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BY A. H. DOTY, M.D.,

The New York Quarantine Station is well equipped for the protection of this port against the entrance of infectious diseases. During the past two years active experimental work has been in progress at the laboratory connected with this department. The pathogenic organisms, the bacilli of the plague, cholera, anthrax, and diphtheria have been cultivated and studied. In conjunction with this the germicidal power of different disinfectants, particularly steam and formaldehyde, has been carefully investigated. The results obtained, which were very satisfactory, have already been published in the American Journal of the Medical Sciences, August, 1897, and the New York Medical Journal, October, 1897.

We are now dealing with facts, not with theories, and are able to perform disinfection in a prompt and scientific manner, with a certainty as to the result. Thorough disinfection is one of the great safeguards in preventing the extension of infectious diseases. Without it we are practically unable to deal with such an emergency. The failure to appreciate the importance of this has frequently been followed by disastrous consequences; therefore, every effort has been made at the New York Quarantine Station to prepare for the disinfection of vessels of all kinds. With the improvements which have been made during the past two years, including the construction of a disinfecting-steamer and laboratory, and the radical changes which been made in the disinfecting outfit at Hoffman Island, I feel justified in saying that this station is the best equipped of all in the world. The means for disinfection consist of the steamer "James W. Wadsworth," which is about 115 feet in length and is fitted with a steam-chamber of the most improved and modern pattern, placed in the stern of the vessel for disinfection with steam. A steel tank or chamber, having a space of 115 cubic feet and constructed for disinfection with formaldehyde gas, has been placed in the forward cabin. In addition, there is a furnace for the generation of sulphur dioxide, tanks for disinfecting solutions, etc. Bath and dressing-rooms are placed on each side of the boat, the ceilings, walls, and floors of which are supplied with enameled metal covering, in order that they may be properly cleaned and disinfected.

On the arrival of a vessel requiring disinfection, the "Wadsworth" steams alongside, and all persons, clothing, bedding, etc., which are to be disinfected are transferred to it. While this is in progress the ship, or that portion of it, presumably infected, is also submitted to a thorough disinfection. In this manner the work is promptly and thoroughly done, and commerce is interfered with as little as possible. This steamer can reach a vessel at any part of the bay or adjacent waters. The vessels usually disinfected by the "Wadsworth" are comparatively small, carry but few passengers, and come from Southern ports, in some of which infectious diseases usually exist. Occasionally, it is necessary to disinfect a steamer carrying a large number of steerage passengers. In such an instance, persons held for observation, with their baggage, and also the bedding belonging to the ship, are removed to Hoffman Island for treatment. The "Wadsworth" acts as a transport, and, after having removed the people to the island, returns to disinfect the ship.

About 2000 persons can be cared for on Hoffman Island. Bath-houses have been constructed which can accommodate one hundred bathers at one time. The large disinfecting-apartment on the island contains three double-jacketed rectangular steam-chambers, constructed of steel, each twenty feet long and about four by five feet in diameter. On the arrival of the persons above referred to, they are conducted to the bath-houses, where their clothing is removed, tied in bundles, tagged, and sent to the disinfecting-chamber. After the bath, woolen gowns are supplied. These are worn until the clothing is returned. These persons are detained until the expiration of the period of incubation.

The hospitals on Swinburne Island will accommodate about 200 patients, and although the buildings are old and not of modern construction, they are well supplied with beds, bedding, and apparatus for heating and lighting, and will answer the purpose until new pavilions are substituted. The State legislature has already appropriated money for the drawing of plans for the erection of new buildings both at Swinburne and Hoffman Island, and as these have been made and submitted to a committee it is expected that the necessary money for the buildings will be appropriated during the coming winter. Each of the islands is in charge of a superintendent, with a sufficient corps to keep the buildings and property in order and ready for immediate use. This duty is faithfully performed.

During 1896, 252,350 steerage passengers were examined at this station, and out of 12,127 vessels which arrived at the principal ports of the United States during the same year (1896), 6241, or more than one-half of the entire number, were inspected at the New York Quarantine Station. The work of 1897 will show about the same result. During this period, the plague, cholera, smallpox, yellow fever, and typhus have existed in numerous ports throughout the world, which have been in constant communication with New York, and although numerous cases of smallpox and yellow fever have reached this harbor no infection has passed the station. This fact will be appreciated when it is remembered that during certain portions of last year, also of this, from 200 to 300 cases of yellow fever, and an equal number of cases of smallpox, daily existed in the city of Havana. As this place is about three-and-one-half days' journey by water from New York, it is within the period of incubation of both diseases. In order that passengers arriving from Havana and other ports on the north side of Cuba, shall not be a menace to the health of this country, and at the same time that commerce should not be unnecessarily interfered with, it is required that all persons coming from Havana shall be supplied with a certificate to the effect that they have had yellow fever, or are natives of Cuba. In either case these persons are rarely subject to this disease and can be safely allowed to pass quarantine. Persons who do not present these certificates on their arrival are removed to Hoffman Island, there to remain until the difference in time between the period occupied by the passage and five days (the period of incubation of yellow fever) has elapsed. A number of persons thus held have developed yellow fever and have been transferred to the hospital at Swinburne Island. All vessels arriving from Cuban ports are subjected to disinfection. Their crews are not held for observation, as these persons are not allowed to leave the vessels, which are not docked but remain in the stream, where they are loaded and unloaded.

During the past summer yellow fever appeared at Panama and during a short period was quite active. A number of persons who reached Panama in transit to Colon, to embark on the Panama steamer bound for New York, became infected and the disease developed during the voyage; some died and were buried at sea and others were removed at this port. This condition required careful inspection of all persons on board, the removal of some for observation, and thorough disinfection of the ship. As some types of malarial fever are very similar to yellow fever and are frequently found among the passengers and crew of these vessels, it will be appreciated that a differential diagnosis is not easily made; consequently it is the rule to remove suspicious cases until the diagnosis has been fully decided. I am glad to say that in no instance has a case of this disease reached New York. These results have been secured only after the greatest care and watchfulness on the part of the officers of this department and the carrying out of most thorough disinfection.

In order that authentic information may be procured from ports which are frequently infected, and with which New York is in more or less constant communication, representatives or correspondents have been appointed at some of the Mediterranean ports, Egypt, and South America. For a comparatively small sum these correspondents, who, as a rule, are physicians, keep this department supplied with a knowledge of the sanitary condition of these places. This is usually done by letter, although in some instances the cable is brought into use. Such information is usually more valuable than that which is obtained by the ordinary bill of health issued by a consul or consular agent.

With the arrangements above described I feel confident that the Health-officer's Department of the State of New York is prepared for any emergency which may occur at quarantine.

Source: The Medical News, A Weekly Medical Journal. Edited by J. Riddle Goffe, Ph.B., M.D., Volume LXXI,June-December 1897. [New York: Lea Brothers & Co., 1897], pages 632-633.

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