Filariasis

More Facts About

How It Is Being Dealt With In Fiji

IN an interesting interview with an officer of the Fiji Public Relations Office, Mr. D. W. Amos. Senior Mos quito Inspector in Fiji, recently reviewed the anti-filariasis campaign since its in auguration in 1944 in Fiji. Mr. Amos, as well, supplied some further interesting data on the disease and its primary cause, the mosquito pseudo scutellaris.

Filaria, and its attendant disease, ele phantiasis, is a scourge in the Eastern Pacific, as malaria is in the Western Paci fic. A few months ago we published an article on what is being done in French Oceania, where the incidence of Filaria is very high.

The campaign in Fiji began in the Lau Islands as it had been proved that the spread of the disease was from the east to the west, and it was proved early that the mosquito carrier of the filarial worm in Fiji had a very short flight range from its breeding place. The car rier of the disease was named as long ago as 1912, by Sir Philip Manson-Blair, although at that time its habits were unknown.

Since the campaign began in 1944 a drug (Hetrazan) has become available and is said to be able to clear the micro filariae from the blood' stream, and pos sibly also to kill the adult worm within the body. Mr. Amos said that, in his opinion, its real value lies only in its use in those communities which have already achieved a more or less complete

control over the breeding: of the mos quito, so as to assist in rendering: harm less the human carrier of the filarial embryo.

The drug (like quinine in the case of malaria), will not prevent reinfestation.

The control of the mosquito is a first essential —the drug can only be an as sisting medium.

THE full name of the Filarial mosquito is Aedes (Stegomia) scutellaris pseu do scutellaris, and it has a maximum flight-range from its breeding place of less than 150 yards. It breeds in small re ceptacles capable of holding a little rain water —such as discarded tins or bottles, coconut shells, rot holes in trees, broken bamboo stumps, hollow stems of old shrubs, and the leaf axils of certain plants.

It does not breed in ponds or ditches, or in swamps, or in large or flowing water. It lays its eggs singly in a row on the edge of a container holding a little still water. It cannot lav its eggs on water like some other mosquitoes, since its eggs are not provided with floats and they would sink and be destroyed it dropped in the water. The embrvo of the mosquito must mature in the egg for 48 hours before it can take to the water as a first-stage larvae.

The adult shelters only in long grasses, in bushes, and under the leaves of low growing trees. Unlike other varieties of the mosquito family, it does not shelter in buildings or houses. It will, however, fly into houses for a blood meal, and when its stomach is full, will return to its out side shelter.

Mr. Amos explained that if the mos quito is not an infected one. a verv irri tating bite is the only result, but, if it happens that the person bitten is the provider of a blood meal for an infected

mosquito, he will receive in exchange for the meal a tiny worm or worms. They drop off the mosquito onto his skin, bur row their way through the pores into the lymphatic system, and there grow, in the course of some nine months, into adult worms four or five inches long.

THERE are now 34 inspectors and three supervising inspectors (all Fijians) at work in the field in Fiji. The corn

plete staff visualised for the work is 40 inspectors and four supervising inspec tors.

They have already made over 40,000 blood tests which prove that approxi mately 20 per cent, of the total Fijian population harbour the active Filarial worm in their bodies.

This is very much higher than the medical forecasts before the campaign be gan, but it is much in keeping with the estimate made by Sir Phillip Manson — Bahr as the outcome of his investigation during 1911.

The first work of a team is to make a blood survey, and also a larval survey, of all villages within its province, and to advise the people what they have to do in order to stamp out Filariasis. The original work completed, the inspectors are each allotted a district, or districts, within which each makes a regular rou tine inspection. He reports on them to the Roko, and sends copies of his report to the Assistant Medical Practitioner of the district, and to headquarters. The reports sent to the Roko are meant to keep him informed of the state of the

villages in his Province, and. where ne cessary, give him early advice of condi tions which may require some form of prompt, corrective action. Those sent to headquarters are carefullv tabulated and recorded in such a way that deterioration or improvement can be seen at a glance and this movement is recorded in quar terly reports to the Colonial Secretary, the Director of Medical Services, and Dis trict Commissioners. During their inspec tion visits, the people are constantly reminded that only through a persistent hygiene can it be hoped to eradicate Filariasis.

The co-operation of the people has been, as was expected, slow in making itself manifest. It was realised, however, that a people who had a wrong concep tion of the cause of Filariasis would re quire to be handled with patience. Hy giene is the key-note of the campaign, and its benefits should be very much more than the mere eradication of Filaria sis.

MR. Amos explained that the mosqui toes’ effective range of flight, that is, its disease-carrying ability, is something considerably less than its maximum flight range because the in fected mosquito is a sick mosquito—it becomes sick of the disease itself, and its flight is impaired very considerably.

A high incidence figure of Filaria was always found where there was a high in cidence of pseudo scutellaris. A high incidence of pseudo scutellaris was always found in the dirty villages where the grass was overgrown and the bush-scrub was thick and uncut. This naturally meant much rubbish strewn around in the undergrowth—which, in turn, meant good breeding conditions for pseudo scu tellaris and beneficial shade for the rest ing mosquitoes.

Research and investigation being made in England at the present time by Sir Philip Manson-Bahr is a bio-chemical one. Among other things, the investiga tion will probably help to answer the question why certain mosquitoes carry diseases and others cannot; and why some are able to carry one disease and not another. For example, whv can pseudo scutellaris carry the filarial worm if no others can do so?

Aedes Aegypti and Yellow Fever

THE anopheles is not to be found in Fiji. It belongs to a tribe of disease carriers, one of its worst being mal aria, and if it were there it would be a bad business for Fiji, since, owing to the exigencies of the war there are now many carriers of malaria in the Colony. It is the primary duty of the Mosquito Con trol to see that the anopheles mosquito never becomes established in Fiji, said Mr. Amos.

He then referred to another variety— “ One I fear even greater than the ano pheles—the mosquito aedes (stegomyia) Aegypti, carrier of the dreaded vellow fever. Here we have the mosquito, but no carrier—as yet. Every one of the European and Indian centres in Fiji are heavily infested with aedes Aegypti. It only needs the entry of one yellow fever subject (so easy in these days of air travel), and then perhaps the survivors of the European and Indian population will listen to suggestions of future pre ventative measures against the entry of diseases into the Colony.”

For the benefit of air passengers, Maison Ballande have installed a shop in the entrance hall at Tontouta Airport, New Caledonia, for the sale of French perfumes and liqueurs. .Australian and American passengers are expected to be the main buyers.