FLS - 104 - 1939

April glst. Holiday. Tiradentes.

The following five persons had luncheon at the laboratory:
Drs. Kerr, Jacoos, Linh:res, Mr. Burris and myself.

April 2nd. Day at the office.
April 2érd. Sunday,
April 24th. Left Rio by Panair plane at 8 Al arriving in Buenos Aires

about four in the afternoon, having made only one stop en
route at Porto Alegre.

April 25th. Most of the day with Dr. Sordelli at the Bacteriological
Institute. Loox over tne proposed quarters for the virus
laboratory unu fina them highly satisfactory with the

modifications which Sordelli has planned. Discuss fellowship candidates and find

thut two suitable men are available.

Meet Dr. Alberto Fernandez of Venezuela who nag been named
Direc‘or of the new Institute of Hygiene in Caracas and is now visiting other South
American countries in order to get ideas. (Dr. Hugenio Suarez of Chile nas recently
been in Venezuela and is apparently duplicating there wnat he did in Lima some years
ago. The end result of Suarez may well be good although nis initial interest is
always the same, name], the production of biologicals having a marxet v-lue).

Luncaeon at Sordelli's home, Drs. Fernandez, aus and
Soriano being the other ,uests.

velit at the Department of Hygiene but find that Dr, Sussini,
the President, has alr cay left.

io the Brazilian Consulate only to finu that my old friend,
Di. Peixoto, hus ratired oecause of age and is now in Rio.

Meet the 10.30 train from Tucuman at tne Retiro Station and
find Dr. Barber without an overcoat although it is uncomfortably cola. Dr. and urs.
Del Ponte and Dr. Barver have Deen on a five day jaunt to the pseudopunctipennia
country between Tucuman and Jujuy.

April 26th. — Attempt to secure passage for Dr. Baroer on the 23th but find
the plane full. Arrange passage for May lst.

With Dr. Barber to the Health Department and call on Dr.
Mizuel Sussini. Dr. Sussini says he has taxen up the matter of Foundation ;
collaboration in the virus laboratory with the Minister of the Interior and has |
secured Government approval,

 
FLS ~ 305 - L959

April <6th. Dr. Sussini states that he is leaving the Health Department
~continued- Om & permanent retirement basis early next month. He is

unwilling to muxe a guess as to fhis probable successor.

Dr. Barber sees and hears, in Spanish, Ferdinando bel Toro
to fill in the long wait between tea and dianer in Suenos Aires. Dinner at the
Plaga Grill with Dr. and ars. Sordelli, Dr. and irs. del Ponte, Dr. Zuferini, Dr.
Barocer and Dr. Fernandes preseat. Dr. Sussini was unuble to be present because of
the wedding of his only son touay. (Josephine Saser nad also din at the Plaza
Grill put not at our taole).

April <?th. Finally complete tne work of getting visas for Dr. Barber and
my sel? to enter Brazil,

Long discussion of uetuils of the proposed collaboration in
virus wors with Sordelli. Sorcelli has some men who can begin work ia the near
future and has un adejuate supply of mice. He aiso has some influenza virus which
be brought from Bagland & few months ago.

Se discuss fellowships and agree on recommenuing two men, one
to ve trained uspeciall; in wors with virus, the other to take additional training -
in physical chemistr, in which he has already done some special work. The physica -
Chemist is 4 young Jew who is said to be un exteptionally intelligent person.
Sordelli is uowilling to orag so much about the qualifications of tae other
candidate put feels that he will be satisfactory.

Dinner with brs. Sussini, Burbver and Fernandez at the Jockey
Club.

During the past two days I have had an opportunity to discuss
the gambiue question with Dr. Barber and am making arrangements for aim to go to Vv
north-east Brasil to loox over the local situation there und give us what help he
can. Dr. Barver explained very carefully that he is beyoud the Foundation age limit
and is down here at present eatirely on his own. I assure him I will not taxe this-
fact into consideration out will shamelessly try to get just «as much out of his
visit as if he were on the Foundation payroll.

April 28th. Leave Buenos Aires at 6 Ad arriving in Kio at 5.45 Pid with just
enough light to land comfortably. The trip is the first I
have made hy way of Paraguay. Mr. Norment ana air. Hughes, old

friends from the American College in Asunfcién, were at the flying fiela together

with Dr. lnsdurralde, the Director of tne Public Health Department, whom I had not
previously wet and u youn, aoctor, Dr. Emilio Velilla, who is comin; to Brasil

soon for training in yellow fever vaccination. Une of my olu guardus, Fatecha,

was also present.

At Iguassd I meet Professor Osuna of the Universit; of Porto
Rico, once more. Qsune is en route to Buenos Aires to maxe arrangements for the
Educational Congress there in case the Brazilian negotiations fail: entirely.
FLS ~ 106 - 19393

April 29th. Day at the office.
ril SOth. Sunday .
May ist. Long discussion with EC regarding the organization of

the Malaria Service in the North. KC states that there

is good work in the distribution of medicine and some
beginning of good work in anti~larval service. However, the laboratory and
research end of the work is not properly staffed. EC says that we ali already
know that there are aot available in Brazil men to do the work which must be done
if the gambise situation is to ce properly studied.

Dr. Barber arrives.
Today is 4 holiday and everything is closed after lunch,

The Brahma restaurant closes its doors while we are iunch. In the parade banners
in favor of Vargas, Roosevelt and Aranha also have words recommending peace.

May nd. Call with Dr. Barber at the Health Department on Dr.
Barros Barreto.

Also call with Dr. Barber on Dr. Fontes and Dr. Neiva
at the Qswaldo Cruz Institute.
FLS - 107 - 1939

May Sra. Drs. Barber and Jacobs to dinner with Dr. and Mrs. E.
Chagas and airs. Wilson.

May 4th. Leave Kio by local Panair service at 6 AM. At Victoria
the right motor refused to do any more work but we
remained on the float in the middle of the river from 8
in the morning until three in the afternoon wien the decision was tacxen to remain
the night in Victoria. We passed by the Rex Hotel and the Hotel Imperial to go
to tne Majestic Hotel !
yer

I put in a eall for Dr. Durval’ Lima, the airector of the
SFA for the State of Espirito Santo. DL arrives at tne hotel after considerable
delay explaining that his chauffeur had resigned yesterday om arrival in Victoria
after a hard trip in the interior stating frankly thit he was unwilling to submit
to the discipline of the SFA.

With DL and WAS call at the Health Department und see one
of my old frienus who attempted in all good faith some years ago to create a new
subgenus of Anopheles to be called Soperia 1! But fortunately his attempt failed
and further confusion in the entomological literature was avoided, We found the
director of the State Health Service out and went on to the SFA where Dr. Americo
Qliveira, director of the Stute Service soon appeared.

Had we found him at the Health Departaent the length of
our visit could save been determinea by us | AO and I aiscussed the present
situation of yellow fever in the State of Zupirito Santa, J assured aO that the
epidemic which has cost over 90 cases proven vy viscerotomy is now on the aecline
and that only a few cases are to be expected next month. I admit that there have
been failures of vaccination but point out that, even in the worst results we have,
at least 50% of those vaccinated have been immunized as shown oy tae mouse
protection test. This year's wora, in “hich vaceination was carried out in
October, November anu Uecember in the aistsicts where outvureaks of yellow fever
were anticipated during the summer and where they did in effect occur, hus given
us & better checé on the results of vaccination than we might otherwise nave nad
at the end of 5 or 10 yeare't work. I point out that nothing has been found so
far to alter our opicion of the value of tne present method of vaccination and
also am disagreeable to tie point of reminding AO of the big outbreak of smallpox
in Rio in 1926 in which some 2500 fatal cases occurred. (Dr. AO has been a
staunch supporter of the SFA for many years and has taken an active part in
getting full collaboration of all local authorities ‘or the vaccination program
in the infected districts. AO was in tne Health Department in 1932 and was sent
to the Valle do Canaan to investigate reported suspect cases. AO autopsied one
of the three cases from which liver sections were ovtained in the Canaan outbreak, )

Dr. Durval shows with pride the organization of the local
office and insists that he has no evidence of stegomyia in the southern part of
the State in recent months with the exception of a few adults fount near the
railway station which suggests to him (as was to nave been expected) that the
FLS ~ 108 -. 1929

May 4th. adults were prought in from outside the State by the
~continued~ trains.
May Sth. MaB and I leave on the plane which refused to work

yesterday and reach Recife about 3 PM. We visited
the SFA office with Dr. Odair Franco. eet Dr. Geraldo de andrade, a local
light, who presents me with a very attractive volume of which he is the autnor
on the diagnosis of aAneurism ! I promise to tal« for the local Medical Society
some time when passing through Recife on the suoject of yellow fever since in
extending the invitation GA assuresme that no manuscript will be required,

May 6th. Arrive in Fortalesa by Commodore before three ofclock,
and are met by Drs. DBW, Anibal Franca and Mello Silva,
the local regional airector for the National Department

of Health. (S was previously in a similar position in Matto Grosso and is said

to have JBB bluffed. S& knows that R took receipts from the Pansir Company for
some eight contos' worth of passages and plans on using this knowledge to secure

a trip to Rio and back for himself from R).

- #AB and I put up at Dr. Wilson's house which is much
more comfortable than is the hotel.

Sentairmail letter to WaS asking for authorization to
pay MAB'S expenses from BA to Miami and suggesting that I go to New Yor« for a
conference on the future of the Services in South America.

May 7th. Spend a fairly quiet Sunday in Fortaleza. We learn that
DBW is somewhat more o istic regarding the situation as

      
  

 

  
     

 

   

Whole than he was just a short time ago, DBW believes
on the basis reports hat the gambiag is being blocked in that region
and he speaks highly of the work of the three men on the frontiers of the gambiae
invasion.

 

 

 

 

May 8th. ae pol Leave for the gambiae district. Lunch at Guarani which
a is in a zone still free of gambiae. After lunch we stop
at Cristaes where a large shed for tne disinfection of
trucks ig being built. This shed has a cement floor, roof and sidewalls of
zinc covered sheet iron. The end walls are of cloth on an adjustable frame
which permits the volume of the shed to be disinfected to be varied with the size
of the truck and its load. (At the present time there is very little traffic on
the highways but in a few weex3 when the crops begin to move the traffic will be
intense and might well be an important factor in the spread of gamoive on towards
Fortaleza. A twenty-four hour staff is being put in at Cristaes and every car
and every truck coming out of the infected district will be disinfected with a
FLS ~ 109 - 1939

May 8th. pyrethrum spray. The application of the spray will be
~continued- very easy since 4 motor and compressor have been

inatalled,. Another shed is being planned for the upper
end of the infected district in the Juguaribe Valley and will probably be placed
just above Ouro Branco below the point at which the roads Tram Lavras and
Alagoinhas come together.

On to Russas where we found Dr. Seaff in charge of the
work. We see for the first time one of the treatment clinics which I mistook at
first for a school, such is the order and decorum of the large group seated on
benches awaiting treatment.

Drive to Limoeiro where we find Dr. Gerbatin and Dr.
e Drs. Antwnes and Gast8o arrive later to be on hand for a visit to
the Service here with MAB in the morning.

May 9th. Spend two or three hours in the morning looking over the
drainage work which seems to have been very successful
as far as it has gone out which must ce extended fy An._
considerably to make it fully effective. Additional control has veen gotteh here
by the use, or rather abuse,of Paris Green which is to be seen clearly on the
ground where the water has long since disappeared.

Before leaving Limoeiro we call on the Prefeito who says
that there has oeen a great deal of malaria here and a number of deaths, When
he is confrorted with the local statistics he says that the statistics ara not
valid since a number of new cemeteries and some old ones which the SFA had closed
years ago were reopened some _t to take care of the
emergency situation. These cemeteries he says were opened only after he had
gotten permission from the interventor of the State | In any case the prefeito
admits that the situation is guch better than last year.

   
 

Drive on to Jaguaribe were we found Dr. Novis, who is
no heavyweight, in charge. Only now nas N gotten instructions to use Paris Green!
On to df@eeiro where I put up at the home of Dr. Luis Lessa (three children -
Ivan 4 years plus, Elson 2% years and Murly l year), With Mis and DBW going to
the hotel.

Late afternoon looking over the Le.z&a wa Terre where some
breeding of gambiae has been found.
YS

 

 

FLS We uO ~ 1939
uf
ab
May Oth. | Trip to Cajazeiras and Lavras. Gambiae found readily
a with the umbrella technigue at two houses ut the adge of
/ } the agude at kilometer 26 from Icé. Lessa states that
breeding ‘was found in Ouro Brgnco some ten day ago but that only one focus with a

few larvee right at tne edge of the road was found. Wilson and I drive on from
Quro Branco in 4 dangerous frame of mind. Fortunately wé are in different cars
$0 that poor Dr. Lessa suffers from the ire of oniy one of us at a time.

 

 

An attempt to ring adults with the gc in Lavras failed.

WAB ana I attempt to fina larvae and adults at an agude
at «ilometers 50 from Icé, only 4 kilometers from where we found tnem this morning,
without success. (Is it possible that the focus in Ouro Brun@@ was un isolated
one and that the area vetween Icé and Ouro Branco is infested only up to
kilometer 26 at the present time?) Paris Green is not yet being used here and the
problem of control of apread is ceing attacked only Very superficially.

 

May 11th. MAB demonstrates poth the wet and dry methods of using
Paris Green. He believes that in most of our work here
the dry method will be wetter and more economical. Lessa

for the first time oegins to get some idea of what Paris Green can do. He had

tried Paris Green on a focus and been disappointed vecause tue culex larvae were

We drive to Lima Campos and find Anopheles gambiae with
the greatest of ease in the houses. A short unsuccessful search for pambise
along the margin of the ajude without success. Adults are, however, found at a
house along the road which goes to Iguatu some kiloweters above the agude put
about three kilometers awa, frou the impounded water above tne ajude. (Shannon
failed to find Anopheles gampiag in the impounded waters iast year). In the
afternoon DBW remains with LL to work oui administrative uetails for covering the
frontier area. DsW calls LL's attention to order_in March thet Lavras

and other points oe treatea just as though they were in the infeste district,
which has not been carried out. arrangements are being made to send in special
capture men and check carefully the distribution of gamoiae in these regions and

all potential foci in the infested area and in all contiguous areas are to be
treated with Paris Green.

    

 

 

MAB and 1 return to Lima Campos, he to search for
Angopheles gampixe in luke above the dam while I go on tc look for aaults and
oreeding along the roaa to Iguata. Nothing was found by either section of the
expedition.

May 12th. Leave Icé with DBW and MAB at 7 AM stopping at Jaguaribe
once more to see Dr. Novis for 20 minutes.

Find Dr. Scaff at Russas where we have lunch. Deaths
still continue from malariu here but in smaller scale than last year.

 
FLS -lu- 1939

May Leth. In the afternoon MAB and ] go-to Aracaty in the car with

~continued- Dr. and idrs. Gilberto Freitas Who have just been recently
married and are travelling in the company of a female
dachshund, (Trouble ahead most probably).

Fiad Drs. MF, Paulo Antunes and Castro Oliveira anxiously
awaiting arrival of Mab. Tic laporatory is veginning to put on the appearance
of a laporatory.

In the evening another long discussion of the Anopheles
pamoise problem; MAB oelieves from what he nas seen that we are underestimating -
the enemy. I assure him that this Is not the case and that sone of us are
satisfied with the present situation but that it taxes time to get an
organization working especially so since there nas been no reserve of trained men
to draw from. MAB suggests that we should have 2% or 4 youny-fi_eame here
to Keep checking everything that is done in the frontier areas and

Dia peak MAB states that thers is a much better than the one-to-a

5 DU sists
that more good men are needed and much more money. I assure MAB thut we have
no reiusais ior money and that we began with this project knowing that
millions of dollars would be needed to do the wor ana that even then the attempt
might fail. MAB says thut toe extension of A.g. to other parts of the continent
would surely be a more serious setback for the human race than the so-much
discussed European war of ihe immediate future. Once spread it would undoubtedly
be a curse to the continent for centuries. MAB calls the problem a "planetary"
one rather than merely a continental one a3 we huve been duing | I assure MAB that
I realize the truth of His remarks and that even before we came to the field
this time I had written for authorisation to go to New Yors to discuss the needs
of this Service with Dr. Sawyer.

 
 
   
  

    

     
 

     
      

Way Léth. HAS gets all set and the first dissection of A.g. was
made at 9.50 ad. (Taxe in custody MAB's passport ana
$800 of letters of credit for safe xeeping in Fortaleza).

Drs. MF, OC and PA and I spend wost of the day learning yirg
technique from Dr. Barber and getting ready for to-morrow's trip to Caigard, id

Late in the afternoon MAB looas for a suitable place for
field observations on the egg to adult period for A.g. under natural conditions.

Those present for dinner at Chico Leite's were: Dr.
Barber, Chico Leite, Manduco, Paulo Antunes, MF, Oliveira Custro, Gilberto Freitas
ania Mrs. Freitas.

May Mtn Sang Sunday. Up at 4.1% in order to catch the tide out. |
/ 7 . Arrive at Caiguré at about 7 AM after two hours! drive, the
party consisting of MAB, MLS, MF, Chico, Mamduco, OC and
PA. Find Dr. Gast%o Cezar in Caigard ay expected and the day's work begins at |
once, First; demonstration of Paris Green mixture using Kerozene with a Little
FLS -~ le - 1929

May 14th. egg white to prevent agglomeration of Paris Green
~continued~ particles. oecond; demonstration of preparation of

Paris Green dust mixtures. Third; demonstration in
the Sield of the use of Puris Green in kerosene and with sand with aetual foci
of A.g. Fourth; search for interesting points for study of the distribution
of Aeg. Fifth; capture of adults in houses for tomorrow's dissection. Sixth}
demonstration of umbrella method of finding whether A.g. are or are not present
dn a house. Seventh; collection of bloods for parasite index. Kighth; spleen
index on those giving blood samples. Ninth; examination of places where Paris
Green was used earlier in the day. Tenthj studies of distrivution of avg. in
two abandoned houses and in nearby inhavited houses. Eleventh; return to
Aracaty late in the afternoon at low tide once more. All agreed thut they nad
never seen anything just like the panorsma before us. as we drove over the wet
sand towarus the setting sun with the shallow beaok on our right und tie cliffs
weathered uy booth the wing and the waves on our left.

The local collector of federui taxes reports that he has
not been ill with fever and that three others had the same record up to yesterday
out one of these three took sicx today. It is believed thut all of the other
persous living in Caigard have had maluria this year. (Caigard has 140 houses).
The deaths during the month of day 1938 were six, during 13. daya of May 19%

o7 { and this in the face of 4 rather heavy use of treatment against malaria
carried out by our Service. Yesterday afternoon $580 mosquitoes were tasen from

I haa an opportunity to demonstrate the value of the
umbrella method to several of the men. A house not previously worked was chosen
and four weli-trained ca “e wen turned loose in it for five minutes during which
time they caught 57 A.g. With the umbrella method we got 91 mosquitoes in four
minutes. In the same house one square meter of floor gave 56 dead A.g., another
gave 17 and two square meters in the lightest room of the house gave 14 more.
There must have been over 500 A.g. in the house when we began work.

 

The afternoon check on the areas treated with Paris Green
in the morning gave only 1 small larvae and this died later,

Last evening received telegram from WaS authorizing
payment to MAB of excess air passage over coat passage from B.A. together with
living expenses while in Brazil !

May 15th. Much fun, sport and amusement with MPF purchasing 4 old
umorellas with rotten covers und arranging to huve them
covered with white cloth.(Here everything tukes a great

amount of time and patience).

Drs. Wilson and Hargett arrive witan information regarding
an outbreax near Passagem das Pedras which has not yet been treated. Thus more
material for study is available close to the laporatory. (GC has stated it as his.
Main eye in life to make gambiae wnavailable for study near Aracaty wy the end
o* June),
FLS ~ 113 - 1939

May sta. DBW says he has decided to take the frontier at Icdé away
~continued~ from Dr. Lessa and way even boring him bac«x into thenon-

infected district still “urther !

May 16th. Invitation received for MF to give lecture on malaria
before the Commercial Association in Fortaleza. This
invitation comes as 4a result of ECts failure to vive

his talk last weex because of affairs in Belém.

Receive from JAK pupers relatin, to the special cradit
of 2000:000%000 for dinistry of Viagio for the uirmapping and aiso a letter
from Mr. Inman protesting agains @ arrangements which have been made with the
Ministry. As a result of CGI's letter wire JAK as follows:

   
    

PLaSS EXPLAIN DR. VIeTha URGENCY SITUATION REQUIRING wARLY
SENDING PLANKS. mALARIA SERVICE UNGENTLY NEEDS RAPID MOSAIC
MAP WHICH CaN ba #ADE IN OUR LgBORATORY aT FORTALEZA/ PLEASE
ADVISE WHEN WH MaY EXPECT PLANS WITHOUT GHOUND PexSONNAL WHICH
IS NO? NESDeD FOR THs MAPS FOR THs MaLaRIa SEARVICK PONTO
RECENT TRIP LIMA CAMPOS INLIVAT&S NigbD OF 2XPeNOIVs EXTENSION
OF WORK THROUGHOUT SNTIRn FRONTIAR ZONES PONTO GRtaTsST ECONOMY
POSSIBLS NECesSARLY IN MAPPING PxOGRaMMS TO ALLOW FUNLS FOR
GUNTROL WORK. SOPER

Dise.ss with DBW his outline of laporatory activities
for the immediate future which was prepared by aim after consultation with MF,
OC and PA. Advise DEW to get MaB¥s suggestions and criticism of this plan,

As« Dr. Hargett to join tne staff of tne Malaria Service
Since this service is now in the throes of organization and much more experience
can be nad here than oy spending more time in the Yellow Fever Service. MH agrees
and says he is ready for anything. Mi insists that there is no need of taking
the matter up with his chief, Dr. Thompson, since Mii was definitely assigned to
work under RF orders here. In MHts preeence I advise DEW tint Mio is in the
gambiae army now and taxes suggestions from Rim just as reguiar staff members would.

Get the first model of the Barber Ferreira Soper sjuare
umbrella. Further suggestions for modification were made anu a design made for a
square umorella with a detaciauble handle which js also detachable for sork under
the roof or at right ungles under tables, beds etc. OU also suggests it have a
Spike at the tip so it can be stuca in the ground inside the houses to permit of
one-man operation.

In the afternoon to the field or ratuer to the swamps to
see a demonstration of ths Paris Green application with Maneco, DBWm Damasceno
Costa, Plinio ang a number of inspectors under training.

Dr. Barber, OC and PACA go to 4 small village 5 miles
FLS ~ lla - 1939

May loth. away where malaria is now raging. All have a good
~continued~ afternoon.
May 17ta. Morning at Aracaty. Get ready to tuke over purt of the

adlnistrative rasponsioility here during the next week

or ten uays while DBW goes to Natal. We agree on sending
DC to Lavras, M. Hargett to worx with Silva and PACA to the coastal sone between
here and the capital of the State.

‘ turn to Fortaieza in the afternoon inspecting thea lagi
station at Crpstaes. The metaod is still far from perfect and the shed must” ~~
undergo several Changes before it will be ready to handle the big trucks used to
bring in the season's crop. At present the road traffic is light consisting
mostly of closed cars whica can ove properly handled almost without using the shed
at all.

; Get duly impressed once more oy the amount of water there
is in the region close to Fortaleza which is not yet infested with jambiae.
Should it get into this ragion the additional cost of control will be enormous.

Arrive Fortuleza at 19.30 and go to Wilson's house for
the night. What a comfort to coe all abet in a house for one night after tne
five days in the free regiblic of Chico Leite and Munduco !

May 18th, Fortunately I did not ,o to the office last night on
arrival so had a very good sleep in a hammock at Dr.
Wilson's home.

Learn that Lessa has assed leave to go to Alagoas to
ses his father and step-mother, both of whom are ill. The situation in Icé is
guch that I cannot imagine that DBW will give leave at this time. Im fact it
comes 43 4a Complete surprise to me that Lessa would as« for leave under any
circumstances now especially after the visit made by DBW and myself last week !

Refuse to furnish 20,000 tuolats of atevrin to Dr.
Evandro Chagas explaining to him that I am hers af the present time doing work of
an assistant of DBW; that the question of atebrin for nis service was decided py
the three of us in ilarch and that anything which is done now must be done by OBW
On the basis of my autnorisation given at that time. In the face of the urgent
need in Timoatbas I authorize M. Frauca to loan hin 5,000 tablets sphile waiting for
an answer to the telegram which ne hus to send to GSW. (Inciaentally tell C
that I neard DBW say that 72 tuolets of atebrin aaa been found in one house which
shows that tne people ure not taxing tne medicine as distriouted by him but are
storing it for future neeis. HC says S days treatment with atebrin does not prevent
relapses out thut seven uays does. I assure him that the people in this part of
the world are generally refusia, wreatwent at the and of three days). Have a
hectic day with Dr. Franca as the principal victim. MF seems to have no idea ef
training other people to wors and get records summarized so that one can keep track
of the details of the Service.

  
FLS ~ 115 - 1939

May 18th. Receive news that Dr. Burke and family arrived in Rio
-continued- on the 12th of May and are now in Bello Horizonte.

Prepare wire to Kerr reading as follows: ADVIS# PINOTTI
AND ERNANI DETAILS SITUATION STOP UNDER NO CIRCUMSTANCES PERMIT SUBMISSION NEW
PROPOSAL BEFORE MY ARRIVAL STOP SIGO ICO SABADO  SOPER.

. Discuss difficulties of construction of disinfection
post at Crystaes with Inman and suggest shortening the Length by about two meters
or puttion doors on both ends for the entry of cars wita a roll curtain above the |
door which can be raised for the passage of trucks with high loads.

Although today is Ascension Day ami a federal holiday
most of the SMNE is at work. Dr. Franca remains until after 10.50 PM. It reminds
one of the SFA during the hectic uays of 1930 to 1923). (Lunch at Jangada Club
where I get a wonderful build ur on the fly in the beer zag).

Arrange collection of very trashy books for Dr. Barberts
use from iirs. Stafford. :

May 13th. Purchase Chevrolet station wagon on a 125" wheel base
for 25 contos as an emergency measure. Most of the
day spent purchasing umbrellas and other special items
for the Service.

May 20th. Drive from Fortaleza to Icé stopping for lunch at nussas
with Drs. Damasceno Costa, Evandro Chagas, Scaff and
Gast#o Cesar.

EC advises that a cuse of leishmaniosis has been found
at Agua Fria with the primary infection in wild guinea pig. He also shows the
results of nis house-flitting work at Timpatoas. He reports that simple flitting
in all the houses of a district is sufficient to change the gambiae nysorrhyncus
larval ratio. in foci from 80/20 to 20/80.

Arrive at Ic’ at 8 PM.

May 21st. Sunday at Icé.

Ksmerino reports at some length on the survey made between
Icé and Quro Branco. He reports finding adults at Kilometer 426 in several houses
about the agude Mariuzinha. At Kilometer 429 gambiae larvae were found in the
Riacho Urubu. Between Kilometer 429 and 430 a barreiro wes found with larvae and
was treated with Paris Ureen, At Kilometer 420 one female zambiae was found in
house captures bout no foci were found close to the agude Maria Sonita. Between
Kilometer 430 and Ouro Branco, at Kilometer 488, no larvae nor adults were found.
At Ouro Branco, where a single focus was found two weeas ago, 75 houses were
investigated with the umbrella technique with negative results. An additional
6 kilometers beyond Ouro Branco have deen carefully investigated with searches for
both larvae and adults with negative results. .
FLS - 116 - 1939

 

 

May glist. Lessa reports that A.g. is now within 2 kilometers of
~continued- Tguata tit

Worx is now being done with g.c.'s and Paris Green.

Armando Albuyguerque uuring last week chief of the 6th
district, kilometer 400 to 432, all of which is infected. When I ask about recent
ext£@§ion of A.g. here he replies that he does not know since he is new to the
district. When asked whether he has worked before, he says in the 8th district,
which is that of Iguatu. When asked avout this advance he says that they worked
during three weexs without material, either petroleum or Paris Green ! (This I
presume iS due to the fact that Lessa did not want to use Paris Green and did not
have oil). Gives, with help of Lessa, details of his worse of the week. Reports
finding A.g. at kilometer 429 ana ut a point one league from tne road at the level
of Mariazinna.

 

Snr, Sebastifo de Paula Madeira, Guirda Chef'e of the 9th
district which includes the zones next to Iguati. He reports finding gambiae
about £ kilometers from Iguati along the road out 1 xilometer from the road whicn
goes from Lima Campos 10 Pousti. This last focus was less than 1 «ilometer from
the Jaguaribe River. This point is some 42 kilometers from Foryuilhas «where we
found gagbiae last week just above the ugude Lima Campos. The yuestion then is
whether this point was infected by the river or along the road by some passing

car. _
(Tre HiTlire )
WILSON. Worked with Dr. Lessa. Does not now wiat he
did during the week apparently vecause of a lack of records which he says were
given to Dr. Lessa each jay aad appurentl, because he worxed with Lessa all week
and is afraid to tell all that happened during the week.

 

Esmering reports that ne has six men at Ord Branco; that
nothing has been found in Ord Branco uor six kilometers beyond Oré Branco. It
woulu appear that 0.B. itself is now clean and that there is a cleun zone of 6
or 8 kilometers on this side and at least 6 kilometers on the other side | Gave
Esmerino the following instructions: 1) Return to 0.S8ranco today and begin work
this afternoon on the roads which diverge from Casumbé towards Ord Branco,
Alagoinhas and Lavras. If gambiae are founa by capture with umbrellas they should
continue 6 kilometers beyond the last focus. 2) If no gambiae are found ismerino
should return to Icé with two men leaving the guarda chefe and three men with
instructions to make a complete capture in Patos.3) If gambiae are found they
shoula then work up the river to Lavras searching for both larvae and adults and
noting findings. €) If no gambiae are found at Patos they should descend the river
Salgado towards Icé searching for both adults and foci. Until gamolae is located
5) the guarda chefe should then return to Icé for instructions.

Copy of written instructions to Ksmerino:

 

FASER COM GUAKDA-CHUVAs

SO - 1. Completar a estrada Ouro Branco 4 divisa aa estrada.
FLS -~ 117 - L939

May 21st. 2. Estrada & Alagoinhas seis qguilometros.
~continued-
o. Estrada 4 Lavras seis quilometros.

Si encontrar gambiae hoje ou amanh&® na
estrada acima de Ouro Branco, devem continuar a captura
até seis quilometros aldém ao achado.

SI NAO =NCONTRAR FOCO DE GAMBIAE:

Esmerino com dois capturadores devem
voltar a Icé deixando o guarda chefe a trez guardas
para fazer a captura completa em Patos. Si nfo
encontrar em Patos deve descer o Rio Salgado em
direg%o ao Icé procurando /écos e capturando com
yuarda-chuvas até encontrar ou fdéco our adulto de
gambiae,

SI ENCONTRAR GAMBIAE i PATOS:

Devem subir o Rio em diregHo « Lavras
até Lavras mesmo procur:auo e anotando fdécos e
adultos.

The microscopic examination confirms gambiae close to
Iguati. Take Damasceno Costa, Lessa and the Guarda Chsfe of the 9th district and

leave for 196 at 11 o'clock. Lif _ .
7 oo , : fi? / f
Leave the Ls nee EE houses the RR just

outside of Iguatu, that is, about 3 kilometers from the town. Here we turned to
the left and walked about 1 xilometer before coming to a mud fhole where some
eleven or twelve larvae of gambiae were found yesterday. Tiflis focus was the
only one Sound here and the people give no history of recent malaria, Rapid
captures in two of the nearby houses failed to give gambiae even though iney were
made with Flit and with an wobrella. On the return trip to the car the Gerda Chefs
of the 3th district, who was with us, adwitted that he did not xnow whether ti.ere
was water in a rice field we were passing or not. We went into the field and
found plenty of water and some foci.of Anopheles although there were fish in ‘he
darger pools. Most of the larvae found were Nyssorhynsus but one was though? to
be suspicious oy DC. There seemed to be some doubt in the mind of the Guarda
Chefe as to whether the focus found belonged to the 8th or 9th district. Lessa
has no very clear idea of tie geography of tne river and town. First, he said
that this focus (which is at a sitio known as Cajazeiras) was on the same side of
the river as Arar4 where the SFA found and delivered to the Gambiae Service three
adults two days ago. Later, in Iguati I found that the mapa shows Arard across

the river from Iguatu but that gambiae were found in zone 71 of the same side of

the river as Iguatd. We finally reached Iguatt at about 3.30 after crossing the
t
FLS ~ 118 ~ 1929

May <élst. river in 4 boat and walking on into the town through the
~continued- sand. No lunch available except eggs and rice and the

canned food we brought with us. After the late lunch
we visited the post and learned a number of facts. From the map little could
be definitely determined but it is clear that the focus found yesterday is up-
river from Iguati due to the fact that the river maxes a sharp bend here.

On the return trip we met the camionette and LL's
Secretary who reports that an inspector at Lavras says he found a focus of
gimolae there three weeks ago ana turned it in to the chief inspector who Pailed
to report it to the office. ~ (This may or aiay net be true).

 

 

Possibly wore serious is the report that there is a
eocus waiting for us in Iod. from Cedro already diagnosed as gambiae. This is
indeed bad bad bad news if true.

Discuse the local situation with the Prefeito Dr.
Gouveia of the hospital and. return to Icé at 7 Px.
FLS - 119 - 1939

May 22nd Examined the focus from the rice field of yesterday failing
to find gambiae. Likewise, oxamined seven larvae from the
sus ,ect focus at Cedro, all of which are Nyssorhynchus,.

(This is indeed good news), =

 

Esmerino reports complete absence of gambiae in all houses
6 kilometers each way from Casumb& junction. On the basis of this information decide
to place disinfection post Just this Side of the junction. Wire Inman "Place for
post has been chosen",

Send Esmerino and two men to investigcte the place close to
Lavras where it was reported gambiag had been found three weeks ago but not turned in
by the Guarda Chefe. He reports latur in the day and reports finding only larvae of
Nyasgorhynchus. The rest of the afternoon Esm:riny and his two men work at the Lagoa
das Correias about 21 kilometers from Icé on the rcad to Ouro Branco finding only
lervee of Nyssorhynchus elthough this lake is within the 9 <ilometer range. The lake
is in many parts deeper than gambige prefers and has much vegetation both sorizontal
and vertical, anc has many tinypiabinhas. I examinea some eight larvae collected by
Lessa, DC and myself in this laxe and confirmed the diagnosis of Nyssorhynchus. The
lake is being given a good dose of “aris Green but if this type of lake and the aygudes
can be shown definitely not to be breeding gambiae a great amount of labor and
material can be saved.

With Lessa and DC and Wilson, the brother of Deusdedite.
spent part of the morning and the afternoon working along the road to Ouro Branco,
The house at Mariazinha, where gambiae were found with Dr. Barber, was today negative
as was also another house nearby. A third, however, which had a shady lean-to
covered with straw both in the wind-swept lean-to and in the darxened
bedroom. Later four houses were searched at Malnada Bonita (also known in my records
as Maria Bonita) without resukts. This is 1 kilometer 30 from where Dr. Barber and I
failed to find gambiae but where a smali focus and three adults in one house were
founa a few aays ago.

     
 

Drive to Casumbé and decide on placing the Cancella for
uiginfection at a point 3 kilometers this side of the juncticn of tne roaus to Lavras
and Alayoinhas, The owner of the house we picked as headquarters was not too
enthusiastic at first but finally agreed to rant two rooms in the front of the house
and permit a woman to come in from outside to prepare tue food for our men who will
be working the Narrier,.

Tried out the spray-gun with flit in the houses worked today
and believe it will be the best equipment to use where transportation of the tank is
easy.

See one of the insyectors working with Paris Green, or
rather see him bossing two laborers who were working with Paris Green. This was at
the Lagoa das Correias referred to above as giving foci of Hyssorhynsua. Tne men were
applying, as was to have been expected at this stage, entirely too mucn and were
throwing it too close to the ground. At another point we found the men worcing with
FLS ~ LcO ~ 1983

ay end Paris ureen in xerosene water mixture where it would have
~continued~ been possible to get road dust nearby out where the cartn -
around the lake was damp.

During the day and in the evening after dinner Lessa
constantly refers to happenings in the SFA with due -toehasis on all of his own good
qualities and good work of the past. Is it possible that Lessa is on the defensive?

May eird. To dima Campos taking Drs. Lessa anu D. Costa and Wilson,
@ Hittite. Asmerino and two capture men come and are

instructed to capture in a double row of some 50 houses,
not over 4 minutes in a house with the exception of vacant houses, wuich should be
completel; worked. The first two vacant houses yielded one mule and one female
gambiae each. Four houses worked by us gave no otmur gambive und the men were
reporting the same things after about ten houses. Visit two nouses on the hill where
both families of “ive persons each report having nud LOO% o! wilaria, some with a
second atiucs ulter taking regular treatmeat for five days.

Programme left for nota Dr. Lesss to carr; out: new
division to be formed with DC in charge first at Iguatu but later at Lavras, The
most important thing now is protection of Izuati and the river apove and below
together sith the railroads radiating out of Izwati. Limits to new zone are to be:

a) viver below Iguatd including present sones 171, 17z, 173, i8i,
182 and 1383;
b) road Iguatd to Lim Campos but leaving Lime Campos unu the
Agude with Lessa to be worked from Iced;
c) railroad to Agua Fria (I gave Lessa to work the railroad
Agua Fria to Ordés;
a) Railroad Iguati to Haixio;
e) Railroad to Alugoinna;
f) river and railroad to SSo Matheus;
&) railroad and rive quinguéd to S8o José;
h) road Icé to Ouro Branco beginning at and including the
Agude at Mariazinna kilometer 24;
1} waintain present limits of service at Lavras.
Jj) 4 circle of 10 kilometers radius about Iguatd as a center ig
to be thoroughly investigated and control measures organized
to sones of kilometers 16 -- last soint in which gambias is
found.

(This is a general order and means that work must be curried out for 1lé kilometers
of clean area in svery direction beyond the last «<nown focus. The area must be
thoroughly covered oy searci for foci and oy house captures with Flit and umbrella
technique).

a . Iastructions are given to get tie maps of the SFA of this
region. (It seems regrettable that Lessa, who worked here with the and Knows

these maps perfectiy well, has not alread gotten them). I agree to leave tamerino

 
FLS ~ 121 - 1939

May cord. and the six capture men for survey work. Transportation
~continued- at present will consist of the new stution wagon

purchased four days ago in Fortaleza for tnis job. Also
agree to leave the railroad trolley if it can be had from the SFA.

I explain that, although the direct responsioility for
the administration of the new division will be with LDC, IT consider Lessa's most
important work in the near future is to furnish the best possible personnel Tor
DC's work. DC requests, and I agree, that the payment of his personnel be sade by
Lessa, thus avoiding the necessity of organicing a new office force trained in this
WOrke Point out to Lessa that he is to consider those parts of his district which
lie in contact with DC's district as Barrier zones and is to wors them most
intensively ana with his best versonnel.

Lessa is to be in charge of ail necessary treatment work
in the region and DC is to do nothing but anti-mosquito wor.

Leave Icé about 2 PM and because of long delay in
_erossing Jaguarive river decide to spend the night at Limoeiro. At Limoeiro find
one of the capture men recently transferred from the Yellow Fever Service. He

reports finding 60 houseSof 164 satooned fa Limoeiro with gambiae, This does not

look hopeful.

Find Dr. Gebertin arguing that many people must be taxing
medicine uselessly since a rather high percentage of his cases are 40 years old and
over. (G has read some place that malaria in endemic regions is limited to children
under 12 years of age !) and this is the man who is charged with the treatment work
in this area. When I discussed the fact that treatment is not being Ag_given at Feix:
Gordo but that the local store there is_selling atebrin at 700 reis a tablet, G
admits that the guarda there had been found?/,000 tablets short even according to his
own records. It is clear that a careful system of checxing treatment similar to
that used many years ago in the hook worm caupaign must oe inaugurated.

e4the brive from Limoeiro to Aracaty ana spenu a couple of
hours there remaining for lunch at the Repuslic. Learn
without surprise that Dr. Harver is not happy over the
speed with which immediate wants can be satisfied in this outlying point.

Start prophylactic atebrin at miaday today instead of
waiting until tomorrow as scheduled. an hour later,en route to Fortaleza, 1
realized I was having another attac« of malaria. I stop en route at Russas and hav
Dr. Sca@f maxe a smear which showed the presence of vivax. Continued trip to
Fortaleza, arriving 6.50 PM right side up with care.

 

May goth. . DBW arrives from Rio Granae do Norte ana brings a rather
hopeful report of the situation there.
FLS ~ 122 + 1939

day <6th. E. Chayas' material for Macambira, Mucambira is to be
“Control place foF éxpurgo ana antimalarial work. EC has

received 56,000 atebrin anu after cdiscussion of what would
be a reasonable basis of closing out our contributions of atebrin to the studies at
Timbatibas, I agree to authorize more maxing a total of 50,000.

After discussion of personnel situation with Wilson, agree
to request the YFS to transfer Drs. Acguer and Jefferson, and the two office employees
Castanheira and Heckel. gf. CIES ant
rr Ro a aE a“

Send the following telegram to New York: SUGGEST CAUSEY
COMis IMMEDIATZLY STUDYING WITH BARSER WHO PLANS DEPAKTURE END JUNH STOP AM ARRIVIN
RIO MONDAY AFTER THREE WEESS IN GAMBIAE ZONE I BELIEVE CONFERENCE SAWYER HAnLY JUNE
INDICATED NEWYORK OR FORTALEZA. a ee

AAT gh ttt te

en
————

”

May 27th. Pamair plane for Camocim tases off as scoeduled out
returns to Fortaleza because of impossivisity of lensing
at Camocim. Decide to drive through to Recife to maxe

 

connections for Rio there.

Leave Fortaleza at 11.50, muxe a side trip to aracaty und
arrive in Mossoré at 9 PM. In Aracaty find MAB on the war path as was anticipated.
Furnish what appeasement is possible ana arrange for antunes to accompany Harber
during the coming week. _

May 28th. Sunday. Leave dosaoré at 8 All arriving in Kecife at 5 Pi,
Between Angicos anu Cumpinu Urande there #woulu seem _to be

no suitable uistrict for gambiae to invade except some
very narrow river valleys waich could be easily controlled. Part of the region
traversed has suffered from drdught this year and was omce more -~ as in 1952 —~
the spectacle of entire families gathersd ut the roadsiae in front of every house
with both arms extended in a bevvine gesture. We probuoly passed 4,000 to 4,000
people alon, the road unger these conditions. Some families,iivin: away from the
highway, hua coastructed saad) uhelters aiong tue highway to aace their contact with
the travelling public more cca‘cs table.

 

May £9th Recife to Rio by Panair plane.
FLS © ~ 125 - 1959

May SOth. Missa for Dr. and irs. Servulo Lima's silver wedding |!
I promote Princeza to Duyueza copying the precedent set
by Eaqward, Prince of Wales who became the Duge of Winccor.

Protection test result on the blood of the only suspect
case of yellow fever to occur south of Rio ue Janeiro this year is haspily negative.

Qe e 2 par

Wire from WaS advises Causey cannot sail pefore the lbth
of July and as«s for more information regarding needa for r_ conference now in New York.
Following reply sent: GAMBIAE SITUATION HOPEFUL BUT REQUIRES MORE MONEY JORE
2 STRATIVE PERSONNED STOP KAINY SEASON NOW ENDING FAILUKS TO TAKE WiaSuniS NOW
WILL DELAY PHOJeCT FULL YEAR STOP CONSIDER SEPTHwUelt TOO LATE STOP TwPOSSIBLE CARRY
PRESENT PROGRAM SOUTH AMERICa WITH PRESENT STAFF STOP IF IMPOSSIXLE seNU ADDITIONAL
PERSONNEL SUGGEST TRANSFER SMITH TO BRAZIL AND WHITMAN TO MALARIA LETTING YELLOW
FoVER THMPORARILY REST ON ITS LAURALS STOP ALSO SUGGEST TRANSFER COLUMuIA VaNEZUELA
BRITISH GUIANA TO CagIBBEAN REGION STO? SUGULST WINUwod INCREASE GabibIak 1939 —
$50 000.00. STOP BELIAVE GOVENMeNT AND FOUNDATION SHOULD PLAN ON TOTAL OF ONE
MILLION DOL: DOLLARS 1940 TO ASSURE FIN: TOOTH CLEANUP KHSULTING IN GRoAT ULTIMATS BOONUMY
AND MINIMIZING DANGEA OF FUNTHER SPREAD STOP PHESENT OITUaTION DUES WOT JUSTIFY w¥
VACATION THIs YAK STOP BAKBER WORKING HARD AND HAS ALASADY BiN INVALUABL: PROBABLY
REMAINING END JUNE STOP I CANNOT aGREE PAYING SWALL PERCENT TRAVEL EXPEND BOLUS
AIRSS MIAGI STOP IPF IMPOSSIBL: Pay FOUNDATION FUNDS REQUAST AUTHORIZATIUN PaY
Galiblas BUDGET.

 

 

 

  

 

Learn details of the accident to tne Pamair plune at
Santarea in which W. 5. Antunes was a passenger. Just at the tauxe off the hull
struck a log and sank seven minutes later. By great good luck 4& small canoe was
Close by and was able to save all the passengers. (KSA never learned to swim).

 

500,000 vaccinations in 1939 completed toaay. (If all
had been done with good virus our satisfaction Woulea be greater).

Letter from Dr. Torres reports failure of present
government in Bolivia to pay their ,yuota for the Yellow Fever Service. (There is a
new tolitarian government and some one from this office shoulda have gone over there
pefore now to get. things lined up properly. However, there nas been no possible
opportunity for any one to get away from Brazil).

Dr. Georges Clareoout is here for study on behalf of the
Medical Service in the Jeleian Congo. I first met Dr. Claresout at Jonannesburg

in 1935. |
LY

May 31st. Dr. Pinotti orings tn Dre Candgau who is taxen on for
wors in the gambiae region. re Candgau is coming to

the gambiae service with the idea of showing during the
period of one year that ne is the type of indiviaual who shoula be considered for a
fellowship in the United States.

Discuss with Drs. Servulo ana Waldemar the possibility of

hy 0S

ie RS ‘ a
oh orcad
i