The vaccine prepared by Dr. Hideyo Noguchi, of the Rockefeller Institute for Medical Research, has played an important part in recent developments of the campaign, more than 7,500 persons having been vaccinated according to latest reports. The results so far obtained are distinctly encouraging, and several central American countries have agreed to accept certificates of vaccination in lieu of quarantine detention. Stocks of this vaccine, prepared by the Rockefeller Institute, are now available in all countries where there is any likelihood that yellow fever may appear. Malaria control. — Marked progress has also been made in the control of malaria. In the summer of 1920 the International Health Board and local authorities organised a concerted antimalaria demonstration which included 52 towns in 10 southern States of the Union. The results obtained were very gratifying, adequate control being secured and the amount of malaria being definitely reduced at a per capita cost of 78 cents, exclusive of central supervision. The work, which began in Hinds County, Mississippi, in 1918, was continued and demonstrated that a reduction of 76.7 per cent in malaria could be secured at a reasonable cost. In these anti-malaria campaigns the top-minnow (gambusia) has proved an effective agent, it being estimated that each minnow consumes about 155 mosquito larvae and many eggs a day. In the so-called bayou (sluggish stream) region of Louisiana the top-minnow has found a useful ally in the cow, which is employed to clear away the vegetation on the banks, where the anopheles find a breeding place out of reach of the top-minnows. In Hookworm campaign. - During 1920 the hookworm work, always undertaken in concert with government agencies, went steadily forward in nine States of the South. In the West Indies campaigns were prosecuted in Jamaica, St. Lucia, and Trinidad; a survey was made in Santo Domingo; and in Porto Rico, after a field study, relief measures were inaugurated. In Central America work was continued in Guatemala, Nicaragua, Salvador, Costa Rica and Panama. South America campaigns were conducted in Colombia and in ten States of Brazil, where government funds in large amounts were provided. In the Far East anti-hookworm measures were carried out in Australia and Papua, Siam, Ceylon, India, Mauritius and the Seychelles Islands. Thus control or survey services were rendered to 42 different governmental areas in 19 countries. In every case the government invited aid, assumed increasing responsibility, and looked forward to taking over the entire enterprise. In the Southern States it has been the policy of the Board to encourage the establishment of country health administrations and, through these agencies, to broaden the scope of local effort from hookworm disease to other maladies and sources of danger. The Board's assistance has been limited to a few demonstrations and has been conditioned upon State and county appropriations, which_aggregate half or three-fourths of the total budgets. In the States where the county plan is most firmly established, the Board's aid is gradually being withdrawn. It may be said that so far as the United States is concerned the Board's specific hookworm work is practically at an end. Anti-hookworm measures from now on will be a regular part of the health campaigns of countries and States. Brazil affords a striking example of the educating effects of antihookworm measures. The work began in 1916; in four years it extended to the Federal District and to nine States, which appropriated, for 1921, the sum of $ 23,00,000 for rural sanitation. Last October a national department of public health was created. Thus, from hookworm measures as a beginning, general public health policies are being formulated. Queensland, in Australia, two years ago entered into a five-year arrangement with the International Health Board for an anti-hookworm campaign. Last year the work was extended in Papua; now it is proposed to include New Guinea. The undertaking aroused widespread interest, not only in this specific disease, but in public health generally. An agitation was begun for the creation of a national department of health. Late in 1920 the Far Eastern Director of the International Health Board sailed for Australia. During his stay there the Government decided to create the new department. Other Activities. Besides the above-mentioned activities, the Rockefeller Foundation during the year 1920 has made large appropriations for the following objects: for new buildings and endowment for increased educational and research activities of University College Hospital and Medical School, London; for the endowment of "La Fondation Reine Elizabeth" for medical research in Belgium; for the complete rebuilding of the medical school of the University of Brussels; for providing American and English medical journals or laboratory supplies for II medical schools and medical laboratories in 5 European countries; for the school hygiene and public health of the Johns Hopkins University; for the teaching of hygiene in the Sao Paolo medical school; for 90 fellowships in public health and medical education in 13 different countries; for bringing to the United States commissions of medical teachers and hygienists from England, Belgium and Czecho-Slovakia; for bringing war-time anti-tuberculosis work in France to the point where it could be left entirely in French hands; for assisting the government of Czecho-Slovakia to reorganise its public health laboratory system; for rendering various services in organising committees to study the training of nurses and of hospital superintendents, sending officers abroad to study conditions, etc., and for terminating its participation in war-time emergency relief, giving a million dollars to the fund for European children. BALTIC MEDICAL CONFERENCE. AT T the suggestion of the American Red Cross, a conference was held in Riga at the headquarters of its Commission to Western Russia and the Baltic States, July 25-27 last, with the object of determining preventive measures against the danger of cholera spreading from Soviet Russia. Representatives of the armies and public health departments of Esthonia, Latvia and Lithuania attended the conference. Among the preventive measures adopted are the following :the establishment of strict quarantine regulations at all lines of communication between the Baltic States and Russia; the compulsory registration of all cases; the isolation of all suspected and determined cases; and the spreading of health propaganda among the inhabitants through the medium of the press and local physicians. Failure on the part of any one to comply with the provisions of the decree adopted, which covers every possible method of transmission of the disease and its treatment, will be punishable by six months' imprisonment. It was further agreed that the Paris Convention regarding the combating of epidemics would be adhered to, and arrangements were also made to establish a central office for the purpose of collecting data pertaining to health conditions in the Baltic States. THE "EMILIO MARAINI PREVENTORIUM " FOR INFANTS. The Italian Red Cross took over last June the "Emilio Maraini Institute", founded in Rome in June 1920 by Donna Carolina Maraini. The Bulletin has already spoken of the work carried out by this institution 1. Its readers will doubtless be interested to find the following details on the organisation and working of this institute, which from the beginning has been under the direction of Dr. Francesco Valagussa, professor of pediatrics at the Medical Faculty in Rome, and is considered a model from the social welfare point of view 2. THE HE Emilio Maraini foundation has as its sub-title: "For the infants of poor mothers." This sufficiently explains the ethical and social character of the institution. The first article of the statutes of the institute further illustrates the guiding motive of the foundress, declaring that the foundation has for its object "to shelter, nourish and assist the poor children of both sexes, born in or out of wedlock, whose mothers are unable to give them breast feeding owing to illness, especially of a tubercular nature," and adds that in case of abandonment by the mother, or the latter's death, the institute shall continue to care for the child, and shall do likewise whenever, for urgent reasons, immediate help is necessary to save the life of new-born children. The rules of the institution also contain the following provisions: the institute cares for the infants until entirely weaned; no nursing mother, whether married or unmarried, taken into the institute, is separated from her child; the institute undertakes, when necessary, the moral regeneration of the women it receives, making a point of persuading mothers to recognise their children; finally, the directors of the institute have established relations with charity homes for children so as to prevent the latter returning to dangerous home surroundings after the institution in question has finished with them. Accepting the principle that human beings, although not born tuberculous, are exposed to this danger, and that "the danger of tuberculosis is all the greater in the case of children born of tubercular mothers, inasmuch as these are obliged to live in close contact with the latter during the breast feeding period "," the Maraini preventorium intends to solve the prophylactic problem of tuberculosis from the very beginning by removing the infant from the infected atmosphere, thus avoiding the danger of latent tubercular infection, which "in certain cases may be considered as a means of defence against the most serious forms of tubercular infection, but which, as a rule, marks the starting point of the tubercular invasion of the entire organism of the child." For this reason, Professor Valagussa, who has charge of the Maraini institution, can affirm that it differs from other organisations of the Cross. 1 See Bulletin of the League of Red Cross Societies, vol. I, n° 2, page 92. The following information is contained in the 6th number of the Official Journal of the Italian Red same sort, inasmuch as it takes up the fight against tuberculosis from the moment the new-born infant utters its first cry, that is to say, when the lymphatic system is still free from all tubercular infection. Taking as basis the fact that, by whatever means the germ. may penetrate, tuberculosis is always at the outset a glandular infection, the Maraini preventorium makes a point of segregating the new-born infant as soon as possible from the infected environment, instead of waiting for the lymphatic system to undergo repeated invasions of the Koch bacillus before starting the anti-tuberculosis fight. As regards possible objections concerning the advantages of immunisation during the first months of life, Professor Valagussa remarks that infants taken into the Maraini institute find themselves "in the same conditions as all other children living in an atmosphere in which germs do not abound, but which none the less certainly contains, though in small quantities, enough of the Koch bacilli to bring about relative immunity. " According to the statutes and rules of the institute, the following are the conditions for the admission of needy children: a) They must not have passed the third month of life (in the case of children of tubercular parents) 2; 1 The difference between the Maraini preventorium and the Euvre Grancher is that the latter, which has the same aims in view, makes provision for children exposed to tubercular infection, whether owing to predisposition or for reasons of environment, by placing them with families living in the country. The Euvre Grancher is specially devoted to children beyond the stage of infancy. Children whose mothers are temporarily suffering from ordinary illnesses and unable for this reason to nurse them, as well as those whose mothers have died, are received at any age less than one year. |