The washing of walls, floors, ceilings and furniture with disinfectants is unnecessary.
3. As it has been demonstrated that yellow fever cannot be conveyed by fomites, such as bedding, clothing, effects and baggage, they need not be subjected to any special disinfection. Care should be taken, however, not to remove them from the infected rooms until after formaldehyde fumigation, so that they may not harbor infected mosquitoes.
Medical officers taking care of yellow-fever patients need not be isolated; they can attend other patients and associate with non-immunes with perfect safety to the garrison. Nurses and attendants taking care of yellow fever patients shall remain isolated, so as to avoid any possible danger of their conveying mosquitoes from patients to non-immunes.
4. The infection of mosquitoes is most likely to occur during the first two or three days of the disease. Ambulant cases, that is, patients not ill enough to take to their beds and remaining unsuspected and unprotected, are probably those most responsible for the spread of the disease. It is therefore essential that all fever cases should be at once isolated and so protected that no mosquitoes can possibly get access to them until the nature of the fever is positively determined.
Each post shall have a 'reception ward' for the admission of all fever cases and an 'isolation ward' for the treatment of cases which prove to be yellow fever. Each ward shall be made mosquito-proof by ware netting over doors and windows, a ceiling of wire netting at a height of seven feet above the floor, and mosquito bars over the beds. There should be no place in it where mosquitoes can seek refuge, not readily accessible to the nurse. Both wards can be in the same building, provided they are separated by a mosquito-tight partition.
5. All persons coming from an infected locality to a post shall be kept under careful observation until the completion of five days from the time of possible infection, either in a special detention camp or in their own quarters; in either case, their temperature should be taken twice a day during this period of observation so that those who develop yellow-fever may be placed under treatment at the very inception of the disease.
6. Malarial fever, like yellow fever, is communicated by mosquito bites and therefore is just as much of an infectious disease and requires the same measures of protection against mosquitoes. On the assumption that mosquitoes remain in the vicinity of their breeding places, or never travel far, the prevalence of malarial fever at a post would indicate want of proper care and diligence on the part of the Surgeon and Commanding Officer in complying with General Orders No. 6, Department of Cuba, 1900.
7. Surgeons are again reminded of the absolute necessity, in all fever cases, to keep, from the very beginning, a complete chart of pulse and temperature, since such a chart is their best guide to a correct diagnosis and the proper treatment.
| By Command of Major General Wood: |
| H. L. SCOTT, |
| Adjutant General. |
