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The Great Fever
Toward an Understanding of Yellow Fever

Arrival of boat from Cuba at train stop Marine Hospital Report, 1898 -- Trains

Another section of the Marine Hospital Service Report of 1898 prescribes methods of preventing the spread of yellow fever through the management of railway lines. As can be seen, many of the recommendations -- using cane seats rather than upholstery -- are based on the assumption that the disease can infect and be transmitted through inanimate objects like bedding.


Train-Inspection Service
By P.A. Surg. G.B. Young

PREAMBLE.

In conducting a system of train inspection for the purpose of preventing the spread of disease and of facilitation intercourse and trade as far as is consistent with safety, it is most important to always keep in mind that the limitation of the spread of the disease should be paramount to every other consideration, the facilitating of traffic being of only secondary importance.

I lay stress upon this because my own experience has taught me that it is often difficult to maintain the proper point of view in the face of the senseless and vexatious oppositions of local origin that often upset one's carefully considered plans. One is apt to become absorbed in the task of opening lines, moving trains, and the like unless careful to remember that such things, while unquestionably of great importance for the public good, are not the most important part of the work.

RELATIVE IMPORTANCE OF QUARANTINE AND TRAFFIC.

I do not mean to belittle the importance of opening up traffic, however, for the suffering and loss that accompany the interruption of trade and travel during the presence of yellow fever, and the resulting local quarantines, are among the most dreadful consequences of the scourge.

Next to preventing the actual spread of the disease the most important thing to do is to strive to minimize the distress that the fear of its coming brings to all within the threatened territory.

In conducting a system of train inspection, then, our first duty is to facilitate in all proper ways the escape from infected places into noninfectible territory of those who desire to go; second, to supervise the movement from place to place in infectible, but clean territory, of those whose necessities compel them to travel; and, finally, to do what we can toward keeping open the channels of trade.

Let us consider the principles that should govern our action in securing each of these several ends, and then take up, somewhat in detail, the methods to be followed in maintaining these principles.

Under the first head, then, the rule can be laid down that all persons can be permitted to leave for noninfectible territory if a reasonable certainty can be secured that they will not return into infectible territory before the expiration of ten days from the last possible exposure to infection, which, however, may be and often is a very different thing form ten days since their departure from an infected place; but that this movement must be so conducted that no danger results to the territory through which they pass en route.

ALL PERSONS MUST GIVE SANITARY HISTORY OF THEMSELVES.

Under the second head the fundamental principle is that only those should be permitted to travel who can give a good sanitary history; and that while en route they shall be preserved from contact with any infected or suspected person, place, or thing.

Given the observance of these principles as to both persons and things and the opening of the channels of trade would seem to follow as a natural corollary, but on account of the peculiar conditions which arise under local quarantines it does not naturally do so.

For the proper opening of trade it is necessary, first to secure the confidence of the various local authorities and, second, to maintain sanitary control of the transfer and junction points, the "strategic points" in our sanitary campaign.

FORMULATION OF DETAILED RULES AND DESIGNATIONS FOR CLASSES OF PERSONS AND THINGS.

An attempt will now be made to formulate somewhat detailed rules of the conduct of a system of train-inspection service.

For the purpose of brevity the name "suspects" will be applied to persons from infected territory and that of "passengers" to those from uninfected territory.

Where mail, freight, or express cars are referred to they will be called "cars," passenger cars being spoken as of "coaches."

"Train crews" will refer to all persons employed on the train in any capacity, except that in some instances, to be noted at the time, the Pullman conductor and porter are treated as belonging to a slightly different class.

PASSENGER TRAFFIC FROM OR THROUGH INFECTED TERRITORY.

CLASS OF COACHES PREFERRED.

Whenever possible, the coaches used in conveying passengers from or through infected territory should be of the kind equipped with cane seats. These are much less apt to become infected and are much easier to clean. No matting should be allowed in the central aisle and, as far as possible, all curtains and hangings should be prohibited.

WHERE TO DISINFECT COACHES.

Wherever possible, coaches used for carrying suspects should be disinfected at the ends of their runs, i.e., in clean territory.

This disinfection can be done by the employees of the road, but should be under the supervision of a sanitary inspector, who should be informed by wire on the departure of each train from the infected place of the numbers of the suspect coaches, and after disinfection the coaches should be placarded with the date of disinfection and the signature of the inspector.

TRAIN SHOULD NOT STOP IN THE INFECTED TOWN.

The train should not stop at the infected place, but should pick up the refugee coaches at some point outside the town, even if only a few hundred yards, and the necessary couplings and setting of switches must be done by employees other than the train crew.

ARRANGE WITH HEADS OF RAILROADS AT FIRST.

Arrangements must be made with all the roads in the territory to furnish transportation for all officers and inspectors, and to issue orders to all employees that the train inspectors are in absolute control of all sanitary matters on the trains and that their orders must be obeyed to the letter.

Provided one goes to the head officers to make arrangements he will find it a pretty general rule that the larger the corporation the more intelligent will be its cooperation in his work.

A clear understanding must be promptly reached with the express companies and with the superintendent of the Railway Mail Service and with the Pullman Company as to just what you want them to do. In all such cases treat only with the man at the top; it will save some trouble and a great deal of time.

TIME IS OF PRICELESS VALUE AT BEGINNING.

Time is of priceless value at the beginning. If it is a question of losing time or having misunderstandings with local authorities and railroads, act first and straighten things out afterwards; it is surprising how much you can do without any real authority if you insist on having your own way.

A competent steward should be in charge of the central office, and, if the territory is a large one, a stenographer and typewriter.

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