Upon arriving at Manila Dr. Strong will prepare and forward direct to you
for transmission to the Red Cross Society a detailed report on the
conference proceedings. Along with this report Dr. Strong will transmit
for your information some pertinent observations on the political
aspects of the conference.
[Inclosure.]
[From the
Peking Daily News, May 5,
1911.]
the results of the international
plague conference of mukden.
[Official statement by the Wai-wu Pu.]
The following communiqué has been issued by the Wai-wu Pu:
The opening ceremony of the International Plague Conference took
place in Mukden on April 3, and the closing ceremonies were
performed on April 28. The original intention of the Government in
the organization of the conference and in extending an invitation to
scientists from the different countries represented to participate
in the work of the conference was to obtain further information
regarding epidemics of pneumonic plague which would be of value both
to this Empire and to the world at large. The work of the conference
was divided into two sections, (1) epidemiology and (2)
bacteriology. In all, 23 sessions were held. The original program,
which was most comprehensive in outline and which covered
practically every point in connection with the investigation of the
pneumonic plague, was fully carried out.
During the last week of the sessions the time was devoted to the
framing of the provisional conclusions and of recommendations. These
conclusions and recommendations will be published with the final
report of which they are a part.
Among the more important conclusions and resolutions of the
conference the following are mentioned: The disease spread by direct
infection from man to man, and whatever may have been its primary
origin there is no evidence that a concurrent epizootic in rodents
played any part in its general dissemination. From Russian medical
sources it has been reported that an epizootic disease exists among
Tarabagans and that it is not unlikely that this disease is plague;
but that it is plague has never yet been proved bacteriologically,
and this question needs further study.
The chief factor in the decline of the epidemic has probably been the
preventive measures which were enforced either in accordance with
scientific methods or by the efforts of the people to protect
themselves. The decline has not been due to any loss of virulence of
the bacillus.
Infection was introduced into towns and villages by persons actually
suffering from plague or by those in the incubation stage of the
disease. There has been no positive epidemiological evidence to show
that the disease has been spread by clothing, merchandise, or other
inanimate objects.
The epidemic has been almost without exception one of primary
pneumonic plague. The incubation period varies as a rule from two to
five days. A rise in temperature and an increased pulse rate are
usually the earliest symptoms observable, but a diagnosis can not be
made until the organisms are recognized and the sputum has become
characteristically bloodstained. An accurate diagnosis can be made
only by a bacteriological examination of the sputum with the view of
excluding pneumonic infection due to other microorganisms. Since the
evidence points to the conclusion that in the epidemic all the cases
became septicæmic, an examination of the blood microscopically or
culturally may be a valuable aid in diagnosis. The physical signs of
lung involvement are too indefinite and appear too late in the
course of the disease to be of diagnostic value, and even in cases
in which the condition of the person is grave they may be very
slight.
The fatality of the disease during the past epidemic has been
extremely high, scarcely any cases of recovery having been reported.
The general experience has been that no method of treatment has been
of any avail in saving life, but the serum treatment seems in a few
instances to have prolonged the duration of the illness.
The strain of bacillus isolated during the past epidemic has differed
in no essential respect from, strains of the Bacillus pestis
previously isolated from other sources. So far as can be ascertained
the only infective agent in the epidemic has been the sputum from
the plague patient. In the majority of the cases the disease has
been contracted by the inhalation of plague bacilli in droplets of
sputum (so small as to be visible only by the microscope), causing
infection of the lower portion of the trachea and bronchi. In the
case of inhalation the risk to the person exposed bears a direct
relation to his proximity to the patient and the duration of
exposure.
[Page 64]
In view of the special danger of infection by inhalation that has
been manifest during the past epidemic, masks and goggles should be
worn by all those who come in contact with cases of the disease or
suspected cases. The best form of mask is a simple three-tailed
gauze and cotton wool pad, which should be destroyed or disinfected
after each exposure to infection.
The statistics which have been collected during the past epidemic did
not allow of any definite conclusion about the value of active
prophylactic inoculation against plague pneumonia, although it was
argued that some degree of protection is conferred against bubonic
plague by the use of vaccines. It was recommended that further
experiments be made on animals in reference to securing immunity
against pneumonic-plague infection.
A number of resolutions relating to the question of sanitation and
disinfection were also presented. * * *
The evidence before the conference was to the effect that it is
unnecessary and undesirable in respect to pneumonic plague to
restrict the transit of goods (other than personal luggage) and of
mails. Should there be evidence at any subsequent time of an
epizootic in rats it would become necessary to take measures to
destroy the animals.
The services of the Imperial Commissioner Sao-Ke Alfred Sze have been
greatly appreciated. He has outlined the principles to be followed
at the conference in his opening address to that body and in other
ways directed its care. The Government also appreciates the fact
that the period of the epidemic was short, and acknowledges the
assistance of both foreign and Chinese doctors who volunteered their
services for the purposes of combating the epidemic.
