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PUBLIC HEALTH SERVICE.

RÉSUMÉ OF OPERATIONS.

Although the year has passed without any notable invasion of epidemic disease from foreign lands, the quarantine season just closed has been one of considerable anxiety, necessitating, by reason of the dangers threatened, close watchfulness on the part of the Bureau, and certain special measures involving much labor. Early in the season the certain increase of yellow fever in Cuba on account of the insurrection, and the possibility of its extension to the neighboring islands having trade relations with the United States, gave rise to a feeling of insecurity. Cuba, by reason of its close proximity and the constant infection of its principal port, Havana, with yellow fever, is a source of continued anxiety on the part of health officers of the South Atlantic and Gulf coasts between May and November, and this year the danger was materially increased.

In addition to the three sanitary inspectors regularly stationed during the quarantine season at Havana and Santiago, special inspectors were appointed to visit all the ports of Cuba to make report on the prevalence of yellow fever and any special danger of its being transmitted to the United States. In view of the insurrection, also, and the fact that surreptitious communication between the island and the neighboring coast of Florida would undoubtedly be attempted, it was determined that the whole of the Florida coast should be patrolled by four revenue cutters, each carrying a sanitary inspector of the MarineHospital Service, and each provided with a launch to enable the inspector to search the inlets and shallow waters which the revenue cutters would not be able to enter.

This service was imposed on the cutters in connection with their regular duty of enforcing the neutrality navigation and customs laws, and they were instructed by yourself to be especially vigilant with regard to the small fishing smacks which sail from the port of Havana without a bill of health, and which, under the guise of fishing in Florida waters, engage in smuggling. It is believed these measures had a deterring effect upon this dangerous and illegal communication.

In the meantime a suspicious fever was reported in Tampa, which city harbors a large number of Cuban refugees and patriots. Great

care was necessary to make the necessary inspection of Tampa and determine the nature of the fever without exciting alarm and inflicting consequent damage upon the commerce of the port. Sanitary Inspector Guitéras was assigned to this duty, and his first reports were of such a character that the Bureau was confronted with the possibility of receiving word at any time of the infectious character of the fever and the necessity of making all preparations for combating it. Accordingly the portable sulphur fumigator and the portable steam disinfecting chamber were shipped from Washington, where they had been stored, to an available point in the South, and the preparation of a movable detention camp was begun at Waynesville, Ga., where is stored the camp equipage of the detention camp used during the epidemic of yellow fever in Brunswick in 1893. A movable detention camp for the accommodation of 1,000 persons was prepared under the direction of an officer of the Service. This camp, which is now ready to be moved at any time, will require about fifty cars for its transportation. It consists of tents and flies, tent frames and floors, cots, mattresses, ranges, cooking utensils, and other accessories, including a steam boiler for supplying hot water for cooking and laundry purposes. A sketch plan of the camp and specifications for a number of wooden buildings to be quickly erected were also prepared.

Though fortunately the fever at Tampa proved to be malarial, these preparations were not only necessary at the time but were considered advisable, in order that in succeeding years the Bureau might have a camp of this character ready to be established at any point with short notice. Further particulars concerning this movable camp will be

found in the chapter on yellow fever.

While these preparations were in progress, on account of the preva lence of smallpox in a large number of localities in the Western and Southern cities the Bureau was called upon to aid in its suppression in a number of localities, notably, Staunton, Va., and New Orleans, La., and began a systematic vaccination of the crews of all vessels on the Mississippi and Ohio rivers.

In September information was received of the return from Mexico of some 400 negro colonists, a large number of whom were afflicted with smallpox. These colonists were corralled at the Texas border (Eagle Pass) by the State quarantine officers, and an officer of the MarineHospital Service was immediately detailed to see that the regula tions of the Treasury Department were duly enforced. It soon became evident that the State health authorities were unable to meet the demands of the situation, and the Marine-Hospital Service assumed charge. A camp was formed near Eagle Pass, tents and camp equipage furnished, the colonists divided into groups, additional medical attendance provided, nurses and guards employed, and all sanitary measures taken to prevent the further spread of the disease among the colonists, and to prevent its extension beyond the cordon lines.

Four hundred and eleven refugees were received in the camp, of which number 178 had smallpox, there being 51 deaths from this disease. The camp was closed October 21, the disease having been kept confined entirely within the established limits. A full report concerning this camp will be found in the chapter on smallpox.

In August public alarm was felt on account of the widespread prevalence of cholera throughout China and Japan, and the appearance of the disease at Honolulu. Special regulations were issued to the officers upon the Pacific Coast, sanitary inspectors were appointed to assist the United States consuls at Yokohama and Honolulu, and the quarantine force increased at the national quarantine station, Angel Island, San Francisco Bay. Previous inspections had been made during the summer in accordance with Treasury Regulations of all quarantine ports on the Pacific Coast, and all deficiencies rectified, so that when the reports concerning cholera were received the Bureau was able to give assurance that all necessary precautions had been taken. No case of cholera has appeared in the United States.

The details of the above-mentioned operations, and an enumeration of other efforts of the Marine-Hospital Service in behalf of the public health and its relations thereto, are stated in the succeeding pages, under the following heads:

1. National quarantine stations.

2. Sanitary inspection service.

3. Division of sanitary reports and statistics.

4. The Hygienic Laboratory.

5. Epidemic diseases.

a. Cholera.

b. Yellow fever.

c. Smallpox.

6. The national quarantine law.

NATIONAL QUARANTINE STATIONS.

Following are reports in detail of the national quarantine stations for the fiscal year ending June 30, 1895. These stations, 12 in number, are named and located as follows: Camp Low Quarantine, Sandy Hook, New Jersey; Delaware Breakwater Quarantine, near Cape Henlopen, at the entrance of Delaware Bay; Reedy Island Quarantine, near Port Penn, Del., about 45 miles from Philadelphia and 50 miles from the mouth of the bay; Cape Charles Quarantine, the boarding station near Old Point Comfort, Va.; detention barracks, hospitals, and disinfecting plant on Fishermans Island, off Cape Charles, Va.; Southport Quarantine, near Southport, Cape Fear River, North Carolina; South Atlantic Quarantine, Blackbeard Island, Sapelo Sound, Georgia; Brunswick Quarantine, Brunswick, Ga.; Key West Quarantine, Dry Tortugas, Florida; Gulf Quarantine, Ship Island, Mississippi; San Diego Quarantine, San Diego, Cal.; San Francisco Quarantine, Angel Island, San Francisco Bay, California; Port Townsend Quarantine, boarding station at Port Townsend; barracks, hospital, disinfecting plant at Diamond Point, Washington.

CAMP LOW QUARANTINE, SANDY HOOK, NEW JERSEY.

The operations of the quarantine service at Camp Low during the fiscal year ending June 30, 1895, were confined, as last year, to the care and preservation of the buildings and contents. The equipment and personnel remain the same. Subsequent to June 30, however, the steward was ordered to other duty and two of the attendants discharged, leaving the station in charge of the keeper. Many of the articles stored there were sent to Fishermans Island (Cape Charles Quarantine) for equipment of the barracks, and to the detention camp at Waynesville, Ga. The naphtha launch was transferred to the new quarantine station at Southport, N. C. The station is still in condition to be used at any time should it be necessary, and a full descrip tion of this establishment may be found in the annual reports of 1892 and 1893.

DELAWARE BREAKWATER QUARANTINE; POST-OFFICE ADDRESS,

LEWES, DEL.

A description of this station will be found in the annual reports of 1892 and 1893. The following is a detailed report of the station by the medical officer in command. P. A. Surg. W. T. Bratton was in com

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