Cholera, which was reported to be present in several coastal towns @uring Jun@, appeared in. the International Settlement during the month for the first time this year, The first case was notified among the Chinese on the 12th inst. and further notifications were received @uring the month in gradually increasing numbers.
Confirmation of the diagnosis was guade in the Municipal Laboratory 'On the 17th inst., and the information was sent to the Far Eastern Bureau of the League of Nations at Singapore, the Shanghai Harbour 'Authorities, the Public Health 'Authorities' of the French Concession and of Greater Shanghai and of the U.S. Public Health Service, the Medical, Authorities of the British law and Army and of the Japanese Among the Chinese altogether 01 gases were notified from Hospitals within the International Settlement, and of these 35 cases came from the Tnternational Settlement, three from the French Concession and 58 from the surrounding Chinese districts. One case occurred among resident, foreigners, the patient being an Public measures for the preven tion of Cholera are the following, and in places like Shanghai which are under the control of more than one authority, complete practical ce-operation is necessary Between the various authorities, to make these measures efficient. They are:—
(1) Education and publicity. (2) Provision and maintenance of pure water supplies, Safe and efficient systems of sewage and refuse disposal:
Prevention of breeding and the destruction of, Aies, Control of traffic by land "and water, (6) Effective maritime guaran. diagnosis,. notification, is lation and treatment of cases. Control of contacts and carriers, Disinfection of infected *1(10) Satisfactory disposal of the dead.
"\Q11) Provision, when necessary, of free prophylactic inocu-
Personal measures are based upon the fact that every fresh case arises, directly or indirectly, from tthe infected excretions of a previous ease. This is obviously, to a great extent, a matter of the hygiene of the person and of the kitchen, and the safest and surest way to avoid infection is to eat or drink nothing that has not been recently cooked 'oF boiled or otherwise sterilized.
The Public Health Notice, which gives full instructions concerning food and drink, is obtainable on request, from all the Branch Health Offices and from the Public Health Department.
For persons living in, or travel. Jing through, infected regions, and who cannot control and safeguard their food and drink supplies, a prophylactic Cholera vaccine is of pecial value and will give considerable protection for about a year. Cholera vaccine is procurable Zrom the Municipal Laboratory.
A few fresh cases of Cerebrospinal "Fever were notified during the month among residents, three were foreigners, and 10 Chinese. The foreign cases wore one British, one Indian. and one Fi A fatal case of Bubonic Plague, occurred among the foreign crew of the s, City of Tokio on the from Singapore to Shanghai the diagnosis was confirmed.in the Municipal Laboratory. Preventive measures were immediately put into operation and no further case occurred.
Twenty three eases of primary, Benign Tertian Malaria were notiGed, chiefly from among the British troops stationed in the Western District. For the last thirty years it has been pointed out, year by in the Annual Reports of the municipal. Public Health "'Depuctment, that Malaria. of the: benign tertian type may be contracted in and around Shangh:
Text read from the printed page and cleaned; old type leaves the occasional error.