HEALTH SERVICE. 147

pital for observation and diagnosis and proved to be cerebrospinal
meningitis. Two vessels were fumigated for the destruction of rats.
The fiscal year 1919-20 has had the largest number of quarantine
transactions in the history of the station. The greatest number of
vessels boarded up to this year was in 1913, when 43 vessels were
boarded, the percentage of increase over that year being 93 per cent.
The increase over the average of all previous years is 147 per cent.

It seems practically certain that the increase during the coming
fiscal year will be much greater. This year the number of crew in-
spected was larger than in any of the previous years, while the num-
ber of passengers inspected has been much larger than in any pre-
vious year with the exception of 1913 and 1914, when the number
onlv slightly exceeded that of this year.

fteedy Island {Del,) quarantine, — Post-office address, Port Penn,
Del. ; telegraphic address, Reedy Island, Del. ; Attendant Charles N.
McMunn in charge, under supervision of Surg. H. McG. Robertson,
in charge of quarantine system on Delaware Bay and River.

Three vessels, with a total personnel of 103, were inspected and
passed on July 1, after which date the inspection of vessels was dis-
continued at this station owing^ to the acquisition by the service of the
Marcus Hook quarantine station from the State of Pennsylvania.

The station is held in reserve to care for vessels that may be re-
mauded thereto for disinfection, and for detention of passengers and
crews on account of quarantinable diseases. Accommodations for
detention and treatment of personnel are available as follows : Bar-
racks, 264 bunks ; quarters for crews, 72 bunks and 18 beds ; isolation
hospital, 18 beds ; general hospital, 13 beds ; quarters on disinfecting
pier, 34 bunks. Owing to the increased facilities afforded by the new
barracks for the detention of personnel, as well as those now avail-
able at the Marcus Hook quarantine, the hulk Lancaster^ formerly
used for this purpose, is no longer considered necessary, and the
matter of her transfer to another station of the service is under con-
sideration. Thirty shower heads are provided on the disinfecting
pier for bathing passengers and crews, and two large rectangular
Kinyoun-Francis steam chambers, with formaldehyde attachment,
for the disinfection of clothing, bedding, etc. Fumigation of vessels
is accomplished with sulphur or cyanide.

During the year the new barracks have been equipped with 264
Gosso sanitary bunks, and kitchen equipment, consisting of electrical
dish washer, electrical vegetable parer, steam vegetable cooker, steam
coffee and soup urns, etc., has been received ready for installation.

Extensive repairs to the south ice breaker of the disinfecting pier,
which were started during the preceding fiscal year, were completed.
The entire top of the old wooden breaker was removed down to low-
water mark and replaced with reinforced concrete.

The new lOO-liorsepower boiler purchased for use on the disinfect-
incr pier has been installed, and the dynamo for the electric-lighting
system transferred from the pier to the new laundry building.

Many minor repairs to buildings, gangways, plumbing, and equip-
ment have been made during the year by the station force.

Riogrande City {Tex,) quarantine, — Acting Asst. Surg. G. W.
Ed^erton in charge.

The service maintains at this port a building wherein all ne^e«s*\ry
inspection and treatment of incoming travelers are performed. The



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148 PUBLIC HEALTH SERVICE.

use of office space is also extended to the Immiffration Service. Dur-
ing the year 82 persons were treated for the destruction of vermin,
and a like number were vaccinated. In addition to the quarantine
function^ the service representative performs medical examination
for immigration purposes.

Sabine (Tex.) quarantine, — Acting Asst. Surg. P. H. Chilton, in
charge, reports as follows:

This station passed from State control to that of the United States
Public Health Service on September 1, 1919, in accordance with the
terms of lease between the State and Federal Government. In the
sundry civil act of 1921 Congress provided funds for the purchase of
Texas quarantine stations that were still owned by the State of Texas,
of which number the Sabine station was one. Since September 1,
1919, Sabine has been operated as a national quarantine station. It
is located on Sabine channel, and there inspection is conducted of all
ships destined for Sabine, Port Arthur, Beaumont, Orange, and Port
Meches. Most of the commerce of the Sabine Lake district is com-
posed of vessels engaged in oil trade between Tampico and ports of
the United States. During the last 10 months of the fiscal year 556
vessels were inspected, and of these 32 were fumigated with sulphur
and one with cyanide gas.

The facilities of Sabine station are inadequate for detention of
crews and passengers. The only Government-owned building is that
of the quarantine officer's residence. The floating equipment consists
of two launches, both in need of repairs.

In view of the lack of detention facilities, it would be necessary,
should the occasion arise, to remand an infected vessel to Galveston.
The importance pf Sabine Lake ports is sufficient as to justify the
establishment of a modern quarantine station at Sabine, including
quarters for employees, detention barracks for crews, a landing
wharf, and protection for launches.

St, Johns River quarantine. — Post-office and telegraphic address,
Mayport, Fla. Acting Asst. Surg. F. E. Maura in charge.

During the year 159 vessels were inspected, containing 36 passen-
gers and 3,876 crew. Eighteen vessels were fumigated for the de-
struction of rats, and, although only 90 rats were found killed, the
total number was very probably greater, as conditions did not permit
of a thorough search. Fumigation is performed by the pot and pan
method, and sulphur is the agent used for fumigation. No quaran-
tinable diseases were observed, and no vessels were detained except
for the purpose of fumigation.

Sa7i Diego quarantine station^ Point Loma^ Calif, — Surg. J. R.
Hurley in charge.

This station is located on the south side of Point Loma at the en-
trance to San Diego Bay ; is situated about 1^ miles from the west-
ern extremity of Point Loma ; about 4 miles distance from San Diego
by water and something over 7 miles by overland road.

The floating equipment consists of one steam launch 55 feet long
and three rowboats of various sizes.

The buildings on the station include quarters for the medical
officer and for the station force of attendants, a station hospital of
normal capacity of 10 beds, two small isolation hospital buildings
of 7 beds each, detention barracks for steerage passengers and shibs'
crews, a suitably equipped disinfecting dock with shower baths for



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PUBLIC HEALTH SERVICE. 149

both sexes, boathouse, carpentcfr shop, a small office building, store-
house, and garage. There is also a large mess hall, with waUs form-
erly partly formed by wire fly screening. This building, of flimsy
construction, was erected by the Navy during the war, as was also
the small office building. There is no building especially constructed
and equipped for the detention of cabin passengers. However, the
mess hall building aboA^e mentioned could, without difficulty and at no
great expense, be remodeled so as to accommodate about 50 cabin pas-
sengers. The steerage passengers' barracks as at present arranged
will house 50 persons ; but with the addition of standee bunks could
be made to accommodate 250.

All land on Point Loma from the quarantine station out to its
western extremity is owned by the Government. That immediately
adjoining the quarantine station is occupied by the Navy as a coal-
ing station and wireless station. Farther to the west lies Fort Rose-
crans, a small Coast Artillery post of the Army.

The quarantine station is almost ideally situated for its purpose,
and no other place nearly as suitably located could be found in the
vicinity of San Diego.

No quarantinable diseases have been observed during the year.
A total of 976 vessels entered quarantine during the year. Of
these there were inspected and passed 864, with a total of 5,397
crew and 3,418 passengers. There were 112 naval vessels boarded
and passed, hailed and passed, or passed by radio on medical officer's
certificate during the year.

By request one naval vessel was fumigated with sulphur dioxide
for the purpose of destroying vermin.

Cooperation rendered other Government departments:
The Lighthouse Service : Permission has been accorded this service
to store a few spare can and spar buoys on the west end of the disinfect-
ing dock pending the time when they will be needed ; and the use of
a station storeroom for the landing and temporary storage of light-
house supplies has been afforded. The acetylene flashing light, also
the fog bell located on the east end of the station dock has been ap-
propriately started and stopped by a station attendant throughout
the year.

Coast and Geodetic Survey : A tide gauge with automatic recording
instrument attached is located in a small building adjoining the
boathouse. This instrument is cared for and the recorded readings
periodically forwarded to Washington by one of the station per-
sonnel.

United States Navy: Upon request of the commandant of the
neighboring coaling station, emergency medical and surgical as-
sistance has been rendered sick or injured marines or civilian em-
ployees of that station, also physical examination of a number of
applicants for employment there have been made. Also emergency
treatment has been given sailors on colliers and other small naval
vessels lying alongside the coal dock upon request of their respective
commanding officers, other medical assistance not being readily
available in this locality.

San Francisco quarantine. — Surg. Friench Simpson, in charge, re-
ports as follows :

During the current year only one vessel has been detained in
ijuarantine, namely, the American steamship Broad Arrow. Prior



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150 PUBLIC HEALTH SERVICE.

to the arrival of this vessel this station was advised by wireless that
on December 10, 10 days out of Nagasaki, Japan, an able-bodied
se?.man became ill and that the diagnosis of smallpox had been
made. This vessel arrived at quarantine at 2 p. m. Sunday, Decem-
ber 21, and proceeded immediately to the station. She was at once
boarded and the diagnosis of variola vera discrete confirmed. Im-
mediately following the illness, the captain of the vessel isolated the
patient and prevented further contact with the crew. The patient
on arrival was immediately transferred to the station, isolated, and
placed under the charge of a trained nurse. The cr^w, consisting
of the captain and 41 men, were next removed ashore, vaccinated,
and kept under observation until the completion of 14 days follow-
ing last exposure to the case, when, no smallpox having developed,
they were released.

The compartments of the ship, consisting of quarters^ toilet, and
messroom, occupied by the patient, were fumigated with formalde-
hyde gas and the remainder of the ship with cyanide gas. A new
crew was placed aboard and the vessel allowed to depart. The
patient continued under medical care until recovery on January 24,
on which date he was discharged.

Cooperation with military authorities :

Cooperative work for the assistance of the militarjr authorities
on Angel Island and in charge of the transport! service has con-
tinued. Semiweekly fumigations of infected clothing received from
the hospital at Fort McDowell have been carried out. On August
22, 1919, 13 enlisted men, arriving from Siberia via Army transport,
were received at the station, bathed, and their clothing deloused.
On October 6, 500 men from Siberia, arriving via the transport
Thomas^ were received at the station, the personnel bathed, and the
clothing deloused.

On February 26, 1920, in response to a request of the military au-
thorities representing the Western Department, this station received
for quarantine and observation the crew of the U. S. Army transport
Mount Vernon^ consisting of 510 men. This vessel had been regu-
larly admitted to the port, but while undergoing repairs at the Mare
Island Navy Yard a fireman, recruited from Napa C ounty, developed
smallpox and was isolated in the Mare Island Navy Yard Hospital.
An indeterminate number of the crew had been exposed to this case
prior to isolation. The surgeon in charge of the yard was without
quarters for the isolation of the crew, and informed the War De-
partment that their removal for observation would be necessary be-
fore the continuation of repairs. The military authorities, being un-
able to properly segregate and care for these men, requested their
isolation at the quarantine station. They were received on short
notice on February 26 and were released on March 4. No smallpox
having developed during this period of isolation, they were dis-
charged and returned aboard the transport, with the exception of
six men from the fireroom, who developed epidemic parotitis and who
continued isolated and under observation at the station until March
11, when they were discharged, recovered. The care of this crew,
consisting of 510 men, was a severe tax upon the facilities of the sta-
tion, and, the number exceeding the beds available, approximately 100
men were domiciled on various floors in selected buildings. This crew
Avas reported as possessing an unenviable reputation, but without



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PUBLIC HEALTH SERVICE. 151

military guard and under their own police supervision they reacted
very satisfactorily to disciplinary measures and returned aboard
with only minor charges of improper conduct.

Other cooperative measures included routine fumigations follow-
ing the arrival of Army transports engaged upon oriental duties.

During the year, in addition to quarantine duties, quarantine board-
ing officers have assisted in the medical examination aboard vessels
of all arriving aliens. Fifty-eight thousand five hundred and eleven
passengers and 47,375 members of crews, representing a total per-
sonnel of 105,886, have been inspected, of which number 484 alien
passengers and 51 alien members of crews were certified.

During the year 610 vessels have been fumigated, 482 with hydro-
cyanic acid gas, 127 with sulphur, and 1 with formaldehyde. This
work has required the use of 36,782 pounds o5E sodium cyanide, 53,200^
pints of sulphuric acid, and 56,910 pounds of sulphur. Forty-five
vessels were fumigated by request, 33 being with cyanide and 12
with sulphur. The number of fumigations exceeds the previous
fiscal year by 85 and shows a marked increase in the use of cyanide.
In fact, although optional with shipping interests, cyanide is now
the fumigant of choice, and in the majority of the 127 cases sulphur
was resorted to because the hour of fumigation or the location of
the vessel would not permit the use of cyanide. Notwithstanding
the increased use of cyanide, no relaxation has been permitted in
connection with the measures necessary to safe exposure of the ship.
All personnel is removed ashore and certified to in writing by the
master. No one among this personnel is allowed to return until the
vessel has been personally inspected by a medical officer and its
safety certified to over his signature. A fatality has occurred but
once, in which case three ignorant Mexican stevedores were asphyx-
iated. An investigation by this office and by the coroner's office
developed evidence to warrant the belief that these men purposely
secreted themselves aboard to escape duty, and, being ignorant of
the nature of the gas, failed to go ashore when warned.

As a result of fumigation work 3,004 rats and 620 mice were found
and identified, as follows : •

M. Norvegicus 6

M. Uattus 716

M. Alexamlrinus • 1,676

Unidentified 606

Mice 620

Of this number of rodents obtained, 1,464 were transmitted to the
laboratory for examination, and a report received as follows covering
such examination :

Ships from which rats were obtained 112

M. Norvegicus examined 12

M. Rattus examined 455

M. Alexandrinus examined 997

Total a 1, 464

Plague-infected rats found

San Pedro^ Calif, — Acting Asst. Surg. G. T. Van Voorhees, in
charge:

During the fiscal year there has been a very marked increase in
transactions at San Pedro, which is the port of entry for Los
Angeles. There were inspected 368 ships in contrast to 140 for the



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152



PUBLIC HEALTH SERVIOB.



previous year. The only Quarantine facilities at San Pedro consist
of the barge Disinfector^ wnich is principally used for the storage of
fumigation materials; but there is sufficient space for detention of
two or three persons. The increase in shipping in this port harbor
would justify the establishment of a quarantine station with ade-
quate equipment for treating infected snips and personnel.

Daily inspection is maintained of all foreign ships for the purpose
of enforcing the requirements of fending oflf vessels and of rat-
guarding lines. The service officer at San Pedro also makes medical
examination of aliens and extends relief to service beneficiaries.

Terlingtta^ Tex, — ^Acting Asst. Surg. R. A. Wilson, in charge, re-
ports as follows :

This station is located in the extreme southern portion of the Big
Bend district, midway between Santa Helena and La Jitis, and it is
through these two latter places that travelers enter this district.
Across the river from Santa Helena the Mexican Government main-
tains a garrison of about 500 troops. There is some illegal crossing,
but the country is sparsely settled and the clandestine crossings are
believed to be not conmion. Most of the work in this station consists
of vaccination of the travelers from Mexico. Inspection of travelers
is made for the purpose of excluding any infectious or contagious dis-
eases. V^ry few louse-infested persons have been observed.

Transactions at foreign and insular stations for fiscal year ended June SO, 1920,



Stations.



ApiadiJla, P. R

Amoy, China

Arecibo, P. R

Arroyo, P. R

Callao, Peru

Cavite, P. I

Cebu, P. I

Christiansted, Virgin Islands

Fajardo, P. R

Frederiksted, Virgin Islands ^

Ouanica, P. R

Guayaquil, Ecuador

Habana, Cuba

Hilo, Hawaii

Hongkong, China

Honolulu, Hawaii

Humacao, P. R

Hoilo, P.I

Jobos (Aguirre), P. R

Jolo, P. f.

Kabul ui, Hawaii

Koloa, Hawaii

Lahaina, Hawaii

Mahukona, Hawaii

Manila, P. I

Messina, Italy

Naples, Italy

Olongapo, P. I

Palermo. Italy

Ponce, P. R

Port Lobos, Mexico

Progreso, Mexico : . . .

Puerto Mexico. Mexico

St. Thomas. Virgin Islands

San Juan, P. R

Shanghai, China

Tampico, Mexico

Tuxpam, Mexico

VeraCniz, Mexico ,

Zamboanga, P.I

Total



Total
number of



inspected.



9

32

3

6

224

21

34

4

18

32

90

100

1,409

41

414

683



46



46

14

2

5

2

776



7,639



Number
of vessels
fumigated.



Ill



72
*25i'



0?6




3




45




109




231


28


339


125


6


4


27?


1


468


13


345


37


339


339


91


10


63


5


21





1,384



Total
number of
passengers
and crews
inspected



108

11,633

53

154

37,668

2,307

1,719

35

114

3,514

4,226



178,532
1,359



172,543
"*2*47i



3,490

408

47

325

18

127,594

775

89,790

130

17,547

11,513

14,397

13,946

194

15,309

48,834

66.791



5,804
4,542
3,077



882,051



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PUBLIC HEALTH SERVICE. 153

Foreign and Insular Quarantine.



AMOT, CHINA.



Acting Asst. Surg. E. J. Strick reports as follows :
General health conditions at Amoy have been somewhat better
than in previous years. Bubonic plague, which has ravaged Amoy
and vicinity every year since 1896, has shown a marked decrease
during the summer of 1919. There were many deaths from cholera,
but the epidemic was much milder than in Foochow and Shanghai.
There were numerous deaths from cerebrospinal menin^tis, small-
pox, measles, whooping cough, malaria, and tuberculosis endemic,
but it is impossible to furnish statistics, because, with no' health de-
partment in Amoy, no records are kept. During the year there were
inspected 32 vessels bound for the United States or its possessions.
Six thousand eight hundred and sixty-nine steerage passengers were
bathed and inspected, their baggage and personal effects disinfected.
Two thousand three hundred and three members of the crews were
similarly treated.

CALLAO, PERU.

Acting Asst. Surg. J*. L. Castro-Gutierrez reports as follows :

During the year 224 vessels destined for ports of the United
States or its possessions were inspected and appropriate treatment
applied. Eighty-three vessels were fumigated prior to departure
for the destruction of rats or mosquitoes. Nineteen thousand eight
hundred and fifty-one members of crews and 17,807 passengers were
inspected. Amongst the latter one was refused permission to embark
because of suspecttd plague and one sick with diphtheria. Three
thousand five hundred and forty-six persons were vaccinated because
they came from localities infected with smallpox. During the calen-
dar year of 1919 there were in various districts of Peru 654 cases of
plague. This indicates that it is less prevalent than in previous years,
but the decrease apparently is due to the operations of natural causes
rather than to any effective antiplague measure.

After many years of freedom from infection, yellow fever again
appeared at Tumbez and Piura, and despite the application of con-
trol measures there occurred during the first part of the fiscal year
131 cases, with 41 deaths, and during the last part of the fiscal year
400 cases.

Investigation indicates that the first case of yellow fever in Peru
occurred at Tumbez on the 6th of December, 1918, in the i)erson of
a commercial agent from Guayaquil, and from this case the infection
has spread to a number of localities in Peru. In June, 1919, the first
case was reported in Piura, later on at Payta, at SuUana, and various
other sections of the country.

The general health conditions of Peru are not good. Tentative
plans have been made for the sanitation of 32 principal cities, but



Online LibraryNew York (State). Superintendent of Public WorksAnnual report of the Surgeon General of the Public Health Service of the ... → online text (page 18 of 44)