HISTORY OF MEDICAL DEPARTMENT ACTIVITIES 
ANTILLES DEPARTMENT 
PREVENTIVE MEDICINE 
This history is being Bade available in manuscript form 
pending the completion of the official History of the Medical 
Department in World Ifar II, and must be considered as a draft 
subject to final editing and revision. Persons finding errors 
in facts or important omissions should communicate with the 
Historical Division, Army Medical Library, Washington 25, D. C. 
It is emphasised that all statistical data in this history 
are tentative and subject to revision when tabulation of 
individual sick and wounded report cards has been completed. TABLE OF CONTENTS 
Page 
Ac VENEREAL DISEASE 
General , 1 
Problem , 1 
Control ..... 9 
Nomogram 19 
VD Statistics 20 
B. MALARIA 
General 29 
Problem 29 
Control 31 
Co INSTALLATIONS 
Fort Brooke . , 41 
Henry Barracks 47 
Fort Buchanan . 49 
Losey Field 61 
Camp Tortuguero 65 
Borinquen Field . . . , 69 
Camp 0*Reilly 79 
Fort Bundy 87 
Batista Field (Cuba) , 91 
Jamaica, B.W.I 93 
Antigua, BoW.Io • 99 
St0 Lucia 102 
St. Thomas 107 
St0 Croix 109 
Aruba, N.W.I. ...... 115 
Curacao, N.WJ. . 117 
Waller Field ... ..... 121 
338th Medical Dispensary (Port-of-Spain) 127 
359th Station Hospital, Fort Read (Trinidad) . . , 135 
British Guiana, S.A, 151 
Dutch Guiana 155 VENEREAL DISEASE 
General 
Venereal diseases have always ranked high as a cause of ineffec- 
tiveness in this Department., It has been a continual struggle on the 
part of the Medical Department to combat these diseases, both prevent- 
ively and clinically, using every available meanso The high prevalence 
of venereal disease in tropical areas is a well known fact, and may 
be due to the psychological attitude accompanying the warm, slow moving, 
tropical enchantment of the area,, One of man's most primitive drives 
may be most easily satisfied when the environment offers such conducive 
measures o 
Army installations in this Department are scattered over an area 
with climatic and geographical variations, cosmopolitan populations, 
bizarre customs, varied religious beliefs, and where different allied 
nations have jurisdiction over the civilian population0 Governmental 
measures for the control of venereal disease among the civilian pop- 
lation are almost non-existent or if present are haphazardly applied 
due to political and economic conditions * Throughout the entire De- 
partment, and particularly in Trinidad and Cuba, venereal diseases are 
perhaps even more prevalent than in Puerto Rico<> Clandestine relation- 
ships are easy to obtain since poverty, overcrowding, and consequent 
low standards of living are the lot of a large portion of the civilian 
population,, Promiscuity, the basic cause of a high venereal disease 
rate, is difficult to remove in these areas where economic conditions 
render it either necessary, or at least tempting, to a large proportion 
of the women of the underprivileged classes to engage in prostitution 
regularly or upon opportunity,, 
It is only through the combined efforts of the Armed Forces, the 
USPHS, and the IPHS (in Puerto Rico), that these diseases have been 
held in check to insure a minimum rather than a maximum rate of 
ineffectiveness in the time of warQ 
Problem 
The origin of genito-infectious diseases is lost in the by-ways 
of the early his-cory of mankind„ They have long been a public health 
problem of importance in Puerto Rico and all the islands of the West 
Indieso The "morbusgallicus" appears in historical documents in the 
early sixteenth century when Captain Salazar, noted Spanish warrior 
and right hand man of Ponce de Leon, although untouched by Indian arrows, succumbed as a result of syphilis. The spread of syphi.lis9 as 
well as other venereal diseases, takes added impetus concurrently with 
war. During World War I, there were more than one hundred men suffering 
from venereal diseases for each casualty in the battlefield,, A total 
of 338,746 men lost seven raillioh days of service daring the war as a 
result of venereal diseases. According to the Veteran8s Administration 
a total of over $82,000,000 had been used from the close of World War I 
until 1940 to pay," through the taxpayer, for these diseases among veterans. 
A substantial proportion of this amount has been spent among the veterans 
of Puerto Rico. 
An analysis of available mortality statistics showed that syphilis 
during 193S was about two and one half times as prevalent here (Puerto 
Rico) as in the continental United States. Syphilis was the responsible 
cause of death of 2603$ out of 61 cases of sudden deaths investigated 
by postmortem at the School of Tropical Medicine daring 1934^ 
The prevalence of prenatal syphilis among expectant mothers attend- 
ing the Puerto Rican Health Units and at the San Juan Municipal Hospital, 
was 13o6 positive serologically in 2,955 cases, according to the Bio- 
logical Laboratory report 1934-350 
Special reference is made to the venereal disease problem in 
Puerto Rico since Puerto Rico is the area of birth of this Department. 
It is used as the example because of the information available at the 
Headquarters. Constant liaison between the Medical Department of the 
Armed Forces, the USPHS» and the IPHS (in Puerto Rico), has been main- 
tained at all times during the existence of military operations in the 
area. 
The following extract is from an annual report by the USPHS, 
Bureau of Venereal Disease, dated 30 June 1941» ® 
MThe past 50 years have witnessed the development of public health 
practice in this hemisphere . . , the 4 fundamental needs of human wel- 
fare, namely, food, shelter, defense, and propagation have been warmly 
accepted and worked at with due interest by the people in general. 
oo0 The administration of the control of VD has been modified and 
intensified in Puerto Rico since 1938 in pursuant to the inclusion of 
the island in the authority contained in Section 4-B of the Act of VD 
of 24 May 1938, Statute 459, as well as to the extension and our (USPHS) 
participation in Social Security Act, Title VI, during 1939„ 
Consequently, since 1938 the Bureau of VD with a full time director 
in charge was established in our Health Department, whose work was to 
be developed in full cooperation with the Public Health Units program. 
Prior to this time the Bureau of Transmissible Diseases and Vital Statis- 
tics was in charge of the work. 
2 In Puerto Hico the Commissioner of Health is responsible for all 
health activities in the entire islands 
000 The function of the VD Bureau is to protect public health by 
endeavoring to reduce the prevalence of VD all over the islands carry- 
ing out a continuous attack in all fronts. 
(1) To uncover all positive cases of YD and the contactsD 
(2) To bring each case discovered under competent medical care. 
(3) To keep infectious cases under medical care until they are no 
longer a menace to society or to themselves„ 
(4) To prevent new infections through medical education of the 
public in general, and through legal measures gaining thus the public 
concern and making them responsible ip regard to the sanitary duties,, 
VD’s can not and do not originate in the army, but of necessity 
they come from the civilian population,, Nevertheless;, they occupy the 
first place among the disabling infections in our military forces, as 
the records of the last World War had demonstrated. 
The serologic examination of conscripts show a tremendous 
increase of the laboratory activities during this current year, because 
20,248 selectees were tested and of those 2,416 gave a positive Kalin 
and Kline tests reaction0 Our efforts to register this special type 
of patient in our YD clinics and restore them to military duties in a 
short time are shown when it is considered that 901 of the positive 
cases are receiving specific medical attention in our clinics,, 
o.. The continuous search for foci of infection, tending to reduce 
the incidence of YD among the armed forces and personnel working at 
industries for the defense, have brought about a registration of 1,367 
prostitutes. These are kept under continuous, intensive, and adequate 
specific treatment„ 
... Syphilis and other genito-infectious diseases are without 
doubt two of the most important secret agents or nfifth columns** which 
might weaken our manpower and consequently our national preparedness 
in this respect„ 
The problem confronting the military forces coming from the States 
and of those drafted here in relation to YD is an acute one demanding 
prompt and agressive prophylactic measures to be developed among the 
civilian populations 
1„ Ten additional YD clinics for prophylaxis and treatment need 
to be established for day and night services, specially nearby where 
armed forces are stationed and where national defense industries are 
at work, 
2„ It is also essential that hospital or an annex to an already 
functioning hospital be established for the isolation to contagious VD 
cases and for those which in accordance with sanitary regulation No. 107 
for the control of Transmissible Diseases should be isolated, because 
at present all hospitals exclude VD cases from their list of benefitiaries 
3. The enactment of laws compelling premarital and prenatal sero- 
logic tests and a medical statement included in the birth certificate as 
to the syphilitic status of the newborn. 
3 In a speech given by the Department Surgeon on National Social 
Hygiene Day - 4 February 1942, the following facts were ascertaineds 
M,,. During the year 1941, the Insular Health Department made 
20,248 blood tests of Selectees, out of which 2,260 had a positive 
serology, indicating the presence of syphilis. This is a good indi- 
cation of the magnitude of the local VD problem. A good percentage 
of these cases so discovered are now under treatment in the 35 VD 
clinics of the IH Department throughout the Island, 
... It must be stressed, however, that VD will always be present 
in the armed forces as long as it is present among the civilian popu- 
lation, The cooperation of the civilian population is most necessary 
in control of Venereal Disease, as it is from this population that these 
diseases must stem„M 
Early in 1942 an investigation of conditions existing in Puerto 
Hico revealed that 1,006 women who acknowledge themselves to be prosti- 
tutes were registered in Health Department clinics daring the month of 
December 1941 alone. It was estimated that approximately 5,000 such 
women were operating in the San Juan district. Conditions as this 
persisted fors 
1, 35$ of population illiterate 
2, 54 $ of families live in 1 room houses 
3, 5,7 persons in average family 
4, $3,50 - $10.0C)/week - average family income,, 
It is next to impossible under such circumstances to suppress this means 
of income from the women without offering them other means of livelihood. 
The high rate of infection among these women necessitated immediate 
medical attention — among 120 examined in Aguadilla over 100 were 
infected with one or more venereal diseases. 
In reply to a letter concerning a question of the value of accepting 
Puerto Rican men with venereal disease into service, the Department 
Surgeon5 s Office sent the following indorsement dated 23 June 1942 to 
The Surgeon General®s Office, 
Bl, Under the special circumstances obtaining in Puerto Ricos an 
unlimited number of volunteers for Army service is always available. 
It is felt that the acceptance of volunteers or selectees with venereal 
disease and making special provisions for their treatment, while many 
good men without venereal disease are attempting to get into the service, 
is wasteful of good manpower and of the government’s time and money. 
4 2, a, Upon examination of 20,248 Selectees in Puerto Rico, 
the Kahn and Kline tests both were positive in 11,16$ of these 
selectees. This does not include doubtful tests, 
h0 Examination of 680 selectees and volunteers at Henry 
Barracks in February 1942 revealed 83 positive blood Kahns, or 12,2$ 
positive., 
c0 Examination of 1007 selectees and volunteers at the 
Reception Center, Fort Buchanan, P0H,, in May 1942 revealed 53 
positive Kahn tests, or 5,3$ positive., 
d0 Acute gonorrhea and chancroid occurs in six and two 
selectees respectively, out of 1000 in Puerto Hico from study of 
available figures, 
3o It may readily be seen that the venereal rate, especially 
that of syphilis, is much higher than would be found in a comparative 
group in the continental United States, and the acceptance and treat- 
ment of these selectees would place an unnecessary burden on the 
Army personnel, hospitalization and other facilities in this 
Department0 
4, Acceptance of selectees with venereal disease would place 
a comparatively greater burden on the facilities of the Puerto 
Rican Department than would be borne by Army facilities in the 
United States, due to the higher venereal rate among selectees 
in this Department as compared to the rate among selectees in the 
United States, 
5, The acceptance of these men with venereal disease would 
also have the tendency of raising the venereal rate which, though 
credit is not taken for disease contracted in civil life, is more 
likely to occur again in the type of man who already has had venereal 
disease, 
6, Recommend that, should the policy of accepting men vith 
venereal disease for Army service be adopted, the Puerto Rican 
Department be exempted from the provisions of that policy,fl 
With funds made available by the La Follete Bulwinkle Act, 
together with an Insular appropriation, the Insular Health Depart- 
ment initiated an island wide program for the control of these 
diseases daring the year 1938, By July 1943, there were in 
operation a total of 57 dispensaries for the diagnosis, follow-up 
and treatment of venereal disease patients, A total of 45,682 
patients, out of which 3,334 were women of low moral character, 
received treatment during the fiscal year 1941-42, Although 
there were no statistics available, it was believed that not less 
than 20,QUO women were engaged in prostitution on this island, a 
large number of whom were living In large centers of population 
especially in the vicinity of military reservations. 
5 The following information is extracted from a speech given at 
a Venereal Disease Control Conference by Colonel C. C. Johnston9 
Department Surgeon, 11 December 1944s 
In the years 1943 and 1943 the number of cases of syphi- 
lis reported to the Insular Health Department (in Puerto Rico) were 
10*060 and 12*018 respectively, with corresponding rates per 100*000 
of 517.2 and 611.7. The number of cases of gonorrhea reported for 
the same period were 3,095 and 3*587, with corresponding rates of 
159.1 and 181.3. These figures undoubtedly represent only a small 
percentage of the actual number of venereal disease cases among 
the civilian population. 
In 1943* Costa Mandry, from a review of the literature on 
investigations based on serology calculates the percentage of posi- 
tive tests for syphilis for the urban population at 10$ for the 
rural population at less than 5$ with a fluctuation between 5$ 
and 6$ for the entire island. 
An epidemiological analysis of 1*238 cases reported in the 
Antilles Department for the first ten months of 1944, reveals the 
followings 
... army population 
36$ of the cases failed to take any prophylaxis 
33$ of the cases used a condom 
55$ of the cases had V-Packettes in their possession 
45$ of the cases named the ”pick-up” as the type of contact 
11$ of the cases used pro-pills 
1 to 5 was the ratio of cases of syphilis to gonorrhea 
1 to 1.4 was the ratio of cases among continental troops to 
insular troops (P.R.). (in this connection* 1 to 1.1 represents 
the strength of continental and insular troops),” 
The high incidence of venereal diseases among troops stationed 
in this area since 1939* presented a problem which has been only 
partially solved. 
Contributing factors are as follows? 
(l) The high incidence of venereal diseases among the civilian 
population. When local governmental agencies initiate a 
vigorous venereal disease control program for the civilian 
population* the Army program will not have to be so all- 
inclusive. The suppression of prostitution - a civilian 
function - will in the long run* make for lower Array 
venereal disease rates. Unfortunately for the reasons 
stated above, this has not been the case in this depart- 
ment and will only occur after some years of education 
of the populace. 
6 (2) The cheapness of alcoholic "beverages and consequent 
over-indulgence in places where pick-ups are readily 
availablec 
(3) Laxity in moral standards "brought about by a number of 
conditions such as foreign environment where restraining 
influences of society are not bindings nostalgias pro- 
longed stay in isolated places, and resentment against 
regimentation,, 
(4) The neglect of prophylaxis, brought about by a variety 
of factors such as drunkenness, low morale and misplaced 
trust, presents a real problem,, 
(5) The ease of cure with penicillin may abolish the sense 
of fear that has been connected with these diseases and 
will probably result in increased exposures without 
prophylaxis* 
(6) The removal of administrative penalties for venereal 
disease so that they are now considered as any other 
disease as far as pay is concerned* 
The non-effective rate (or days lost from duty) for venereal 
disease cases has been high* The rate for 1943 was 3*7 and for 
1944, 304 (first 10 months)* The present trend is downward and 
with the advent of penicillin for the treatment of these diseases 
a decided drop is anticipated* One important factor in the high 
non-effective rate was the prevalence of sulfa resistant gonorrhea 
germs in this area, necessitating prolonged hospitalization* 
Evacuation of that type of cases to General Hospitals from scattered 
areas also contributed to the non-effective rate* 
The progress in lowering the venereal disease rate in Fherto Rico 
and all other bases of this command is one of fluctuating progress. 
Prom 1939 through 1945 the overall picture describes its story 
through sporadic increase and decrease* It is a problem created 
by climatic and geographical variations, cosmopolitan populations 
giving rise to different customs and varied religious beliefs, 
local government political and economic conditions, and numerous 
contributing factors that may be labeled under any one of hundreds 
of headings* 
While the Medical Department stands constantly ready to give 
advice and make timely recommendations relative to the professional 
aspects of venereal disease control, 'the implementation of all these 
7 measures lies in the hands of the various troop commanders, The 
success of the application of control measures must of necessity- 
then depend squarely upon the initiative and interest displayed 
by all commanders. 
Control 
Faced with a real disease problem,, the Army devised 
/an aggressive program for the control of these diseases. Making 
1 ■ ——•‘"'•"T'ijmiiinin n1 TnhfiMwwBCiiligiiu- i 
the control a function of commands commanding officers have sup- 
ported measures designed to suppress prostitutions reduce promis- 
cuous sexual exposures and have cooperated with civilian authorities 
to this end. They have made appropriate use of “off limit” author- 
ity and provided recreational activities such as entertainments 
athleticSs and other recreational facilities to keep the soldier 
in the intra-cantonment areas. This program was not horn overnite 
to flourish and bring forth amazing and miraculous results * It has 
been a slow progression from month to month hitting the individual 
issues as they presented themselves. 
The disturbing war factors (overcrowdings famines importation 
of large human masses which convey virulent venereal viruses to 
infect other or are greatly susceptible to be infected by the 
present virusesp fatigue,, laxity of morals and the concurrent 
excitement due to possible war risks) aggravated the situations 
mainly and mostly in the largest urban centers. It created an 
attractive and lucrative market for prostitution, which in turn, 
influenced greatly the maintaining of the reservoir of venereal 
disease among the encamped troops. There was a decided migration 
of males and young female members of the family attracted by the 
higher wages offered at the construction centers near the largest 
towns. The young girls migrating were either prostitutes or 
eventually became promiscuous lured by the more experienced girls' 
story of easy money. The prevalence of infections the lack of 
personal 8ex-hygiene9 and the absence of sanitary facilities led 
to the early infection of these new recruits. The influx of 
thousands of presentable young soldiers from the States with 
plenty of money in their pockets tremendously increased the number 
of sex exposures and thus the corresponding increase in the possi- 
bilities of infection—-not only among themselves but among the local 
people, 
A Medical Officer, on duty at the Department Surgeon's Office, 
was appointed Venereal Disease Control Officer (1940), in an advisory 
capacity in relation to the medical aspects of the control program, 
evaluation of trends, and the gathering of statistics. At each 
8 post9 camp, and station a Medical Officer was designated post VD 
officer.. This officer worked under the direct supervision of the 
Post Surgeon and was responsible for the medical aspects of the 
VD program.o 
The Dept. VD Control Officer directed his efforts entirely to 
the prevention of venereal disease and the passing on to subordinate 
medical units the latest information on the control of such diseases 
He was responsible for the distribution of posters,, pamphlets,, and 
movies designed to teach the soldier the danger of exposure, the 
dangers attendant upon illicit sexual relations,, as well as to 
teach him the proper use of prophylaxis. The tools for mechanical 
and chemical prevention were on hand at all times,, but their proper 
and careful use depended entirely on the individual„ 
This Dept. Control Officer worked in conjunction with civil 
agencies to locate diseased prostitutes for the purpose of giving 
them medical treatment in civilian clinics and retiring such sources 
of infection from circulation,, Ail cases were fully investigated, 
recording the results of the investigation on the prescribed form 
(M.D. #140 dated 30 October 1942). Contacts were reported to the 
civilian health agencies for their investigation* 
The year 1942 saw the inception and discontinuance of several 
abortive attempts of various agencies to control the venereal. dis= 
eases on the island (P. R.). 
During the early part of 1942, venereal disease control as 
far as the Army was concerned,, consisted of periodical lectures 
to itroops, issuance of prophylactic materials,, and inspection of 
various civilian areas to determine whether or not these areas 
should be placed Hoff limits” in the interests of venereal disease 
cont rol0 
During the months of May and June 1942, Dr. 0. C* Wenger of 
the Venereal Section of the TJ„ Sc Public Health Service arrived 
in Puerto Rico to establish a system of venereal disease control,, 
aimed at the profession of prostitution on the island. The very 
energetic Dr. Wenger first made himself acquainted with the 
venereal disease problem through the Insular Department of Health 
and the Army and Navy, as well as his own service,, and personally 
held conferences with large groups of prostitutes in the various 
cities of the islands instructing them in approved methods of 
personal hygiene, and in methods of prevention of venereal disease 
as fax as their patrons, both military and civilian, were concerned. 
He met with an enthusiastic response on the part of the local 
prostitute population who apparently had never heard of personal 
hygiene as concerning their profession. He induced these women 
9 to provide individual prophylaxis kits for themselves, including 
douching materials and'to have hot water heaters installed in their 
rooms* Many of these girls purchased both and were wedded to the 
idea that Dr0 Wenger had brought to them—the idea of both self 
and patron protection.. These girls, many of whom made sexual con- 
tact away from their rooms, carried with them in a handbag the 
necessary prophylaxis materials* These handbags became the standard 
mark of their profession, and the girls could be easily recognized 
by the police as prostitutes* An agreement had been made with the 
Chief of Police that girls carrying these bags and conforming- to 
the prophylaxis measures as laid down by Dr„ Wenger would not be 
molested by the police, because they were recognized prostitutes; 
and for a while, these measures were in effect throughout a great 
portion of Puerto Rico* Dr* Wenger also made lip posters describing 
both in words and pictures how to take a proper prophylaxis for the 
benefit of the patrons, which posters were prominently displayed in 
the rooms of these prostitutes„ The girls furnished mechanical 
prophylaxis to their patrons, which materials had been furnished 
to them in turn by the Insular Department of Health,, The local 
supply of hot water heaters and douche syringes was exhausted by 
the large purchases made by the prostitutes,. 
Just about the time this system of venereal disease control 
was taking effect, Mrc Fellhauer of the Federal Security Agency 
in Washington, arrived in Puerto Rico, with proposition that the 
policy of the authorities in Washington for venereal disease con- 
trol was Msupression*” This meant that all prostitutes recognized 
as such and practicing their profession should be arrested and 
detained by the police„ A conference was held in the office of 
the Insular Governor, Dr„ Tugwell, attended by the Chief of Insular 
Police, representatives of the U0 S0 .Public Health Service, the 
Army, the Nary, the Governor8s Office, and the Federal Security 
Agency, at which time the system of Msupression" was discussed, 
and accepted, for the control of venereal disease in the Puerto 
Rican Department„ This obviated all previous work done by 
Dr» Wenger* Prostitutes seen carrying their prophylactic mater- 
tala in their characteristic containers were immediately recognized 
as prostitutes by the police, and arrested* Naturally, the prosti- 
tutes immediately stopped carrying such identifying materials, and 
individual protection for prostitutes and patrons was discontinued* 
In 1942, the Insular Department of Health, armed with funds 
supplied by the U* S0 Public Health Service, established and opened 
two locked hospitals for the incarceration and treatment of vener- 
eally infected prostitutes* One hospital, a remodeled tobacco 
factory at Caguas, P* R*, containing approximately 150 beds, the 
10 other several wards of the umsed Aguadilla District Hospital at 
Aguadilla, P. R., were shortly filled with venerally infected women. 
These women, a very small fraction of the estimated prostitute 
population, were kept in these hospitals on an average of six weeks, 
and released to again follow their profession. A system was estab- 
lished by the Insular Department of Health whereby prostitutes 
arrested by the police were examined by the Insular Department of 
Health and, if found infected, issued a yellow card bearing on the 
face of the card data as to their identification and a small photo- 
graph. On the back of the card was data to be filled in as to 
treatment. Each prostitute furnished such a card-was registered 
and had to appear at the local venereal disease clinic for periodic 
(usually weekly) treatment. At the proper time, the Insular Health 
Department dispatched a female investigator who requested the girl 
to report for treatment, as required, holding over her the threat 
of arrest and incarceration should she fail to appear. 
In 1942 an agreement was made with the night club owners in 
San Juan and the Insular police, whereby the prostitutes who fre- 
quented the night clubs of San Juan in order to meet soldiers, 
sailors and civilians, would not be allowed to leave the premises 
of the night club which they entered for such purposes, until 
12?30 A. M„, nor to leave at any time with a soldier or a sailor. 
Since soldiers and sailors were required to be present at their 
organizations for bed check at midnight, this obviated to a great 
extent the possibility of contact by the military personnel and 
prostitutes inhabitating these night clubs. The question arose 
as to whether or not these girls found it profitable enough to 
abide by such regulations. Due to a system which the night club 
owners had set up with the prostitutes who habitually attended 
their night clubs, the girls were given a "cut” of the drinks 
which they induced soldiers, sailors or civilians to ptirnhase 
in these clubs, and thereby they earned a pittance which, with 
other patronage they may pick up during other times of the day, 
enabled them to earn a living. Insular police, military police 
and shore patrol were posted in the night club area to make certain 
that the girls and the military did not leave the preraises of the 
night club together, the Insular police enforcing the rule as far 
as the prostituted were concerned. An agreement was also made by 
the San Juan hotel owners and the Chief of the Insular Police 
whereby no soldier or sailor was allowed to enter a hotel in San 
Juan which had previously been used by the military merely for 
purposes of contact with prostitutes. Several inspections made by 
inspectors of the Army and Navy and the Public Health Service, failed 
to reveal the presence of military personnel in these hotels subse- 
quent to the agreement mentioned above. However, upon questioning 
of some venereal cases in military hospitals, it was found that 
11 venereal disease had been contracted from sexual contact made at 
local hotels. These hotels were put "off limits" for military and 
navy personnel„ 
During the month of July 1942* due to the large number of VD 
cases occupying many beds in the various Station Hospitals of the 
Departments the Department Surgeon’s Office established a new policy. 
All uncomplicated cases were to be treated while on full duty status 
with their organizations, to be confined to camp limits during the 
time of their infectivity. This system worked well and certainly 
reduced the venereal population within each Station Hospital. Spe- 
cial latrine facilities were made available during the period of 
infectivity, and the Post Surgeon supervised and administered the 
necessary medical treatment,. 
In 1943 definite progress was made to control venereal diseases 
in the Department. The following list of measures used in achieving 
results were extracted from the Medical Department 1943 Annual Re- 
ports 
a. Provision has been made for the efficient operation of 
venereal prophylactic stations in all posts, camps, stations, and 
in civilian communities frequented by troops. 
b0 Making venereal disease control a function of command. 
c. The applying and enforcing of "off limits” restrictions 
against certain areas and establishments in civilian communities0 
do The education of soldiers concerning the nature of venereal 
diseases, the mode of their spread, the dangers attendant upon sexual 
promiscuity, and excessive indulgence in alcohol, and the stressing 
of venereal disease prophylaxis. These measures have been accomplished 
by means of lectures, radio transcriptions, films, pamphlets, posters, 
and demonstrations where possible. Use is made of data obtained in 
reports, Form 140 MD. 
e. The apprehension of, and administration of prophylactic 
treatment to Intoxicated soldiers. 
f. Providing soldiers with individual prophylactics free of 
charge, and making available such items to all men going on pass. 
g. The assignment of medical officers as full time venereal 
disease control officers at all posts, camps, and stations. 
h. The appointment of Department Venereal Disease Control 
Officer. 
12 io The disciplinary control and restriction of soldiers of 
the "venereal disease proneM typec 
j0 The interrogation of soldiers9 upon return from pass5 in 
order to administer prophylactic treatment to all of those who admit 
and have not already received such treatment© 
k0 The epidemiological investigation (making use of Form 140 
MD) of all cases of venereal disease among soldiers in order to 
report them to civilian health authorities9 so that infected sex 
partners may be placed under treatment0 This measure has not 
yielded hoped for results and can be given little credit in Puerto 
Rico and less credit elsewhere for the progress made in venereal 
disease controlo 
lo The provision of wholesome recreation and entertainment 
for troopso 
mo The adoption and giving publicity to the policy that where 
insular soldiers are scheduled for transfer from Puerto Rico9 
venereal disease will defer their subsequent movement to their new 
station only until treatment and cure has been effectedo 
n0 The conduct of routine and surprise physical inspections 
in order to'discover manifest cases of venereal disease0 
Oo The "quarantine"’ restriction to the limits of camp of 
venereally infected soldiers© 
p0 The inspection and testing of samples of condoms to be 
sold or offered gratuitously to troops9 and the condemnation of 
condoms of inferior quality© 
q© The discouragements by military and civilian of 
prostitution and sexual promiscuity in the vicinity of military 
reservationss particularly the activities of street walkers9 
procurers and taxicab drivers© 
r© The employment of insular social workers (female) to 
discover prostitutes and report them to military authorities© 
Upon examinetion* if such are found to be infected5 to see that 
these women are sent to insular hospitals for the venereally diseased© 
So The use of sulfathiazole by mouth in the prophylaxis of 
gonorrheao 
13 In April 1943 .the following letter from Department Venereal 
Disease Control Officer to the Chief of Staff and AG, Headquarters 
Antilles Department, dated 4 April 1943, discusses one phase of 
the relationship between the Medical Department of Armed Forces 
and the Insular Health Department of Puerto Rico. 
’•According to information furnished by Dr. Joseph Dean of the 
U. S„ Public Health Service, federal venereal disease control funds 
in the amount of $381,411.49 were made available by that agency to 
the Insular Health Department for a program to be carried out during 
the fiscal year 1942-43. Besides an Insular appropriation'of $75,000 
for this name purpose, there are other funds from Title VI, Social 
Security Act, available for venereal disease control, making a total 
of approximately $500,000. However, out of the appropriation of 
$381,411„49 available from Federal venereal control funds for the 
fiscal year 1942-43, only $268,221.57 had been budgeted by the 
Insular Health Department up to March 31, 1943. Should the present 
trend of expenditures continue, Dr. Dean is of the opinion that by 
June 30, 1943, there will be a balance of approximately $200,000 
appropriated for venereal disease control which will not be 
a large part of which will have to be returned to the Federal 
Treasury. In view of the acute venereal disease problem, both 
among the military and civili&n population, this seems to be most 
undesirable. The Medical Department has repeatedly urged both the 
Federal and Insular Public Health Service of the necessity for ex- 
pansion of treatment facilities to ambulatory patients with these 
funds that have been made available. Out of nineteen new venereal 
disease clinics budgeted by the Insular Health Department and 
approved by the U„ S. Public Health Service on January 1st, 1943, 
only six were opened as of March 1st, 1943. One of the greatest 
difficulties in the Venereal Disease Program of the Insular Health 
Department during the past few months seems to have the lack or 
an adequate supply of sulphonamide drugs for the treatment of 
gonorrhea patients. During the months of January, February and 
March, a large number of clinics have not had sulphonamide drugs 
for the treatment of patients, and the personnel has been entirely 
inadequate as revealed by the report of the Surgeon, Losey Field. 
It is believed that this has been a factor in the increased incidence 
of venereal diseases among enlisted men during this period. In order 
that diseased prostitutes who serve as sources of infection to.' the 
Armed Forces can receive treatment, the Army has agreed to sell the 
Insular Health authorities one hundred thousand (100,0OO) tablets 
of sulfathiazole.H 
In December 1943 the following letter of Command from AGO, 
Headquarters Antilles Department, dated 15 December 1943 was issued 
the commanding officers of posts, camps, and major units in Puerto 
Ricos 
14 "1* There will he a meeting each month of Venereal Disease 
Control Officers at all posts, camps, stations and major units on 
the island of Puerto Rico* 
2* o«o on the first Tuesday of each month „«. APO 8510 
So Each officer will familiarize himself beforehand with 
Venereal Disease rates at his unit, control measures, problems, 
etc* He will formulate recommendations and questions* 
4o These meetings are for the purpose of acquainting the De- 
partment Surgeon with all problems and activities of Venereal 
Disease control* He will relay information to Commanding General 
for use at monthly meetings of Commanding Officers of Posts, Camps, 
Stations and Major Units*18 
Definite steps were taken in 1944 to improve prophylactic sta- 
tion facilities in order to improve the quality of early treatment 
and publicize prophylaxis* New or renovated stations were equipped 
with hot water and with fresh and properly prepared drugs* Efforts 
were made to constantly improve management and personnel* The im- 
portance of clean, properly designed, and properly managed pro 
stations was stressed, since in reality it is a dispensary and 
reflects the interest of the Command in the venereal disease problem* 
In April 1944 the Commanding Officer of each company, or unit 
of similar size, designated a subordinate officer to function as 
the company Venereal Disease Control Officer* He was to be assisted 
by the company non-commissioned officers* 
The following information was extracted from a letter sent to 
General Dooling in Panama by the Department Surgeon, Colonel G* C0 
Johnston, dated 3 August 1944g 
“The progress in lowered venereal disease rates is not as 
constant as I would like to see* While it is true there is a 
steady diminution of the number of cases per month, we are faced 
with a situation which will make for sporadic rises in our rates, 
as is evident for the month of July* Whenever there is a con- 
siderable troop movement indicating a staging for subsequent 
transfer to sectors other than the Island of Puerto Rico, the 
soldiers involved at once seek to find a means of remaining be- 
hind o (While the following cannot be proven, it is the concensus 
of opinion of venereal disease control officers, Puerto Ricans too, 
that some of the men deliberately hunt for an infected prostitute 
in hopes of contracting venereal disease and gaining at least a 
delay in leaving the Island)* It is very significant that whenever 
there is an extensive troop movement scheduled, the number of cases 
in that group rise sharply*18 
15 The following letter in reference to time lost was received 
in January 1945 by the Commanding General, Headquarters Antilles 
Department s ® 
•’During 1944 there were nine hundred ten (910) new cases of 
venereal disease in the Panama Canal Department and one thousand 
seven hundred thirteen (1,713) new cases in the Antilles Department. 
The average number of days Ibst per case during the year in this 
Command was twenty and sixtenths (20.6) days. The average number 
of days lost per thousand menlbr the year was eight hundred twenty- 
eight (828), The total number of days lost in this Command during 
1944 from venereal disease was sixty-five thousand six hundred 
seventy-one (65,671) days. Of these, eleven thousand six hundred 
eighty-nine (11,689) days were lost by treatment of EPTS cases. 
The time lost from venereal disease in 1944 is excessive. 
Such time lost can be reduced by a significant lowering of the 
venereal disease rate and/or reduction in the days lost per 
infected case. 
The diagnosis of venereal disease must be accurately estab- 
lished on a scientific basis but no unnecessary delays in reaching 
a diagnosis should be permitted. The administrative delays in 
admitting to or discharging a treated case from the hospital will 
be kept to an irreducible minimum. Treatment time should be re- 
duced by maximum use of penicillin as outlined in TB MED 96, 
21 September 1944 and TB MED 106, 11 October 1944 and as outlined 
in letter CDC 441, addressed as above subjects ’’Penicillin Therapy 
of Gonorrhea and dated 31 October 1944. In order to 
reduce administrative and patient time lost, paragraph 2c of above 
letter is hereby rescinded. Forms GDC II, 15 November 1943 already 
completed will be forwarded to this Headquarters,” 
Throughout the Antilles Department an educational program 
has been in effect over the period of years covered by this history. 
The objective of the educational program has been to provide max- 
imum indoctrination of each soldier in the ways and means of pre- 
vention of venereal disease. The techniques employed for attaining 
this objective have been as follows? 
Lectures? Lectures on venereal diseases are given to all 
enlisted men in this Department periodically. A six hour course 
on instruction in venereal diseases and their prophylaxis is given 
to trainees. Officers and non-commissioned officers are instructed 
on venereal disease control measures and teaching technique. 
Motion pictures? Motion pictures in English and in Spanish 
have been shown periodically to all service men. 
16 Posters? Posters in English and Spanish have been distributed 
to all posts, camps and stations for display at regular intervals in 
bath-houses, other places where men congregate,, 
Pamphlets? Pamphlets produced in this Department and others 
requisitioned from the Surgeon General, in English and Spanish, have 
been widely distributed*. 
All these educational aids have emphasized the fact that absti- 
nence is the only fool-proof preventive of venereal infection and that 
prophylaxis or early treatment, is effective when properly usedo 
Educational efforts have been directed to the enlisted man in 
groups of 3 to 5* To teach proper use of chemical prophylaxis, actual 
demonstrations have been encouraged*. To teach mechanical prophylaxix 
models have been improvised.. 
Favorable results of the Venereal Disease control program in 
this Department are evidenced by the declining yearly rates obtained 
since 19420 The annual rate for the old Puerto Hican Sector for 1942 
waa 81 per thousand per year„ The rates for the Antilles Department 
for the years 1943, 1944, and 1945 per thousand per year were 73, 
48, and 29 respectively,, 
Venereal disease control is definitely a Command responsibility 
and is so considered by the Commanding General of the Antilles De- 
partment o When this point is appreciated to the fullest extent by 
each and every officer concerned, then and then only can the reduction 
in Venereal disease incidence be lowered to the point desired « a 
point where the Armed Forces might consider the diseases negligible,, 
The problem has been meticulously approached from all angles and 
measures designed to lessen the incidence, but the final solution to 
control lies in the full cooperation of each and every individual con- 
cerned,, 
17 THE [NOMOGRAM IS A MATHEMATICAL CALCULATOR USED 
Whmwmmiqib 
FOR HURRIED CALCULA1JON OF VENEREAL DISEASE RATE0 A 
FORMULA IS NOT NECESSARY0 IT WAS DESIGNED BY MCK 
A0 CARTER, 1ST LTo, MAC, WHILE ON DUTY AT CAMP 08REILLY, 
Po Ro, DURING THE EARLY PART OF 194-5* 
19 STATIONS 
JAN 
FEB 
MAE 
APR 
MAY 
JUN 
RATE 
JUL AUG 
SEP 
OCT 
NOV 
DEC 
Borinquen Field, Pc 
H. 93 
93 
gs| 
10U 
76 
93 
115 
127 
«?q 
92 
82 
90 
Continental 
101 
96 
7*H 
110 
77 
95 
128 
155 
106 
96 
98 
86 
Insular 
J1j 
88 
„ jmL 
,95 
_75 
9Qj 
83 
71 
86] 
U6 
101 
Fort Brooke, P. Ha 
90 
11 
7oT 
us 
1+1+ 
5V 
5^ 
"521 
Ui1 
133 
132 
63 
Continental 
9U 
16 
76; 
53 
U3 
69 
52 
53 
32 
159 
136 
65 
Insular 
82 
0 
611 
-J2 
ii 
HI 
u_, .58 
23, 
r-lj 
121 
Fort Buchanan, P„ R 
39 
5$ 
801 
281 
r 66 
62 
701 
101 
69 
92 
Continental 
85 
173 
207S 
17 
7U 
79 
■ 63 
88 
15 
H7 
105 
1+2 
Insular 
30 
38 
56! 
30 
6U 
38 
62 
67 
e? 
98 
6l 
102 
Henry Barracks, Pa R. 6h 
1081 
108! 
'IT 
1+2 
62 
721 
9o 
79 
100 
111 
99 
Continental 
5U 
202 
172 
67 
1+9 
30 
93 
166 
79 
133 
77 
69 
Insular 
72 
- u5j 
Sjj 
39 
js 
62 
62 
79 
U_II 
138 
126 
Losey Field, P* E0 
52 
951 
1?5| 
119 
83 
1+7 
6T 
77 
100 
51 
33 
96 
Continental 
52 
99 
12U 
1U6 
79 
38 
57 
81 
105 
59 
30 
91+ 
Insular 
0 
0 
_ 255 P, 
102 
76 
62 
78 
0 
91+ 
108 
Camp Tortuguero, P„ 
R, UO 
86^ 
5°1 
36 
19 
21 
591 ui 
71 
89 
81 
85 
Continental 
0 
0 
0 
0 
0 
0 
839 
671 
0 
1+52 
0 
28^ 
Insular 
UO 
86 
50 
36 
19 
21 
l_55. 
78 
78 
0 
38j 
71 
86 
82 
83 
Benedict Field, St« 
Continental 
Insular 
Croix, V,I0 
333$ 
3331 
Of 
0 
0 
0 
6u 
6U 
0 
2l+2 
2l+2 
0 
188 
188 
0 
78 
To8 
~6T 
6o 
31? 
317 
0 
0 
0 
0 
ANTILLES DEPARTMENT 
62 
75 
8U| 
o3 
55 
1$ 
80 
77 
93 
79! 88 
Continental 
88 
102 
107 
9*+ 
71 
in 
79 
99 
126 
82 
102 
89 
80 
Insular 
Jtij 
_ §3i itS. 
- *3 
65 
U] 8L 
i- 73J 
MONTHLY VENEREAL DISEASE BATES FEE THOUSAND FOR STATIONS COMPRISING- 
THE ANTILLES DEPARTMENT FOR YEAR 19U1 
20 BOMOOBAM TOE COMPUTING MOHTBLY 
VENEREAL DISEASE BATES 
(four-tfeek Month) 
To determine the monthly VD p 
for 5 cnees at a station with 10< 
strength. -'rew a straight Hoe o< 
nectlng tbes* t*o uolr.ts and rea< 
the rate of ner thousand per i 
nua from the "Hate" scale. 
for strength In excess of 100! 
divide both strength and ease* b; 
10 before locating on scales. LI) 
vise for cases in excess of 5* d 
wide both cases and strength by 
before plotting. 
Example: 
To determine the monthly TD rate 
for 5 cases at a station with 1000 
strength, drew a straight line con- 
necting these two points and read 
the rat# of 65 per thousand per an- 
num from the "Bate" scale. 
Tor strength in excess of 1000, 
divide both strength and cases by 
10 before locating on scales. Like- 
wise for cases in excess of 5, di- 
vide both cases and strength by 10 
before plotting. Tire-Weak Month STATION 
JAN 
FEB 
MAE 
APR 
MAY 
JUN 
JUL 
RATE 
AUG 
SEP 
OCT 
NOV 
DEC 
Borinquen Field, P„ H, 
8*1 
I 101 
89 
68 
614 
57 
67 
102 
58 
38 
Ul 
61+ 
Continental 
si 
125 
99 
66 
6k 
57 
67 
67 
58 
38 
l+l 
61+ 
Insular 
65 
22 
51 
78 
0 
0 
0 
0 
0 
0 
0 
0 
Fort Brooke, Pe R0 
1311 
nil 
168 
90 
100 
92 
80 
98 
129 
106 
91 
91 
Continental 
153, 
11U 
lU9 
101 
99 
93 
77 
108 
138 
108 
91+ 
107 
Insular 
-JO 
uk 
261 
r 
10l| 
SM, 
100 
l+l 
80 
93 
_J2 
27 
Fort Buchanan, P. Rc 
sB 
iog 
6l 
78 
IS 
si 
“T5 
91 
109 
68 
Continental 
102 
136 
50 
89 
sk 
62 
1+2 
101 
87 
Ik 
89 
65 
Insular 
32 
93 
63 
76 
sk 
75 
1+9 
67 
92 
122 
JO 
Henry Barracks, P, R0 
66 
9^ 
193 
9^ 
10k 
54 
116 
63 
61+ 
2l+ 
102 
Continental 
90 
102I 
173 
95 
121 
58 
18 
115 
61 
78 
20 
107 
Insular 
ui 
IS 
sij 
91 
33 
13 
117 
67 
1+0 
32 
3iL 
Losey Field, P0 R, 
77 
65 
90 
1+1 
TO 
107 
75 
TD7 
91+ 
IS 
72 
101+ 
Continental 
6$ 
73 
89 
70 
107 
75 
ni+ 
91+ 
72 
72 
10U 
Insular 
133 
0 
107 
0 
0 
0 
0 
0 
0 
0 
...o. 
0 
Camp P0 R0 
. 
13a 
73 
us 
r 93 
10U 
151 
73 
26 
Continental 
118 
88 
32 
157 
156 
iUo 
97 
23 
Insular 
i 
ll+3 
61+ 
22 
1+1+ 
170 
37 
29 
Camp Tortuguero, P0 Rc 
IB 
92 
103 
1081 
85 
32j U9 
53^ 
7? 
"I? 
72 
Continental 
226 
5S5 
0 
1182 
0 
0 
0 
uig 
0 
315 
39l+ 
1182 
Insular 
_9k 
1 gg 
• 941 101 
108 
85 
32. 
1+8 
53 
77 
JR 
L 61 
Antigua, B. W0 1. 
of of ■ .6 
0 
13l+i 
50 
80 
1+8 
> 22 
l6l 
81 
291+ 
Continental 
0 
0 
1 0 
0 
13U 
50 
80 
1+8 
22 
l6l 
81 
29U 
Insular 
r~b 
L 0 
, 0 
0 
... o. 
1" P, 
0, 
0, 
0 
J 
L_ 0 
0 
Benedict Field, St.Croix,VI. 
0 
195] 1311 2 6' 
141 
51 
93!” ' 62] 111 
79 
r-~W 
■■ 'So 
Continental 
0 
228 
. 210 
k2 
1U1 
51 
93 
62 
111 
79 
66 
60 
Insular 
. 0 
im 0 
l 0 
0 
0 
0 
+- 0 
L 0 
L_ Qj 
0 
Jamaica, B0 
0 
j 
0 0 
21 
56 
■ ■ , J 
167 
S 
117:1 1U6 
63 
68 
130 
Continental 
0 
0 
0 
21 
56 163 
117 
ll+6 
63 
6U1 6s 
130 
Insular 
01 0 
... c» 
U=-—PL— PL—p!—0 
0 
0 
A 
0 
0 
0 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND POR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT POE YEAR 19H2 
21 STATIONS 
JAN 
FEB 
MAE 
APR 
MAY 
RATE 
JUN . JUL 
AUG 
SEP 
OCT 
NOV 
DEC 
St„ Thomas, V0 IQ 
T| 
179 
ru 
: „ 
20 
63 
57 ! 
78 
60 
! 0 
„ 
Continental 
o 1 
0 
0 
155 
0 
0 
0 
01 
0 
106 
0 
0 
Insular 
_o! 
-122_ 
8U 
5.6 
27 
72 
66 j 
UU 
52 
! 0 
3 U2 
ANTILLES DEPARTMENT 
90 1 
101 
99 
7 
89 
77 
51* 
80 j 
78 
85 
! 63' 
79 
Continental 
98 1 
118 
112 
72 
82 
' 
77 
81 
102 j 
88 
78 
| 68 
93 
Insular 
_§5_L_8al_l9j 
_Jh_, 
-_2&j 
75 L MJ 
_58_1 
68 
1 '57 
L. 62 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND FOR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 191*2 (Con^d) STATIONS 
JAN 
FEB 
MAE 
APR 
MAY 
JUN 
JUL 
HATE 
AUG 
SEP 
OCT 
NOV 
DEC 
Borinquen Fields, P0 R, 
12? 
U2 
U6 
SO 
56 
50 
55 
33 
71 
27 
Continental 
6g| 
127 
U2 
59 
69 
67 
51 
36 
65 
17 
7? 
17 
Insular 
0 
0 
0 
g 
202 
92 
SO 
39 
5k 
70 
66 
Fort Brooke9 P. R„ 
soT 
77 
103 
r 
79 
50 
62 
69 
25 
33 
55 
31 
U2 
Continental 
9i 
76 
100 
55 
37 
65 
IS 
31 
56 
22 
21 
Insular 
31JL 
,_.sj 
... a 
-J2 
120 
3111 
25, 
35 
5U 
U5 
56 
Fort Buchanan, P„ H. 
77] 
97 
g9 
123 
gU 
Ug 
U3 
3S 
29 
51 
96 
Continental 
5U 
6^ 
70 
85 
Uo 
Ul 
5^ 
57 
38 
38] 
91 
Insular 
jjoL 
117. 
100, 
lUU 
100 
50 
ii 
2S 
2S 
25 
57 
100 
Heqry Barracks, P, R0 
ipgf 
gg 
129 
9U 
S2 
36 
2V 
65 
19 
62 
23 
Continental 
71! 
98 
132 
77 
70 
62 
16 
6U 
2S 
77 
86 
UO 
Insular 
iUL 
1\ 
118 
... 121 
9U 
0 
31 
69 
0 
3U 
0 
Losey Fields, P, R0 
2UUj 
257 
167 
Hot 
”2? 
2U 
51 
11 
. 
117 
10U 
93 
Continental 
aH 
257 
167 
Us 
105 
23 
27 
25 
12 
76 
101 
SI 
Insular 
_oL 
0 
0 
.-263. 
0 
0 
0 
L 101 
0 
U6g 
, _ 111 
1Q9 
Camp 09Reilly, P0 R* 
83 
77 
118 
go 
87 
5? 
55 
71 
121 
551 
39 
6s 
Continental 
61 
103 
87 
68 
6!+ 
37 
5U 
60 
59 
28 
36 
71 
Insular 
90S 
69 
129 
S5 
96 
.... 53 
55 
16, 
.. 150, 
Uo 
6s 
Camp Tortuguero, Pc R„ 
m 
112 
7S 
125 
67 
63 
56 
ko 
'42 
36 
28 
Continental 
170! 
213 
0 
0 
0 
126 
0 
0 
0 
335 
0 
0 
Insular 
ioUj 
110 
_ 
12S 
6S 
59 
. .57. 
Ug 
M 
39 
37 
28 
Antigua, BWI 
59! 
92 
110 
' ‘ 75 
57 
96 
160 
77 
r~ 5T 
57 
76 
ll6 
Continental 
591 
92 
110 
75 
57 
96 
160 
77 
61 
57 
76 
106 
Insular 
_oL 
_0 
, . JO 
0 
0 
0 
0 
ol 0 
0 
. . 0. 
_ 2U2 
Batista Field, Cuba 
~T 
151 
75 
126 
175 
0 
0 
0 
0 
O1 
87 
Continental 
ii 
t 
SI 
25 
3Ug 
129 
0 
0 
0 
0 
0 
97 
Insular 
1 
t 
. Usk, 
22U 
0 
0, 
0 
0 
0 
0 
Benedict Field, St,Croix,VI', 
B7f 
0 
r 
0 
111 
36 
1971 93 
301* 
r 151 
Ul 
18 V 0 
Continental 
87 
0 
0 
0 
102 
103 
76 
92 
0 
0 
302 
0 
Insular 
ol 
0 
Ol _158 
.. 0. 
. 2kl 
> Ipu 
_ _ 35k 
.12? 
82 
102 
0 
Jamaica, B. W0 I0 
56= 
23 
it] 35 
go 
78 
r 20 
0 
59 
38 
‘ 53 
82 
Continental 
561* 
23 
76 
S5 
go 
is 
20 
0 
59 
38 
53 
82 
Insular 
0! 
_ - p 
. _ 
_ _o 
7 n 
_ 0. 
" • 
0 
r " 
0 
I 0 
u 
01 0 
0 
0 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND FOR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 19U3 
23 STATIONS 
JAN 
FEB 
MAR 
APR 
MAY 
JUN 
RATE 
JUL AUG 
SEP 
OCT 
NOV 
DEC 
St, Thomast V. I» 
68 
86 
76 
15 
36 
37 
15 
*+3 
0 
97 
1UU 
112 
Continental 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
Insular 
79 
101 
’40 
l6 
ho 
hz 
17 
99 
0 
116 
u_m 
13U 
ANTILLES DEPARTMENT 
90 
8 V 
97 
80 
72 
62 
5U 
U7 
”521 
**7 
52 
59 
Continental 
72 
82 
85 
70 
70 
55 
5L‘ 
Ul 
Ug 
U2 
57 
57 
Insular 
3k 
97 
106 
J 
\-3Q3\ 
7U 
68 
_55l 
—5L 
kk 
_5Q_ 
61 
MONTHLY VENEREAL DISEASE BATES PEB THOUSAND FOB, STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 19U3 (Con’d) STATIONS 
JAN 
FEB 
MAR 
APR 
MAY 
JUN 
JUL 
RATE 
AUG 
SEP 
OCT 
NOV 
DEC 
Borinquen Field, P„ R„ 
69 
H9 
Hi 
38 
51 
12 
31 
32 
10 
H5 
3S 
?6 
Continental 
6? 
50 
Hi 
33 
lH 
5 
31 
37 
11 
39 
39 
22 
Insular 
102 
_iZ 
H3 
6l 
222 
57 
0 
0 
0 
650 
0 
137 
Port Brooke, P. R„ 
69 
H7 
Ho 
35 
U6 
lH 
25 
35 
~19 
30 
H5 
HO 
Continental 
36 
28 
31 
19 
Hi 
17 
10 
27 
11 
lH 
12 
10 
Insular 
91 
55 
H5 
kj 
Us 
39 
Hi 
28 
H3 
7H| 
66 
Fort Buchanan, R„ 
51 
701 
53 
h 61 
53 
57 
33 
26 
37 
—¥ 
Hi 
Continental 
H7 
77 
62 
53 
61 
Hi 
17 
HH 
15 
35 
56 
8 
Insular 
L_62 
Jk. 
H7 
62 
58 
76; 
29 
3? 
39 
57 
52 
Fort Bundy, P0 R. 
30 
Hi 
38 
16 
86 
71 
' 19 
Continental 
0 
0 
0 
0 
295 
173 
0 
Insular 
. 
0 
0 
32 
HH 
h7 
19 
50 
55 
22 
Henry Barracks, P0 R„ 
60 
32 
32 
57 
~Hpl 
20 
20] 
116 
95 
6r 
76 
Continental 
0 
38 
17 
65 
67 
37 
75 
0 
62 
80 
0 
0 
Insular 
1U2 
0 
L- 0 
0 
0 
52 
0 
7J 
128 
98 
67 
31 
Losey Field, P0 R0 
12? 
0 
110 
129 
6H 
50 
122 
60 
67 
9k 
lH? 
25 
Continental 
107 
Oj 217 
163 
159 
0 
0 
0 
lH2 
0 
88 
0 
Insular 
1H1 
0 
!. . 0 
_ -Q, 
L 58 
52 
177 
65 
62 
102, 
... ms. 
21 
Camp 0°Reilly, Ta R, 
“So 
72| 70 
3HI 22 
f? 
27 
30* 
29l 
is1 
23 
21 
Continental 
28 
Hi 
53 
0 
Uo 
60 
56 
51 
*5 
0 
17 
0 
Insular 
7k 
. 72 
38 
20 
30 
23 
27 
30 
U5 
2H 
23 
Camp Tortuguero, P0 Ra 
Hi 
72 
80| l62| 13 
50 
82 
52 
55 
kj 
93 
58 
Continental 
lUl 
Q 
115b 
0 
0 
0 
0 
325 
0 
0 
0 
0 
Insular 
19 
?H! H?| 167) lH 
52 
. .J5Q, 
55 
55. 
_ .,5a 
Antigua, B0 ¥0 IG 
121 
17 
57 
oj n 
28 
3b 
0 
3H 
86 
128 
3H 
Continental 
101 
27 
ol 0 
HO 
0 
0 
0 
H2 
105! 105 
0 
Insular 
227 
L . 0 
293! Oj 0 
JL09, 
... '1 US; 0 
. 0, 
1 o, 
238 
173 
Aruba, N. W0 X, 
28 
90 
35| °7 
t 
25 
32 
13 
67 
i 115 
18 
0 
Continental 
39 
35 
31 
0 
Hi 
0 
H3| 591 0 
0 
Insular 
231 111 71 \ 22 
?k 
33 
29 
18 
.. 76 
133 
, ZL 
0 
Batista Field, Cuba 
0 
57 
30 
102 
71 
91 
179 
20 
5’4 
130 
9H 
r'TU6 
Continental 
0 
. OS? 17:! 100? 52 
0 
82 
0 
HO 
125 
28 
115 
Insular 
_oL__o 
_ 10Hj 1081 ll6 
3iA 
6b 
112 
i 207 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND FOR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 19UI4. 
25 STATIONS 
JAN 
FEB 
MAR 
APE 
MAY 
JUN 
RATE 
JUL AUG 
SEP 
OCT 
NOV 
DEC 
Benedict Field, St„Croix, VI 
0 
0 
168 
2Ul 
0 
0 
325 
0 
0 
0 
0 
0 
Continental 
0 
0 
2U^ 
7821 
0 
0 
565 
0 
0 
0 
0 
0 
Insular 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
British Guiana, S, A0 
72 
11 
UO 
53 
22 
Ul 
U2 
22 
Continental 
52 
17 
Ug 
Ug 
26 
32 
U9 
27 
Insular 
227 
0 
0 
gi 
0 
89 
0 
0 
Curacao, N, W0 I„ 
IS 
59 
70 
37 
7U 
27 
8 
Ug 
27 
7U 
35 
87 
Continental 
12 
85 
56 
56 
16 
UO 
17 
27 
53 
53 
7U 
lU5 
Insular 
22 
7U 
8? 
22 
U8 
10 
0 
66 
0 
20 
0 
71 
French Guiana, S, A. 
0 
0 
0 
105 
0 
0 
119 
96 
Continental 
0 
0 
0 
1U6 
0 
0 
6 
0 
Insular 
0 
0 
0 
0 
0 
0 
U06 
V+7 
Jamaica, B. W. I, 
d 
Ul 
52 
57 
22 
lh 
59 
0 
35 
0 
0 
7U 
Continental 
Ul 
76 
18 
55 
0 
105 
U2 
0 
37 
0 
0 
37 
Insular 
176 
58 
179 
6l 
67 
0 
102 
0 
0 
0 
0 
0 
St, Lucia, B, W„ I, 
29 
109 
96 
0 
go 
lo1 
0 
0 
Continental 
37 
33 
0 
0 
0 
67 
0 
0 
Insular 
0 
700 
76s 
0 
371 
0 
0 
0 
St„ Thomas, V* I, 
0 
0 
0 
U9 
21 
17 
0 
0 
0 
0 
Ul 
10U 
Continental 
0 
0 
0 
6 
0 
0 
0 
0 
0 
0 
0 
0 
Insular 
0 
0 
0 
58 
2U1 
20 
0 
0 
0 
0 
U61 
llU 
Trinidad, B„ W. I, 
59 
76 
51 
27 
lg 
U3 
22 
21 
Continental 
5U 
36 
53 
76 
21 
Ul 
22 
9 
Insular 
76 
* 
UU 
0 
U9 
2U 
36 
Zandery Field, Surinam, S, A, 
# 
125 
35 
0 
59 
110 
75 
159 
Continental 
170 
U7 
5^ 
0 
72 
U5 
9U 
78 
Insular 
111 
0 
0 
0 
0 
377 
0 
511 
ANTILLES DEPARTMENT 
581 
55 
56 
U? 
38 
Ug 
35 
38 
5l 
"~59 
39 
Continental 
51 
52 
U5 
U2 
UU 
70 
76 
72 
25 
Ul 
7U 
21 
Insular 
6U 
— 
r—59 
66! 
—50 
UU 
_55 
JII 
U6 
- 5* 
65, 
Ug 
MONTHLY YENSSEAL DISEASE RATES PER THOUSAND FOR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR (Concd) 
26 STATIONS 
BATE 
JAN 
FEB 
MAR 
APR 
MAY 
JUN 
JUL 
AUG- 
SEP 
OCT 
NOV 
DEC 
Borinquen Field, P. R. 
39 
19 
15 
37 
18 
23 
U3 
38 
38 
6 
37 
37 
Continental 
ko 
20 
16 
39 
19 
23 
kl 
38 
39 
6 
31 
39 
Insular 
0 
0 
0 
0 
0 
0 
176 
0 
0 
0 
158 
0 
Fort Brooke, P« Re 
33 
22 
T6 
20 
20 
21 
16 
9 
11 
11 
k2 
7 
Continental 
2k 
0 
10 
12 
- 2k 
30 
26 
10 
0 
0 
31 
0 
Insular 
ko 
39 
21 
25 
18 
15 
0 
8 
19 
18 
hi 
11 
Fort Buchanan, P„ R. 
W 
k2 
37 
60 
21 
19 
3^ 
“23I 
11 
“T9I 
lk 
38 
Continental 
3*+ 
36 
66 
33 
*+7 
3U 
2k 
0 
0 
0 
0 
Insular 
ko 
k2 
_il 
58 
18 
8 
_ 35 
22 
15 
25 
U3 
kl 
Fort Bundy, P„ R, 
2k 
39 
0 
U9 
0 
lk 
0 
0 
0 
0 
0 
Continental 
0 
0 
. 0 
0 
217 
0 
0 
0 
0 
0 
0 
0 
Insular 
28 
28 
L 
0 
27 
0 
83 
0 
0 
0 
0 
0 
Henry Barracks, P, R„ 
36 
Ul 
122 
28 
72 
~0 
0 
0 
0 
0 
85 
U60 
Continental 
0 
ll6 
0 
0 
0 
0 
0 
• 0 
0 
0 
0 
0 
Insular 
39 
L_H 
136 
30 
76 
0 
0 
0 
0 
0 
102 
56s 
Losey Field, P. R, 
2h 
65 
kk 
&L 
•31 
ki 
12 
28 
30 
19 
1 
65 
Continental 
81 
0 
60 
72 
0 
112 
0 
58 
81 
0 
219 
0 
Insular 
21 
p 
60 
3U 
37 
13 
26 
26 
21 
0 
69 
Camp 0“Reilly, P„ R* 
23 
27 
~25| 
101 
17 
2k 
13 
20 
"IT 
ik 
Ts 
19 
Continental 
0 
0 
23 
32 
0 
kb 
0 
17 
0 
0 
38 
6 
Insular 
26 
30 
26 
„ 7 
19 
21 
15 
... _ 21 
15! 
16 
20 
Camp Tortuguero, P, R.. 
56 
37 
3b 
31 
"P5I 
25 
9 
if 
15* 
97 
39 
Continental (W) 
0 
0 
0 
0 
0 
0 
0 
0 
0 
’ Oj 
0 
0 
Continental (B) 
Insular 
57 
- , 31 
31 
31 
33 
. 25 
130 
?Mi 
?j 
IS 
15] 
, 33 
39 
Antigua, B„ W. I„ 
~ut! 
95 
0 
kQ 
0 
0* 
Oj 
3V 
1331 
0 
129 
Continental 
59^ 
118 
0 
5 7! 
571 
0 
0 
-0 
33 
19W 
0 
0 
Insular 
OS 
°4 
0 
6 
Oi 
0 
0 
os 
0 
. _ OS. 0 
2U8 
Aruha, N0 W0 I0 
iOTi 
27* 
6[ 
0 
28; 
0 
oj 
°l 
0 
90 
0! 
0 
Continental 
0? 
o.! 
°j 
0 
oj 
0 
0 
Oj 
0 
Of 
oi 
0 
Insular 
i?o« 3gf 
i 
kdj 
0 
. . i 
. ol 
Oi 
-—X8m. 0 
0 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND FOR STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 19U5 STATIONS 
JAN 
FEB 
MAS 
APR 
MAY 
JTIN 
RAf 
JUL 
UE 
AUG 
SEP 
OCT 
NOV 
DEC 
Batista Field* Cuba 
i 
id 
50| 
65 
US 
9l| 
90I 
77 
9s| 
l 
17 
65 
I 
75! 
0 
Continental 
p4 
39| 
27 
87i 
171 
2U 
gi+1 
26 
107* 
0 
Insular 
d 
981 
lid 
98 
98j 
0 
52 
86! 
0 
d 
loUl 
0 
Benedict Field* St„ Croix,VI* 
0 
0 
°J 
0 
0 
265 
0i 
0 
0 
ol 
1 
0 
Continental 
oj 
0 
0 
0 
0| 
0; 
79U 
Ol 
0 
0 
01 
0 
Insular 
o 
0 
0 
0 
oj 
0 
0 
oi 
0 
0 
0 
0 
British Guiana, S„ A„ 
id 
55 
22! 
0 
0j 
36 
29 
U0 
T3 
12 
17 
62 
Continental 
id 
32 
26: 
0 
05 
77] 
25 
17 
0 
20 
32 
Insular 
0 
172 
0 
0 
0! 
68 
87 
01 
0 
87 
0 
115 
Curacao, N0 We I. 
Up| 
107 
50 
67 
uii 
16 
U0 
’“of 
0 
~o| 
0 
Continental 
90! 
U5 
110 
0 
uu; 
0 
0 
0 
0 
0 
0 
0 
Insular 
0 
157 
0 
117 
79 
29l 
72 
0 
1U1 
0 
OS 
0 
French Guiana, S. Ae 
1271 
11? 
“7? 
0 
0 
87 
0 
0 
0 
0 
0 
0 
Continental 
X76| 
0 
01 
0 
0 
01 
0 
0 
0 
0 
0 
0 
Insular 
0| 
782 
25++’ 
0 
0 
27U 
0 
0 
0 
0 
0] 
0 
Jamaica, B„ Wc I. 
0! 
78 
0 
0 
37 
P 
77 
61 
121 
0 
0 
7^ 
Continental 
Oj 
uo 
0 
0 
39 
0 
83 
66 
87 
0 
0 
0 
Insular 
ol 
0 
0 
0 
0 
0 
0 
0 
565. 
0 
0 
650 
Sto Lucia, B, W0 Ic 
5?' 
10? 
si 
55 
“o1 
129 
O' 
78 
10Uf 176 
101 
0 
Continental 
66, 
70 
58 
0 
0 
113 
0 
0 
68 
21+5 
18U 
0 
Insular 
0 
272 
179 
206 
p 
* 182 
0 
176 
22 U| 0 
0 
0 
Sto Thomafe, Vc Ic 
TF 
0 
71 
i. 0 
0 
7? 
U5 
0 
0 
0 
0 
0 
Continental 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
Insular 
1+9 
0 
78 
0 
0 
78 
51 
0 
0 
; 0 
0 
0 
Trinidad, Bc Wc Ic 
25 
* 
21T 16 
w 
17 
25 
20 
19 
27 
26 
U6 
Continental 
20 
62 
22 
7 
37 
lU 
28 
22 
19 
15 
19 
29 
Insular 
29 
11 
20 
27 
U0 
L 2J_ 
11 
17 
IS I 37 
29 
i 57 
Zandery Field, Surinam, S< A, 
0 
0 
i63+ 
f 159 
0 
US3 0 
F 39 
101+r v 
99 
0 
Continental 
0 
0 
79 
1+7 
0 
28 
0 
0 
71 f 51 
0 
0 
Insular 
0 
0 
589 
L J5P. 
1 0 
196 i 0 
315 
k59 
0 
2l+O 
p 
ANTILLES DEPARTMENT 
7U 
37 
■5U 
70 
29 
25| 26 
27 
20 
20 
U6 
78 
Continental (W) 
28 
72 
25 
25 
27 
26 
29 
29 
27 
19 
2U 
15 
Continental (B) 
1 
I 
; 130 
1 
\ 
i 
Insular 
i_3JL 
L. -JlL 
1 31 
70 
n-z 
£-1 
1 27 
IS 
11, 
* 20 
57 
U6 
MONTHLY VENEREAL DISEASE RATES PER THOUSAND FOE STATIONS COMPRISING 
THE ANTILLES DEPARTMENT FOR YEAR 1945 (Coa5d) 
28 MALARIA 
iSfcUERAL 
One of the most serious health problems encountered in the 
history of Preventive Medicine in this area, has been caused by the 
persistency of the Anophelene mosquito,, The warm, damp, tropical 
climate of the Caribbean Zone harbors conditions conducive to the 
establishment of excellent breeding nests* 
Through careful and accurate planning and action the Medical 
Departments efforts have held the foci of infection in hand, thus 
permitting safe operation of troops throughout the theater* At 
one time the greatest cause of non-effectiveness, malaria now ranks 
in the very lowest category in this respect* 
Greatest reference is made to Puerto Rico since it is the 
center of operation for the Department, and information is readily 
available at Headquarters* The 392nd Medical Malaria Control Unit 
History adequately covers the pertinent Malaria information in the 
southern extremities of the Department* It may be found as a section 
of Block VI of this history* 
PROBLEM 
In spite of the low malaria rate in the Antilles Department for 
the year 1945, malaria still presents a serious threat to the health 
of the troops stationed in this area if the proper preventive measures 
are relaxed,. Among civilian populations, malaria maintained a very 
high rate of morbidity and mortality in the areas covered by the 
Antilles Department., The very low rate of malaria incidence among 
troops in this area was directly attributable to the education pro- 
gram, individual control measures, environmental control measures 
and the application of the latest developments in the field of 
mosquito repellents, insecticides and larvicideso 
In the Antilles Department, as in most all tropical areas, 
malaria presented one of the greatest obstacles to the construction 
and maintenance of military installations, and on its control depend- 
ed the practicability and efficiency of troop operations,, Because of 
the physical characteristics of the area and specific military re- 
quirements many of our bases were located in low marginal areas where 
prolific mosquito breeding has always required vigorous and continuous 
anti-mosquito measures,. Extensive temporary control work was usual- 
ly started along with the first construction operations, while the 
29 plans for permanent work were incorporated into the over-all plans 
for the bases*, 
Malaria constitutes one of the most serious health problems of 
Puerto Rico* This disease kills an average of 2000 inhabitants every 
year* It ranks fifth in the list of deaths for Puerto Rico0 During 
the year 19408 the Insular Health Department reported a total of 
238758 cases of malaria and 1817 deaths with rates of 1268*. 9 and 
97o0 respectively per In 1941 a total of 238484 cases and 
2282 deaths were reported,, with rates of 122807 and 12406 respectively 
for l00c000o In the year 1942„ a total of 218301 cases and 1933 
deaths were reported with rates of l099o8 and 99<>4 respectively per 
1008000o The mortality rate expected for the year 1943 is about 
63ol8 a substantial reduction from previous yearso With very meager 
funds the Insular Health Department continues its program of Malaria 
Control8 which consists essentially of the treatment of patients to 
reduce mortality and eliminate foci of infection8 anti-larval work 
in a number of typerendemic districts8 and the use of permanent 
measures in selected districts where the disease is most prevalent.. 
Malaria ranked as the first cause of disability among the 
armed forces of the island during the year lS42o During 19438 malaria 
ranked last as a cause of disability among the armed forces in the 
island,, A total of 731 cases of malaria were registered among military 
personnel during 1943 as compared with 1698 cases in 1942 and 2502 
cages during 1941o Sixty seven percent of the cases for 1943 were 
reported in the first six months of the year„ 
Since malaria is highly endemic in Puerto Rico8 continuous 
surveillance of anopheline densities is warranted and has been exercised 
throughout camps0 posts8 and stations in this sector0 within a two- 
mile limit of the reservationso Reduction of anopheline densities 
are accomplished by temporary and permanent control measureso In 1943 
gratifying progress was made in the permanent elimination of anopheline 
breeding in the vicinity of Losey yield,, Camp Tortuguero0 Buchanan 
and in Camp 0°Reilly0 p0 R„ reservation,, A study had been made of 
anopheline breeding areas in Ensenada Honda and recommendations were 
submitted for permanent control measures at this base„ 
It is believed that protection of the troops against the bite 
of mosquitoes through screening,, insecticiding and use of mosquito 
bars has been responsible to a large extent for the relatively low 
malaria incidence as there was no significant reduction in the ano- 
pheles density within a radius of two miles around Army posts8 parti- 
cularly at Port Buchanan„ where the greatest reduction of malaria in- 
cidence has taken place8 and which formerly furnished one-third of the 
cases for the Departments 
30 CONTROL 
Protection of troops against mosquito 'bites by screening, insect- 
icidal sprays, mosquito bars, the use of headnets, gloves and repel- 
lents by night guards, and follow-up treatment of patients to elim- 
inate garnetocyte carriers was a major consideration of the malaria con- 
trol program inside Army reservations, especially during the latter 
part of 1942o Several Department memoranda were issued covering the 
methods to be employed in order to reduce the risk of infection among 
troops at different stations* In view of numerous large areas of 
anopheles breeding existing in the vicinity of several military re- 
servations where adequate treatment with larvicides was practically 
impossible, measures directed against adult mosquitoes were- of para- 
mount importance in the malaria control programs such measures to be 
carried out until the anopheles density within a two mile radius 
of Army posts could be reduced to a safe level by temporary or 
permanent control measureso 
Special efforts to protect toops from mosquito bites were made 
at Port Buchanan where hydraulic fill operations undertaken by the 
U0 So Engineer Department had created extensive breeding areas, due 
to lack of concurrent compensatory drainageD These areas, together 
with heavy breeding in sugar cane fields in the immediate vicinity of 
the reservation and a large swamp located within a two mile radius, 
made larval control extremely difficult as revealed by a prevailing 
high mosquito density throughout the yearD 
Beginning with July 1942, screens were provided for troops 
living in unscreened barracks, doors were adjusted, old screens were 
repaired, spraying with pyrethrum was started, the treatment of carriers 
was enforced, and guards were inspected to encourage the use of head- 
nets and gloves* As a result of this program, the average monthly 
attack rate at this reservation was reduced to 50 per 1000 strength for 
the period September to November 1942, as compared with a rate of 212 
for the same period during the previous year, and an average monthly 
rate of 170 for the previous three months of the same yearc 
Upon recommendation of the Department Surgeon, the IT0 So Engineer 
Department has approved a project for the construction of a dragline 
ditch which will provide partial drainage for the Buchanan area at a 
cost of approximately $94,000o A second project which provided for 
the complete drainage of this post was submitted and awaiting approval« 
A third project which contemplated filling of low areas inside the 
reservation and concrete invert lining of present drainage ditches 
was preparedo 
During July 1942, the Uo So Engineer Department made available 
a sum of $40,000 for malaria control activities within Army postso 
31 Ad. additional appropriation of wag made available in January 
1945 for the same purpose by this agency,, These funds were spent under 
th® direction of post engineers with the advice of post surgeons to 
eliminate anopheles breeding by permanent methods inside Army reservationge 
Post Commanders were requested to prepare projects for the complete 
elimination of anopheles breeding at each post on the island and sub- 
mitted them to the Commanding General for final approval.. These pro- 
jects were prepared with the technical assistance of the Department 
Malaria Control Officer and members of a Malaria Control Boardo As 
soon as these projects were completed,, they were reviewed by the 
Board, and funds for the execution of work was requested the U„ So 
Engineer Department0 
The flight range of the anopheles mosquito in Puerto Rico is 
approximately two milesc Anopheles control in the vicihity of Army 
posts is the responsibility of the U0 So Public Health Service,, with the 
exception of the treatment of patients and gametocyte carriers among 
the civilian population, which is being carried out by the Insular 
Health Department0 Up to the present time, the U0 So Public Health 
Service had limited its activities to the use of iarvicide and minor 
drainage operations,, Approximately four hundred men were employed by 
this agency In larvicidal work in the neighborhood of .Army reservations, 
and over six thousand pounds of paris green per month were used in 
the treatment of several thousand acres of wet land at a total cost 
of over $25,000„ 
At Lossy field, Camp Tortuguero and Port Buchanan, extensive 
marsh and swamp area, together with large wet fields of sugar cane, 
were responsible for the major portion of anopheles breeding,, At 
Camp 0°Reilly minor water courses, including old sugar cane ditches 
and four small streams, constituted the main breeding areasc At 
Borinquen Field large areas of sugar cane land and one large swamp 
were the major sources of breedingo 
Mosquito traps were located inside each Army post and within 
a radius of two miles in their vicinity in order to determine 
anopheles density.. Frequent search for larvae was carried out both 
inside and outside Army reservations,, 
In 1940 a project sponsored by the Insular Health Department 
for the permanent eradication of anopheles breeding in the vicinity 
of Losey Field,, Camp Tortuguero and Fort Buchanan was approved by the 
Works Progress Administration,, This project contemplated the ex- 
penditure of $425,881 primarily on tile drainage of wet land with 
considerable anopheles breeding within a radius of two miles of 
32 these Army reservations.. During the month of July 1942, a 
second project9 sponsored hy the Insular Health Department and the 
Uo So Public Health Service9 was submitted to the Wo Po A0 providing 
for an additional appropriation of $344,610 for the continuation of 
permanent malaria control activities on an island-wide basiso Out 
of the original appropriation $2O60944 was expended at Losey Field, 
$84,628 at Port Buchanan, and $49,727 at Camp Tortuguero under this 
program conducted by the U, So Public Health ServiceD Considerable 
progress has been made in the permanent elimination of anopheles 
breeding in the vicinity of these three Army posts.. 
Considerable progress had been made during the year 1943 in 
improving laboratory diagnostic standards, field studies in dif- 
ferent areas and the collection of epidemiological data0 Field 
surveys have been made at Borinquen Field, Salinas Maneuver Area, 
Ensenada Honda, Benedict Field, Sto Croix, and Port Simmonds, 
Jamaica, 
A malaria report card was introduced in January 1943, and has 
proven to be of great value for collecting data in a convenient 
form for analysis. Preliminary analysis of the malaria report cards 
received during the first six months of the year were completed. The 
findings are presented in the accompanying table. Method of analysis 
and definition of terms is as follows? 
a. Probable Source of Malarias The cards of primary cases 
were divided into five groups? 
(1) Camp? Those indivldtials who did not. leave the home 
station during the 30 days prior to onset of illness, 
(2) Camp and Pass? Those individuals who left camp on 
an overnight pass during the period from 8 to 30 days prior to onset, 
(3) Camp and Different Night Station? Those individuals 
who left camp to asstime duty at a different station during night, 
(4) Maneuvers? Those individuals who were on maneuvers 
from 8 to 30 days prior to onset of illness, 
(5) Civilian Life? Those individuals entering the army 
from 8 to 30 days before onset, 
(6) Relapses? A case of P, vivax malaria was arbitrarily 
assumed to be a relapse if there was a history of previous malaria 
within a twelve=month period. In P, falciparum malaria the time 
limit was set at six months. 
33 bo Number taking Prophylaxis? Those individuals receiving 
prophylactic atabrine or quinine at some time during the two months 
prior to onset of illnesso 
Co Delayed Hospitalization? - Changes of Stations Cards on 
primary cases reporting a change of station were arbitrarily class- 
ifieds 
(1) If a change occurred 7 or less days prior to onset of 
illness, case was attributed to the old home station,, 
(2) If change occurred 8 to 30 days prior to onset, the 
cage was arbitrarily attributed to the station where the greater 
proportion of time between the 8th and 30th days was spent» 
d0 Discussion of findings? 
(l) It is felt that in general the analysis presented an 
accurate picture of malaria in Puerto Rico„ For example, in the past, 
numerous cages of malaria were attributed to Henry Barracks although 
anopheline catches have been lowg of the 34 cases hospitalized there 
during the first six months of this year, only 2 can be attributed to 
the post0 
Sanitary Corps Officers were generally assigned to act as Post 
Malaria Control Officers with gratifying results In camps and sta- 
tions where extensive malaria control projects were undertaken, two 
Medical Department enlisted men, specially selected and specially 
trained, were assigned to Station Hospitals for full time malaria con- 
trol duty® They were charged with assisting in the development of 
malaria discipline among troops by aiding in instruction and supervision 
under the guidance of the post Malaria Control Officer,, Anti-malarial 
details, referred to in paragraph 5c (3), Training Circular No„ 108, 
War Department 1943, and consisting of a minimum of two enlisted men, 
including one non-commissioned officer, were formed in each company 
battery or similar unit in order to assist unit' commanders in the control 
of malaria,, These details were carrying out ordinary anti-malarial 
house**keeping measures in and around the company encampment0 
In order to have available information as to the status and 
progress of mosquito proofing measures, degree and extent of adult 
mosquito hazard, and for the purpose of comparison of control measures 
in camps and stations where extensive malaria control projects were 
undertaken, data was gathered in the last two months of the year 
1943 and reported in the form of an intra-cantonment adult mosquito 
34 index and a mosquito proofing' index,, In the former index, mosquitoes 
were collected each week from a representative number of occupied 
buildings and classified as anopheline and non-anophelinec In the 
latter index, a representative number of buildings were inspected and 
mosquito proofing defects notedo Since establishing these Indices a 
reduction to zero in many cases, of adult mosquito population in 
occupies barracks were obtained, indicative of excellent malaria dis- 
cipline among troopSo A reduction in the number of defects in mosquito 
proofing of building was also noted0 
A Department Malaria Control Officer, functioning under the De- 
partment Surgeon, was appointed by the Commanding General in December 
4, 1942, in order to all malaria control activities to be 
carried out at different Army Posts and to collaborate with other 
agencies in charge of the extra cantonment malaria control program- 
He was authorized to make inspections as to the progress of malaria 
control activities in the various posts, and advise Commanding 
Officer, Post Surgeons, and Post Engineers of approved measures for 
the control of malaria in the Department,, Many visits were made 
during the year 1942 to various posts in conformity with the 
above instructionso 
In December 290 1942, a Malaria Control Board was established, 
consisting of the Department Malaria Control Officer, a representative 
of the United States Public Health Service, and a representative of 
the District Engineer Office,, This board was charged with advising 
and assisting Post Commanders in the formulation of plane and pre- 
paration of projects for both intra and extra cantonment malaria con- 
trol work as concerned their posts,. 
Post Commanders made full use of the Department Malaria Control 
Board to insure that their plans and projects were in accordance 
with the best malaria control principles, were adequate in scope, 
and insured the proper technical execution of their projects 
At posts where the United States Public Health Service was not 
operating an extra cantonment malaria control project, the District 
Engineer executed the extra cantonment malaria control project and 
availed himself of the advice and assistance of the Department Mala- 
ria Control Board in the execution of the post extra cantonment 
malaria control project formulated by respective Post Commanders,, 
During the year 1943, new methods and new larvicides were 
developed which offered the possibility of providing adequate 
control in areas which formerly were inaccessible for temporary 
control measures, and which presented such serious obstacles for 
35 permanent work that the cost and time for completion became ex- 
cessive for the results required* One of the most practical of 
those was furnished be the development of DDT and the utilization 
of an airplane in its application.. Being able to spray this 
powerful insecticide from the air over inaccessible swamps brought 
most all conditions within the possibility of satisfactory controle 
Also, the time required for treating large areas was cut to an in- 
comparable llwg an area which formerly could not be completed 
covered with a crew of laborers in days could now be treated in a 
few hourSo 
Preliminary data indicated that with this new method of control,, 
combining quick coverage with low cost, many of our ideas on the 
necessity for costly permanent work could be revised and0 in some 
cases, abandoned., Some projects which were scheduled tp begin 1944 
fiscal year were postponed until a study under actual field conditions 
could show whether the advantages gained by this method did not 
overshadow the original plans.. 
Most all preliminary data was obtained from work done at Port 
Bundy, Puerto Rico* The area selected consisted of some 1900 acres 
of marginal land and inaccessible mangrove swamps* All post ac- 
tivities were unable to control the breeding in the area during the 
wet season., Annual bait traps located on the swamp margins period- 
ically gave catches of over 1,000 anopheline mosquitoes per night, 
despite an active program carried on by both the Army and the U* S* 
Fablic Health Service., 
In October 1944 an L=4 type plane was equipped with a Husman- 
Loncey spraying unit, and an M-l type Chemical Warfare decon- 
tamination unit was obtained for mixing DDT in diesel oilo Pour 
hundred gallons of diesel were placed in the decontamination unit 
for each batch.. To this, 160 pounds of DDT dissolving powder wag 
added for a 6$ solution.. The holding tank of the spraying unit 
held about twenty gallons of the solution, and at an application 
rate of one quart per acre, each flight could theoretically cover 
80 acres* Pirst applications were not as evenly distributed as 
desired, but subsequent flights had improved the technique until 
then, a fairly uniform dose could be expected over the entire areac 
This allowed 0ol pounds of DDT per acre which was considered suf- 
ficient to kill the mosquito adults and larvae present at the time 
of spraying, but had to be repeated regularly to control the later 
influx* 
The effect on mosquito reduction was observed by the continuous 
operation of animal bait traps and New Jersey light traps for adults, 
36 and by systematic dippings for larvae„ Results showed a marked 
reduction in both adult and larvae numbers following the sprayingo 
Trap catches made two days later usually showed only from 0$ to 
10$ of the pre-spraying number0 This condition remained in ef- 
fect for about a week when, unless the area was resprayed, the 
densities tended to increase againc More recent observations in- 
dicated that after a series of these light applications a residual 
might be built up which allowed an increase in the time between 
sprayings® Much more study and observation would be required before 
the full possibilities of DDT could be stated, but from results seen 
it could be assumed that airplane spraying of a DDT solution would 
have an important part in future malaria control planso 
Further uses of the chemical for malaria control consisted of 
spraying the solution on the walls and ceilings of native huts on 
and adjacent to military establishments in an effort to reduce the 
number of infected mosquitoeso This was done by dissolving DDT powder 
in kerosene in an amount equal to 5$ by weight, placing the solution 
in knapsack sprayers and applying at a rate of about one gallon per 
thousand square feet of area® Unrecorded observations lead to con- 
clusions that mosquitoes, after biting an individual, landed on the 
treated walls to rest, and were thereby killed® In some instances 
killing effect had been noticed two months after the treatment® 
Other advances in the efficiency of temporary control were 
made outside of the DDT field® A cooperative effort between the Array 
and U® So Public Health Service had succeeded in utilising an M-4 
Chemical Warfare apparatus for creating an emulsion of oil and water 
for use as a larvicide to replace straight oilo The emulsion combined 
the advantages of larvicidal effect, penetration, and durability with 
a reduction in oil quantities to show an equal, if not better, larvicide 
at a marked reduction in costo The solution was made by power mixing oil 
and water under high pressure until a milky emulsion was formed which 
exhibited homogenized propertieso Optimum ratios of water to oil appears 
to be about 3 to 1® Very favorable results with this Were obtained by 
the Uo So Public Health Service at Losey Field, Puerto Rico, where they 
had put it to widespread use® The truck which mounted the decontamination 
unit could be driven into the control area where it could act as a focal 
point for operationso Emulsion could be distributed directly from it to 
the water surfaces by pumping from the tank through a distributing hose, 
or, in areas which were inaccessible for the truck, it could act as a 
nearby supply point for a crew with knapsack sprayers and thus save the 
time usually lost by men returning to their base for bank refills® 
With the advantages of new materials and the knowledge of their 
uses obtained during the year 1943 it could be expected that satisfactory 
malaria control could now be obtained more efficiently than ever before® 
37 Airplane spraying of DDT solutions to a large breeding areas, residual 
DDT applications to be inside of native huts and army quarters, and the 
uses of oil-water emulsions offered new effective aid to the permanent 
work already completed.. Having a pilot assigned to the airplane spraying 
work insured prompt control of areas in Puerto Rico which created 
unforeseen hazards by sudden and continuous flooding after torrential 
rains.. Attempts were made to obtain similar advantages in other areas 
of the Department., 
In previous years and during part of 1944, the greatest amount 
of work and funds were expended on drainage and ditching operations 
plus larvicidingo The primary consturction work for enviromental 
control work was completed and in addition to the larviciding work 
the only environmental control work resorted to consist of the main- 
tenance of the previously constructed drainage ditches.. Hence, the 
major factor in the cost of malaria control work was practically 
eliminated., 
% 
In 1945 in the larvicidal work an emulsion of water and oil 
(diesel or fuel) in the rates of 3 parts water to 1 part oil was still 
utilized.. The addition of DDT to the oil portion of the emulsion had 
further increased the efficiency of this larvicide and the results were 
very satisfactory., This larvicide was applied by knapsack sprayers 
or by the M-4 Chemical Warfare apparatus in which the emulsion was 
prepared., 
During the early part of 1945 two L-4 type planes, equipped with 
a Husman-Loncey spraying unit were in use0 This method was inefficient 
and time wasting in spraying large areas and required frequent loadings.. 
Recently a C==47 plan© was furnished, equipped with two 250 gallon tanks, 
each tank discharging into a two inch pipe which was suspended below 
the plane., Discharge was by gravity and spray was formed by the 
wind \ction0 By this method large areas could be sprayed in short 
timso The plane flies at 120-140 miles per hour, at elevations from 
50-150 feet above groundo The solution used was a 5-8$ solution of 
DDT in kerosene or diesel oil and the DDT was applied in a density 
of 0o2 pounds per acre., Spraying intervals varied from 2 weeks to 
6 weeks, depending on rainfall and temperature conditions.. No set 
schedule was maintained for the spraying., Mosquito densities, adult 
and larvae, determined the interval of spraying.. The C-47 spray 
plane was based at Borinquen Field and was dispatched whenever needed, 
one airplane being sufficient for the needs of the entire Department., 
Fort Bundy, Atkinson Field, Waller Field, Fort Read, Fort Simonds, 
and Yernam Field were the areas utilising the aerial DDT spraying.. 
Use of aerial DDT spray was not utilized in areas where sugar cane 
fields fall into the control areas since the effect of DDT on the 
38 cane and the final refined sugar product was unknown* The use of a 
second C-47 plane was requested in view of increased use of aerial 
DDT spray planned for the coming year* 
The use of aerial DDT spray made it possible to increase the 
efficiency of temporary control measureso Great expense was saved 
in eliminating large larviciding crews and greater efficiency was 
obtained since it was possible to cover large areas more thoroughly 
as well as areas which previously were impenetrable and impossible 
to spray by hand methods* 
As indicated by weekly adult and larval collections made, DDT 
aerial spray, applied at a rate of 0*2 pounds DDT per acre, residual 
effects were obtained for as long as six weeks* Spray falling on 
bushes, leaves and open ground also acted as an insecticide, killing 
adult mosquitoes which might be resting in these areas* 
DDT sprays, applied by knapsack sprayers or mechanical spray 
units, to the interiors of barracks at bi-monthly intervals were 
effective in killing adult mosquitoes that find their way into build- 
ings* In addition to spraying buildings on the posts, residual DDT 
spray was also applied to huts and homes in native villages and towns 
neighboring the posts* This was an effective measure against mos- 
quitoes which might carry the malaria parasites from infected civilians 
and natives to the military personnel* This same procedure was also 
effective in preventing the spread of filariasis* 
In addition to the enviromental control measures, both tem- 
porary and permanent, individual control measures were stressed at 
each base* These became increasingly important as the strength at 
various posts was cut to the point where large scale enviromental 
control measures were no longer economically feasible* 
39 1 2 5 4 5 6 7 8 9 10 11 12 15 14 15 16 17 18 19 20 21 
72 Name: Rank: Serial No.: 22 
Last First * Middle initial 
71 Age: Length of service: yrs., months. Organization: 23 
70 Reporting Hospital: Date onset illness: Date admitted: 24 
69 Residence before enlistment: Town: State; 25 
For month prior to illness give following data: 
68 “ 26 
(a) Station (quarters)?: 0&) Night duty station (locality)? 
67 Was there a change in station? Yes Wo Change in night duty station? Tes -fo ' 27 
If "yes” give old station Old night duty station? 
66 Date of change? Date of change 
65 (c) Was patient on maneuvers during this period? Yes No . If "yes" list general areas where 29 
night stops were made: 
64 30 
(d) Was he on overnight pass? Yes No .If "yes" give town visited: 
65 ' “ ” 31 
(e) Were sleeping quarters at station screened? Yes No • 
62 32 
Type of malaria: P. vivax ; P, falciparum • P, malaria*? ; Unclassified • 
61 33 
Has patient had malaria before? If ”yes" when did last attack occur? 
60 Yes No 0-3 months 6-12 months 2-4 years 54 
5-6 months 1-2 years 4 plus years 
59 Has patient received prophylactic quinine or atabrine in last' '-two months? Yes """T ¥o 55 
When was this prophylaxis started? When stopped? 
56 ' 56 
Additional data: Please enter additional pertinent data on reverse side of card. 
57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 WAR DEPARTMENT 
Office of The Surgeon General 
Washington 
MONTHLY REPORT OF MOSQUITO CONTROL ACTIVITIES 
STATION* FOR MONTH OF* 
1, Clearing or Brushing 
a, Acres 
FOR 
MONTH 
CALENDAR yr. 
TO DATE 
2. CHANNEL OR DITCH CLEANING 
a. Lineal feet 
3. NET DITCHING (Main ditches and; laterals, no lining) 
a* Lineal feet r • vl-mii’ ■ •' ... 
11* jV i j ■ * 
A, FILL 
a« Cubic yard3f..iin., n(f ,,. . . 
5. DITCH LINING PLACED 
a. Lineal feet 
6. AREA WATER SURFACE ELIMINATED 
a. Acres 
7. LARVICIDAL WORK 
a. Gallons of bil applied ( 
b. Pounds of Paris green nibciture applied 
c. Amount of other larvicide applied , 
8. LABOR DURING MONTH 
a. Common (civilian) No, hours 
b. Semi skilled (civilian) No. hours 
c. Skilled (civilian) No. hours 
d. "Other” labor (WPA, NIA) No. hours 
e. Soldier labor, No, Hours 
9. MOSQUITO PREVALENCE - SUMMARY (Detailed reports 
may be submitted separately) 
a• Larvae 
(1) Collections, total number 
(2) Number of which contained malaria- 
transmitting mosquitoes 
b. Adults 
(1) Collections, total number 
(2) Total number of adults indentified 
(3) Number of malaria-transmitting mosquitoes 
10, REMARKS ( Use back of page if necessary) 
11. DATE SUBMITTED SIG 
NED 
Form SG 98, Xl/9/42 MONTHLY REPORT QF MOSQUITO CONTROL ACTIVITIES 
(Reference: Sec I,' Memo #54, Hq AntD, 8* Apr 46) 
STATION; 
JFOR MONTH OF 
FOR CALENDAR YEAR 
MONTH TO DATE 
1, CLEARING OR BRUSHING (Acres) 
2* CHANNEL OR DITCH CLEANING ( lineal Feet) 
3. NEW DITCHING (lineal Feet) 
(Main Ditches and Lateral a Gnlyj TJolined) .... 
4, FILL (Cubic Yards) ■ , . 
DITCH LINING PLACED ('lineal Eeetl 
6, AREA WATER SURFACE ELE INvTED (Acres) 
7. LARVICIDAL WORK 
a. Gallons of Oil Aoplied . 
b, pounds of Paris Groan Mixture Applied ...... 
c. Pounds of Pure DDT (lOCjih) Applied .......... 
d. Gals' DDT—Residual Effect Spray Applied ..... 
8. LABOR DURING MONTH 
a, Common (civilian! Mo Hours t 
bT Semi-skilled (civilian) No Hnnrs . 
o. Skilled (Civilian) No Honrs 
d. "Other" Tabor (PRRA WPA) No Hours 
e. Soldier No Hours ,,,,,, 
9. MOSQUITO PREVALENCE (SUMMARY) 
a, Larvae 
(1 ) Col 1 act iops Total Number 
(2) Number collections vdiich contained 
Malaria-transmitting mosquitoes ...... 
b. Adults 
(l) CollootionSj Total Number T... 
• 
ID. PAINE ATI. ( Jn . j 
11. REMARKS 
12. DATE SUBMITTED SIGNED 
Form SG 98, 9 Nov 42 (Revised Mar 46) 
incl #1 MOSQUITO CONTROL - tabulation of monthly activity reports 
SANITARY ENGINEERING BRANCH, 
PREVENTIVE MEDICINE DIVISION, 
OFFICE OF THE SURGEON GENERAL.S.O.S. 
FOR MONTH OF 19 
SFRVICF COMMAND 
CLEARING 
OR 
BRUSHING 
ACRES 
CHANNEL OR 
DITCH CLEANING 
LINEAL FEET 
NEW DITCHING 
LINEAL FEET 
FILL 
CUBIC YARDS 
DITCH LINING 
PLACED 
lineaiTfeet 
WAT 
SURF 
ER 
LARVIC1DAL WORK 
LABOR 
MOSQUITO PREVALENCE 
REMARKS 
ACE 
OIL 
GALLONS 
PARIS GREEN 
MIXTURE 
POUNDS 
OTHER 
LARVICIDE 
GALLONS 
total 
CIVILIAN 
HOURS 
"OTHER " 
HOURS 
SOLD 
HOI 
IER 
LARVAE 
ADULTS 
ACRES 
ms 
NUMBER 
COLLECTIONS 
COLLECTIONS 
CONT. A. QUAD. 
NUME 
COLLE 
ER 
CTIONS 
NUMBER 
IDENTIFIED 
NUM 
A. Q 
BER 
UAD. 
STATION 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
FOR 
MONTH 
TO 
DATE 
- 
\ FORT BROOKE 
Malarias 
A total of cases have been admitted up to 1 October 
1945 o No deaths have occurred0 The standard atabrine treatment 
recommended by current medical bulletins has been employed0 Reac- 
tions to atabrine when administered by mouth have been seen in 
very few cases. These consisted mainly of abdominal discomfort or 
pain and anorexia0 No mental reactions are recalled0 When ata- 
brine was given intramuscularly to cases in which vomiting was 
prominent symptomf a systemic reaction was observed in two Indi- 
viduals, This was characterized by swelling with subcutaneous edema 
at the site of the injection (buttocks). The reaction appeared fol- 
lowing defervescence after the 5th and 6th day of therapy and was 
accompanied by fever and leukocytosis. No abscess formation occurred. 
Investigations concerning the action of atabrine in one 
large single dose (l gm,) intravenously in saline,, on the parasite 
index and length of symptom°free period following the administration 
of the drug were carried out in 1944° Bone marrow studies prior to, 
during, and following treatment were done also, A few severe imme~ 
diate reactions characterized by marked abdominal pain and sensation 
of impending death were observed following administration of atabrine 
as mentioned above. 
Enteric Diseases! 
It was the general impression that although these were 
characterized b;jr the usual explosiveness and discomfort to the patient, 
the various conditions were readily controlled by the drugs at hand0 
No critically ill patients were observed and no deaths occurred0 
One brief bacillary dysentery (Newcastle type) epidemic was 
encountered in May 1942 on the post of Fort Brooke0 Five diarrhea 
cases9 two of which were positive on culture$ were admitted to this 
hospitalc All the personnel of the detachment to which these patients 
belonged (300 men) were cultured and 38 were found to be positive for 
the same strain of bacillary dysentery, It was the opinion of the 
Commanding Officer of the Puerto Rican Department Laboratory that this 
was a man to man spread after the introduction of a positive ease to 
the barracks which case had been infected from an outside source0 
Upon treatment of these cases and carriers with all 
were cured and rendered carrier free.7 Helminthic Diseases: (Schistosomiasis and Filariasis 
excluded)« 
Intestinal parasitism has been found in about 80* percent 
of native Puerto Rican soldiers0 In a group of 150 Puerto Rican 
enlisted men studied at this hospital the following parasites were 
encountered: Trichuris trichiura in 55 percent of the cases; hook- 
worm in 4-5 percent and strongyloides stercoralis in 12 percent of the 
caseso Although hookworm disease with its associated severe anemia 
is occasionally encountered among the civilian population of Puerto 
Rico, no cases are recalled of severe anemia secondary to hookworm 
infection among Puerto Rican soldiers0 An explanation of this fact 
may be as follows: (1) The presence of light and moderately severe 
infection with the parasite| (2) adequate amount of protein provided 
in the enlisted man°s diet; (3) resistance and immunity to a chronic 
infection probably acquired during childhood or adolescence; (4.) in- 
terest of medical officers in treating the infection. 
Infection with strongyloides has been treated with gentian 
violet with variable results0 This drug when given by the usual 
route (oral) and in standard doses is not believed to be more than 
50 percent effective in the treatment of this helminth® 
Ascaris lurabricoides infections have been few and hexyl= 
resorcinol cristoids have been employed0 
An article entitled "The Blood Picture in Asymptomatic 
Schistosoma Mansoni and Other Intestinal Parasitic by 
Z0 To Bercovitz, Harry Shwachman, and Rc Rodriguez-Mokina discussed 
the blood changes observed in Puerto Rican soldiers infected with 
several intestinal parasites,, A summary of the report follows: 
(1) A study of the blood picture was made by 147 
Puerto Rican young men who had no clinical symptoms but in 
whom the infection with Schistosoma Mansoni as well as other 
intestinal parasites such as hookworm, trichocpphalus tri- 
chiurus, strongyloides stercoralis and ascaris lumbricoides 
were found on routine fecal examination,, 
(2) There were 17 individuals Infected with So 
mansoni alone0 In this group 5 had leukocytosis and 6 had 
eosinophilia. The highest count was 14. percent and there 
were 3 persons who had no eosinophilesc 
(3) The only alterations from normal in the remain- 
der of the group were increases of varying degree of the per- 
centages of eosinophiles and slight leukocytosis„ The highest 
eosinophilia was 30 percent0 The highest counts being in 
those in whom there were SD mansoni, hookworm, and T0 trichi- 
uruso There were 17 individuals of the 14-7 studied in whom 
no eosinophils were found. (4) In spite of the various parasitic infections 
present in the group of 147 young men, the blood picture shows 
a striking resemblance to the blood findings in 450 healthy 
Puerto Rican males who were free from intestinal and blood 
parasiteso 
Schistosomiasis % 
Infection with the trematode worm Schistosoma mansoni which 
is the etiological agent of the disease known as Schistosomiasis man- 
soni or Intestinal Schistosomiasis, was reported to have occurred in 
531 Puerto Rican soldiers admitted to the l6lst General Hospital from 
January 1942 to 1 October 1945» No other varieties of Schistosoma 
worms are found in Puerto Rico0 
A review of the total number of cases of Schistosomiasis 
mansoni admitted to the Station Hospital, San Juan (l6lst General 
Hospital), Puerto Rico from January 1, 1941 to March 29, 1943 inclu- 
sive is hereby summarized:9 
i9a 
23 cases 
1942 
4-9 cases 
Jan 1, 1943 to 
Mar 29, 1943 
9 cases 
Total 
81 
The total of 81 cases comprises 80 Puerto Rican patients 
and one Continental patiento In this series of 81 cases there was 
one death, which occurred March 6, 1943® 
Thirty“three or 40<=7 percent of the cases were admitted with 
Schistosomiasis mansoni as the primary diagnosis, forty-eight or 59o2 
percent of the cases were admitted for other reasons and Schistoso- 
raiasis was an incidental finding0 
The length of service in this group of 81 cases varies from 
a minimum of 3 days to a maximum of 26 years„ The average mean length 
of service is one year and four months for the entire group0 
It is the opinion of some competent authorities that infec- 
tion with Schistosoma mansoni is present in about 20 to 25 percent 
of the rural population of this Island„ A survey conducted among 
Army inductees and based on only one stool examination revealed an 
incidence of this parasite in about 10 percent of individuals0 The 
condition is widely disseminated throughout the Island, as the inter- 
mediate host required for the transmission of the disease from on© 
43 person to another, a fresh water snail (Planorbis) is found in brooks, 
rivers and in ditches and canals employed in the cultivation of sugar 
can©0 Chronic invalidism and death are frequently observed in indi- 
viduals suffering from the advanced and late stages of the disease0 
Fortunately it is felt that the great majority of cases studied at the 
l6lst General Hospital harbored either light or moderately severe in- 
fectionSo Cases with clinical evidence of severe liver damage (cirrho- 
sis), splenomegaly, and anemia (Banti°s syndrome) were few and were 
separated from the service0 Those cases showing persistent positive 
stools for ova following repeated therapy with fuadin, and in which 
symptoms referable to Schistosomiasis persisted in spite of therapy, 
were also separateda 
One hundred and fifty-five (155) cases admitted in 1944 
were used as basis for study in a paper entitled of Human 
Schistosoma Mansoni Infections - Proctoscopic picture in asympto- 
matic Schistosomiasis mansoni infections* by Lt0 Col0 Z0 T0 Bercovitz 
and associates«10 
One hundred and fifty (150 other cases admitted during 1943, 
1944 and 1945 comprised another article still unpublished, titled 
"Fuadin Therapy in On© Hundred and Fifty Cases of Schistosomiasis 
Mansoni Following Study in‘Sixty CasesSummary and conclusions 
follows -• 
(1) Fuadin was employed in the treatment of 150 Puerto 
Rican soldiers with Schistosoma mansoni ova in their stools0 
(2) No cases of Schistosomiasis mansoni were encountered 
in North American troops stationed in Puerto Rieoo 
(3) Fifty or 33 percent of those treated were asymptomatic0 
(4) The frequency of various signs and symptoms encoun- 
tered in the remaining 100 cases are presented0 
i 
(5) The drug was given in courses of 45 cc0 each, com- 
prising a total of 10 intramuscular injections0 The first 3 injec- 
tions of lo5, 3o5, and 5 ccQ each, were given on successive days 
and the remaining 7 injections on alternate days0 
(6) Toxic reactions of a mild degree occurred in 18 or 
12 percent of the cases0 Two patients developed constitutional 
reactionso 
(7) The immediate effect of therapy employing 5 consecu- 
tive negative stools after completion of a course is as follows: 
114 cases or 76 percent negative after 1 coursej 21 or 14 percent 
negative after 2 coursesj and 15 or 10 percent positive after 2 
courseso (8) Follow-up observations for a period of 1 to 15 months 
after treatment reveals 33 individuals or 55 percent with negative 
stools (at least 5 specimens examined on each case)e Three continued 
to have complaints9 the remaining 30 were asymptomatic0 Twenty- 
seven men or 45 percent continued to pass Schistosoma ova after treat- 
ment* Ten men or 1607 percent were asymptomatic9 whereas the 17 others 
or 28*3 percent who had positive stools had complaints* 
(9) Fuadin is not a very efficient drug in the treatment 
of Schistosomiasis raansoni in the chronic stage as determined clini- 
cally and by the presence of ova in the stoolsD The search for other 
and more effective remedies should be encouraged. 
Filariasis: 
The incidence of filarial infection in Puerto Rican sol- 
diers has been estimated about 3o5 percent but the incidence of 
proven filarial disease has been rare* . This subject has been exten- 
sively discussed in a report by Z* T* Bercovitz and H* Schwachman 
entitled "Filarial Survey Among Puerto Rican Young Men" which has 
been presented for publication and approved by The Surgeon General8s 
Office* Microfilariae bancrofti has been the only filaria encountered. 
Typhus; 
Typhus fever9 murine type is the only Rickettsial disease 
encountered at the l6lst General Hospital and a total of 8 cases were 
observed from 1942 to 1 October 1945o No deaths occurred0 In con- 
trast to the relatively low incidence of typhus in this area among 
Army personnel9 the number of cases reported from the civilian popu- 
lation of the Island of Puerto Rico has increased since 1940 and the 
incidence of death has been about 5 percent0 The cases of typhus 
observed at this hospital were treated symptomatically; sulfathiazole 
in 1 case; sulfanilamide in 1 case; penicillin units) in 1 
and sulfadiazine in another9 were employed without signs of 
improvement* 
45 f HEMY BARRACKS 
Venereal Diseases 
During 1941 there was a total of 74 cases of venereal disease, 
with gonorrhea 44, syphilis 23, and chancroid 7o In 1942 there were 
three prophylactic stations, one in the 25th field Artillery Area, one 
in the 162nd field Artillery Area, and one in the town of Oayey, P* Eo 
All stations were manned hy Medical Department personnel., Until 17 
September 1942, a prophylactic station in the town of Caguas, P* B*, 
was also manned by the Medical Department personnel from this Post since 
the town was a frequent source of contacts* On the above date the 
duties concerned with the maintenance of this station were assumed by 
the Medical Department, Camp 0*Reilly* 
Other methods of venereal disease control were? 
(1) Periodic personal hygiene lectures by company officers* 
(2) Periodic personal hygiene lectures and films shown by Medical 
Officers* 
(3) Compulsory prophylactic treatment for all men returning from 
pass intoxicated* 
(4) All men returning from pass must report to the prophylactic 
station and either take a prophylactic or certify that they have not had 
intercourse* 
(5) All men going on pass were afforded the opportunity of obtain- 
ing condoms from the charge of quarters* The condoms were tested 
periodically by the Medical Department* 
(6) All known contacts have been reported to the Public Health 
authorities* 
During 1943 the above measures for the control of venereal disease 
were supplemented to include the proper technical instruction of all 
prophylactic men in the procedure to be followed in the administration 
of sulfathiazol in the prophylaxis of gonorrhea* Also Medical Depart- 
ment enlisted men doing charge of quarters duty were concerned with the 
preparation of reports made by soldiers returning from pass denying to 
have had sexual intercourse* A register book was kept for that pur- 
pose* In addition to the three prophylactic stations already in 
operation, another was opened at the Salinas Training Area, Salinas, 
P* R« , in September 1943, as this town was a frequent source of contacts* 
This station was manned by Medical Department personnel of this Post* 
47 A total of 112 cases of venereal disease of all types were reported 
in 1943. Contacts were reported to Public Health units, which hospital- 
ized them. 
The 296th Infantry Bn. arrived from Panama 4 April 1945 and was 
given a 30 day furlough. Smears were taken which revealed 9 cases of 
gonorrea and 4 cases of syphilis. 
Malaria; 
During 1941 there was an epidemic of malaria with a grand total of 
113 cases with 14 recurrent cases. Troops were on maneuvers in the 
Salinas Area during the high rate of malaria. 
The Malaria Bureau, which was composed of both military and Insular 
Health Department officials as early as 194C helped to control mosquito 
breeding in extra military areas. In combating malaria, blood and spleen 
surveys of populations residing within the mosquito flight range of the 
post were made with free drug treatment administered to those individuals 
found infected with malaria parasites. Drainage systems were installed 
in local areas to prevent mosquito breeding. 
It is maybe that a large contributing factor to the high malaria 
rate of 1941 was the low level of military discipline obtaining at that 
time. 
In 1942 screening of the post was almost 100$. Malaria discipline 
was tightened and all personnel were required to use mosquito bars at 
all time. The malaria problem was at a minimum since the number of 
anopheles mosquitoes was less than 1$. 
In 1943 mosquito control was maintained by proper drainage and by 
oiling. 
Filariasiss 
•Microfilariae smears were made on all Puerto Ricah personnel on 
1 June 1945 with 3 positive,, 
Schistosomiasis s 
In 1945 smears and stools were taken on Boy Scouts who were using 
the swimming pool, hut of 22 individuals examined 21 were positive,, 
Therefore the practice of allowing Boy Scouts and other civilians the 
use of the swimming pool was discontinued,, 
Since the malaria epidemic in 1941 there has been no epidemic on 
this posto 
48 PORT BUCHANAN 
Venereal Disease Control? 
Venereal Disease Control on the Post may be considered under the 
following heads? 
I - Moral 
II - Recreational 
III - Educational 
IV - Medical 
V - Disciplinary 
VI - Suppression of Prostitution and Case Finding 
lo Moral: 
The fact that continence and self-control are the best 
and only sure method of prevention of venereal disease has been em- 
phasized as a fundamental of the VD Control Program by all concerned* 
Tne value of moral purity has been pointed out in talks by the Chaplains 
and given further emphasis by the example and admonition by Commanding 
Officers of all grades* in periodic appeals to men 6f all organizations* 
II. Re creational t 
Improvements in recreational facilities and encouragement 
of participation in sports* educational programs and supervision social 
activities have played an important part in providing use for leisure 
time and a needed outlet for physical and mental energy which might 
have led in many cases to sexual adventures had these outlets not been 
provided. The stimulation of interest in making a home for the enlisted 
men in their own quarters and dayrooms has decreased the urge to go to 
town and forget the Army for a while. All these activities are to the 
credit of Commanding Officer* Company Officers* and the Special Service 
Organizations of the Post, 
III. Bducat ional? 
The burden of the Educational Program has been distributed 
among a wide number of persons and carried on in a variety of ways6 
The Post Venereal Disease Control Officer has been principally charged 
with supervising it* providing materials and training other instructors.. 
The purpose has been; 
(l) To acquaint every man of every organization on the 
Post with the essentials of what the various venereal diseases are* 
their effects on the human body and possible results of neglecting 
treatment* 
49 (2) To make sure that every man knows how to avoid these 
diseases by continence or by the use of prophylaxis if he is exposed® 
(3) To acquaint all men with the facilities provided for 
their protection in the prophylactic stations and hospitals® 
To provide this instruction a variety of methods have been used® 
Films provided by the Signal Corps and by the U® S® Public Health 
Service have been shown periodically to members of all organizations® 
Formal lectures have been given at frequent intervals by the Venereal 
Disease Control Officers and battalion surgeons® Company officers have 
given regular and frequent talks to men of their units® The most recent 
and probably bne of the most successful methods has been the appoint- 
ment of non-commissioned officers as leaders of small groups to which 
they give weekly instruction on some phase of the subject. These men 
are given special instruction by the medical VD Control Officers and 
tested on their knowledge by written examinations® A definite time 
is set aside by the companies for this instruction and additional 
material is provided by the organizations' VD Control Officers. 
An additional helpful method of constantly keeping the facts of VD 
before the men's eyes has been by posters provided by the Surgeon General's 
Office and by printed material from this office and several very valuable 
pamphlets in Spanish from the Insular Department of Health® 
IV* Medicals Purely medical measures are 
a® Regular monthly and other physical inspection of 
troops® 
b® Examination of all civilian personnel employed on 
the Post, particularly the monthly examination of 
female domestics® 
c® Prompt treatment and follow-up of all cases dis- 
- covered® 
d® The establishment and operation of prophylactic 
stations. 
Prophylaxis is operated by specially trained men of the Station 
Hospital Medical Detachment and the Dispensaries® A station was estab- 
lished in the nearby town of Bayamon in October 1942® In May 1943, three 
new stations were constructed at the three gates of the Post, Main9 South, 
and West, and in the following month 269 treatments were given at these 
stations® An officers9 pro-station was added in May 1944 in the Station 
50 Hospital, bringing the total to eight stations0 Beginning in April 
1944, the patronage of these stations dropped off to 40 per month 
and has continued low. This is attributed to the opening of other 
stations nearer the source of contact, and for this reason is not 
considered a serious loss to the program0 SuJ f athiazole pills 
have been used as adjunctive treatment in the pro-stations since 
November 1943, but only 51 cases adequately observed and reported 
the effect of their use, and the results cannot be accurately judged. 
V. Disciplinary: 
In December 1943 the "Pro-Pass Book1* was first insti- 
tuted in an attempt to provide a check on the men who were not uti- 
lizing prophylaxis. Disciplinary action has been taken in a number 
of cases where men have failed to report an exposure, but there is 
still a tendency for men to be reticent0 Following the discontin- 
uance of the operation of AR 35-1440 in VD cases , an attempt was made 
to add the stimulus of group censure and loss of privileges0 The 
leader is responsible for his group’s instruction under the super- 
vision of the VDCO, and all men of the group are subject to 30 days 
loss of pass privilege if one contracts an infection. 
VI, Suppression of Prostitution: 
This, one of the most effective methods of reducing 
VD rate, must always depend upon cooperation of civilian health 
authorities. It can be stated that in general this cooperation has 
been extremely good. It was highlighted by the visit to the Post 
in February 1944 of Drc Thomas Parran, Surgeon general of the U, So 
Public Health Service, 
Post Venereal Disease Control Officers 
December 1942 Capt0 V, J<> Montilia 
July 1942 Major E0 Garrido Morales 
May 1943 Capto Herman Winkelman 
October 1943 ' 0apto Juan Basora Defillo 
November 1943 1st Lt0 Jo G0 Sugranes 
January 1944 1st Lto Ho Vazquez Milan 
April 1944 Capte E0 Lo Matta 
June 1944 Capto Philip M0 Reilly 
June 1945 Capto Donald E0 Babb 
Malaria Control: 
In order to present the malaria which existed at 
Fort Buchanan when military activities began after the outbreak of war 
51 it is necessary to elaborate on the physical aspects of the area. 
The section to the north was very swampy, and in order to establish 
the Naval reservation and the Army Terminal on the available ground, 
hydraulic filling operations were begun, By this process, bottom 
sediments with large amounts of water were pumped from San Juan Harbor0 
The solid material was allowed to settle, and the disposal of the ex» 
cess water became a serious problem0 Drainage from the entire Post 
area was practically blocked since no satisfactory outlet to the 
harbor existed,. During heavy rainfall, many swampy areas existed 
within the Postc To the north of the cantonment, opposite the Ord- 
nance area, a large swamp existed, and where no swamps were present, 
canefields with their network of irrigation ditches which created 
mosquito-breeding spots were found0 To the east of the Post was 
Brugal Swamp, a potential raosquito«breeding area. In the west of 
the cantonment was Barrio Santa Ana, a community in which many mal“ 
aria carriers were Also within flight range of the Ac 
albimanus were Barrio Juan Domingo, Villa Caparra, and a small portion 
of Bayamon, where some malaria carriers may also have been presents, 
Aggravating the generally serious malaria problem was the creation 
of many man-made mosquito“breeding places as a result of railroad, 
warehouses, roads, and other construetions0 
From the preceding paragraph it can be readily realized 
that anopheline mosquitoes, as well as pest mosquitoes, at this Post 
were very prevalent due to poor drainage conditions. The source for 
infecting the anopheline mosquitoes was very near to the cantonment 
due to the presence of carriers in the communities adjacent to the 
Posto Since the physical examination for military personnel did not 
include malaria smears, many soldiers stationed at Fort Buchanan 
may also have been malaria carriers0 A glance at the malaria rates 
for the months of 1942 will readily convince anyone of the problem. 
Malaria rates are computed as followss 
(No, of x 1000 a Malaria rate/1000 
(During month) troop strength men/year. 
Therefore, two cases per month for a troop strength of 1000 men means 
a malaria rate of 24 per 1000 men per year. In 1942 the malaria rate 
for the year was 122 which corresponds to 793 cases occurring,. In 
1943 a total of 104 cases of malaria occurred, while in 1944 there 
were only 19 cases0 One item should not be overlooked5 the fact that 
all troops assigned to this station were considered in computing the 
rates and cases0 This means that during 1942, many troops assigned 
to the Post were not actually quartered here, since they were stationed 
at various searchlight and anti-aircraft positions outside of the 
control zone 
52 The initial approach to the problem consisted of study and plan- 
ning by members of the Medical Department and the Dorps of Engineers0 
The problem was so serious that time would not permit waiting for 
improvement of the drainage,, Hydraulic fill operations were not com- 
plete at the Army Terminal* Funds had not been provided for such an 
extensive drainage program, and it would have taken much time to 
improve drainage conditions to eliminate mosquito-breeding areas* 
The Insular Health Department began the construction of sub-soil 
drainage in the head waters of El Toro Creek in February 1942* How- 
ever, as far as drainage improvement was concerned within the Post 
only minor ditching was performed* The Insular Health Department 
was also in charge of larvididing the many cane fields and marsh 
lands in the vicinity of the Post* 
In May 1942, however, malaria control operated more or less 
separately in the cantonment areas Two enlisted men from the Medical 
Detachment and eleven W, pc A* laborers were assigned as a malaria 
control team. They were engaged in paris-green larvicide dusting 
throughout the Post and Army Terminal Area, using dusters furnished 
by the U. S. Public Health Service* Also during May plans were made 
for providing properly screened quarters, to secure grass cutting 
crews to eliminate vegetation from drainage ditches and from edges 
of swamps, to conduct blood smear surveys to locate malaria carriers, 
to conduct an extensive educational program* It was felt that these 
plans were the only ones feasible since drainage improvements would be 
slow and we could not rely on larvicidal control measures alone* 
In July 1942 regular inspections were instituted for all organi- 
zations on the Post* Each barrack in every organization was inspected 
and the organizations were rated or scored on the following itemss 
doors, screening, presence of adult mosquitoes, use of mosquito bars, 
and cooperation with the control program* (The included inspection 
form was used.) At the end of each month the Post Engineer crews 
were at work mosquito-proofing barracks, but due to the lack of screen 
wire because of other demands and shipping, this program was somewhat 
delayed. The drainage of the Terminal area was somewhat improved by 
the construction of a temporary drainage ditch near Catano* This 
ditch drained a mangrove swamp which in turn drained the Army Terminal 
swamp* Also during the month the United States Public Health Service 
enlarged their crews and took over the larvicidal program within the 
cantonment. 
Malaria control among enlisted men and officers involved careful 
application and enforcement of regulations pertaining to bed-nets, 
drainage and other factors connected with successful control of the 
disease. With the approach of the rainy season and the consequent 
increase in malaria-transmitting mosquitoes and the pest variety, all 
53 STATION HOSPITAL 
Office of the Surgeon 
Fort Buchanan, Puerto Rico 
Date 
MEMOS ~ 
TO ; - Commanding Officer, Fort Buchanan, P, R. 
lo In compliance with orders the undersigned has this date inspected 
COo . and found malaria control conditions to be as follows; 
SCORE 
a. Doors and Windows? - 
Kept closed_ 
Properly Adjusted 
Adequate Springs and Latches 
b. Screening; « 
Tent or Barracks frames and 
screens in good repair____ 
Co Adult mosquito controls « 
Insecticide sprayers 
Supply of Insecticide 
d„ Larval mosquito controls - 
Oiling of places near barracks 
which contain water as fire 
barrels, ditches etCo 
e. Presence of mosquitoes 
(None, few, many) 
f» Mosquito Bars; - 
Properly used 
In good repair 
gc Headnets and Gloves for sentinels, l£bor 
details, and drivers at night 
h„ Willingness to cooperate with the 
malaria control program 
TOTAL 
DEFECTS NOTED; commanders were directed to exercise proper malaria control measures 
within their organizations. The measures were outlined in a memo- 
randum from Post Headquarters, entitled,, "Malaria Control." The 
memorandum contained provisions for the appointment of anti-malaria 
details", instructions on malaria to enlisted men, the use of bed- 
nets and aerosol bombs, and the proper care of screens in barracks 
and kitchens. It was ordered that torn bed-nets and screens that 
contained holes were to be reported and repaired at onceQ The aero- 
sol bombs were particularly effective in ridding buildings of ants, 
roaches, flies, mosquitoes, and other insects. 
In August 1942, the malaria rate continued to be excessive even 
though every effort was being made to destroy the anopheline larvae 
by paris-greene larvicide, by providing proper mosquito-proofed quar- 
ters, and rigid supervision of organization malaria control measures 
by the Post Medical Inspector and Post Malaria Control Officer0 Blood 
smear surveys were made of all troops who had malaria during the pre- 
vious months to determine whether carriers existedo Checks were made 
of barracks to determine what mosquito-proofing defects needed cor- 
rection, so that the Post Engineer could send his crews to make neces- 
sary repairs. The first strictly malaria control allotment of $19,000 
per quarter was secured to eliminate "man-made" mosquito breeding 
areaso The Insular Health Department completed the El Toro Creek 
project which was begun in February. 
The great drop in malaria at this Post in September 1942 from 
14.8 to 64. was probably due to the mosquito-proofing program and the 
cooperation of the unit commanders in the Post Malaria Control Program0 
During October 1942 the Post Engineer began the Post drainage 
improvements program with funds alloted quarterly0 The mosquito- 
proofing program continued, and the larvicidal program increased0 A 
new phase of malaria control was initiated in December, when plans 
for a permanent malaria control project were submitted for approval. 
This project, estimated to,cost $292,000 was to include filling and 
grading of low areas, and"the placing of concrete linings in the 
earthen ditches. While waiting for this project to be approved by 
higher headquarters, various epidemiological surveys were conductedo A 
blood smear survey was made by members of the Antilles Department Medical 
at the Colonia Santa Ana community which revealed many mal- 
aria carriers. As a result of this study the residents were evacuated 
during September 1943 to a new location. A study was also made to 
determine the manner in which the troops at this station had con- 
tracted malaria. This study revealed that more than 50 percent had 
been on guard duty at night, and corrective measures were recom- 
mended. 
During January 194-3 work was begun on the large canal from the 
Army Terminal to San Juan Harbor with the outlet west of Catano. 
55 This project, costing $94,000, was recommended during November 1942o 
However, construction could not be begun until the hydraulic filler 
had been completed and consolidated. Work continued on this project 
until May 1944, when it was completed. 
In order to discharge normal water flow into the harbor and to 
prevent tides entering into the swampy areas a large pumping station 
having a capacity of 90,000 gallons per minute was constructed at an 
estimated cost of $75,0000 This project has been very instrumental 
in maintaining a low malaria rate at the Post0 Since this drainage 
system has been placed into operation, many acres of mangrove swamps 
and stagnant waters have been eliminated, and the drainage system of 
the Post has been satisfactory even during excessive rainfall. 
During April 1943 paris-green larviciding operations by airplane 
was begun over Brugal swamp, located east of the camp. 
During May 1943 freon aerosol bombs and repellent No0 612 were 
made available to troops0 Due to the ease in which the insecticide 
could be applied, more efficient spraying of barracks was possible0 
From January until June 1943r malaria control was principally 
temporary in nature, but in June the Post Engineer obtained $14.,64.O 
under PEM0 359 for replacement of 17,900 cu0 yds0 of fill, and to 
construct 3,900 feet of 12 l/2 inch concrete ditch lining in the 
general Depot of Army Terminal, area0 But work on this project was 
delayed due to the shortage of*trucks. 
From June until September 1943, routine malaria control measures 
continued in effecto Barracks continued to be inspected monthly and 
temporary ditching and the larvicidal program continued. 
During September 194-3 the work on the permanent malaria control 
drainage project beganG Concrete Panama type inverts, side slabs and 
half round concrete tiles were constructed by the Uo So Public Health 
Service at their Rio Piedras warehouse on a materia! replacement basis 
and hauled to AP0 84.6, where Post Engineer and W.P.AP labor made ne- 
cessary excavations and placed the concrete linings0 In addition to 
lining of ditches, many fill areas were completed0 By the end of 
November 1943, due to lack of funds, the project was suspended but 
in April 1944- a request was made for $41,702 for the purpose ox 
completing the ditch lining and fill projects0 This project had not 
been approved up to early 1945o 
56 In October 1943 three enlisted men were assigned as Malaria Control 
Technicians to assist eht Post Malaria Control Officer, as entomologists 
in the larvicidal program and also to secure “Adult Mosquito Indices in 
Barracks* and ttMosquito~Proofing Indices0M (Forms used were as those 
included.) To secure “Adult Mosquito Indices in Barracks*1 the enlisted 
men would spray weekly ten barracks scattered throughout the Post 
during the early morning hours and collect the dead mosquitoes„ The 
mosquito proofing indices were determined by checking barracks for 
holes and cracks in walls and floors, defective windows and doors,.and 
number of torn bed=nets0 This program, was continued until 1 October 
1944o In addition to carrying on this program, the Malaria Control 
Technicians assisted in checking mosquito breeding areas and in the 
Malaria educational program0 
Ever since the first quarterly allotment of 119,000 was made in 
August 1942, similar allotments have been made continuously, however, 
in gradually smaller amounts0 In the beginning the funds allotted 
were used for minor filling, new ditching, ditch maintenance, and mos- 
quito proofing of barracks0 However, from March 1944 the funds were 
allotted to carry on the continuous larvicidal program within the Post, 
and ditch maintenance expenditures were to be obtained from ground 
maintenance funds. In view of the fact that it was decided in March 
1944 to make an effort to control both anopheles and culicine mos- 
quito breeding within the Post, the U0 Se Public Health Service dis- 
continued paris“green larviciding within the Post, and larviciding 
with oil was begun by Post Engineer labor and supplies0 This program, 
though effective against both types of mosquito breeding within the 
Post, did not mean that pest mosquitoes would not continue to invade 
the barracks, since pest mosquitoes were not controlled outside the 
boundaries of the Post by paris-green dusting0 Larvicidal control by 
means of diesel oil is very expensive when controlling th© larg© areas 
necessary for A0 albiraanus0 To control this species it is necessary 
to larvicide all stagnant bodies of water found within approximately 
22,000 acreso Within the boundaries of this station there are approxi- 
mately 1900 acres, and when diesel oil alone was applied, some 950 
gallons were used monthly0 Since it was felt that a considerable sav- 
ing of diesel oil was possible by producing a diesel oil-maker emulsion 
in the Chemical Warfare Service Decontamination Unit and applying the 
emulsion as the larvicide, this practice was begun in September 1944® 
However, it was found that the emulsion was not as effective as de- 
sired, and instead of using one drum diesel oil, to three drums of 
water in preparing the emulsion, one-half drum diesel oil, one-half 
drum kerosene, and three drums of water was experimented with and 
continues to be used at the present tirae0 Results have been as 
effective as if diesel oil alone were used, and the amount of oil has 
been reduced 75% by this emulsion larvicide. On several occasions DDT 
has been added to the emulsion, but no outstanding results have been 
obtainedo 
57 During 1944, no outstanding accomplishments have been made with 
the exception that malaria among troops at this station has been kept 
at a low level by close supervision of the larvicidal program, proper 
maintenance of lined ditches, and cooperation of organizations stationed 
her©0 The malaria rates for 1944 have never been more than 12, and 
during three months no malaria occurred,, 
In 1945, eleven laborers arid one foreman employed and admin- 
istered by the Post Engineer were performing the larvicidal activi- 
ties o Two of these men, assisted by the Malaria Control Technicians, 
worked ahead of four men operating sprayers, checking all bodies of 
water within the cantonment for mosquito larvae0 When larvae, 
anopheles or culicines were found, a small white flag was placed 
in the body of water; these areas were then thoroughly treated by 
the sprayer operators, who also treated all bodies of water even 
though no larvae were found in them0 Several hours after the spray- 
ing operation, the "flagged** areas were again checked by the Malaria 
Control Technicians, and if no live larvae were found, the flags 
were removed0 In order to minimize the amount of larvicidal treat- 
ment necessary and to secure more efficient treatment, five laborers 
are engaged in cleaning vegetation from the unlined ditches, and minor 
ditchingo Formerly it required five days to completely larvicide 
the Post area, but on many occasions the work has been completed in 
three or four days. 
With this small crew of laborers, vegetation was cleared from 
the large dragline constructed channel, heading near the Army Terminal, 
and reconditioning the channel of El Toro Creek0 
Recently the Army Terminal, El Toro Creek, Ordnance, Radio Stations, 
Incinerator, and Post Garden drainage areas have been greatly improved. 
The following data, though incomplete, will give some indication 
of the amount of work done; 
10 877c8 acres of land cleared or brushed. 
20 9S.1 miles of channel or ditch cleaned. 
3o 12c? miles of new ditching constructed. 
4o 32,000 truck loads of fill (3 cu0 ydsQ each), 
5o 4°5 miles of lined ditching constructed0 
60 112 drums of oil applied. 
7. 61 tons of paris-green mixture applied, 
8, 44 men have worked each week for the 3 years period (av0)« 
9® 2,196 larvae collections made. 
58 Malaria Control Officers 
Capto Harry C0 Greenfield, SnC 
Sanitary Inspector 
25 June 1941 - 26 June 1943 
Capt. Irving Fox, SnC 
Asst, Sanitary Inspector 
Assto Malaria Control Officer 
24 April 1942 • 26 June 1943 
26 June 1943 - 30 July 1944 
Capto Norman Winch, SnC 
Assto Malaria Control Officer 
Malaria Control Officer 
28 May 1943 - 27 August 1943 
31 July 1944 - 18 September 1944 
Capto Henry Lo Dabney, SnC 
Malaria Control Officer 
6 October 194-5 *17 February 194-5 
Capto Wm0 A, Moggie, SnC 
Malaria Control Officer 
21 February 194-5 to this date. 
59 OSES’ FIELD 
Venereal Diseases 
Previous to January 194-5 all maids and waitresses who worked on 
the post were given complete physical examinations whenever the Post 
Command deemed it necessary but3 since that date5 examinations have 
been performed once a montho Any maid or waitress examined showing 
a positive smear for venereal disease was. discharged immediately and 
her name submitted to the Public Health Officials0 
Commendation was given the Medical Detachment of the 301st Sta~ 
tion Hospital by the Commanding General9 Antilles Department on 
25 April 194-5 $ for maintaining a perfect venereal disease record for 
the past fifteen months. 
Following is a monthly list of venereal disease cases and reports 
of activity by prophylaxis stations run by this hospital during part 
of 1945: 
May (a) Three cases gonorrhea and six of syphilis. 
(b) Number of prophylaxes administered during the month 
Fonc© Pro^Station 
78 
Base Pro°Station 
135 
Hospital Pro~Station 
1 
Total * 
2 U 
(c) The interior of the Ponce Pro~Station was painted 
white and two straddle sinks were installed« 
June (a) Three cases of gonorrhea and six cases of syphilis 
charged against this station for the montho 
July (a) Two cases of syphilis and no cases of gonorrhea 
charged against this station. 
(b) Number of prophylaxes administered during July 
Ponce Pro-Station 
O 
Base Pro-Station 
170 
Hospital Pro-Station 
Total 
237 
61 August (a) Two cases of syphilis and four cases of gonorrhea 
charged against this Station for August. 
(b) Number of prophylaxes administered during August 
Ponce Pro-Station 
82 
Base Pro-Station 
130 
Hospital Pro-Station 
2 
Total 
2U 
September 
(a) No cases of syphilis and five cases of gonorrhea 
charged against this Station for September. 
(b) Number of prophylaxes administered during September 
Ponce Pro-Station 
208 
Base Pro^Station 
77 
Hospital Pro-Station 
0 
Total 
285 
No records of venereal disease reports were found at this hosp- 
ital prior to August 194-4-0 Following is the post Venereal Disease 
rate by monthss 
Month 
Year 
Rate per 1000 per annum 
August 
1944 
26o54 
September 
1944 
57 o 82 
October 
1944 
72.63 
November 
1944 
96.63 
December 
1944 
6.32 
January 
1945 
19o45 
February 
1945 
74o26 
March 
1945 
38.70 
April 
1945 
- . 
56.12 
May 
1945 
24=52 
June 
1945 
38 = 07 
July 
1945 
0.00 
August 
1945 
26021 
September 
1945 
30.28 
62 The report indicated a sharp rise in the venereal disease rate 
from 26o54 per thousand per annum in August 1944- to 96063 per thou°> 
sand per annum in November of that year0 At that time an educational 
program was instituted and the trend has been generally downward 
since then0 
Malaria Controls 
Very little Information was available on malaria control measures 
at the 301st Station Hospitalo However3 some difficulty in choosing 
the hospital site was encountered9 as specifications stated that it 
must be at an elevation of at least 300 feet above sea level on well 
drained land to lessen the mosquito hazard<, 
The monthly total of malaria eases for 1945 is as follows? 
January 1 cas© 
February 0 cases 
March 0 cases 
April ; 2 cases 
May 1 case 
June 1 case 
July 4 cases 
August 5 cases 
September 5 cases 
October 4 cases 
Epidemics? 
Late in December 1941 an epidemic of typhoid fever in the nearby 
city of Juana Diaz3-4 threatened the health of the post0 Up to Decern™ 
her 1941* there were 1? known cases of typhoid fever which had 
been reported officially9 and there were at least 40 other diagnosed 
cases of typhoid which had not been reported to local health author!™ 
tieso Definite steps were taken by the Juana Diaz Health Department 
to control the epidemic0 Liquid chlorination of the water supply 
was begun5 a chlorine residual of 0C2 to 0o5 parts per million being 
maintainedo At the same time immunization with typhoid serum was 
beguno The populace was warned to boil all cooking and drinking 
water* 
Drastic steps were undertaken at Losev Field to safeguard the 
health of military personnel0 All personnel who had not had a ty= 
phoid series in the previous six months were innoculated, Juana 
Diaz was placed off limits and a warning issued to all troops against 
63 eating or drinking anywhere outside the base* In addition all food 
handlers forking on the base and living in or near Juana Diaz were 
barred from the post for the time beingc 
An outbreak of typhoid fever occurred in Ponce$ Puerto Rico,, 
in August 1942Approximately the same precautions were taken 
by civilian health authorities to stop the epidemic.and by military 
authorities to protect troops as was done in the Juana Diaz out- 
break eight months previously0 No record of infection of military 
personnel is known„ 
64 'CAMP tortuguero 
Generals 
The Sanitary conditions present at the Post when the Army took 
over in October 194-0 were far from satisfactory0 It may be said., in 
fact3 that they were considerably below minimum standards for an army 
installation This section,of the history will concern itself mainly 
with the demonstration of these conditions and the various remedial 
measures employed in combating so that the Post conforms 
to high health standards0 
It will be recalled that Camp Tortuguero is in a highly endemic 
malaria areaG The two towns in its close proximity have high malaria 
rateso Sanitation within these towns is very poor0 Marsh lands and 
lagoons in the camp area were excellent breeding places for malaria 
bearing mosquitoes0 The sandy soil whipped up by the almost constant 
winds gave rise to a very dusty atmosphere0 
Venereal Disease Problem and Controls 
The Venereal Disease problem at this post has been complicated by 
the fact that the population is transient and not regularly assigned0 
The two main organizations on the Post5 the Unit Training and 
Replacement Battalion are in a highly fluid state as far as personnel 
is concernedo Thus it was difficult to properly inculcate the men 
into the habits of venereal disease control since many of them would 
be here for only a few daysc In addition men shipping out overseas 
and those returning from overseas received their furloughs from this 
station thus making the problem more acute0 In spite of this the 
venereal disease rate has shown constant improvement and has always 
stayed under the maximum limits set forth for the department0 
Venereal Disease control became a major function of the Station 
Hospital with the advent of large numbers of troops into the Post0 A 
Venereal Disease Control officer whose sole duty was VD control was 
assignedo Control consisted of education of the troops together with 
the control of sources of infection by cooperating with the local 
health authorities0 Prophylactic stations were set up both on the 
post and in adjacent town areas„ 
65 Prophylactics, both mechanical, and chemical were made available 
to the troopso Four prophylactic stations were placed in operation. 
They are located at Vega Baja, Manati, Arecibo, and on the Post itselfo 
These pro-stations are inspected regularly by medical officers0 All 
information regarding contacts with enlisted men are forwarded promptly 
to pertinent civilian authorities0 The Post VD Control Officer has 
held conferences with Public Health and Insular police officers and has 
conducted raids with their cooperation in all of the adjacent munici- 
palities. Social agents have been assigned to this Post by the Insu- 
lar police for the purpose of ferreting out suspicious women who loiter 
about the Fosto 
Malaria Controls 
Malaria control activities were intensified immediately,, Malaria 
discipline was taught to the troops and a constant check for compliance 
was maintained„ Anti-malarial details were organized and house-keeping 
measures carried out effectively,. Insecticides and the use of screens 
and mosquito bars were taught0 The quarters for troops at this post 
were in such poor condition that much maintenance was required0 Activ- 
ities in the intra and extra-cantonment areas which were carried out 
may be summarized as follows! 
aQ 
Clearing and brushing? 
(1) Acres 
mi 
573.87 
19U 
106o43 
bo 
Channel and ditch clearing: 
(1) Lineal feet 
119,147 
828,?60 
C o 
New ditching: 
(1) Lineal feet 
129,592 
18,173 
do 
Fills 
(1) Cubic yards 
20,799.7 
98o5 
eQ 
Larvicidal Works 
(1) GalSo of oil 
4,184 
The control measures used in 1943 were the same put into 
practice in 1944° Mosquitoes were controlled by destroying their 
breeding places, killing the adults and preventing their entrance into 
the living quarters of troops0 Ditching, drainage filling applica- 
tion of larvicides and elimination or control of artificial containers 
of water are the means employed in combating breeding,, Screening of 
all buildings occupied at night, spraying of insecticides and the use 
of mosquito nets are the measures employed in protecting the troops 
from the adult0 
66 There have been $06 cases of malaria hospitalized at this station 
The majority of cases have been of a mild variety and no serious com- 
plications have been encountered* The average period of hospitaliza- 
tion has been 6 daysQ The treatment was carried out according to th© 
Surgeon General directives for the corresponding periods0 It is in- 
teresting to note the marked decline in malaria hospitalizations with 
th© succeeding years which is a reflection of the effective malaria 
control measures instituted at this posto 
Year 
Number of hospitalized cases 
Rat© 
19a 
350 
73 
19a 
606 
88 
19a 
105 
19 
1944 
32 
10 
194-5 (up to Nov.) 19 
4 
The venereal diseases have always been a major problem for this 
hospitalo As was stated previously in this report this problem has 
been attacked vigorously from the start0 A single medical officer whose 
sol© responsibility is venereal disease control has been assigned to 
the task and extensive educational programs have been instituted„ 
aG Syphilis 
Year 
Number of Cases 
Rat© 
1941 
31 
6 
1942 
27 
4 
1943 
118 
21 
1944 
24 
8 
1945 (up to Nov0) 
35 
a 
b0 Gonorrhea 
1941 
162 
34 
1942 
141 
20 
1943 
375 
66 
1944 
36 
12 
1945 
85 
3 
Enteric Diseases! 
In all there have been 502 cases of enteric diseases which have 
received treatment at this Station0 No deaths occurred* They varied 
67 from the mild diarrheas to rather severe bacillary' infections„ There 
was a smaller percentage of acute amebiasis cases0 No serious com° 
plications were encountered0 
Helminthic Diseases: 
All patients upon admission to this hospital for whatever cause 
receive a routine stool examination0 In cases where the presence of 
parasites is more strongly suspected9 stools are run on the patient 
for three successive days0 On other gastro-intestinal patients these 
examinations are run for much longer period until a definite conclusion 
is arrived atc The hospital population at this station is predomin~ 
ately Puerto Ricanc As a result a very high percentage of the patients 
have one or more parasites on their stools„ All hookworm cases were 
treated with tetrachlorethylene according to the Surgeon GeneralBs 
directiveo A rather significant group of Strongyioides stercoralis 
cases were treated with Gentian Violeto Schistosomiasis cases were 
evacuated to the General Hospital for more definitive treatment,, 
Filariasis: 
The experience with filariasis at this Station has not been 
largeo There are on record only 25 admissions for this disease0 
This however, is not an index of the amount of filariasis present on 
the post for the vast majority of the cases were not hospitalized0 
Typhuss 
There is no record of any admissions for typhus fever at this 
hospitalo Since the presence of endemic typhus on this island is 
well knowns and since it is known that the disease here tends to 
run a very benign courset it is logical to suppose that a small 
percentage of the undiagnosed fevers might have fallen into this 
groupo 
Dengue; 
There have been 17 cases of dengue fever hospitalized at this 
station,, All cases occurred between January to May 1941 which seems 
to indicate that there might have been a slight epidemic of this 
disease at that time0 
68 ORINQUEN FIELD 
Venereal Disease Control: 
The incidence of venereal diseases among Army troops stationed 
at Borinquen Field sine© the year 1942 has shown a marked improvement 
up to the present time0 The average rate for 1942 was 72 per 
per annum, 1943 - 50 per 1 ,,000 per annum g 1944 “ 36 per 1§000 per 
and for the first nine months of this year, 31o4 per per 
annumo 
Contributing factors have been? 
lo The high incidence of venereal disease among the civilian 
population*, When local government agencies initiate a vigorous 
venereal disease control program for the civilian population9 the 
Array program will not have to be all-inclusive0 The suppression of 
prostitution9 a civilian function9 in the long man? make far 
lower Army venereal disease rates0 
2o Cheapness of alcoholic beverages and consequent over-in- 
dulgence in places where pick-ups are readily availablee 
3o Laxity in moral standards brought about by a number of 
conditions such as foreign environment where restraining influences 
of the individual5s local or hometown society are not 
nostalgia,, prolonged stay in isolated places 9 and resentment against 
regulations 0 
4o Neglect of prophylaxis, brought about by a variety of factors 
such as drunkenness 9 ignorance9 poor and misplaced trueto 
5o Ease of cure with penicillin which tends to abolish the 
sens© of fear that has been connected with these diseases and re- 
sults in increased exposure with disregard of prophylaxis• 
60 Removal of administrative penalties for venereal diseases 
so that they are now considered as any other disease® 
The non-effective rate (as days lost from duty) has shown a 
great decrease with the advent of new medications for the treatment 
of venereal disease0 The non-effective rate for the year 1942 was 
3629 1943 » 2299 1944 ~ 589 and ,1945 (first nine months) 25o 0m 
important factor in the high non-effective rate in the early years 
was the prevalence of sulfa-resistant gonorrhea germs in the 
necessitating prolonged hospitalization0 
69 For a period after the establishment of this no organized 
attempt was made to control venereal diseases other than the sex 
hygiene lectures? the monthly physical inspectionss as required by 
Army Regulations9 and the maintenance of the ordinary provisions for 
prophylaxiso Because of the migration of prostitutes to the surround<= 
ing communities9 the venereal disease rate among personnel of this 
Base became unusually high by October 1941° 
In January 1942 the Venereal Disease Control Officer instituted 
an educational program which has been followed through by the present 
VD Control Officer0 It has resulted in substantial lowering of the 
rate0 An enlisted man was found with ability as a cartoonist and 
posters were made illustrating various phases of the problem0 These 
have been distributed to all barracks and other meeting places of 
soldiers and are changed frequently0 Military sources have supplied 
printed posters which have replaced those which were first produced 
locally0 
Prophylactic stations were established both in and off the Bases 
Intra-cantonment area 
Dispensary A - opened in January 1942 and operated from 
7s00 P0 Mo to 12s00o Number of prophylaxis taken here decreased because 
soldiers entering the Base in taxi cabs which brought them to the bar- 
racks did not want to get off for a **prow and then have to walk to the 
barracks area which is about one and a quarter miles from the Main Gate0 
This station was discontinued 27 November 1944o 
Dispensary B ■» opened August 1942, was in operation 24 hours 
daily9 but because of decreased number of “pros1* and decreased medical 
a change of hours was made 27 November 1944 to from SsOO P0M0 
to Is00 AoMo Because of further decrease of personnel Dispensary B 
was closed 15 September 194$® 
Extra-cantonment area 
Aguadilla City Hall <=> opened April 1942 and operated 24 
hours dailyo With the decrease in the number of personnel9 the number 
of “pros’1* taken at this station did not warrant its remaining open 24 
hours and so on 27 July 1943 the hours were changed to from Is00 P0M0 
to 12s00 Mo With the still further decrease in personnel and •pros,* 
the hours were again changed in August 1944° At present the station 
is open daily from 6s00 P0M0 to IsOO A0M0 
San Sebastian - opposite City opened November 19420 
Because of the few “pros** taken there this station was discontinued 
in June 1943. 
70 Mayaguez Fire House - opened July 1944 when that city was 
put back non limitsan This station is opened from Is00 P0M0 to 
1% 00 A oM © - 
To combat cases of venereal disease coming from exposures 
away from the island 9 a “pro** station was established in the day-room 
of the Detachment stationed at Port-au-Prince9 Haiti9 in June 1944, 
and is operated 24 hours daily,, In October 1944 a **prow station was 
opened at Trujillo City, Dominican Republic9 at the home of the De- 
tachment stationed there but for their own use only* 
As a further precaution against exposure outside the island9 
in August 1944 the responsibility was placed on pilots to see that pro- 
phylaxis was carried out by all individuals exposing themselves in 
these areaso All planes making these trips have been required to 
carry prophylactic materials0 Since October 1944 prophylactic mater- 
ials have been made available at the Weather Station of the Pan-American 
Trujillo City, Dominican Republic„ 
la the period prior to April 1943 prophylactic materials were 
bought by Unit Funds and then resold to the enlisted raenQ Following 
that dau©5 Unit Commanders were permitted to use funds to purchase 
from the Medical Supply Officer, at cost, supplies of condoms 
and prophylactic kits for issue to the individuals going on pasaG In 
October 1944 a new type prophylactic kit was made available9 replacing 
the two-tube set previously in use0 The present kit appears to be 
more satisfactory in ©very way0 During the same month9 free isbu@ of 
prophylactic materials to units by Medical Supply Officers was per- 
mitted on basis of mean strength 
Sulfathiazole by mouth for prophylaxis against gonorrhea 
was authorized at this station 18 November 1943o The report on the 
use of and results from sulfathizole prophylaxis and the seventh-day 
physical inspection of individuals receiving sulfathiazole for pro- 
phylaxis was discontinued 16 June 1944o 
Because of the high incidence of venereal disease among 
civilian population9 great efforts were made to obtain and maintain 
cooperation of civic authorities especially the Insular Public Health 
Serviceo On 7 July 1943* a civilian field agent was assigned by the 
Insular Health Department to the V0 Do Control Officer for the purpose 
of locating and rounding up reported contacts for examination0 The 
information concerning these individuals was obtained from the in- 
fected soldier and then transcribed on Form MD 140 which was authorized. 
29 October 1943o * 
71 In June 1944 through the efforts of the Venereal Disease 
Control Officer, the Insular Commissioner of Health established a 
& 
detention house in Aguadilla for temporary isolation and treatment 
of prostituteSo 
To supplement methods of control of venereal disease and 
since the success of the Army Venereal Disease Control Program was 
dependent, in a large on the adequacy of the individual 
soldier3s knowledge of the education of the soldier regard- 
ing venereal diseases and their prevention was considered an important 
part of their trainingo Since 4 April 1944- Unit Venereal Disease 
Control commissioned and non-commissioned officers of each organiza- 
tion attend monthly meetings presided over by the Medical Venereal 
Disease Control Officer and held at the 330th Station Hospital0 At 
these meetings are discussed individual cases9 rate for the 
venereal disease control activities for each organizationp and new 
measures are instituted for decreasing the rate. 
At first9 all cases of gonorrhea and syphilis were being 
hospitalized and treated9 in accordance with Circular 174 * Office 
of The Surgeon General# 26 July 19420 From February 1943 uncompli- 
cated cases of gonorrhea were treated on a duty status with one course 
of sulfathiazole or sulfadiazine, treatment consisting of one gram 
four times a day for five days0 A second course of the drug was ad- 
vocated if there was evidence of persistence or recurrence of the 
disease after a lapse of two or three days following the first course. 
If cur® was not affected9 patient was then transferred to the 29Bth 
Station Hospital (now 161st General Hospital) as a sulfa-resistant 
case for penicillin therapyQ 
From 22 September 194-4 this hospital was authorized the 
use of penicillin for cases of gonorrhea resistant to one course of 
sulfa drugs and from 31 October 1944 penicillin was authorized for 
all new cases of gonorrhea„ 
The use of penicillin for secondary and latent 
syphilis was authorized from 31 October 1944o 
During the past year a soldier confined to the hospital 
for venereal disease had to forfeit his pay for the period of hospi- 
talization, and in addition,, on this Base „ he was restricted for a 
period of 90 daysc 
From 9 October 1.943 restrictions for syphilis were 60 days 
from day of beginning of treatment and for gonorrhea and other venereal 
diseases 'during treatment and for 60 days following.. From 17 October 
1944 venereal diseases are being considered as any other disease 
72 since there was no loss of pay during hospitalization. Since 2 Decem- 
ber 1944 all venereal diseases are considered in line of duty except 
when contracted while being A.W.O.L., a deserter, or when the diseases 
is concealed. 
Since 7 and 11 December 1944, the following restrictions 
are applied to infected individuals; 
10 Quarantine to company or similar unit area continuously 
for the following period of time; 
a0 Syphilis - 30 days after discharge from hospital, 
b0 Other venereal disease - during treatment and 30 
days after completion of same. 
20 Denied overnight passes for 2 months after completion 
of quarantine. 
3o Denied all 3-day passes and furloughs for 5 months after 
completion of quarantine. 
4o Other members of V0 D0 Control groups to which a man 
contracting venereal disease is assigned to the denied all overnight, 
week-end, and 3-day passes for a period of 30 days. Furlough privi~‘ 
leges not to be affected. 
Malarias 
Prevention of malaria has been and is accomplished by pre~ 
venting the breeding of mosquitoes, screening and keeping the mosquito 
away from the individual. Before July 1942, malaria control on this 
Base was confined to the use of mosquito bars and the screening of 
buildingso The rate, however, became so high that a vigorous program 
of eliminating breeding places was instituted by oiling and filling- 
in all stagnant pools. The effectiveness of these measures is re- 
flected by the marked decrease in the malaria rate. 
Year 
Cases 
Rate 
19^ 
1942 
333 
41 per 1,000 per annum 
68 per 1,000 per annum 
1943 
24 
4o26 per 1,000 per annum 
1944 
1 
0o37 per 1,000 per annum 
1945 
6 
1075 per 1,000 per annum 
73 All the cases in 1945 occurred in Green Project personnel 
or in transients ferried by planes to the States0 The few new cases 
appeared after the discontinuance of atabrine suppressive therapy 
after the men left Italy„ All the cases, both new and old, in the 
Green Project group were Plasmodium vivaxQ One relapsing case among 
Base personnel was falciparum. 
During the last two years there has been no case of malaria 
which was contracted on the Base0 The few cases were contracted off 
the Base while on pass, etc0 
Suppressive treatment of malaria has not been deemed neces=* 
sary on this Base or in the areaQ All patients leaving the hospital 
with a clinical cure of malaria have been requested to take a daily 
tablet of atabrine for three months to prevent relapses0 
Intestinal Diseases: 
The prevention of diarrhea, enteritis, and dysentery narrows 
down to the prevention of introducing the causative organisms into 
food, water, and inhibiting the growth of the few that may be acci~ 
dentally introduced 0 
The introduction of the causative organisms is prevented on 
this Base by: 
’a0 Proper disposal of all body wastes and garbage0 
b0 Keeping the fly count at a minimum, by control of 
their breeding places0 
Co Thorough and complete screening of all places used for 
food storage, preparation and consumption of food„ 
do Complete cleanliness of all persons and equipment used 
in the handling of food* 
The growth of the few organisms accidentally introduced in 
food is controlled by proper ventilation and refrigeration of those 
foods which lend themselves to such growth of organisms, as custards, 
etc, 
The rates for enteritis have been: 
Year 
Cases 
Rate 
1942 
34 
1943 
72 
12.6 
1944 
50 
18.3 
1945 (thru Sep) 
54 
17o5 These rates do not reflect an accurate picture of the incidence 
of diarrhea on the field because only the severe cases are hospitalizedo 
The great majority are treated as sick call or get self-medication® The 
average soldier accepts diarrhea as one of the tribulation of Army life 
and so treats itG 
An epidemic of diarrhea involving approximately per- 
sons occurred during Christmas week of 1944-. It was traced to a break 
in technique in the process of making reconstituted milk. The cans in 
which the milk was being stored after processing were not being pro- 
perly cleaned and sterilized® All milk and milk products stocked in 
the Base at the time were destroyed® A high pressure steam sterilizing 
plant was installed to facilitate the proper sterilization of all the 
milk and ice cream machinery and cans® There has been no further 
trouble from this source® No definite organism was isolated in the 
above outbreak® 
A minor outbreak of diarrhea involving 11 civilians9 all 
eating at the same mess* occurred IS February 194-5. This outbreak 
was traced to the meat loaf which had been served them at the previous 
evening8s meal® Again the organisms could not be isolated. 
There are always scattered individual cases of diarrhea on 
the Base® These are usually caused by either dietary indiscretion on 
the part of the individual or by eating in the surrounding towns® 
Another factor is the large number of Puerto Rican food handlers em~ 
ployed in the Base commissary and messes® Their knowledge of personal 
hygiene is below standards9 and it requires constant supervision and 
instruction to prevent them from contaminating food. 
An outbreak of diarrhea involving about 100 persons eating 
at the Officers5 Mess occurred early in January 194-5o Colon aerogenic 
organisms were recovered from the buckets of crushed ice used to make 
iced drinks for the diners and at the bar® The ice was sterile when 
it reached the mess in cakes but the crushed ice was being dispensed 
with bare hands® Scoops were substituted and no further trouble 
occurred® 
Dysentery 
Cases 
Type 
Dates 
March - August 1942 
16 
Amoebic 
August - November 1942 
7 
Bacillary 
July 1944 
1 
Bacillary 
The cases occurring in 1942 were apparently not investigated 
for source of infection® The soldier with dysentery in 1944 reported 
eating at the Service Club® All the food handlers there were examined 
and their stools cultured but no dysentery organisms were isolated® 
75 Intestinal Parasites: 
Helminthic Infestation 
aQ Uncinariasis (ankylostomiasis) is extremely rare in 
Continental troops stationed here0 One Continental pilot from Georgia 
was the only one so infested in the past two years0 It is frequently 
found among Insular admissions* It is our observation that if indi- 
viduals have been well fed, the infestation does them no apparent 
harm* Most of the admissions will be heavily infested and yet have no 
secondary anemiaQ The condition responds to treatment very quickly* 
Year 
Cases 
Rate 
Jul-Dec 
19a 
9 
1942 
51 
9o2 per 
1,000 
per 
annum 
194-3 
20 
3o5 per 
1,000 
per 
annum 
1944 
9o2 per 
1,000 
per 
annum 
194-5 (thru Sep) 
1 
b0 Trichuris trichiura is very frequently found and since 
it produces no symptoms and*is difficult to eradicate it is not treated, 
Co Strongyloides intestinalis was found only twice in the 
last two yearso 
do Ascaris lumbricoides and pin worms have not been found 
in military personnel0 
All the above mentioned infestations can be prevented by: 
Proper disposal of feces and urine0 
Wearing shoes which completely inclose the foot* 
eQ Schistosomiasis has not been found in any Continental 
troopso It is comparatively rare in Insular troops because inductees 
so infected are screened out at Induction Centersc Those admitted 
with this condition either were missed At induction or became infested 
subsequently. 
The rates have been: 
Year 
Cases 
Rate 
1942 
0 
1943 
8 
lo4 per 
1,000 
per annum 
1944 
10 
3o2 per 
1,000 
per annum 
1945 
0 
76 The prevention of this condition is similar to that of other 
intestinal parasites with the addition of: 
No bathing in contaminated water. 
No washing clothes in contaminated water 
No drinking of raw contaminated water. 
fo Filariasis has never been found on this Base. 
go There have been two serologically proven cases of endemic 
typhus admitted to this hospital0 One was in a Continental whose duties 
took him all over the surrounding towns where he might have come in con- 
tact with rat fleas0 The second was in an Insular female employee who 
had been exposed in San Juan about two weeks before admission, 
h0 Dengue fever is rare as a source of admission. The 
rate has been: 
Year 
Cases 
Rate 
1 
1942 
4 
7<>2 per 
1,000 
per annum 
1943 
4 
7o5 per 
1,000 
per annum 
1944 
2 
o7 per 
1,000 
per annum 
The prevention of this disease depends on mosquito control0 
i. There was one case of proven sandfly fever in October 
1944 contracted in San Juan0 There are no sandflies on this Base or 
in the surrounding area. 
Quarantine Service 
Because many planes were coming from regions where insects 
borne diseases are prevalent9 in 1942 it was thought necessary to pro- 
vide some means of quarantine0 The use of the hospital Officer of the 
Day in inspecting passengers was not practical. (Reasons are not 
given o) 
In October5 1942,, the quarantine service was organized with 
a medical officer and enlisted men working full time0 Planes were 
sprayed with a hand sprayer and passengers and crew were taken to an 
office in a hangar for examination. 
77 In October 194-3 a trailer equipped for the examining of per- 
sonnel from incoming aircraft was put into use* This trailer, drawn 
by a tug, met each plane, and the individuals to be examined filed 
through ito In October 1943, two hundred and thirty-two planes were 
processed and individuals examined by the Quarantine Service „ 
The service functioned twenty-four hours a dayQ Pictures of the 
trailer used may be found in the individual unit history of Block VI. 
The handling of transient patients (those who were being 
evacuated to the United States by air) while they were on the base 
was supervised by the Quarantine Service0 
One of the functions of the Quarantine Service was to inspect 
the planes for animals0 Every month numerous animals were brought in 
by plane0 
78 CAMP O'REILLY 
Venereal Diseases 
Venereal Disease Control; 
Our aim at this Post has been to reduce the incidence 
of Venereal Diseases to the lowest possible figure,. To accomplish 
this we have conducted multiple activities9 better prophylactic facil- 
ities and an extensive educational program0 
The following Venereal Disease,rates for this Post 
show the results obtained by our Venereal Disease Control Campaign: 
Year 
Highest Rate 
Lowest Rate 
Rate per Year 
19 O 
September - 121 
November « 39 
75 
1944 
February & March “72 
May & November 
- 22 39 
1945 
February - 27 
April - 10 
20 (for 
first S 
months) 
Monthly for first 8 months for the year 194-58 
Jan - 23 
Feb •= 27 
March - 25 
April - 10 
May - 20 
June 24 
July < 13 
August 20 
The above figures show high rates for 1943 which were con- 
siderably reduced during 19443 and have reached their lowest during 
1945, with as low a rate as 10 during the month of April. 
Our rates for 1945 would have been still lower were it not 
for the fact that troops from this post on vivouac status at APOs 
8503 and 848 (and therefore out of our control) have continuously 
supplied us with cases of venereal diseases charged to this station, 
A resume of conditions on this post at different times and 
of the venereal disease control activities undertaken which are 
believed to have contributed towards the lowering of our rate follows: 
During 1942 this post had a rather high venereal disease 
rate as compared to the presento At that time pro-stations were es- 
tablished in camp and in the towns of Gurabo, Juncos and Caguas0 
The lack of recreational facilities in nearby towns and within the 
79 post was blamed to a large extent for the many cases of venereal 
diseaseo The establishment of the USO Club in the city of Caguas 
took placeo Lectures on venereal disease by chaplainss doctors and 
organization commanders were givene 
At the beginning of 194-3 two new theaters 9 an excellent 
service club and a large new Post Exchange were added to the posto 
Such an increase of recreational facilities was an important contri- 
buting factor in lowering the number of cases in spite of the fact 
that the strength of the post was almost doubled0 Many large units 
were stationed at this post (296th Infantry Battalionf 78th Engineers 
26th Medical 326th Quartermaster Battalion)0 
Each of these units had their own pro-stations0 But the rate did 
not come down much on account of the fact that many troops were on 
bivouac status all throughout the island in camps and outposts and 
therefore could not be closely supervised0 Meanwhile troops were 
constantly indoctrinated through lectures9 posters and firms dealing 
with venereal diseases (these being given in Spanish and English)0 
Interviews were held with civilian authorities to bring 
prostitutes under controlo Caguas was the biggest source of infec- 
tion at that time| raids were made and the prostitutes found to be 
infected were detained in the Venereal Disease Hospital for Women 
of that city0 The pro station at Caguas was changed to a better lo- 
cation in the month of April and another one was opened at the Quar- 
termaster gate of the postc Pictures of prostitutes with identifying 
information, which were furnished by the Health Department9 were of 
help in refreshing soldiers0 minds and identifying the prostitutes0 
The new prophylactic package was explained to all troops in connec- 
tion with Training Film B-154-o Other measures which received par- 
ticular attention were those of being more strict with intoxicated 
soldiers returning to camp0 
By the month of June 1943 a new pro-station was opened in 
Humacao and the one in Juncos given a new and. better location*, 
V-Packettes were made available to all men going on pass, and the 
cooperation from the civil authorities in tracing prostitutes con- 
tinued o Lectures were given to all troops including those on raaneuvres. 
NGOs in charge of barracks received illustrated lectures0 
Sulfa drugs began to receive experimental use as a pro 
measureo By the end of the year there was a reduction in the number 
of cases due to the inactivation of a large \mit stationed at the 
post and also to more careful inspection by unit surgeons of troops 
prior to their departure to a new station0 
80 In the early part of 1944- the pro-book was introduced0 
There was at this time a rise in the rate due to contributions from 
other posts and from transient units (3/A of cases from units not 
permanently attached to the Post)<> Most of the sources of infection 
continued to be in the Metropolitan Area* 
In January 1944.* at the initiative of the Post Commander* 
a general meeting of all unit commanders was held at the Station 
Hospital* and the policy and action desired to be put into effect by 
all organization commanders was announced0 The personal attention 
of each responsible officer to the matter of venereal disease control 
was requested* and a vigorous and constant supervision of action of 
subordinate commanders was put into effect and carried througho All 
entertainment facilities were made more active0 Athletics were 
stressed in all organizations* publicity was given to names of units 
having venereal cases* and all factors bearing indirectly upon the 
subject were given special consideration* The results of this vigor- 
ous action have been most gratifying and have produced excellent 
results„ 
As part of this vigorous campaign* in March 1944, troops 
were tested on their knowledge of venereal disease and S5% of all 
enlisted men were found to have adequate knowledge on the subject* 
The venereal educational program nevertheless continued„ The number 
of men using sulfa as a pro-measure increased0 One-third of the 
cases continued to give as a source of infection women from the 
Metropolitan Area0 
Since March 1944* all men who contracted venereal disease 
began to receive special attention and instruction in prophylactic 
technique on Sunday afternoons under a medical officer* 
In June 1944* a venereal diseas control exhibit was opened 
at the 326th Station Hospital for exhibition to all units of the Post 
for an indefinite period of time* 
In September 1944* cadres of the Special Training Center 
began to be trained on special courses dealing with all aspects of 
venereal disease* these cadres to serve upon completion of training 
and upon passing a written examination* as venereal disease NCOs of 
their respective groups0 A similar course was also given to all 
officers on the Post* 
During the year of 1945 the training of NCOs on all aspects 
of venereal disease control and prevention continued, a large number 
of them have received instruction up to the present* The educational 
campaign directed to all troops within the post continues by means of 
81 lectures given by the Post Venereal Disease Control Officer to all 
trainees before they go on their first pass and lectures by the 
trained NCOs to their respective groups every week and before pay 
day* Films on venereal disease continue to be shown to all troops 
as part of the STC program. Civil authorities continue giving us 
their best cooperation0 
Monthly meetings are held, attended by all Venereal Disease 
Control Officers and Venereal Di’sease Control NCOs of the post, to 
discuss all problems and all new measures in the control of these 
diseaseso Pro-books are inspected monthly by the Post Venereal Dis- 
ease Control Officer to assure that they are properly prepared. 
Pro-material is also inspected to make sure it is in good condition. 
During the month of June 194-5 a True and False Quiz sub- 
mitted by the Department was given to officers and NCOs during the 
monthly meetingo Results were goodc A survey of all epidemiologi- 
cal reports during a nine (9) month period was made to serve as an 
orientation means towards the venereal disease problem of the Post0 
This survey was published as a memorandum to all units in the post. 
At present w© have five pro-stations which are functioning 
efficiently; three located on the Post (Quartermaster Gate, ARD 
Gate and Station Hospital)} one in Caguas and one in Juncos. The 
pro-station in Humacao is at present under the supervision of the 
Surgeon of Fort Bundy. An officers8 pro-station was established in 
the hospital area0 
The post VD rate has noticeably come down this year so that 
we have achieved up to the present an average rate of 20 which is the 
goal set by the Antilles Department and Caribbean Defense Command. 
It is hoped that through our continuous educational campaign and other 
related activities our rate will continue to come down to an irre- 
ducible minimumo 
Since as a rule this post contains the largest number of 
troops concentrated in any one place within the Antilles Department 
and generally we have had during 194-5 and part of 1944- the lowest 
venereal disease rate of any post of appreciable size, it is thought 
the data above noted is of interest. 
Malaria; 
Malaria Controls 
When the Post was established on May 2, 1942 the malaria 
problem was not at first appreciated. It was believed that because 
82 of apparent natural drainage the area would not contain serious 
malarial mosquito breeding places0 Soon after the Post was manned 
and in operation the fallacy of this point of view was strikingly 
manifestedo On May 28, 1942 a soldier in th© 130th Engineers died— 
the diagnosis after autopsy was malarial fever, aestivo-autumnal 
cerebral, acute0 
In June of 1942 animal bait traps were placed in operation 
with the aim of ascertaining the density of the anopheline population.. 
Five traps operated once each during the last week of June, 1942 re- 
sulted in a total catch of A0 albimanus mosquitoes, thus indi- 
cating a very definite malaria hazard0 How far we have come from 
this serious situation is shown by the results of ten animal bait 
traps operated during the last week of June 1945, when the total 
a,, albimanus catch was only one specimen.. To be sure, the malarial 
situation here was not so serious as in other posts„ It is very 
probable, however, that had not malaria control measures been effi- 
cient by and continuously applied, the problem would have become on© 
of great seriousness0 
The recorded malaria rate was consistently reduced.. The 
annual rate for 1942 was 113 per thousand5 for 1943 it was 30 per 
thousand and for 1944 it was 6 per thousand0 It is the opinion of 
this office that in 1945 there were no cases of malaria acquired at 
this Post—all the recorded cases being either recurrent or were 
acquired off the Posto 
The factors which have contributed to the successful 
control of malaria at this Post are as followss 
(1) Mosquito proofing of all buildings„ 
(2) Education of personnel in personal preventive 
measures iPe0 use of mosquito bars, headnets, gloves, repellents, 
indoor spraying of insecticides, etc0 and the maintenance of a high 
level of malaria control discipline0 
(3) Improvement of the drainage of the area by ditch 
construction and lining, by grading and filling of low areas, ©tc0 
(4) The routine larviciding of mosquito breeding places 
both in the cantonment area and its near vicinityo 
(5) The medical treatment of all malaria cases, in such 
a way, as far as is known, to prevent relapses and to prevent cases 
from acting as malarial carriers* 
83 At the present time, malaria is no longer a problem0 However, 
continuous maintenance work is necessary to prevent recurrence of the 
conditions that existed in the pasto 
The malaria control program of this post has been in charge 
of U0 So Public Health Service and the Post the former 
being in charge of the extra-cantonment work and the latter of the 
intra-cantonment workc The Public Health Service started its work 
on 20 July 1942, just as this camp was being constructedo Control 
work has consisted mainly of oil and paris green larviciding, and 
minor drainage workc Permanent control work has been inside the can- 
tonroent and was performed by various Federal and Insular agencies, 
such as the WPA, Antilles Division Engineer and Insular War Emergency 
Progranio 
Permanent work consists of installation of pre-cast con- 
crete inverts in ditches, rip-rap, machine grading and fillingo Up 
to date 38,643 lineal ftG of Panama inverts have been laidc Of all 
streams going thru the camp only two (2) sections remain to be Panama 
invertedo 
The extra-cantonment work consists only of larviciding and 
some minor drainage, This work covers area approximately 18 sq0 mi0, 
up to two miles around the post0 Up to this date approximately 16 
tons of parts green and 256 tons of lime have been consumede An 
average of 55 men are used for this work0 
A complete check on the effectiveness of the control work is 
kept by means of larval collections0 Fourteen animal bait traps and 
three New Jersey light traps are scattered at convenient spots through- 
out the control area for this purpose0 Collections in the animal 
bait traps are made once a week and every night in the light traps0 
The collections indicate a downward trend ever since the control 
program was started0 The average of collection at the beginning 
ranged from 34 to 96 albimanus per trap, where as at present time 
the average is one '(1) or less per trap* Two of the bait traps are 
placed outside the control area as a checko Collections in them 
have been as high as 100 albimanus per trapQ 
Due to the topography and nature of the breeding places 
in this area it has not been necessary to use DDT for larvicidal 
controlo 
Malaria Control Exhibit: 
A course on Malaria Control and Discipline has been given 
at this camp since War Department Training Circular No0 108, dated 
21 September 1943, came into effect in this Department Anti- 
malarial details have been appointed by all units in camp, and peri- odic instruction is given by the Post Malaria Control Officer who 
is assisted by four proficient enlisted men in this branch of sani- 
tation » 
In April 1944 the Malaria Control Officer, under the super- 
vision and guidance of the Surgeon, opened a Malaria Control Ex- 
hibit at the 326th Station Hospital* All enlisted men of this 
Command were brought to see the exhibit* -. Each unit was broken up 
into groups of ten men, and each exhibit was explained to them* 
The exhibit pictures the efforts of the military personnel 
in charge of malaria control and the Public Health personnel worfc= 
ing both in the intra=>cantonment and extra=cantonment areas of 
camp* It shows all the permanent construction work done at Camp 
0*Reilly for the proper drainage of the Post* It shows the use of 
Panama inverts and side slabs in the creeks and the sodding of the 
banks with Bermuda Crass* It demonstrates the maintenance program 
of dusting all earthen ditches with Paris Green, cleaning of lined 
and earthen ditches, oiling ditches, etc* Individual protective 
measures were stressed* Demonstration of how to use the mosquito 
bar, how to tuck it well under the mattress? how to repair holes in 
the nets either by patching or mending were shown* Items used by men 
on guard? such as mosquito net, gloves, leggins, indalone, etc*, were 
demonstrated by one of our enlisted men* 
The program of mosquito proofing of all barracks in camp 
has been kept up* Major work is done by the Post Utilities and 
minor repairs by the anti-malarial detail* 
Malaria Control and Discipline have obtained in this Post 
a high degree of proficiency* Cooperation and great interest on the 
part of all concerned have made our malaria control program a success* 
Rates Bases upon statistical reports the malaria rates have 
been reduced to a minimum during the past year* The rate for 1942 was 
113/1000/annum, that for 1943 went down to 30/1000/annum* This past 
year our rate is 6/1000/annum* 
No serious malaria problems exist in this camp, however, 
maintenance efforts shall be continued* It will be necessary to 
continue the program in the intra and areas to main- 
tain the best possible drainage conditions and to destroy the anopheles 
larvae by extensive dusting with paris green and lime* The construction 
of the permanent lining in the ditches and water courses will help the 
maintenance problem considerably* 
85 FORT BUNDY 
Venereal Disease: 
The prevention and control of venereal disease among the 
troops of this post is a problem which has always been dealt with 
vigorously and relentlessly0 Among measures used have been motion 
picture films$ conferences9 quizzes9 informal talks and lectures0 
The recreational facilities of this post have been utilized to the 
utmost and this has been one of the greatest factors instrumental 
in keepingTthe rate of this post at a low level0 
• 
Two prophylactic stations are operated by personnel of 
this posto One is on the post proper and the other is located in 
a nearby townD They are in satisfactory condition and are always 
provided with hot running water and straddle sinks of satisfactory 
type o Posters are prominently displayed to educate the troops as 
well as to instruct them in the details of the technique of pro- 
phylaxis o 
Organized athletics and varied and interesting recreational 
facilities on the post help to make abstinence possible in some cases 
and to cut down the frequency of exposure in others0 The three me- 
thods of prevention of VD are thoroughly presented0 They are 
(1) sexual abstinence9 (2) the condom during exposure3 and (3) pro- 
phylaxis after exposure* 
Malarias 
The malaria rate among UoSoE0Do civilians living in this 
area during the construction of this Post in 194-3 and 194-4-9 was 
very highj however the number of cases among Army personnel since 
the occupation of this post on June 1944- has been only three0 These 
were reported on the 13th$ 14th and 15th of August 1944-c All three 
were primary cases0 There have been no malaria cases among Army 
personnel stationed in the Roosevelt Roads area since that timeQ 
Permanent malaria control drainage in this area was esti- 
mated to cost 1277^680®This work was actually never started 
and the little permanent construction on the post proper was accomp- 
lished by the Post Engineer since the occupation of the Post0 
87 In September 1944* a short while after DDT (Dichloro Di«= 
phenyl trichloroethane) was put into use, an L-4- Piper Cub was assigned 
to this Post for the purpose of spraying an area of approximately 2000 
acres with a solution of DDT in #2 diesel oilc This method of control 
was inaugurated in view of its efficiency and low cost operation (about 
$10,000 per year)Q The expenditure of large sums of money for perma- 
nent control was not justified because of the uncertainty of the 
future of this post0 
The original concentration of DDT in diesel oil used in 
aerial spraying was 10$ by weight0 This was later reduced to 5$ 
because of the shortage of DDT0 However when it became more abundant, 
the concentration was again increased to 10$, In a 10$ solution it 
is applied at the rate of 0o2 lbs0 DDT per acreQ 
Aerial spraying with the Cub plane had been carried out on 
a more or less erratic schedule because of the high winds in this 
part of the island which made flying unsafe at the low altitude neces- 
sary for adequate sprayingo Also on several occasions, a break-down 
in the mechanics of the airplane was responsible for interruption in 
the spraying schedule0 Beginning in November 194-5, aerial spraying 
of DDT for mosquito control work was accomplished using a C-£7 plane 
equipped with two (2), two hundred and fifty (250) gallon tanks and 
a gravity apray unit0 The results to date have been most satisfac- 
tory0 
The Post Engineer has been doing minor drainage and larvi- 
ciding on .the post proper and the Malaria Control in War areas (MCWA) 
division of the U0 S. Public Health Service has been doing temporary 
drainage and minor dusting within the two miles radius around the 
post in areas not accessible to the plane* 
There has remained a critical density of malaria transmit- 
ting mosquitoes in this area during some months of the year because of 
infiltration and inadequate controlj malaria discipline including 
adequate screening, proper use of head nets, gloves, and repellents 
is enforced among the troops0 
Routine smears have been taken from all the personnel to 
determine the number of positive for filariasisj 3$ of the smears 
revealed the presence of microfilaria0 
Enteric Diseasess 
There has never been an undue prevalence of enteric diseases0 
The few cases of simple diarrhea were mild and of short duration0 There 
have never been any cases of dysentery or typhoid fever among the troops 
of this post* 
88 A majority of the soldiers have been found to have intes- 
tinal parasitism although few of them have had clinical manifesta- 
tions o Some of the parasites isolated were schistosoma mansoni, 
mecator americanus, ascaris lurabricoides, trichura trichiuris, and 
strongyloides stercoralis. The incidence of positive blood smears 
for filariasis has been 3% as mentioned above* Only two men how- 
ever, of this group have had clinical manifestations; these consisted 
of epididymitis and funiculitis* 
There were two clinical cases of schistosomiasis confirmed 
by isolating the ova of schistosoma mansoni in the stool; recovery 
ensued following therapy with fuadin. 
89 (CUBA 
Venereal Disease 
The only serious health problem on this base was venereal 
diseaseo Although certain control measures were taken, including 
a prophylactic station in Havana, and another in nearby San Antonia 
de los Banos, no formal program was instituted until January 1943 o 
The venereal disease rate was very high; for example, 7 syphilis 
cases reported in one week among 100 men0 Personnel was propagan- 
dized with venereal disease control information and surveys were 
conducted to detect all latent syphilis. Among the venereal disease 
control measures were the followings 
5 Prophylactic Stations: 2 in Havana, 1 in San 
Antonio, 1 at Main Gate, 
1 at the Hospital, 
Regular Group Informational Lectures and Discussions 
among enlisted personnel. 
Venereal disease control motion picturese 
The "Off Limits1’ procedure was utilized effectively 
in San Antonio de los Bafios and in Havana. 
Men were encouraged to carry prophylactic equip- 
ment when leaving the base on pass. 
The most vexing health problem in this command for the 
year of 1944-, undoubtedly, was venereal disease. In view of the 
prevalence of these maladies in this locality, and the complete 
lack of government control of prostitution, this problem taxed 
more than ever the medical facilities of this hospital. 
At the beginning of 194/-, control of venereal disease was 
accomplished mainly through an educational program consisting of 
periodic lectures in English and Spanish, given at least once a 
month in each organization. These lectures were supplemented by 
movies, 4ealinS with the subject, shown at the Base Theater when- 
ever these films were available. Military Police supervision of 
"Off Limits" places was carried on constantly and as effectively 
as possible, considering the innumerable houses of prostitution, 
small hotels, and bars in Havana and adjoining small towns. 
91 In the last month of 1944, a new plan of venereal disease 
control was put into operation in each barracks„ The barracks were 
divided into two groups of from 10 to 12 men each supervised by a 
venereal disease control non-commissioned officerQ By this time 
Captain Jose S0 MC# was the Venereal Disease Control Officer,, 
The general health of this command remains in an excel- 
lent stateo However9 continuous efforts are made by the hospital 
medical staff to improve the situation,, Daily? weekly and monthly 
inspections are made of the entire base and its personnel and any- 
thing noted on these inspections that may tend to menace the health 
of personnel is quickly remedied or changed0 All foods are in- 
spected 9 water is testedg personnel are physically inspected9 and 
the grounds and buildings are constantly under surveillance of this 
hospitalo The major health problem continues to be that of the 
venereal disease situation in this area0 Changes are constantly 
being made in the venereal disease control program in effect of this 
base0 All houses of prostitution are placed "Off Limits* to mili- 
tary personnel in the surrounding towns0 No houses of prostitu- 
tion are condoned in any manner by the medical staff0 
92  
Venereal Disease; 
Venereal diseases were very prevalent among the native 
populatlon0 Sexual promiscuity was widespread, which made the 
problem of control difficulto Despite constant instruction in 
venereal disease control, the rate was persistently highe Many 
soldiers knew ’’safe" women and had intercourse without taking 
any precautions! it was impossible to impress the men with the 
fact that no woman can be considered to be free of venereal diseases. 
All directives from higher were complied 
with, A medical VD control officer, was in charge of the control 
program,, Emphasis was placed on individual responsibility to self, 
family, and the army, as well as on prophylaxis during the follow 
ing exposureo 
Prophylactic stations were operated at the hospital and 
at the USO in Kingston, where a medical attendant was available 
at all times. Adequate supplies of pro materials were available 
at all timeso 
Prostitution was not controlled in Kingston, Many of the 
cases of venereal diseases were traced to professional prostitutes. 
Treatment was in accordance with TB MED 18, 
VENEREAL DISEASE* 
Month 
1942 
!2M 
1242 
January 
161 
56 
44 
0 
February 
154 
23 
41 
38 
March 
108 
76 
52 
0 
April 
20 
106 
57 
0 
May 
21 
8? 
22 
37 
June 
163 
78 
76 
0 
July 
117 
17 
30 
77 
August 
146 
0 
0 
61 
September 
63 
107 
35 
80 
October 
64 
43 
0 
- 
November 
383 
68 
27 
0 
- 
December 
34- 
113 
43 
34 
- 
Gonorrhea 
— 
243 
(cont'd) 
93 VENEREAL DISEASE (cont'd)* 
1941 
1942 
1943 
im 
1245 
Syphilis 
- 
37 
Primary 
10 
Secondary 
3 
Tertiary 
1 
Unclassified 
* 13 
Chancroid 
- 
2 
Lymphogranuloma 
venereum 
3 
& 
Rate per thousand per 
annum 
Malarias 
Fort Siraonds was located on the coastal plain where malaria 
is most prevalento Two small native villages just off post limits 
had high malaria rates,19 complicating control0 Malaria control was 
supervised by the USED until 1 July 1942, when this work was taken 
over by the array medical department0 In April 19449 the USPHS assumed 
the task of malaria control, though an officer did not arrive here 
until June 1944° Control consisted of drainage, spraying of breeding 
places within a two mile radius of the basest) and individual malaria 
disciplineo The malaria rate was low,21 despite the fact that in- 
fected natives work on the baseD 
94 MALARIA 
CHART 1 
USPHS - January - February 1943» Four hundred smears taken. 
Village 
No, 
Bloods 
NOo Positive 
Type 
Rhymesbury 
12 
1 
P0 falciparum 
Comfort 
28 
5 
3 
2 
Pc falciparum 
Pe vivax 
Content 
25 
1 
Po falciparum 
Yorkpen 
25 
0 
2 
P„ falciparum 
Parnassus 
25 
4 
1 
1 
Po vivax 
Po malariae 
Bowen 
35 
6 
4 
1 
1 
Po falciparum 
Po vivax 
Pc malariae 
Hales Hall 
15 
2 
1 
1 
P0 falciparum 
Po vivax 
Denbeigh 
25 
2 
Po falciparum 
Gimme-a-bit 
52 
4 
Pc falciparum 
Retirement 
25 
3 
2 
1 
Po falciparum 
Po vivax 
Yarmouth 
25 
2 
Po falciparum 
Race Course 
(school) 
42 
5 
4 
1 
Po falciparum 
Po vivax 
Milk River (school) 
25 
1 
Po malariae 
95 MALARIA' 
CHART 2 
Village 
Post-Distance No„ 
Bloods NOo 
Positive 
% Positive 
Rhymesbury 
2 miles 
12 
1 
8.3 
Comfort 
3 miles 
38 
5 
13 ol 
Bullard1s 
Garden 
2 l/2 miles 
2$ 
1 
4-c 0 
York Pen 
3/4- miles 
25 
1 
4.0 
Parnassus 
1 1/2 miles 
25 
4- 
I60O 
Gimme-a-bit 
1/4- miles 
52 
4- 
7c8 
Retirement 
l/2 miles 
25 
3 
12.0 
Yarmouth 
1 mile 
25 
2 
8.0 
No Positive 
13 Po falciparum 
7 Pc vivax 
1 Po malaria© 
96 MALARIA 
CHART 3 
Month 
M 
1241 
1241 
mk 
. 1245 
J anuary 
0 
0 
0 
0 
February 
0 
0 
0 
0 
March 
1 
0 
0 
0 
April 
1 
0 
0 
0 
May 
- 
0 
0 
0 
0 
June 
0 
0 
0 
0 
July 
0 
0 
0 
0 
August 
. • 
0 
0 
0 
c 
September 
0 
0 
0 
0 
October 
8 
1 
0 
- 
November 
0 
, 6 
0 
0 
- 
December 
0 
•? 
0 
0 
97 Enteric Diseases: 
The incidence of gastro-intestinal diseases was low0 
There were a total of *49 cases of diarrhea admitted to the hospital,25 
Of these, 10 were bacillary dysentery, 1 was amoebic dysentery, and 
the rest were classified as "diarrhea,* There were no outbreaks of 
"food poisoning," Native food handlers were examined as possible 
carriers of intestinal diseases, including worm infestations. 
Helminthic Infections! 
' No helminth infections were found among military personnel. 
Schistosomiasis: 
This disease does not occur in Jamaica, 
Filariasis: 
There was no evidence of any infection of military per- 
sonnel, although the disease occurs among the native population. 
Typhus! 
There were no cases of typhus among military personnel. 
Dengue: 
Dengue was prevalent during December 1941 and January 
1942, and a few cases occurred through June 1942,26 There have 
been no cases since that time. 
98 ANTIGUA, B.W.I* 
Venereal Diseases 
Prostitution is extremely prevalent on this island*, It 
is not confined to one area and flourishes quite openly in the 
nearby villages as well as in the town of St* John's* Since the 
inception of the medical installations here, venereal disease con=> 
trol has been the most difficult problem* There has been no pro~ 
vision made for legal Jurisdiction over civilian prostitutes* 
The British possess an archaic precept nominally classified as 
"right of domain" which prevents entry into houses by local police 
without search warrants, even in active pursuit of a prostitute, 
caught soliciting* No detention type or Public Health hospitals 
exist here* The total of voluntary patients treated for venereal 
disease is by no means comparable with the number untreated* 
Hecognition was early given to the fact that provision 
of adequate recreational facilities is necessary in the control 
of venereal disease* Athletics, unit outings, movies, dances, 
well equipped day rooms, service club, and U*S*0* Club, were some 
of the measures utilized. 
In October 1941, the Base Prophylactic Station was opened 
at its present location* In December 1941, an additional station was 
opened in the civilian Jail house at St* John's* In April 1942, the 
location of the town station was transferred when we acquired our own 
installation at the periphery of the "Off Limits" area in St. John's* 
Thus at present, there are two prophylactic stations in operation! one 
on the Base, and the other in the town of St* John's* Both have ade- 
quate facilities, and are manned by trained soldiers of the Medical 
Department* 
The venereal disease rate which has fluctuated greatly from 
month to month as shown on the following chart, indicates, that although 
the incidence of venereal disease has been lowered appreciably, the 
problem still exists. These figures give the rate per 1000, per annum* 
1941 1942 
1943 
1944 
1945 
January 
84 
59 
127 
47 
February 
132 
92 
17 
95 
March 
131 
110 
57 
0 
April 
91 
75 
0 
46 
May 
193 
57 
31 
46 
June 
50 
96 
28 
0 
99  
1941 
mi 
mi 
1944 
1245 
July 
80 
160 
36 
0 
August 
48 
77 
0 
0 
September 
22 
61 
34 
34 
October 
222 
161 
57 
43 
November 
70 
81 
76 
170 
December 
262 
294 
142 
0 
The average percent of cures of gonorrhea with sulfathia- 
zole was 30-40o The acquisition of sufficient penicillin for treat- 
ment of gonorrhea, .starting in 1944, hps obviated the necessity for 
transfer of most cases that might prove sulfonamide-resistanto This 
resulted in reduced hospital days and relative non-effective rate0 
Malarias 
Before this Base was established, it was contemplated that 
malaria would prove the major health problem,, Malaria is very preva- 
lent among the civilian population of this Island, and our Base Area 
had numerous breeding sites in the form of brackish swamps and ponds 
of fresh water,, In addition a malaria hazard of great importance was 
a negro village of some three hundred population that jutted into the 
center of our Base from the west. 
The eradication of breeding sites was found to be a com- 
paratively simple matter„ Surface water was early eliminated by 
filling or drainage„ Costal swamps were cleared and partially filled 
and canalized to make them a part of the ocean„ From the beginning 
a program was instituted of steadily spraying and oiling water holes, 
and seeing that no containers were lying about in which water might 
collect. 
In April 1942, the above mentioned negro village was moved 
two miles away from the Base, eliminating human carriers of malaria 
organismso The trade winds blowing almost continually across the 
Base from the sea, have further helped to reduce the mosquito prob- 
lem0 The following chart shows that by April 1944, the malaria 
rate for this Base had become zero and it has remained so ever since0 
Month 
mz 
mi 
mk 
mi 
January 
0 
U 
0 
February 
1 
2 
0 
March 
0 
U 
0 
April 
0 
0 
0 
May 
2 
1 
0 
0 
June 
0 
1 
0 
0 
July 
0 
1 
0 
0 
August 
0 
3 
0 
0 Month 
1242 
1242 
1244 
1245 
September 
2 
4 
0 
0 
October 
2 
0 
0 
0 
November 
0 
0 
0 
December 
1 
2 
0 
Despite the fact that tropical diseases are extremely 
common on this Island among the civilian population, there have 
been relatively few tropical diseases observed among soldiers at 
this Base0 No cases of malaria have been observed since early 1944 3 
and majority prior to that time occurred in newly arrived Puerto 
Rican troops who evidently contracted the disease on their home 
islando Helminthic diseases also.., have occurred almost exclusively 
among Puerto Rican personnel, as have schistosomiasis and filariasis0 
101 STo LUCIA 
Venereal Diseases 
Venereal diseases were the rule rather than the exception 
among the natives0 Local government physicians could not obtain 
sulfa drugs, arsenicals or bismuth for the treatment of prostitutes 
even if they sought There was an almost total absence 
of white women in the area and the monotony of wartime dispositions 
for combat in an essentially peacetime situation, led men to visit 
native shacks, drink a local rum called "Smack" and have sexual 
intercourse with black native women practically all of whom were 
infectedo The fact that native huts were dispersed throughout the 
Army area on private land increased control problems greatly.^ 
After the initial difficulties of securing adequate medi- 
cal supplies and personnel were eliminated, the major medical prob- 
lem of this Command was the control of venereal disease and malarial 
fever0 In January 194-3, the venereal rate was 283 per 1,000 per 
ahnum0 This high rate was due in part to the lack of a planned 
health and educational program and its rigid enforcement„ The Base 
Surgeon also considered the high rate due to the character of the 
personnel of the worst''offending unit which had an average Ic Qo of 
B9o7% (Grade 4, below average) and the long periods they had served 
in the tropicsc29 
In March of 1943, a clinic for prostitutes was opened under 
the auspices of Dr0 Bristol, British Government physician at Vieux- 
Forto On 3 April 1943, sixty-two (62) women of the "on-limits" vil- 
lage of Beausejour had been examined and 42 cases of syphilis, 5 
cases of gonorrhea, 1 case of chancroid, and 3 cases of lymphogranu- 
loma were found0 Every effort was made to get these women out of 
the infectious stages as rapidly as possible0 No woman refused treat 
In January 1945, a survey was conducted of 25 native women 
from Beausejour0 Five cases of syphilis and 2 of gonorrhea were • 
discoveredo In a more recent survey in November 1945, on 39 women 
of Beausejour, all known to be frequent contacts, 15 cases of sy- 
philis, 10 cases of gonorrhea, and 1 case of chancroid were dis- 
coveredo 
Extensive education programs were started among the troops 
and additional prophylaxis stations constructed.31 Athletic and rec- 
reational activities received increased attention, particularly be- 
tween the hours of 5s30 PM and IIjOO PM. Overnight passes were 
issued only to those individuals whose past records of good conduct 
102 entitled them to reward0 All intoxicated soldiers found in civilian 
areas were taken into custody and returned to the posto Venereal 
disease rates were lowered but remained unduly high and far above the 
goal of 20 per 1,000 per annum0 
The Base Surgeon considered the rates “theoretically"1 in- 
excusable, when .in November of 194-3, after ten months of extensive 
control measures, the rate was 174- per 1,000 per annum, for the 
following reasons: 
10 Medical officers have been in the service long enough 
to have acquired some knowledge of public health technique,, 
20 An excellent course on the venereal diseases, their diag- 
nosis, prevention, and cure has been given to all line VD Control Offi- 
cers and NC05so All other officers and men have also received instruc- 
tion, although not in such detail, other than that concerning pro- 
phylaxis o A general, very high standard of knowledge among line VD 
Control Officers and NCO's was shown in written examination at the 
end of the course on venereal disease control„ No one on this base 
can plead ignorance of venereal prophylaxis„ 
3o Prophylactic measures which the Army provided: 
a0 There is an adequate number of prophylactic stations, 
well equipped, with well trained, well supervised personnel,, 
b0 V-packets are readily available to both officers 
and men0 
Co Diagnosis and treatment of venereal disease is 
available to women at the “Bristol Clinic for Women.11 After exami- 
nation, if found free of venereal disease, women may obtain a state- 
ment to that effect upon request. 
4,o Adequate information has been disseminated, and trained 
personnel is present in each unit to continue instruction plus the 
services of all Medical Officers.^ 
It was concluded that the teaching facilities previously 
mentioned had not been available for a sufficient length of time to 
secure the expected rateQ It was also recommended that men who have 
been in the Caribbean Area for two years or longer, who felt they were 
“forgotten men* be reassigned as soon as possible0 Many men ceased 
to have interest in themselves or their unit.33 
A pass system was instituted in January of 194-A which in- 
cluded treatment and non-exposure forms and required all enlisted 
men to have a physical examination before going on pass0 This allowed 
103 closer supervision and education of men going on pass, especially 
those who left the post and exposed themselves to venereal infection 
most frequentlyo The villages of Pomrae and Augiere were placed off 
limits, making general policing and medical follow-up of infected 
women more effective*34 To assist in allocating new cases, the 
"’shacks" in the village of Beausejour were provided with numbers paint- 
ed in black on a white board and placed in a conspicuous location on 
the front of each buildingo Soldiers were required to record the 
number of the house they visited on the treatment slip section of the 
pass form0 Statistical data provided by completed pass forms thereby 
provided medical officers with detailed information concerning the 
source of infection and preventive measures taken by the soldlers035 
This program was continued and venereal disease rates continued to 
lowerQ However, it was not until combat forces, including Air Corps 
personnelt were reassigned to other stations that the rate approached 
to 20 per 1,000 goal0 The Bristol Clinic for Women was closed during 
October of 1944- since venereal disease rates had been substantially 
lowered and Dr0 Bristol disassociated himself from the project036 
In 194-4 only 6 new cases of venereal disease were reported in both 
the Ground Force and Air Corps organizations0 From 1 November 1944 
to January 1945, no new venereal disease cases were reported* This 
reduction is attributed to continued educational efforts by the 
medical section personnel of this Command, the abandonment of tactical 
dispositions by combat forces, the continued operation of numerous, 
well established prophylactic stations, improved entertainment 
facilities, and the fact that the men of the Command sent in as service 
troops were of a generally higher type* However during the first 
eight months of 1945 the monthly rate among the troops fluctuated 
widely, between 0 and 129, averaging 47o Approximately half of these 
cases occurred among newly arrived personnel0 In September the rate 
shot to 204, October 177, and November 102o The cases occurred, with 
the exception of only one man, entirely a new personnel. Under these 
conditions the entire program of education has been intensively whipped 
up0 It will be necessary to maintain a constant level of propaganda 
and education as old personnel are released for discharge and new 
personnel arrive* 
Malaria? 
The Vieux-Fort area prior to swamp clearance, filling, and 
draining, was a text book example of a "before treatment" malaria 
area„ Large swamps and numerous ditches of fresh water alive with 
anopheline larvae were situated, between heavily infected native popu- 
lation (90ft) on one side and a highly susceptible army population on 
the other03* 
This condition complicated planning for construction layouts 
and resulted in the Cantonment Area being moved from the Vieux-Fort 
104 area approximately a mile north to higher ground provided with natural 
drainage and as far removed from native population as practicable. 
Mosquito control measures were started by the contractor 
with the filling and draining of swamps and were continued by the Armed 
Forces when they arrived on the island during August 194-1 o Until 
December 1941 only 2% of army personnel had been infected and control 
measures were not extensive0 However, between 1 and 22 May 1942, 33 
cases of malaria were reported among army troops stationed along the 
seacoast west of Vieux-Fort River and adjacent to a large swamp0 
(Tourney) As a result of the increase in the malarial incidence, a 
study of the situation was made by Dr0 Wilbur G0 Downs and Mr0 Raymond 
Co Shannon from 2 to 4 June 19420 The elimination of the Tourney 
Swamp was recommended and 1600 gallons of oil were recommended to be 
allotted monthly for mosquito control work0These recommendations 
were followed and the malarial incidence dropped to a low level0 Anti- 
malarial measures were stressed by all unit commanders0 Routine ditch 
clearance, filling, and oiling have continued and the 1944 incidence 
showed 9 per 1,000 per annum0 This improvement is also due to the 
removal of troops from outposts and guard stations adjacent to swamp 
areas which was made possible by improved tactical situations in the 
area0 
The last case of malaria to arise on this base was admitted 
to hospital on 2 May 1944o To date the figures of mosquito catches, 
larval dip findings, etc0, show a very low anophelene population in 
the area0 This has been maintained economically by widespread use of 
unskilled native labor in maintenance of grass-free ditches, tide- 
water drains, tidal gates, exposure of marshes and swamps to open 
ocean tidal changes, oiling, ditching, filling, etc0, wherever these 
various methods were most readily applicable0 
The use of DDT spray from aircraft was considered for this 
base but dicarded because of constant winds in excess of 10 to 12 
ffioPoho and because of the varied terrain which includes many ravines., 
It is felt that the present method of control is most suitable for 
the present status of the baseQ For more permanent control a re- 
survey should be made with a view to constructing concrete inverts, 
concrete lined drainage ditches, etc0 Should the present level of 
control activity relax the incidence of malaria would inevitably 
rise as there is still a large reservoir of the disease in the local 
populationc 
Schistosomiasis: 
Schistosomiasis is endemic in the Soufriere valley where a 
considerable portion of the native population is chronically infected, 
105 The Soufriere river contains large numbers of cerceriae which, it is 
belived by the local medical authorities are the source of the spread 
of Schistosoma mansoni.39 
One case only, of Schistosoma mansoni has been diagnosed 
in military personnel. This case was discovered in June 194-5 in a 
Puerto Rican soldier who was probably infected prior to entry into 
the serviceo 
Filariasis? 
According to Dr0 Greson,40 filariasis does exist to a slight 
degree among the natives of Stc Luciae However, army medical officers 
have not seen any evidence of elephantiasis in the southern half of 
the islands Vectors do exist on this islands 
During a special survey of Puerto Rican personnel in Decem- 
ber 1943, four (4) cases of filariasis were discovered by examination 
of night blood smears0 These were taken to be cases incurred prior 
to arrival at this base0 The affected men were transferred to Puerto 
Ricoo No cases have occurred since that survey0 
Leprosy? 
A Leprosarium is maintained outside the town of Soufriere 
by British medical authorities0 There are approximately thirty (30) 
cases of chronic leprosy isloated in this institution,, While the 
infection exists in the island, new cases are rare and the incidence 
is very lowc Victims of this disease are institutionalized until the 
cases are proven to be arrested and non-contagious„ Then they are 
liable to release to their homes„ However, the period of institution- 
alization is long and, as a result of economic difficulties and dis- 
integration of family life, arrested cases generally elect to remain 
in the leprosarium0 There is no active treatment being used, at 
present, chaulmoogra oil having been discontinued as painful and 
ineffective 
106 ST* THOMAS 
Venereal Disease: 
The venereal disease control program has been very success- 
ful; since July 19UU there have been only 5 cases of venereal disease. 
Of these four were contracted while the soldier was in Puerto Rico 
on furlough* Success of the campaign is attributed to: 
1* The broad educational program. 
2. The close observation of pro-records, and check up on 
frequent contacts in the neighboring city by the local 
health officials, who have been very cooperative in 
this problem. 
3® The strict observation of Department directives. 
Malaria: 
Mosquito control is not a difficult problem in this island. 
The hilly terrain and lack of small streams and lakes explains the 
lack of mosquitoes* There are no insect borne diseases endemic to 
the island. 
* 
Other Tropical Diseases: 
The only tropical disease encountered are fungus infection 
of the ears, axillas, inguinal region and of the feet* These have 
not been of the sever© nature often reported, and have responded to 
usual forms of treatment. Intestinal parasitism has not been an 
uncommon finding among Puerto Rican troops. 
107 STo CROIX 
Venereal Disease: 
Venereal Disease has always been a great problem in the 
Virgin Islands0 
Ninety“five percent of the population of St0 Croix is 
negro and promiscuity is the keynote of the morals of the island0 
The number of prostitutes are but because of the rampant promis- 
cuity among the negroes, the venereal disease rate is highc It is 
estimated that 20 of the population have syphilis9 in all 
different stagesg treated and untreatedo The United States Public 
Health Service under the authority of the Venereal Disease Law has 
made a determined effort to treat every case of syphilis9 and to 
seek out the contact in each so that treatment may be instituted. 
In view of the high venereal disease rate on this islandt 
the incidence of venereal disease in the personnel of this station 
has been considered as satisfactoryQ The following show 
the monthly venereal disease rate at Benedict Field© Many of these 
cases reported were not contracted on the island of Stc Croixs but 
at Puerto Rico0 the records are not complete enough to 
allow an accurate survey of the origin >f the disease0 
TABLE 
INCIDENCE OF VENEREAL DISEASE 1941 - 42 
MONTH 
STRENGTH 
VENEREAL DISEASE 
April 
h 
164 
2 
May 
163 
1 
June 
162 
3 
July 
166 
1 
August 
166 
3 
September 
166 
1 
October 
164. 
1 
November 
81 
2 
December 
4 
0 
109 TABLE 
INCIDENCE OF VENEREAL DISEASE 19-42 - -43 
MONTH 
STRENGTH | 
SYPHILISj 
GONORRHEA 
OTHER Vo De 
TOTAL V. D. 
January 
0 
0 
February 
469 
7 
March 
495 
5 
April 
508 
1 
May 
547 
4 
June 
585 
3 
July 
561 
1 
1 
3 
5 
August 
635 
1 
2 
0 
3 
September 
525 
0 
3 
1 
4 
October 
398 
2 
1 
0 
3 
November 
393 
0 
2 
0 
2 
December 
383 
0 
1 
1 
2 
TABLE 
INCIDENCE OF VENEREAL DISEASE 1943 - AA 
MONTH 
STRENGTH 
SYPHILIS 
GONORRHEA 
OTHER Vo Do 
TOTAL V. D. 
January 
357 
1 
3 
0 
A 
February 
359 
0 
0 
0 
0 
March 
363 
0 
0 
0 
0 
April 
388 
0 
A 
0 
. * 
May 
387 
0 
1 
0 
1 
June 
396 
1 
5 
0 
6 
July 
200 
1 
1 
1 
3 
August 
117 
3 
3 
0 
6 
September 
121 
0 
3 
0 
3 
October 
127 
1 
0 
0 
1 
November 
127 
0 
3 
0 
3 
December 
102 
0 
L_o__ 
0 
0 
110 MONTH 
STRENGTH 
_ m 
>HILIS 
GONORRHEA 
OTHERS 
TOTAL 
Insular 
Continental 
Insular 
1 r" 1 
Continental 
Insular 
Continental 
■ 
Insular 
1 
Continental 
January 
87 
56 
0 
0 
0 
0 
0 
0 
0 
February 
56 
50 
0 
0 
0 
0 
0 
0 
0 
March 
20 
U2 
0 
0 
0 
0 
0 
1 
1 
April 
20 
3^ 
0 
0 
0 
1 
0 
0 
1 
May 
lU 
2k 
0 
0 
0 
0 
0 
0 
0 
June 
15 
2k 
0 
0 
0 
0 
0 
0 
0 
July 
17 
23 
0 
0 
0 
1 
0 
0 
1 
August 
17 
2U 
0 
0 
0 
1 
0 
0 
1 
September 
16 
23 
0 
0 
0 
0 
0 
0 
0 
October 
16 
2^ 
0 
0 
0 
0 
0 
0 
0 
November 
16 
2** 
0 
0 
0 
0 
0 
0 
0 
December 
16 
25 
0 
0 
0 
——■ 
0 
"— — 
0 
0 
0 
INCIDENCE OF VENEREAL DISEASE iqUU - Ur 
TABLE MONTH 
STRENGTH 
SYPHILIS 
GONORRHEA. 
OTHERS 
TOTAL 
. 
Insular 
■ 1 - ;' 1 11 '1 L ' 
Continental 
Insular 
Continental 
. . - 
Insular 
Continental 
Insular 
Continental 
J anuary 
16 
2k 
0 
0 
0 
0 
0 
0 
0 
February 
17 
23 
0 
0 
0 
0 
0 
0 
0 
March 
17 
0 
0 
0 
0 
0 
0 
0 
April 
18 
22 
0 
0 
0 
0 
0 
0 
0 
May 
17 
23 
0 
0 
0 
0 
0 
0 
0 
June 
l6 
33 
0 
0 
0 
0 
0 
0 
0 
July 
16 
33 
0 
0 
0 
1 
0 
0 
1 
August 
17 
35 
0 
0 
0 
0 
0 
0 
0 
September 
15 
35 
0 
0 
0 
0 
0 
0 
0 
October 
12 
30 
0 
0 
0 
0 
0 
0 
0 
November 
lU 
28 
0 
0 
0 
0 
0 
0 
0 
December 
17 
21 
——. 
0 
- —- 
0 
0 
0 
0 
0 
0 
INCIDENCE OF TBNBREfL DISEASE 19U5 - 1+6 
TABLE 
112 The Venereal Disease Control Program was instituted with 
the establishment of the Base0 The following measures were taken 
to insure Venereal Controls 
a0 Prophylactic stations were established in the two 
towns adjacent to the and a prophylactic station on the post 
was also available0 
b. Complete and thorough prophylactic treatment after 
exposure was advised by all Unit Commanders. 
Co Sex morality lectures were given regularly; charts 
and motion pictures of venereal disease were exhibited. 
do Full cooperation with the local health authorities 
was obtainable where contacts could be identified0 Every effort 
was made by local authorities to locate venereal contacts and place 
them under treatment. 
e. Post entertainment in the form of motion pictures and 
USO shows were available. 
f« A tennis and basketball court was completed0 
go New athletic equipment was procured and an athletic 
program was encouraged, 
h0 Periodic picnics9 dances9 and swimming parties were 
arranged 0 
i0 Prostitution was sparseg but promiscuity widespread. 
With the cooperation of the Local Health Authorities and the krmy g 
every effort was made to discover venereal disease contacts9 so that 
treatment could be instituted0 
Malaria: 
The freedom from malaria that is enjoyed on this island 
defies explanation. Anopheles albimanus is present in ample quantities 
to be a vector. Local doctors claim that the disease has been kept 
out of these island by routine blood smears on all incoming people. 
Despite this local temporary freedom from malaria9 previous epidemics 
of the disease have occurred; (the last being in 1936). Since epi- 
demics of malaria are likely to occur again9 anti-mosquito 
cannot be relaxed. 
113 TABLE I 
Malaria 
i9a 
- 1942 
0 
1942 
- 1943 
0 
1943 
- 1944- 
2 
1944- 
- 1945 
0 
1945 
- 1946 
0 
1946 
0 
Tropical Diseases: 
There is a certain amount of tropical diseases on the island 
of St0 Croix0 It is estimated that 25 percent of the population are 
infected with filariasis0 Intestinal parasites are the second most 
important medical problem on this island0 Approximately 10 percent of 
the population infested with ascaris lurabricoides and trichiuris0 
Five percent of the population have hook worm, and 5 percent are in- 
fested with schistosomiasis mansoni, which is imported from Puerto 
Ricoo AH’ civilians coming to this island for residence, hava a 
blood smear made for blood parasites, and stool examinations for in- 
testinal parasiteso In this way new cases of parasitic infestation 
are discovered and treatment instituted0 
No cases of intestinal parasitic infestation, schistosomiasis, 
filariasis, or typhus were reported from Benedict Field0 
A few cases of dengue were contracted by military personnel 
in 194-1 and 1942 <, See Table II. 
TABLE II 
Dengue 
19a - 1942 
2 
1942 - 1943 
3 
1943 - 1944- 
0 
1944 - 1945 
0 
1946 - 
0 
114 ARUBA, No W. I. 
The general health of the command has been excellent The 
favorable climatic environment and lack of mosquitoes are major con- 
tributing factors. 
Intestinal parasitic diseases, malaria, and schistosomiasis, 
have been diagnosed but patients were infected prior to arrival at 
this post. 
Venereal disease control has advanced rapidly. Each organi- 
zation was broken down into venereal disease control teams including 
unit officer and non-commissioned officers. Meetings of leaders and 
men average not less than once a week during the drive. Units were 
finally educated and trained to consider venereal disease on a com- 
petitive basis. With the consent of patients their lesions were 
demonstrated at venereal disease talks. There were two prophylactic 
stations available, one at the hospital dispensary and one in town. 
Mechanical and chemical prophylactics were available to all men prior 
to going out on pass. Prophylactic items were also available at the 
prophylactic stations. Local officials were very cooperative in dis- 
posing and treating infective contacts. Infected girls visiting the 
island as artists for six weeks were immediately deported. Infective 
natives were immediately put under medical supervision. The rate 
from 1 January to 1 September 194-5, for the post was 20 per 1000 per 
annum. 
Statistics and other information vital to the preventive 
medicine history of this post are not available at this time. 
115 CURACAO, No Wo lo 
Venereal Disease; 
Venereal diseases have always been a health problem in 
this camp because of the limited methods available for their controlo 
The existence of prostitution is not officially recognized in the 
island of Curacao so that the control of civilian prostitutes is im- 
possible o Several movements have been tried with this objective but 
official church and government opposition has made them failed in 
the last year or so, however, the Army has had the cooperation of the 
Dutch Police Force in the apprehension of contacts, and of the Dutch 
Public Health Department in their examination. 
The main bulk of prostitution is made of groups of women, 
who under the names of ,s artists* and nurses ,* are granted 
two-week visas to visit the island and ply their trade0 Contact 
and segregation under the circumstances is impossible0 Again, the 
sexual act has always been and is practiced by military personnel at 
a nearby beach, there being no houses of prostitution and no facili- 
ties to be foundo In an attempt to prevent diseases an Army truck 
was once ©quipped to administer venereal prophylactic treatments and 
sent to that beach at night on the week following pay days. On one 
occasion 60 treatments were administered in one single night0 
However, the enterprise seems to have been a failure because of in- 
adequate facilities to administer a good pro and the increase in the 
venereal rate. Mobile pro station was discontinued soon after<,> 47 
The only actual control of venereals, then, has always been 
education of the men0 This has always been emphasized in several con- 
trol plans put into practice, thru films, lectures by medical officers 
and divisions into soldier sub-groups for discussion and controlo The 
use of mechanical and chemical prophylaxis has always been stressedo 
Since more than two years ago the prophylactic items have been made 
available free to Army personnels Other control measures have been 
the generally known ones practiced in all Army camps„ 
One pro station is centrally located in town within one-half 
hour’s distance from the place of exposure0 Since its installation, 
it has been maintained open until midnight every day, and it gives 
service to Army, Navy and Merchant Marine personnelo In addition 
there are sub-stations in the camp hospital and in the Air Field 
dispensary0 Up until the time the Coast Artillery units left the 
island, all out-lying outfits were provided with chests stocked with 
prophylaxis equipment for self use by men in cases of * emergencies,*1 
under the supervision of an aid man or the charge of quarters0 
117 Venereal rates have shown a gradual decrease since the 
landing of troops in Curacao0 Average yearly rates have been as 
follows s 
1942 above 100/l00048 
1943 81/1000 
1944 35/1000^9 
1945 (up to present) 
20-25/1000 
This hospital has always admitted venereal cases into the 
hospitalo On very few occasions have they been treated as out-patients., 
In spite of this the actual non-effective rate has been low except 
during the first months of occupation, when there was a high incidence 
of chancroid casesThe chief disease has always been gonorrhea, 
though there are on record three to five cases of "new" syphilis, 
presumably Curacao acquired0 
Malaria! 
Malaria has never been a problem in Curacao0 There are 
few mosquitoes in the island; the land is arid and dry, of the New 
Mexico-Arizona type0 The two or three cases of malaria fevers re- 
corded in the Army hospital were all acquired in other malarial regions * 51 
Enteric Diseases: 
Increase in incidence in late fall and early winter, the 
’•rainy1* season and what might also be called the ’’fly” season., This 
yearly increase manifests itself in camp among soldierse The diseases 
are specific dysenteries of the Flexner and Schmitz - bacillary - 
type in about 50 percent of the cases 
Helminthic Diseases: 
With the coming of Puerto Rican soldiers, helminthic in- 
festation began to be encounters in routine stool examinations - never 
because of primary complaints0 Schistosomiasis was also met to a much 
lesser extento Both conditions were treated on an out-patient basis, 
Filariasis: 
Filariasis has never been recorded among American troops0 
This is surprising considering the fact that the disease is present 
in about 5 ° 10 percent of the local population,53 which fact can be 
confirmed by the high frequency of elephantiasis among natives of the 
lower classo 
118 Typhus j 
Typhus has never been diagnosed in the hospital. In town 
two or three cases of the murine type occur every year. In its 
transmission the rat found on the island - Ratus norwegian - is a 
link.54 
Dengue: 
Dengue, likewise, is not found in the hospital records. 
Several cases of cryptogenic fevers, however, have been encountered 
which might have been labeled as such torpical fever. 
119 WALLER FIELD 
AIR BASE DISPENSARY 
Venereal Disegtw 
Venereal disease is one of the principle causes of lost 
man days in the Army0 The negro population of the Island of Trinidad 
by far exceeds all other races0 The opportunity for infection of 
the soldier were, and are, numerous and a very large percentage of 
the populace are active carriers0 The social life of the soldier 
was practically negligible so far as association with white females 
were concerned, and consequently association with the colored females 
were numerous0 The morals of the local colored females being appar- 
ently low, and prostitution flourishing, the opportunity for sexual 
contacts was great and consequently a contributing factor in the rate. 
The towns are located nearby, namely Port of Spain and San 
Fernando, the transportation to Port of Spain for the enlisted sol- 
dier was fairly good, The percentage of English and other white 
families at the town of San Fernando was greater than any other 
town on the Island0 Transportation in the method of established bi- 
weekly convoys was permitted there. As a result the venereal dis- 
ease rate of Waller Field usually was lower than other organizations0 
A venereal disease program was always carried on at the 
Air Base and consisted of at least one monthly lecture and showing 
of film to all the personnel of the Air Baseu The lecture was three- 
fold including talks by the Commanding Officer Air Base, Chaplain, 
and Medical 0fficero Full use was always made of posters, pictures, 
and bulletin boards of organizations with prophylactic station loca- 
tions placed thereon. 
An intensified anti-venereal disease program was outlined 
by Antilles Department and put into effect 7 December 1944- as out- 
lined in Training Memorandum No, 15, Headquarters Antilles Department, 
Training Memorandum No, 17, Headquarters Antilles Department, was 
published 23 January 194-5, and served as a guide for Medical Officers 
acting as Venereal Disease Control Officers, The outlined program 
was very comprehensive. The efficacy of said program cannot be 
estimated because of the constantly changing of Air Base personnel 
during that period. 
The largest portion of the venereal disease encountered in 
the Dispensary was acute gonorrhea. The number of primary syphilitic 
lesions seen were small. When a positive darkfield or positive blood 
121 Wasserman was found and reported as such by the Hospital, treatment 
was instituted and continued at the Hospital until the patient rend- 
ered non-infective0 Then the remainder of the bismuth and mepharsen 
injections as prescribed in Circular Letter No, 74, War Department, 
Office of The Surgeon General, dated 25 July 1942, were given at the 
Dispensaryo The spinal fluid examination was done at the Hospital„ 
When the therapy of syphilis was altered to conform with War Depart- 
ment Technical Bulletins No, 106 and 198, dated 11 October 1944 and 
20 August 1945, respectively, using penicillin as the drug of choice, 
all treatments were given at the Hospital, 
The diagnosis of gonorrhea was made by finding gram nega- 
tive intracallular diplococci in smears of urethral exudate or in 
smears of a centrifuged specimen of urine. The original plan of 
treatment was in accordance with Circular Letter No, 74, War Depart- 
ment, Office of The Surgeon General, 25 July 1942, The outlined 
program of treatment consisted of oral sulfathiazole, of sulfadia- 
zene grams i q0i0d„ for five days. This to be repeated in five 
days if no response was gotten from the first course of sulfa. The 
recommended dosage was found to be too small for effective results. 
The prescribing of grams vi the first and second days and grams i t0i,d0 
for the next six days proving more effective0 Urine analyses and 
blood smears were done on the patient routinely in the above dosage 
scheduleo As prescribed in the Circular, if no results or cure were 
derived after two courses of the sulfa drug, the patient was admitted 
to the Hospital for further treatment Medical Technical Bulletin 
No, 16, dated 6 March 1944, prescribed the use of penicillin if the 
patient did not respond to one course of the sulfa drug0 Technical 
Bulletin No0 96, dated 21 September 1944, prescribed penicillin as 
the drug of choice in the treatment of gonorrhea. The recommended 
dosage was 100,000 units given intramuscularly over not less than 
an eight hour period of time. 
The results obtained with penicillin proved to be excel- 
lent, not more than 3 percent proving to be resistant. The initial 
plan was to give 20,000 units every three hours, however better 
results were obtained with 25,000 units given every two to two and 
one-half hours. 
The complications of gonorrhea seen were few in number. 
The most frequently seen complication was a mild prostatitis, which 
responded readily to prostatic massages twice weekly and the use of 
mild local urinary irrigationse The determination of cure of a 
case of gonorrhea consisted of the inability to demonstrate the 
causative organisms in urogenital fluids, including prostatic secre- 
tions, by smears or cultures. The tests were made three days after 
the disappearance of symptoms in an acute case, or six days after 
disappearance of symptoms in a case of prostatitis. 
122 VENEREAL RATES 
(per 1000/yr) 
mi 
1242. 
1242 
1944 
124i 
Nov 24.0 
Jan 
46.0 
Jan 
32.1 
Jan 
12.4 
Jan 
33o8 
Dec 21.6 
Feb 
45.7 
Feb 
55.4 
Feb 
24.2 
Feb 
35.4 
Mar 
24o04 
Mar 
27.1 
Mar 
2102 
Mar 
00.0 
Apr 
47.75 
Apr 
39o9 
Apr 
59o4 
Apr 
18.0 
May 
49.0 
May 
44.3 
May 
55oO 
May 
35.97 
Jun 
77.0 
Jun 
61.0 
Jun 
42.4 
Jun 
00.0 
Jul 
32.0 
Jul 
43.0 
Jul 
41.6 
Jul 
21.4 
Aug 
57.8 
Aug 
46.1 
Aug 
00 o 0 
Aug 
00.0 
Sep 
32.0 
Sep 
65.8 
Sep 
9.84 
Sep 
00.0 
Oct 
12.6 
Oct 
52.0 
Oct 
57.2 
Oct 
00.0 
Nov 
606 
Nov 
32.5 
Nov 
OOoO 
Nov 
.... 
Dec 
1.1 
Dec 
78,0 
Dec 
00.0 
Dec 
.... 
Malaria: 
Mosquito control for the entire post (including the Air 
Base) was under the U.S.E.D. hospital staff until 17 October 1942, 
when it was taken over by the Post Engineer0 The principle control 
measures were oiling, filling and grading, drainage and flood con- 
trol, and foliage inspection, together with screening and use of 
mosquito nets and repellents0 All trees in the area with attached 
Bromeliads growth were chopped down, burned, or stripped of the 
growth. The 392nd Malaria Control Laboratory was inaugurated at 
Fort Read in January 1943 and had the responsibility of mosquito 
control for the entire reservation. The responsibility at the Air 
Base was one of individual mosquito discipline consisting of each 
man adequately using nets, clothes, and mosquito repellents. In 
March 1945, the spraying of DDT was started. The first plane used 
was an L-4, then an L-l, then a C-47, and a B-25 is now contem- 
plated o With the use of DDT the malaria rate decreased and the 
mosquito count was practically zero. The program on the Base has 
been so effective that it is now felt malaria is not contracted 
on the Base, 
123 MALARIA CASES 
Year 
Month 
Primary 
Recurrent 
Total 
Neto Inc 
Neto Dec* 
1942 
May 
8 
0 
8 
0 
0 
Jim 
9 
0 
9 
1 
0 
Jul 
2 
0 
2 
0 
7 
Aug 
8 
0 
8 
6 
0 
Sep 
11 
0 
11 
3 
0 
Oct 
1? 
4 
21 
10 
0 
Noy 
8 
11 
19 
0 
2 
Pec 
5 
4 
9 
0 
10 
1943 
Jan 
2 
5 
7 
0 
2 
Feb 
0 
4 
4 
0 
3 
Mar 
9 
4 
13 
9 
0 
Apr 
$ 
9 
14 
1 
0 
May 
7 
4 
11 
0 
3 
Jim 
5 
3 
8 
0 
3 
Jul 
9 
7 
16 
8 
0 
Aug 
11 
4 
1$ 
0 
1 
Sep 
"9 
10 
19 
4 
0 
Oct 
6 
1 
7 
0 
12 
Not 
7 
2 
9 
2 
0 
Dec 
6 
3 
9 
No 
Change 
Tropical Dermatoses% 
Were fairly common among the personnelp epidermophytoses9 
tenia cruris9 and external otitis were those most commonly encountered. 
The epidermophytoses were largely the interdigital and vesiculo-pustu- 
lap types9 with the former predominatingo Treatments were varied as 
to types9 and few if any can be said to have proved specific. In the 
vesiculo-pustular the vesicles were opened and due caution 
taken in regards to secondary infection occurring- of which few cases 
were seen0 The treatment then was similar to that used for the inter- 
digital type0 Wet dressings or soaks were used in the presence of 
secondary infection or cellulitis„ The solutions used were varied 
consisting of potassium permanganate (1-18^000-1-9s000)9 aluminum 
acetate (1:200)r or magnesium sulphate (saturated solution) or boric 
acid (l*25)o Results were good with all of the above9 each case pre- 
senting an individual response0 The best results were obtained with 
potassium permanganate or magnesium sulphate solutions used fifteen 
minutes t0iod0 
After the disappearance of the cellulitis, or on an ini- 
tial case without cellulitis9 kerolytic agents were used0 Those 
124 found most efficacious were 3 percent salycilic acid in tincture of 
mercresin or tincture of metaphen, and castillanis paint, applied 
toiod, A preparation used extensively and found to be extremely 
efficient and fungicidal in initial cases without cellulitis was 
the following powders 
Rx 
Salycilic acid grams 5 
Menthol ” 2 
Camphor n 2 
Boric Acid n 30 
Starch » 30 
Mix and make a powder 
Sigs Dust on feet t0iod0 
The average duration of treatment was five to six days with 
no lost time0 Hygienic conditions consisting of frequent foot bathing 
and change of socks, in addition to the above, were counseledc 
Tenia cruris was next most frequently encountered9 mainly 
the nonvesicular typea The treatment here closely followed the 
above and the preparation used with greatest success was the dusting 
powder given in the above prescription0 
There was found to be a high incidence of otomycoses and 
frequently three to five percent of the command were affected0 The 
types of treatment used were varied as were the results obtained0 
It was observed that a small accumulation of wax in the canal pre- 
vented the occurrence of otomycoses0 Personnel were cautioned to 
thoroughly dry the ears following showering or bathing0 Personnel 
using head sets, as for example members of an air crew or radio 
detachment, were advised preferably to have assigned head sets used 
only by themselves0 In all cases it was advised that the head sets 
be wiped off with alcohol at least once daily0 
Symptoms of otomycoses varied with the severity of the 
infection0 In mild cases the predominating symptoms were itching9 
burning, and discharge0 If a large exudative mass was present there 
was occasionally some diminution of hearlng0 In severe cases the 
above were present plus severe pain in the affected ear, especially 
aggravated by mastication0 Examination revealed fungus growth which 
may or may not include the drum depending upon the severity9 and 
tympanitis, and low grade temperature0 
Treatment was varied and the responses to the treatment 
were of an individual nature0 General treatment in the more severe 
cases consisted of sedation, heat to the affected ear, and local 
125 treatmento The method found most suitable for application of heat 
was a large lampc Local treatment depended upon the severity of 
the external otitise In all cases it was necessary to remove the 
exudate9 in the severe cases the cellulitis and pain were allowed 
to subside before this was done0 The instillation of 3=1/2 - 7 
percent hydrogen peroxide was allowed to remain for five min- 
utes., then the affected ear was gently syringed9 and then dried 
with cotton wicks9 this was repeated each day until the complete 
removal of all exudate and debris was accomplished0 The use of 
applicators in the removal of epithelial debris and exudate was 
omitted due to the usually accompanying trauma to the' canal and 
resulting furunculosis0 
Following the syringing each day the instillation of some 
local application was practiced0 Those used were varied as were the 
results obtainedo The best results were obtained with the use of 
cresatin and 1 percent thymol0 Good results also were obtained with 
the use of 3 percent aluminum acetate solution9 and 5 percent algy- 
rol solutiorio A wick saturated with any of the above was placed 
in the canal and the patient given some medicine to apply directly 
to the wick toi0d0 so as to keep it moist0 After approximately 
2-5 days of the above therapy 3 qttsD of the solution being used 
was applied by the patient directly in the ear t0iod0? no wick being 
usedo Daily examinations and treatments were given to the patients 
in the Dispensary9 and the average duration of the otomycoses was 
5 “ 7 daySo Poor results were obtained with insufflations of powder0 
126 338TH MEDICAL DISPENSARY 
PORT-OF-SPAIN 
Venereal Disease: 
Statistics pertaining to Venereal Diseases from 1943 to 
1945 are as follows* 
January 1943 Syphilis 1 
Gonorrhea 1 
Other Venereal Diseases 0 
Number of prophylactic treatments 
administered during the month - 
1,448 
February 1943 Syphilis 0 
Gonorrhea 1 
Other Venereal Diseases 3 
Number of prophylactic treatments 
administered during the month - 
2,507 
March 1943 Syphilis 0 
Gonorrhea 5 
Other Venereal Diseases 2 
Number of prophylactic treatments 
administered during the month « 
1,619 
April 194-3 Syphilis 1 
Gonorrhea 3 
Other Venereal Diseases 2 
Number of prophylactic treatments 
administered during the month - 
1,713 
Rate per 1,000 per annum - 46o4 
127 May 1943 Syphilis 1 
Gonorrhea 1 
Other Venereal Diseases 1 
Number of prophylactic treatments 
administered during-the month - 
1,878 
Rate per 1,000 per annum - 2601 
June 1943 Syphilis . 0 
Gonorrhea 2 
Other 2 
Number of prophylactic treatments 
administered during the month - 
2,392 
July 1943 Syphilis 0 
Gonorrhea 4 
Other 2 
No0 of prophylactic treatments ad- 
ministered during the month - 2,473 
Rate per 1,000 per annum - 42 
August 1943 Syphilis 0 
Gonorrhea 1 
Other 0 
NOo prophylactic treatments admin- 
istered during the month - 2,471 
Rate per 1,000 per annum - 08ol 
September 1943 Syphilis 2 
Gonorrhea 3 
Other 0 
NOo prophylactic treatments admin- 
istered during the month - 2,423 
Rate per 1,000 per annum - 34*5 
October 1943 Syphilis 0 
Gonorrhea 3 
Other 1 
No0 prophylactic treatments admin- 
istered during the month - 2,330 
Rate per 1,000 per annum - 21c7 
128 November 1943 Syphilis 0 
Gonorrhea 3 
Other 0 
No0 prophylactic treatments admin- 
istered during the month - 2,770 
Rate per 1,000 per annum - 2002 
December 1943 Syphilis 0 
Gonorrhea 6 
Other 11 
No0 of prophylactic treatments admin- 
istered during the month - 3,973 
Rate per 1,000 per annum - 31d 
January 1944 Syphilis 4 
Gonorrhea 2 
Other 0 
No0 prophylactic treatments admin- 
istered during the month - 3,532 
Rate per 1,000 per annum » 1803 
February 1944- Syphilis 1 
Gonorrhea 3 
Other 0 
NOo prophylactic treatments admin- 
istered during the month - 2,537 
Rate per 1,000 per annum - 23o5 
March 1944 Syphilis 2 
Gonorrhea 1 
Other 0 
No0 prophylactic treatments admin- 
istered during the month - 4-,512 
Rate per 1,000 per annum - 3709 
April 1944 Syphilis 0 
Gonorrhea 5 
Other ' 3 
NOo prophylactic treatments admin- 
istered during the month - 3,041 
Rate per 1,000 per annum - 38„7 
129 May 1944 Syphilis 0 
Gonorrhea 7 
Other 0 
No. prophylactic treatments admin 
istered during the month - 1,732 
Rate per 1,000 per annum - 48o0 
June 1944 Syphilis 0 
Gonorrhea 3 
Other 0 - 
Noo prophylactic treatments admin 
istered during the month - 1,789 
Rate per 1,000 per annum ° 49=2 
July 1944 Syphilis 0 
Gonorrhea 3 
Other 2 
Noo prophylactic treatments admin 
istered during the month - 1,531 
Rate per 1,000 per annum - 2803 
August 1944 Syphilis 0 
Gonorrhea 2 
Other 0 
No0 prophylactic treatments admin 
istered during the month - 1,413 
Rate per 1,000 per annum - 3207 
September 1944 Syphilis 0 
Gonorrhea 1 
Other 0 
Noo prophylactic treatments admin 
istered during the month - 1,698 
Rate per 1,000 per annum - 20o4 
October 1944 Syphilis 0 
Gonorrhea 1 
Other 0 
Noo prophylactic treatments admin 
istered during the month » 1,730 
Rate per 1,000 per annum - 2505 
130 November 194-4 Syphilis 0 
Gonorrhea 1 
Other 0 
No. prophylactic treatments admin- 
istered during the month - 1,646 
Rate per 1,000 per annum - 23o55 
December 1944- Syphilis 0 
Gonorrhea 0 
Other 0 
NOo of prophylactic treatments ad- 
ministered during the month - 1,761 
Rate per 1,000 per annum - - O 
January 194-5 Syphilis 0 
Gonorrhea 1 
Other 0 
NOo prophylactic treatments admin- 
istered during the month - 1,590 
Rate per 1,000 per annum - 3008 
February 194-5 Syphilis 0 
Gonorrhea 2 
Other 0 
NOo prophylactic treatments admin- 
istered during the month - 1,296 
Rate per 1,000 per annum - 3809 
March 1945 Syphilis 0 
Gonorrhea 2 
Other 0 
No0 prophylactic treatments admin- 
istered during the month - 1,987 
Rate per 1,000 per annum - 38.3 
April 194-5 Syphilis 0 
Gonorrhea 0 
Other 1 
No0 prophylactic treatments admin- 
istered during the month - 1,8S7 
Rate per 1,000 per annum - 2305 
131 May 1945 Syphilis 0 
Gonorrhea 0 
Other 0 
No0 prophylactic treatments admin- 
istered during the month - 1,629 
Rate per 1,000 per annum - 0 
June 1945 Syphilis 0 
Gonorrhea- 2 
Other 0 
No0 prophylactic treatments admin 
istered during the month - 3,587 
Rate per 1,000 per annum - 31«0 
July 194-5 Syphilis 0 
Gonorrhea 0 
Other 0 
NOo prophylactic treatments admin 
istered during the month - 3,400 
Rate per 1,000 per annum - 0 
August 194-5 Syphilis 1 
Gonorrhea 0 
Other 0 
No0 prophylactic treatments admin 
istered during the month ~ 2,56? 
Rate per 1,000 per annum - 26<>4 
September 1945 Syphilis 1 
Gonorrhea 0 
Other 0 
Noo prophylactic treatments admin 
• istered during the month - 2,221 
* 
Rate per 1,000 per annum - 30o0 
October 194-5 Syphilis 1 
Gonorrhea 0 
Other 0 
No0 prophylactic treatments admin 
istered during the month - 1,64.8 
Rate per 1,000 per annum - 23o9 
132 Malaria: 
Since the organization of this dispensary, 1 April 194-4-, 
only five cases of malaria have been recorded: 
April 1944 
Continental Troops Insular Troops 
2 2 
July 1944 
1 
The 392nd Medical Malaria Control Detachment, operating 
at Fort Read handled the malaria work of this area. A history of 
that unit will include all reference to this disease that might be 
included at this point. 
133 TRINIDAD 
359TH STATION HOSPITAL 
Venereal Disease; 
Venereal Disease Problems 
Civilians 
The civilian population affords an ample reservoir of 
all the venereal diseases0 The local government does not license 
or openly countenance organized prostitution, but definite houses 
are available and may be readily found upon application to almost 
any taxi driver0 In addition, a large percentage of soldiers 
trace their disease casual "pick-upsthe widespread availability 
of girls of this type is a factor which must be recognized as any 
program of venereal disease control, 
Army; 
As is shown in the accompanying tables, the first troops 
arriving at this Post had a high incidence of infections0 This was 
true of both white and colored troops 5 among the latter the rate 
was much higher, primarily because these men were not concerned with 
the racial barriers which inhibit to a certain extent promiscuity 
among the white troops0 Contributing factors in this high inci- 
dence of disease are several0 One of the major factors was the 
availability of sexual contacts in the adjacent small towns and 
communities where prophylactic facilities did not exist0 Of im- 
portance also is the fact that several months are necessary for the 
establishment of a well integrated educational program, and the 
time interval between.the institution of this program and the reduc- 
tion in the number of cases occurringo 
As may be seen from the statistical charts, the non- 
effective rate decreased during the year 194-3® This decrease* may 
be seen to be due primarily to a decrease in incidence of venereal 
disease, rather than a reduction in the days lost per case ratioc 
In December 194-3 penicillin became available for sulfonamide resist- 
ant gonorrhea, and in October 1944- the duty status of gonorrhea with 
penicillin was instituted,. Both of these advances caused a moderate 
reduction of days lost per case* The greatest factor, however, in 
the reduction of the non-effective rate has been the drastic reduc- 
tion in the incidence of venereal disease0 
135 Venereal Disease Control Programs 
The venereal disease control program has been under the 
direct supervision of the Post Commander who has put the responsi- 
bility of control of venereal diseases squarely upon the unit com- 
manders o A Staff Officer of Headquarters9 Fort Read has been ap- 
pointed venereal disease control officer for the Post0 This officer 
functions to correlate the program between the various units0 
It has been the responsibility of the Medical Department 
to provide instruction for the troopsf and especially for the com- 
pany officers and non-commissioned officers0 Medical Officers also 
supervise the operation of prophylactic stations. 
An attempt has been made to locate contacts of venereal 
disease and refer these to the local medical officers for treatmento 
since the majority of men infected with venereal disease 
do not know the names or addresses of their contacts, this has 
\ * 
proved to be of minor importance in the control program in this 
area. 
Treatment of venereal diseases has followed current prac- 
tice o No unusual treatments have been used0 Results are much the 
same as those experienced elsewhere. Since the institution of peni- 
cillin treatment for gonorrhea9 no patient has been evacuated to 
the United States or Puerto Rico for treatment of this disease0 
Syphilis has apparently responded well to both arsenical and peni- 
cillin therapyo Chancroid and lymphogranuloma inguinale have 
offered no unusual difficulties0 The diagnosis of granuloma in- 
guinale has been made in two (2) cases by the demonstration of 
Donovan bodies in the exudate; both cases responded to treatment 
with fuadin0 
Educational measures have been of prime importance in 
reducing the incidence of venereal disease0 Since the command re- 
sponsibility in the control program has been fully it 
has been possible to instruct the company officers and non-com- 
missioned officers concerning venereal disease and have them trans- 
mit this information to the troops0 A monthly meeting has been held 
between the unit surgeon and the company officers and non-commissioned 
officers; these officers and non-commissioned officers conduct 
weekly instruction of the enlisted men in groups of twenty-five (25) 
or lesso In this way it has been found possible to acquaint the 
entire command with the essential facts of venereal disease and 
its control0 Exaggeration of the physical effects of venereal 
disease has been particularly avoided because of the real danger 
of creating phobias which would prove more difficult in treatment 
136 than a case of venereal disease0 Emphasis has been placed entirely 
on the fact that venereal diseases are disgusting and unnecessary; 
an excellent change of complete cure has been promised provided 
that early treatment is instituted0 Educational films and posters 
have been utilized; however, most reliance has been placed on the 
weekly meetings within the company0 
In 1942 prophylactic stations were established in San 
Fernando and Port of Spain, as well as in several towns0 Exposed 
men visited these stations reasonably well, provided that exposure 
occurred in an area where these stations were established, A special 
problem was presented by the isolated gun positions of a colored 
anti-aircraft regimento It was found that exposures occurred in the 
vicinity of these stations0 Accordingly each of the larger sta- 
tions was equipped with prophylactic facilities complete with straddle 
sink and the smaller positions were supplied with individual prophyl- 
actic materials and hot water, A policy was established so that no 
criticism was directed against a man for using these facilities at 
any time, even though he was on duty at the time. The incidence of 
venereal diseases at these stations was reduced by this means„ As 
the Base declined in size, it was found to be impracticable to main- 
tain prophylactic stations at the smaller villages0 Therefore, 
those at Port of Spain and San Fernando were maintained and other 
areas frequented by soldiers were declared "'off limits0n This 
policy has made possible the establishment of large centrally located 
and well equipped prophylactic stations and has limited exposure to 
areas adjacent to these0 
No attempt at control of prostitution has been mad© 
Venereal Disease at Fort Read has been a problem primarily 
because of prevalence and not because of special difficulties and 
diagnosis and treatment. Incidence of new cases of venereal dis- 
eases is shown in the attached charts. The majority of the cases of 
venereal disease have been acquired through sexual contact with 
women of the local population. No unusual means of transmittal have 
been noted. 
Syphilis s 
Records of the 359th Station Hospital, Fort Read,, Trinidad, 
BoW.I, show the following cases of syphilis, not all of which were 
attributable to this Post? 
Primary syphilis 382 
Secondary syphilis 74- 
Tertiary syphilis 3 
Syphilis, unclassified 58 
Neurosyphilis 6 Treatment has followed current recommendations of The Surgeon 
General, No unusual treatments have been used, Six (6) cases 
of neurosyphilis have been diagnosed and have been returned to 
the United States or Puerto Rico for treatment, No serious reac- 
tions to treatment have been observed at this Hospital0 One (1) 
case of exfoliative dermatitis due to Mapharsen treatment of 
syphilis was transferred to this Hospital from the Station Hospital 
at British Guiana0 This man was treated with bland local medica- 
tions and sodium thiosulphate lo0 gram intravenously for eighteen 
(18) dayso Improvement followed and the man was returned to duty. 
In one (1) case penicillin therapy for secondary syphilis was dis- 
continued on the fourth day of treatment because of persistent 
fever to 103,4, cyanosis9 and delirium. Within twenty-four (24.) 
hours following cessation of treatment9 temperature was normal 
and, after a short period of convalescence9 this patient was 
started on a twenty-six (26) week course of mapharsen and bismuth. 
This treatment was tolerated well. 
Gonorrheas 
Gonorrhea9 as is shown on attached charts} has been the 
most frequent venereal disease found in this area. Treatment has 
followed current recommendations of The Surgeon General„ No unusual 
treatments have been used0 
From May 1942 until December 194-3 seventeen (17) cases 
of gonorrhea were returned to general hospitals in the United States 
or Puerto Rico because of sulfonamide resistant gonorrhea0 In 
December 194-3, penicillin became available for the treatment of sul- 
fonamide resistant cases of gonorrhea0 No patient has been evacu- 
ated because of treatment resistant gonorrhea, since that time0 
In October 1944- the ambulatory treatment of new gonorrhea with peni- 
cillin was authorized„ Since that time only two (2) new cases have 
been admitted to the Hospital9 both of these because of lack of 
penicillin at their dispensaries*, Thirteen (13) chronic cases of 
gonorrhea have been admitted to the Hospital since October 1944-J 
all have responded to treatment with penicillin0 No unusual reac- 
tion to the treatment of gonorrhea with penicillin has been observed0 
Chancroids 
Diagnosis of chancroid has been made at the 359th Station 
Hospital five hundred and fifty-eight (558) times since May 1942. 
Diagnosis of chancroid has been made where there appeared a definite 
ulcerative lesion of the penis which could not be attributable to 
other diseases. No effort at identification of the Ducrey5s 
bacillus has been made. Treatment has been with sulfonamide powder 
applied locally. Response has been generally satisfactory. No cases 
have occurred which required evacuation to the United States. 
138 c* © 
■P TJ O 
•id * 
SUMMARY OF VENEREAL DISEASE CASES £ 
FORT READ, TRINIDAD, B. W. I. * o 
1942 ■'£ £ °* 
o +> 
C ti <0 
V> *) O 
MONTH CONTINENTAL WHITE CONTINENTAL BLACK INSULAR TOTAL “ « “ 
.■ - --— —— - — s >> >. 
Days o <s a) 
Strength S G 0 Rate Strength S G 0 Rate Strength S G 0 Rate Strength S G 0 Rate Lost 55 Q Q 
MAY 
JUNE 
JULY 
AUGUST 
i 
SEPTEMBER 
.OCTOBER 
NOVEMBER 
DECEMBER 
4124 
S 
IS 
11 
87 
2201 
6 
10 
SO 
390 
0 
0 
0 
0 
0 
6325 
9 
23 
61 
191 
1218 
6.9 
13 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. W. I. 
1942  
MONTH 
CONTINENTAL 
Strength S G 
WHITE 
0 Rate 
SUMMARY OF 
FORT READ 
CONTINENTAL BLACK 
Strength S G 0 Rate 
VENEREAL DISEASE CASES 
1, TRINIDAD, B. W. I. 
1943 
INSULAR 
Strength S G 0 Rate 
TOTAL 
Strength S G 
0 
Rate 
Day* 
Lest 
Non-effeetire Rate 
Days per Thousand 
Days lost per case 
X 
JANUARY 
3657 
3 
10 
• 
7 
56 
2190 
11 
39 
62 
521 
0 
0 
0 
0 
0 
5847 
14 
49 
69 
230 
1720 
8.4 
13 
X 
FEBRUARY 
3762 
3 
15 
2 
69 
2182 
5 
20 
61 
512 
0 
0 
0 
0 
0 
5944 
8 
85 
63 
232 
1497 
9.0 
14 
X 
MARCH 
4179 
7 
15 
11 
105 
2195 
9 
19 
46 
438 
0 
0 
0 
0 
0 
6374 
16 
34 
57 
218 
1652 
9.3 
15 
X 
APRIL 
4210 
7 
27 
17 
127 
2177 
14 
9 
24 
225 
0 
0 
0 
0 
0 
6387 
21 
36 
41 
160 
178 5 
8.0 
18 
X 
MAY 
4418 
3 
16 
8 
76 
2451 
7 
9 
18 
180 
0 
0 
0 
0 
0 
6869 
10 
24 
26 
114 
1373 
7.1 
23 
X 
JUNE 
4562 
2 
19 
9 
85 
2463 
4 
6 
1 
53 
0 
0 
0 
0 
'0 
7025 
6 
25 
10 
76 
1119 
5.7 
27 
JULY 
7838 
1 
16 
4 
28 
2285 
6 
5 
2 
59 
0 
0 
0 
0 
0 
9623 
7 
20 
6 
36 
1368 
4.1 
41 
AUGUST 
6246 
1 
14 
8 
38 
2392 
4 
2 
3 
49 
XX 
8638 
6 
16 
6 
41 
761 
3.2 
28 
SEPTEMBER 
5321 
7 
11 
8 
63 
2396 
1 
7 
8 
87 
XX 
7717 
8 
18 
16 
71 
775 
3.6 
18 
OCTOBER 
6258 
1 
18 
7 
36 
2265 
2 
4 
3 
41 
XX 
8523 
3 
•17 
10 
57 
608 
2.0 
20 
NOVEMBER 
6361 
0 
15 
3 
57 
2252 
1 
1 
4 
35 
XX 
8603 
1 
16 
7 
36 
431 
1.8 
18 
DECEMBER 
6398 
5 
22 
6 
54 
0 
0 
0 
0 
0 
256 
1 
1 
1 
101 
649 3 
6 
23 
7 
58 
758 
3.3 
21 
X Figure* for these 
month* 
inelude ground 
foroes only. 
$ Approximately 
400 
Inaular Troops included 
among 
continental white. 
202 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. W. I. 
1943 MONTH 
CONTINENTAL YmiTE 
Strength S GO Rate 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. W. I. 
1944 
CONTINENTAL BLACK INSULAR 
Strength S G 0 Rate Strength S G 0 Rate 
TOTAL 
Strength S 
G 
0 
Rate 
Days 
Lost 
Non-offectiTe Rate 
Days per Thousand 
Days lost per case 
JANUARY 
7162 
2 
15 
7 
45 
0 
0 
0 
0 
0 
367 
0 
2 
1 
106 
7629 
2 
17 
8 
47 
504 
2,4 
19 
FEBRUARY 
7242 
1 
13 
4 
32 
0 
0 
0 
0 
0 
357 
0 
1 
0 
36 
7699 
1 
14 
4 
32 
509 
• 
27 
MARCH 
6262 
3 
14 
7 
40 
0 
0 
0 
0 
0 
366 
0 
4 
1 
142 
6628 
3 
18 
8 
45 
624 
3.2 
22 
APRIL 
48 35 
1 
8 
0 
24 
0 
0 
0 
0 
0 
38 9 
0 
0 
3 
100 
5224 
1 
8 
3 
29 
329 
2.4 
27 
MAY 
5202 
4 
13 
1 
45 
0 
0 
0 
0 
0 
362 
1 
0 
0 
37 
5554 
5 
13 
1 
44 
323 
1.7 
17 
•JUNE 
4090 
0 
12 
1 
S3 
0 
0 
0 
0 
0 
426 
0 
0 
0 
0 
4616 
0 
12 
1 
30 
134 
1.1 
10 
JULY 
3234 
2 
9 
0 
44 
0 
0 
0 
0 
0 
116 
0 
1 
0 
112 
3364 
2 
10 
0 
46 
67 
0.7 
5.6 
AUGUST 
2986 
0 
7 
1 
36 
0 
0 
0 
0 
0 
105 
0 
0 
0 
0 
3091 
0 
7 
1 
34 
118 
1.4 
16 
SEPTEMBER 
2978 
1 
4 
1 
21 
0 
0 
0 
0 
0 
111 
0 
0 
0 
0 
308 9 
1 
4 
1 
20 
106 
1.0 
18 
OCTOBER 
2737 
1 
7 
1 
43 
0 
0 
0 
0 
0 
108 
0 
0 
0 
0 
2845 
1 
7 
1 
41 
130 
1.6 
14 
NOVEMBER 
2554 
0 
4 
1 
26 
V 
0 
0 
0 
0 
0 
120 
0 
0 
0 
0 
2674 
0 
4 
1 
24 
92 
1.2 
18 
DECEMBER 
1927 
0 
2 
0 
10 
0 
0 
0 
0 
0 
742 
1 
3 
0 
56 
2669 
1 
5 
0 
25 
63 
0.7 
11 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. W. I. 
1944 MONTH 
CONTINENTAL WHITE 
Strength S G 0 Rate 
CONTINENTAL 
Strength S G 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. ff. I. 
1945 
BLACK INSULAR TOTAL 
0 Rate Strength S G 0 Rate Strength S 
G 
0 
Rate 
Day* 
Lost 
Non-effective Rate 
i&ys per Thousand 
Days lost per case 
JANUARY 
1566 
2 
1 
0 
25 
0 
0 
0 
0 
0 
1296 
0 
3 
0 
30 
2861 
2 
4 
0 
27 
117 
1.6 
19 
FEBRUARY 
1438 
1 
5 
0 
64 
0 
0 
0 
0 
0 
1293 
0 
1 
0 
10 
2731 
1 
6 
0 
33 
78 
1.0 
11 
MARCH 
1422 
0 
1 
0 
7 
0 
0 
0 
0 
0 
1271 
0 
2 
1 
25 
2693 
0 
3 
1 
15 
77 
0.8 
19 
APRIL 
1426 
0 
1 
0 
9 
0 
0 
0 
0 
0 
1279 
0 
1 
1 
20 
2 705 
0 
2 
1 
14 
93 
1.2 
31 
MAY 
16S8 
0 
5 
0 
39 
0 
0 
0 
0 
0 
1289 
0 
6 
0 
60 
2957 
0 
11 
0 
48 
83 
1.0 
7. 5 
JfUNE 
7073 
4 
4 
2 
15 
0 
0 
0 
0 
0 
1258 
0 
2 
0 
17 
8331 
4 
6 
2 
15 
143 
0.5 
12 
JULY 
6282 
6 
9 
0 
31 
0 
0 
0 
0 
0 
1298 
0 
3 
0 
50 
7580 
6 
12 
0 
31 
134 
0.6 
7.4 
AUGUS T 
579 4 
4 
9 
0 
23 
0 
0 
0 
0 
0 
1326 
0 
2 
0 
15 
7120 
4 
11 
0 
21 
141 
0.6 
9.4 
SEPTEMBER 
4807 
1 
7 
0 
22 
0 
0 
0 
0 
0 
1246 
1 
1 
0 
21 
6053 
2 
8 
0 
21 
41 
0,2 
4.1 
OCTOBER 
NOVEMBER 
DECEMBER 
SUMMARY OF VENEREAL DISEASE CASES 
FORT READ, TRINIDAD, B. ff. I. 
1945 Granuloma inguinale: 
Two (2) cases of granuloma inguinale have been seen; 
in both cases typical Donovan bodies were found in smears from the 
lesions. Both men were soldiers; one was colored, the other white 
(Puerto Rican), Treatment consisted of intra-muscular fuadin* Both 
cases responded. 
Lymphogranuloma inguinale : 
Diagnosis of lymphogranuloma inguinale has been made 
thirty-four (34) times at the 359th Station Hospital0 Diagnosis 
has been made on the basis of tender inguinal adenopathy with fever 
plus a positive Frei Test0 Treatment has been bed rest plus sys- 
temic sulfonamide therapy* Suppuration of the glands requiring 
evacuation of the necrotic material has been rare* Convalescence 
has been satisfactory in all cases* 
Emphasis has been placed on instruction of officers and 
key non-commissioned officers in turn, instruct the enlisted 
men in small groups* Large, well equipped prophylactic stations 
have been maintained in central areas, while all areas from which 
a man could not reach one of these prophylactic stations have been 
declared “Off Limits*“ No attempt at control of prostitution has 
been made* 
Malarias 
Malaria of all types has accounted for 8*7% of admissions 
to this Hospital from its activation to the present time* There 
has been a total of one thousand one hundred and forty-two 
primary and recurrent cases0 Classified as to type of causative 
parasite there have been eight hundred and seven cases due to Plas- 
modium vivax, three hundred and eight (308) to Plasmodium 
one (1) to Plasmodium twelve (12) cases of mixed infec- 
tion and fourteen (14.) unclassified0 
Beginning in December 1942 all cases have been treated 
with atabrine* Prior to that time quinine and atabrine combina- 
tions were usedo The majority of cases admitted to this Hospital 
in its beginning received atabrine according to the following 
scheme: 0*5 gram on admission followed in eight (8) hours by 0*4 
gram then eight (8) hours later by 0*3 gram*- Treatment was therx' 
stoppedo It was apparently felt that this was sufficient therapy • 
inasmuch as the patients became afebrile within twenty-four (24) 
to thirty-six (36) hours and the blood smear free from parasites 
at the end of a like period* As might have been suspected, however, 
139 this treatment was inadequate as evidenced by statistics taken 
from the Malaria Control Laboratory at this station which show 
that in March 194-3 9 34o9 percent of all Vivax recurrences occurred 
within one (1) month of the initial attacko These records show 
similar rates of recurrence for succeeding months until June 194-3 
when this method of treatment was dropped*, In connection with this 
routine of therapy it is also significant that the pigmentation of 
the skin from this rapid method of dosage was markedc There was a 
high incidence of nausea, vomiting and abdominal discomfort0 Since 
August 194-3 all cases of malaria at this hospital have received 
atabrine in accordance with ScGoOo Circular Letter #153. 19 Aug- 
ust 194-3o "Follow Up” therapy is now given for ninety (90) 
and ferrous sulphate gr V is given to all patients0 The average 
period of hospitalization has been eight (8) daysQ For Vivax 
infection the average febrile period is three (3) days with nega- 
tive smear by the fifth day0 In cases due to Plasmodium falci- 
the febrile period averages five (5) days with negative 
smears on the sixth to the seventh day„ The usual yellow pigmen- 
tation of the skin has been but none of the other skin mani- 
festations which have been attributed to atabrine have been observed. 
Only occasional complaints of mild abdominal cramping are notede 
There has been one (1) case of toxic psychosis attributed to the 
drugo This occurred on the sixth hospital day and was manifested 
by moderate disorientation and delirium and amnesia lasting about 
seven (7) days® Recovery was complete0 
All the possible complications of malaria have been 
the most frequent being secondary anemia9 bronchitis and broncho- 
pneumonia. Incidence of severe kidney damage has been low and it is 
significant that there have been no cases of blackwater feverQ In 
one (1) case of tertian malaria9 there were marked bilateral retinal 
hemorrhages which occurred on the third hospital day*, The area of 
hemorrhage involved the macular region of left eye causing moderate 
loss of visiono 
Record is found of four (4-) cases of "cerebral” malaria} 
all due to Plasmodium falciparum*, There was recovery in three (3) 
cases with one (1) death recordedo This occurred in October 19-42 
and was a case of estivo-autumnal malaria with cerebral manifesta- 
tions complicated by bronchopneumonia0 There is no record of a 
case of "cerebral” malaria since January 1943« 
While malaria has been by far the most frequent and impor- 
tant single disease at this Base, it should be said in conclusion 
that as control measures have its incidence has decreased, 
sharply thereby rendering it less and less a problem0 Evidence of 
this can be seen in the fact that from 1 January 1945 to the present 
time there have been only one hundred and twenty-five (125) admis- 
sions due to malaria® In view of the fact that the 392nd Medical Malaria Control 
Detachment rendered a complete historical report on all phases of 
Malaria Control for this Command this subject will not be discussed 
further in this unit History*. 
Enteric Diseases? 
In order to control the incidence of enteritis 
and dysentery close supervision of all organizational messes has 
been maintained0 All buildings are there is an adequate 
water-borne sewerage system0 Garbage is carried away daily and dis- 
posed of by a modified sanitary fill method which is located at a 
sufficient distance from any populated parts of the Post*, All mess 
personnel are given a monthly physical examination and are examined 
periodically while on the job* 
Dysentery bacillary and amebic 9 have constituted no 
problem in the Trinidad Base Command9 and their incidence has been 
remarkably low* Careful examination of food with periodic 
stool examinations has probably been largely instrumentalo Few 
native restaurants are patronized by military personnel and only 
those establishments which were approved by medical inspectors were 
placed on limits0 
For the period May 1942 to October 1945 there have been 
only eight (B) cases of amebic dysentery hospitalized among military 
personnelo No new cases of amoebic dysentery have occurred since 
May 1944 and no new cases of bacillary dysentery have appeared since 
January 1945o In all cases the diagnosis was based on actual dis- 
covery of the causative organism in the stools0 In all bacillary 
cases the organism Shigella paradysenteriae was cultured from the 
stools by the usual methods„ No attempt was made to determine the 
strain* 
One case of amoebic dysentery9 an Army Nurse9 had had 
periodic bouts of diarrhea for several years and developed moderate 
diarrhea ten (10) days after arrival in Trinidad0 She was con- 
sidered to have had the disease for some time and 9 since cysts con- 
tinued to appear in the stools after intensive hospital and ambula- 
tory treatmentg carrier state was diagnosed0 In view of her occu- 
pation as a nurse and a food handler she was evacuated to a general- 
hospital to avoid spread to hospital patients„ 
One small circumscribed epidemic of amoebic dysentery 
occurred in January and February 1944o Two (2) officers and three 
(3) enlisted men developed diarrheal symptoms while attending the 
School of Jungle Warfare from November 1943 to January 1944o 
141 Symptoms began almost simultaneously in the latter part of 
January. One of the patients was the Unit Medical Officer. Both 
officers and enlisted men at in the same mess0 Four (4) cases 
were hospitalized shortly after the appearance of symptoms, and 
Endamoeba histolytica was their stools. Shortly 
afterwards an epidemiological investigation revealed that one (1) 
of the cooks in the mess harbored the organism. He had experi- 
enced mild gastro-intestinal symptoms for several months* but had 
not reported on sick call because he felt that his periodic diar- 
rhea was due to drinking beer. All cases responded rapidly to 
the usual forms of treatment. 
Treatment of amoebic dysentery varied' somewhat with the 
Medical Officer in Charge, but consisted chiefly of emetine hydro- 
chloride and Carbasone in standard dosage. Chiniofon and Diodo- 
quin were used to a lesser extent than Carbarsone, but seemed 
equally effective. 
Of the common diarrheas there were two hundred and forty- 
three (243) cases classified in the following manner: enteroco- 
litis 39; gastroenteritis 95; colitis 39; diarrhea 15; and enter- 
itis 55o On the whole, these conditions were of short'duration and 
treatment was usually only symptomatic. Sulfaguanidine was not 
extensively used. In the majority of cases no bacteriological 
diagnosis was made. 
Only one epidemic of food poisoning occurred in the period 
from May 1942 to October 1945o This originated in the 41st General 
Hospital Mess. On 3 October 1943* fifty (50) persons required hos- 
pital treatment for severe gastro-intestinal symptoms. Of these, 
fourteen (14) were Medical Department hospital personnel, thirty 
(30) were patients already hospitalized for other reasons, and six 
(6) were native K.P.8s. Symptoms were remarkably uniform and ap- 
peared almost simultaneously and consisted of rather sudden onset 
of epigastric pain and cramping, nausea, vomiting, diarrhea, head- 
ache and weakness. Fever was generally absent. Epidemiological 
investigation revealed that all of this group had partaken of 
"chicken pie" at the noon meal. This chicken had been cooked six- 
teen (16) hours previously and had been allowed to lie about at 
room temperature before processing into "chicken pie." Bacterio- 
logical studies of the suspected material revealed the presence of 
hemolytic staphylococcus albus. The sudden onset of symptoms with 
2-3 hours after the offending meal, the absence of pathogenic organ- 
isms in the stools, and the fact that the food was re-cooked before 
serving indicate the role of a preformed enterotoxin in this epi- 
demic.' Treatment was symptomatic and the average period of hospi- 
talization was two (2) days. 
142 Helminthic Infections? 
Uncinariasis - there has been a low incidence of this 
condition within this Commando For the most part it occurs in Puerto 
Rican troops who have been infected before their arrival here0 How- 
ever 9 in order to keep this type of infection to a minimum along 
with the other intestinal parasitic diseases, all personnel are re- 
quired to wear shoes outdoors and fortunately the Post Exchange has 
been able to furnish for sale shoes of a suitable type for use in 
the barracks• In addition rigid sanitary discipline has been car- 
ried on in the living quarters„ Outdoor latrines have been pro- 
vided for native personnel at numerous points on the Post so that 
they will not defecate on the ground,, These methods have kept this 
type of Infection to a minimum0 
Helminthic infestations have presented no particular 
problem in this Commando Helminthiasis is usally a secondary diag- 
nosis and has been recorded in only fifty-nine (59) cases at this 
installation,, Of these cases 70 percent were Ankylostomiasis 0 The 
incidence of helminthic infestations in Continental personnel has 
been quite however, in Insular personnel the incidence is much 
higherG In the first part of 194-5 routine stool specimens were 
obtained from one hundred and thirty-six (136) consecutive Insular 
admissions9 of which 32 percent were positive for one or more of 
the common helminths„ In none of these cases was there any cor- 
relation between the presenting complaints9 final diagnosis and 
the intestinal parasites found« Therapy of the helminthic infes- 
tations has been by standard accepted methods and no untoward reac- 
tions have been noted0 
Schis tosomias is s 
The intermediate Molluscan host necessary to complete 
this life cycle of Schistosoma mansoni is not found in Trinidad0 
This disease9 however, is found in Puerto Rico and six (6) cases 
of schistosomiasis have been diagnosed at this Hospital in Puerto 
Rican personnel0 When the U0 S0 Army first arrived in Trinidad 
all of the rivers and creeks on the Post were surveyed to determine 
whether the snail was present and none was found„ 
Schistosomiasis is endemic in Puerto Rico and, although 
there are approximately two thousand three hundred (2,300) Insular 
troops served by this Hospital9 schistosomiasis has appeared in 
the records of this Hospital as a diagnosis only six (6) times0 
All cases were in Insular troops0 Two (2) cases were returned to 
the l6lst General Hospital9 the remainder were treated symptomatic 
cally since the infection was mild and the symptoms seemed well 
ameliorated on this regime0 
143 There have been no intermediate Molluscan hosts of 
Schistosoma raansoni found on the island of Trinidad* 
Filariasis: 
Filariasis is endemic in Trinidad„ Although the exact 
incidence in the native population is not known9 recent surveys of 
native employees on the Post indicate an incidence of approximately 
2 percent. An additional reservoir of the disease is furnished by 
infected Insular troops stationed on the Post, The number of micro- 
filaria positive Insular troops has never been high5 and at present 
there are approximately ten (10) such individuals on the Post. 
Control measures are those directed against the mosquito population 
for malaria control9 including application of DDT in barracks for 
residual effecto Native employees who are positive for micro- 
filaria are excluded from working on the Post at night. 
There are.. approximately seventy~five (75) Insular troops 
at this station who have had on one or more occasion a positive 
blood serum for Wuchereria bancroftio There have been,, however, only 
nine (9) admissions in which a diagnosis of filariasis has been made 
and in only five (5) cases was this the primary cause of admission. 
Two (2) of these had sufficient clinical findings to warrant return 
to the l6lst General Hospital in Puerto Rico0 The other three (3) 
were returned to duty after the acute symptoms subsided0 Treatment 
has been symptomatic supplemented by administration of penicillin 
and sulfonamide in one (1) case with an acute cellulitis of the 
lege 
No filariasis has been seen in Continental troops. 
Typhus g 
Due to the fact that rodents of all types are present on 
the Post in such small numbers and further due to the rodent control 
this disease has not appeared at all in this Commando 
There have been no cases of typhus diagnosed in this Command, 
Dengue; 
Dengue has been diagnosed forty-three (4-3) tiroes at this 
Hospitalo The majority of these cases have been contracted when the 
soldier has ventured out of the mosquito controlled area0 The ex- 
tensive Malaria Control Program on Fort Read has reduced the mosquito population almost to a minimum so there is little chance for the 
soldier to contract dengue without venturing off the Posto Dengue 
is endemic in Trinidad0 
The incidence of this insect-borne disease in the' Trinidad 
Base Command has not been striking0 There have been only forty- 
three (43) cases of dengue hospitalized during the period of May 1942 
to October 1945 and no cases of sandfly fever reported for the same 
periodo It is possible that many of the milder cases of dengue were 
treated on a duty status or were diagnosed as other disease0 
Various vectors of dengue are present in Trinidad9 in- 
cluding Aedes egypti and Aedes albopictus 3 but with the exception of 
a single small and sharply circumscribed epidemic of nir» (9) cases 
in September 1942no attempt was made to determine specific vectors0 
Cases of dengue seen in the Trinidad Base Command have not 
varied greatly from those seen elsewhere0 In most of the cases there 
was a suddan onset of fever up to 103©OF with severe temporo-frontal 
headache9 chills or chilly sensations9 anorexiag and gener- 
alized aches and pains0 Most of the patients complained of severe 
lumbar and orbital ache0 Pains in the hips, knees9 and legs were 
less common, and none presented the severe '’bone-ache" described in 
many texts„ 
Intensity of the symptoms varied considerably0 About a 
third of the patiehts exhibited fever up to 105 F with severe head- 
ache and malaiseo Average duration of fever was five (5) days? and 
the variation was from three (3) to nine (9) days0 A dicrotic fever 
curve was noted in about half of the cases9 and these were usually 
more severe0 Almost all presented a moderate9 slightly tender lympha- 
denopathy of the posterior cervical occipital and sub-occipital9 
posterior auricular9 sub-mental9 axillary and epitrochlear nodes0 
Inguinal and femoral lymphadenopathy was unusual0 
Laboratory studies revealed a leukopenia with progressive 
relative lymphocytosis during the course of the disease0 White cell 
counts of were not uncommon in the terminal febrile and con- 
valescent stageso Aberrant forms of the monocytic series '9 including 
Turck cells9 binucleate transitionals9 and large vacuolated lympho- 
cytes were seen in most of the films during the convalescent stage0 
About 20 percent of the cases exhibited albuminuria to varying degrees0 
Exanthem was noted in dnly about 10 percent of the casesf 
and usually only during the second phase of the fever0 t 
Treatment was entirely symptomatic and seemed to have no 
effect on the course of the diseasee 
145 Cutaneous Diseases 
From May 1942 to October 1945 diseases of the skin have 
accounted for 608 percent of hospital cases in the 41st General and 
359th Station Hospitals9 constituting a total of eight hundred and 
ninety“four (894) cases0 Figures on the number of cases seen and 
treated in the dispensaries are not available, although various 
medical officers estimate that skin disease has constituted about 
20 percent of the cases seen on sick callo 5o9 percent of hospital 
skin cases were transferred to General Hospitals in the United 
States for further observation and treatment0 Specialized skin 
care by a qualified dermatologist and Roentgen therapist was avail- 
able only during the period of August 1942 to July 1944o 
Climatic environmental factors in the production of skin 
disorder have not been of great importance except perhaps in the 
dermatophytoses (30 percent of hospital cases)0 High relative 
humidity has prevented thorough drying of shoes and clothing unless 
hot closets are usedo Hot water for bathing has not been generally 
available, and this situation may have been instrumental in the pro- 
duction of impetigo, folliculitis, furunculosis and other pyoderma- 
tous conditionso Despite heavy tropical vegetation, only four (4) 
cases of plant sensitization have been hospitalizedj two (2) of 
these were specifically attributable to the fruit of the cashew, 
Anacardium occidentals0 A few cases of mild dermatitis of the face 
with cheilitis were attributed to the mango. Mangifera indicaQ 
During the program of eradication of bromeliads (epiphytic aerial 
breeding places for Anopheles bellator) from the trees about Fort 
Read and Waller Field several cases of severe dermatitis due to 
contact with the juice of the manzanillo tree, Hippomane manchinella, 
were seen among the native laborers0 
The general incidence of common cutaneous disease has not 
varied greatly from that seen elsewhere0 (See Table 1), During the 
period 12 May to 10 September 1945 the picture changed somewhat as 
a result of the influx of approximately six thousand (6,000) AAF 
troops from the ET0 in preparation for air evacuation of troops„ 
At this time the dermatologic census rose sharply0 Among this group 
the most common cutaneous disorders were the pyodermas , dermatophy~ 
toses, and scabies. Most of the pyodermas originated in Italy and 
were extremely resistant to the usual forms of treatment0 
Basic principles of dermatologic treatment have, in general, 
been followed in the hospltalo Wet dressings in the acute eczemas 
have consisted chiefly of saturated boric acid solution, Burrow11 s 
solution, and lsl0,000 solution of potassium permanganate0 Azochlor~ 
amid was* used infrequently <> No cases of boric acid intoxication 
have been seen0 Sulfonamides topically as well as systemically 
146 were used chiefly in the pyodermas9 but penicillin locally and 
intramuscularly has proven superior Weak aqueous solutions of 
penicillin (200-300 units per cc0) used as compresses under 
cellophane have proven very effective in the treatment of infec- 
tious eczematoid dermatitis0 Until recently9 benzyl benzoate was 
not available for the treatment of scabies0 Fungicidal ointment 
1322050 has not been used0 Therapeutic ultraviolet lamps have 
been available only since May 194-5o 
From August 1942 to July 1944- superficial Roentgen therapy 
was employed by the Dermatology Service0 The Picker Field Unit was 
used. Three hundred and eighty-two (382) treatments were given to 
one hundred and sixteen (116) patients, fifteen (15) of which were 
treated for nondermatologic conditions9 an average of 3,2 treatments 
per patient. These figures include Uc S0 military9 Uc S. 
and British military personnel. Analysis of these cases appears 
in Table 20 
Dermatitis medicamentosa has been seen in only ,016 per- 
cent of hospital admissions (twenty-two (22) cases) and has consti- 
tuted only 2067 percent of hospital dermatology cases0 Sulfonamides 
accounted for six (6) cases (three (3) «ach for sulfanilimide and 
sulfathiazole)0 In these cases the drug had been administered by 
mouth and the eruption cleared quickly on discontinuance of the 
drug. Other drugs were incriminated to the following degrees 
Calomel (prophylactic ointment) 2; benzyl benzoate 1| salicylic 
acid 1; sulfur 3| iodides 15 phenol 1| crysarobin 2| neosalvarsan lj 
mapharsen 2j and penicillin 1, In several patients undergoing 
penicillin treatment for syphilis an acute vesicular eczema was 
noted at the site of previous chronic dermatophytoses. 
Because of chronicity, unsuccessful treatment9 and lack 
of full facilities for dermatologic 5o9 percent of hospital- 
ized skin cases required evacuation to general hospitals. These 
constituted only 1,82 percent of all evacuated cases, Puerto Rican 
troops accounted for only four (4-) cases (one each of dermatophy- 
tosiSj infectious eczematoid dermatitisg lupus erythematosust and 
lichen planus). Analysis of evacuated patients appears in Table 3o TABLE I 
GENERAL INCIDENCE OF CUTANEOUS DISEASE 
Acne vulgaris 
23 
Alopecia areata . 
2 
Condyloma acuminata 
31 
Dermatitis i 
Atopic , o . . . 
3 
• Eczema to id , 
10 
Exfoliative ...... 
1 
Exudative 
1 
Herpetiformis 
7 
Lichenoid .... 
1 
Venenata * 
18 
Medicamentosa 
22 
Unclassified , 
9 
Dermatophytosis .... 
269 • 
Eczema seborrheicum , , , 
30 
Ecthyma, . , , . , 
3 
Epithelioma** 
4 
Erythema raultiforme T 
10 
Erythema scarlatiniforme 
2 
Folliculitis 
21 
Furunculosis 
151 
Herpes simplex . . 
7 
zoster ............. 
6 
Impetigo contagiosa .... 
37 
Intertrigo .............. 
3 
Lichen planus , 
6 
simplex ............ 
•6 
Lupus erythematosus .......... 
3 
Molluscum contagiosum .... 
1 
Pediculosis pubis . T . . T , . . . 
13 
Miliaria rubra . . . . 0 . . 
7 
Pityriasis rosea ..... 
11 
versicolor ......... 
7 
Pruritis ani 
8 
Psoriasis ....... . . 
u 
Pyoderma . . ...... 
32 
Sycosis vulgaris . 
11 
Verruca vulgaris 
20 
Vitiligo ......... 
1 
Sunburn . . ....... 
0 0 9 0 
11 
Scabies , „ . . 
72 
~w. 
* Clothing 1| diesel oil 1| gasoline 2; 
plant 4 
undetermined 10. 
** Squamous cell, lower lip 2; basal cell, face 
1; benign9 lower 
lip lo TABLE II 
Hospital and out-patient cases treated by superficial Roentgen 
therapy by the Dermatology Section9 41st General and 359th 
Station Hospitals from August 1942 to July 1944o 
UoSoMdlitary 
UoSoCivilian 
British Military 
TOTAL 
Acne varioliformis 
1 
; 
1 
Acne vulgaris 
9 
9 
Dermatitis venenata 
5 
1 
6 
Dermatophytosis 
34. 
2 
13 
49 
Dogbite 
1 
■1 
Eczemaf chronic 
$ 
2 
7 
Erythrasma 
1 
1 
2 
Furunculosis 
2 
1 
3 
Hldrosadenitis, axi.' 
Llary 1 
1 
Keloid 
2 
2 
Lichen planus 
4 
4 
s implex 
3 
3 
Lymphopathia venereum 1 
1 
Neurode rmati tis 
6 
1 
7 
Onychomycosis 
1 
1 
Otititis externa 
11 
1 
12 
Parotitis 
1 
X 
Psoriasis 
1 
1 
Sycosis vulgaris 
4_ 
1 
5 
TOTAL 
$5 
c 
5 
~I8T 
n? 
149 TABLE III 
Dermatologic cases transferred to General Hospitals- in the United States 
from May 1942 to> October 194-5„ All diagnoses are primaryo 
DISEASE 
May 1942 to 
Dec 1942 Incl 
w 
1944 
19-45 (to 
19 October) 
TOTALS 
Acne vulgaris 
• 
2 
3 
2 
7 
Alopecia areata 
1 
1 
Dermatitis atopic 
1 
2 
3 
herpetiformis 
1 
2 
3 
medicamentosa 
1 
1 
unclassified 
1 
2 
3 
Infectious eczematoid 
1 
1 
2 
Dermatophytesis 
2 
4 
3 
9 
Erythema vultiforme 
2 
2 
Eczema,, chronic 
1 
1 
4 
6 
Furunculosis 
1 
1 
Lichen planus 
1 
1 
simplex 
1 
2 
3 
Lupus erythematosus 
1 
1 
2 
Psoriasis 
2 
3 
5 
Sycosis vulgaris 
1 
1 . . 
2 
TOTAL 
8 
19 
11 
13 
51 
150 BRITISH GUIANA, S0 Ao 
Preventative medicine has been an important function of 
the Medical Department since the activation of this base0 The sta- 
tistics, given later in this section of the history, will show 
the value of the great amount of stress that has been placed on 
this program of improving the sanitation of the Base to prevent 
large-scale epidemics of communicable diseases amongst the personnel 
These statistics have shown a steady decline in the incidence of all 
communicable and venereal diseases0 For the sake of simplicity, 
this section of the history will be discussed under the following 
subdivisions: 
lo Personal Hygiene 
20 Tropical Diseases 
3o Venereal Diseases 
lo Personal Hygiene0 
At least once each month, all the barracks and day- 
rooms on the post are inspected to see that the proper sanitary pre- 
cautions are being carried out0 The construction of the barracks 
is typically tropical having screening all around in place of windows 
and built on concrete pillars 6 feet above the ground0 The screens 
are kept in excellent condition at all times. 
A routine physical examination of all the personnel on 
the Base is conducted once each month0 The men are checked for all 
communicable diseases including skin infections, presence of lice, 
and venereal diseases0 
A particularly prevalent disease in this climate is the 
fungus infection0 It is peculiarly resistant to all forms of treat- 
ment and the prevention of its spread has been a major problenv The 
men are given instructions as to the nature of the disease and told 
how to prevent it0 In spite of everything that has been done to 
keep it under control, it is the most prevalent disease seen in the 
dispensaries of this Base0 There has been a large number of mycotic 
infections of the ear which were thought to be transmitted through 
the swimming pool* Addition of more chlorine to the water in the 
pool has done much to reduce the incidence of this condition al- 
though an occasional isolated case is still seen in the clinics0 
151 The attempts thus far to combat the incidence of fungus 
infections have not been as successful as the preventative measures 
for other diseases, although it has not been a total failure. 
Without our unceasing efforts to combat this condition who can 
tell to what limits it might have progressed. 
The diet for the troops has been adequate0 With the advent 
of the hydroponics garden in August 194-5, there have been plenty of 
fresh vegetables for all the men0 In 1944- numerous cases of gingi- 
vitis were appearing in the dental clinic and were attributed to 
lack of fresh vegetables0 
Alleviation of this condition to a marked degree was noted 
immediately upon shipment of these perishable items from the States 
by plane. 
20 Tropical Diseases« 
The malaria control program has functioned smoothly 
and efficiently and with great success in the prevention of malaria 
among the military personnel0 The benefits obtained from the in- 
creasing fight against this disease can best be demonstrated by the 
following statistics; 
1941 (5 months) - 97o4 cases per 1000 per annum 
1942 - 50o0 cases per 1000 per annum 
194-3 - 19*0 cases per 1000 per annum 
1944- - 5o9 cases per 1000 per annum 
1945 (8 months) - 5*0 cases per 1000 per annum 
The effectiveness of this malaria control program has been 
a remarkable achievement in one of the most highly infective areas 
in the world0 
The program consisting of education of all military per- 
sonnel in the manner of transmission of the disease and its preven- 
tion as well as active measures of mosquito control has been 
vigorously carried out0 Regular malaria control lectures were 
given periodically to all service raen0 They were instructed as to 
the use of the insect .repellent and the importance of sleeping under 
mosquito netting0 Spraying of their barracks and periodic checking 
of the screening was stressed0 The active measures used in mos- 
quito control are discussed in paragraph 6 of this section. 
Enteric diseases have not been a serious problem at this 
Base due mainly to the excellent sanitary conditions existing here. 
The measures used in control of these diseases will be explained 
fully under-the sanitary service later0 The statistics available, 
152 are for those cases of simple diarrhea9 gastro-enteritis9 and 
dysentery that were of a serious enough nature to be admitted to 
the hospitalo Many mild cases have been seen in the Out Patient 
Department which are not included in these figures0 The number 
of cases since 1941 are as follows? 
1941 (5 months) - l6o0 per 1000 per annum 
1942 - lo33 per 1000 per annum 
1943 • 18o0 per 1000 per annum 
1944 - 14o0 per 1000 per annum 
1945 (8 months) » 3g,0 per 1000 per annum 
There have been no serious outbreaks of these diseases 
since activation of the Base and no deaths have- occurred., 
There is no record of any helminthic infections admitted 
to this hospital prior to 1944° Any cases prior to them were seen 
in the Out Patient Clinic and accurate statistics from those records 
are impossible to obtain0 In 1944 there were 8 cases admitted to 
the hospital with 15 cases in 19450 Ankylostomiasis predominated 
with Ankylostoma duodenale being found in 20 of the 23 cases0 The 
remaining 3 cases consisted of one case of tapeworm (tenia saginata) 
and 2 cases of ascaris lumbricoides0 
Schistosomiasis has been no problem on this baseQ There 
have been 5 cases in the hospital between August 1st 1941 and 
October 31st 1945c 
These cases were found in Puerto Rican soldiers and in 
all probability they brought the infection with them from there0 
No cases have been seen among the Continental troops0 
There have been 6 cases of filariasis treated in this 
hospital since its activation in 1941c This low figure in an area 
in which 35 - 40 percent of the civilian population have micro- 
filaria in their blood stream speaks well for the mosquito control 
program of this base0 
In most cases of filarial infection the parasite exercises 
no manifest injurious influence whatever and for this reason many 
cases of this disease have no doubt been overlooked since blood smears 
for filariasis have not been routinely taken on military personnel 
leaving this Basec 
There have been no cases of typhus fever since 
and only 12 cases of dengue fever have been diagnosed0 Here again 
the mosquito control pregram has done much to keep down the inci- 
dence of dengueo 
153 3o Venereal Disease. 
Four years of venereal disease control at this Base has 
shown a continuous attempt to lower the venereal disease rate by 
education and systematic organization of all units on the Base, 
so that all types of information could be more readily administered. 
The venereal disease rate for the last six months of 194-1 
was stupendouso Beginning in 1942 * the overall rate for each six- 
month period has shown a gradual decrease , so that during 194-5 the 
venereal disease rate on the base has come to much lower than the 
average rate for the troops stationed in the United States, even 
though this base is situated in the tropics among a large negro 
population which is noted for its high venereal disease rate the 
iorld aroundo 
During the past four years, numerous and varied attempts 
have been made to seek the best way of reducing the rate which was 
so high in 1941o This consisted, primarily, of various quarantine 
and restriction measures, as well as punishment measures to the 
individuals, to the unit if the rate was too high, or to the group 
in the unit to which the individual belonged0 Apparently, the two 
best measures which have led to the low rate the base now enjoys are, 
first and foremost, a stressing of personal morals, and secondly, 
by stressing continuously and unrelentingly, the importance of 
personal hygiene by the Venereal Disease Control Officer, the Unit 
Commanders and the Non-Commissioned Officers in charge of Venereal 
Disease Control groups„ Perhaps profiting by the mistakes of others, 
and in particular reference to the troops first stationed on this 
base, it is possible that this has been a contributable factor to 
its all-time-low present figure0 Another small factor has been the 
dispensing of prophylactic facilities by units, which purchases are 
made from unit funds, so making them available to all men of th£ir 
respective units as an expendable item, to be used entirely as 
neededo DUTCH GUIANA 
Venereal Diseases 
At this station venereal diseases were a major problem 
and by 15 March 1942, sixty-four (64.) cases of gonorrhea, thirteen 
(13) cases of syphilis, and fourteen (14-) cases of chancroid had 
been contracted by Army personnel0 Surinam authorities generally 
took a Hhush-hu&htt attitude56 toward venereal diseases! no statis- 
tics were available and no laws were available controlling infected 
and non-infected prostitutes0 
A complete venereal disease program was instituted9 in- 
cluding individual education, individual prophylaxis, and the 
establishment of Prophylaxis Station in down-town Paramaribo0 Each 
camp also had its own prophylaxis stations, but the venereal rate 
had reached three hundred (300) per 1000 per annum by March 1942° 
Intensive efforts on the part of Medical Officers to locate re- 
ported contacts and with the cooperation of Dr0 Wolfe, Surinam 
Public Health Officer, most contacts were persuaded to submit 
to examination and treatment However, the rate reached an all time 
high of three hundred and thiryt-seven (337) per 1000 per annum in 
September 1942 o 
For the entire year (1942) the rate per 1000 per annum 
was two hundred and twenty (220)5 sixty (60) percent gonorrhea, 
twenty-seven (2?) percent chancroid, eleven (11) percent syphilis, 
and the remainder other venereal diseases0 
Prior to the advent of penicillin it was found that very 
few cases of gonorrhea were cured after five (5) days of sulfonamide 
treatments and the majority of cases required a second course0 The 
greatest problem in treatment was in chronic sulfonamide resistant 
caseso Perhaps this high incidence of resistant cases was due to 
a peculiar strain of gonococci or to the lessened resistance of the 
individual,57 jt was found that about six (6) months after coming 
to this area, white blood counts ran about five thousand (5000) per 
cubic millimeter, which is a marked decrease from that of white 
blood counts in the temperate climate0 Penicillin proved to be 
more effective, but it was still necessary to use double or triple 
of the prescribed oxfort units to obtain effective cures0 In a 
few penicillin fast cases, fever therapy was used successfully. 
In one (1) case as much as 900,000 units of penicillin and two (2) 
courses of sulfa-therapy were used without any results0 
155 Syphilis, chancroid, and lymphogranuloma, have appeared 
very rarely, and in all cases have responded satisfactorily to 
treatment® 
During the last two (2) years (1944~45) the venereal dis- 
ease rate has varied from zero (0) to one hundred sixty-four (164) 
per 1000 per month, with an average of seventy-nine point two (79o2) 
for 1944 and fifty-six point six (5606) for 1945o The highest rate 
in the history of the force was three hundred and seventy-six (376) 
per 1000 per month in January 1943, and has been held down since 
that time only ty careful orientation of newly arrived personnel 
and constant venereal disease education and pass control® 
Malarias 
Cases of malaria were infrequent in spite of high endemic 
infestation among natives of Surinam058 Intensive and constant mos- 
quito control measures have held the rate per 1000 per annum for the 
entire year (1942) to approximately twenty (20)0 In the majority the 
cases observed were the vivax type and all patients recovered0 
There has been very little malaria in the force and no new 
cases at Zandery0 In the majority hospitalization has been for re- 
current cases among recently imported Puerto Rican troops0 Intense 
and constant malaria control programs, both personal and general, 
have made the troops mosquito conscious and held malaria to a negli- 
gible factor in a country where the anopheles mosquito is as common 
as a house fly around a barn lotQ Careful drainage, planning and 
spraying have nearly eliminated all mosquitoes from the Zandery Field 
area, and from Camp Rochambeau in French Guiana0 No fatalities have 
occurred in the entire history of the Force as a result of malaria0 
Dysentery? 
During the month of December (1942) outbreak of Bacillary 
dysentery occurred at Zandery of epidemic proportions, forty-six (4-6) 
being hospitalized before certain unsanitary methods of sewerage dis- 
posal were ascertained and eliminated0 
Occasional mild outbreaks of dysentery have appeared at 
sick call, but at no time have outbreaks been sufficient to involve 
any hospitalizationQ 
156 Dengue Fevers 
A few scattered cases were seen during the early portion 
of 1942, but during the month of December 1942, fifteen (15) Army 
personnel were hospitalized with dengue,59 Upon classification, * 
mosquitoes caught in the Headquarters building proved to be Stegomia 
fasciata and after the elimination of all breeding places and the 
mandatory use of mosquito repellent by ail personnel, no new cases 
appeared. 
No new cases of dengue fever have been reported since 
April 1943 when one (1) case appeared in French Guiana. 
Filaria: 
It is estimated that over twenty-five (25) percent of the 
native population show definite symptoms of filariasis and that 
seventy-five (75) percent were infected.6° However, upon complete 
survey of troops by microscopic examination in December 1942, no 
positive smears were found. 
Although still prevalent in a high percentage of natives, 
the latest complete surveys of all troops have shown no positive 
smears among Continentals0 The malaria control program has, of 
course, also controlled the culicine mosquitoes and consequently 
lessened the filaria infections0 Before being hired, all native 
employees have been submitted to blood smear examination and those 
found having a positive smear have not been permitted on the base 
after 1700 (5:00 P0M0) hours0 A few Puerto Rican troops have shown 
positive smears and upon being sent to the l6lst General Hospital, 
San Juan, P0 R0, have been returned immediately to this station 
for duty, defeating the morale advantage of totally negative per- 
sonnelo However, the chance of infection was minor because of 
mosquito discipline0 
157