DESCRIPTION OF ANTI-AEGYPTI TECHNIQUE

INTRODUCTION

Following the unexpected outbreak of yellow
fever in Rio de Janeiro in 1928, the Brazilian
Government, realizing that the control of yel-
low fever is a national rather than a local
problem, took steps which resulted in bringing
under one administrative head, on January 1,
1932, all responsibility for the investigation and
control of this disease throughout the country.
These steps were:

1. Assuming early in 1929 partial financial
responsibility for the Yellow Fever Service
operating since 1923 in North Brazil under
the auspices of the International Health
Division of The Rockefeller Foundation.

2. Extending on December 1, 1930, the zone
of operations of the Cooperative Yellow
Fever Service to include all Brazil, except
the Federal District.

3. Amalgamating on January 1, 1932, the
Yellow Fever Service of the National De-
partment of Health, operating in the Fed-
eral District, and the Cooperative Yellow
Fever Service.

On May 23, 1932, Federal Decree No. 21,434
was issued giving the Yellow Fever Service ade-
quate authority to carry out measures for the
prevention of mosquito breeding and to investi-
gate possible yellow fever cases occurring
throughout Brazil (see pp. 129-133). No legal pro-
vision was made in this decree for administrative
detail, which was left to be worked out according
to local conditions, and subject to such modifica-
tions as might become necessary.

While it may be possible to organize small
health services on the basis of word of mouth
instructions, all details of established techniques
must be written down for ready reference if uni-
form work is to be done on a national scale. The

 

description of the technique of anti-aegypti
work which follows is an adaptation of corre-
sponding sections of the Administrative Manual
of the Yellow Fever Service of the Ministry of
Education and Health of Brazil as they were at
the end of 1939. The Brazilian Yellow Fever
Service is not static: modifications of technique
are being tested constantly, and those found use-
ful are adopted. And so it is that the Service
Manual, in evolution since 1930, continues in a
loose-leaf mimeograph form which is easily al-
tered.

In the field of yellow fever control, to an even
greater extent than in many other fields of pub-
lic health administration, the literature on ad-
ministrative details of the work is inadequate. In
the special case of anti-aegypti work, all of the
few reports available refer to emergency urban
campaigns carried out for the purpose of getting
rid of yellow fever, rather than to permanent
programs for the eradication of the vector.

An essential difference between an emergency
campaign and a permanent one is the attitude
which must be taken toward cost. At the time of
a yellow fever epidemic, or under threat of im-
portation of the infection from near-by epidemic
areas, adequate funds are easily obtained to pre-
vent a public calamity, and the health officer is
judged not by the amount of money spent but
by the immediate results of the campaign. Once
the threat of yellow fever passes, however, gov-
ernment authorities and the health officer begin
to consider the question of expense, which is in-_
deed heavy in comparison with other important
health measures. The director of an emergency
campaign must know how, regardless of cost, to
reduce the density of Aedes aegypti rapidly to a
point where yellow fever transmission becomes
impossible, whereas the director of a permanent
anti-aegypti service must be able to prevent
INTRODUCTION 7

aegypti breeding at such a low cost that the ex-
penditure can be carried by the annual budget.
The experience of the Yellow Fever Service in
Brazil shows that aegypti breeding cannot be
controlled economically by the time-honored
methods of simply reducing the intensity of such
breeding; only when species eradication, begin-
ning in the larger centers, is carried to the smaller
towns, villages, and even rural districts of the
surrounding areas, which would otherwise rein-
fest the larger centers, can Aedes aegypti be con-
trolled at little cost. Fortunately a technique has
been developed which makes possible the com-
plete eradication of the aegypti mosquito at a
reasonable cost from urban, village, and rural
areas.

The Brazilian Manual is based on Brazilian
conditions, which are sufficiently varied to in-
clude most of the problems to be found in other
parts of the Americas. No attempt has been
made to adapt the techniques described to
African and Asiatic conditions, under which cer-
tain special problems are encountered.

Theoretically, anti-aegypti measures should
be easy, since the breeding foci of this mosquito
are generally limited to artificial water contain-
ers in, and in immediate proximity to, human
habitations. In practice, the discovery and elimi-
nation of the final traces of aegypti breeding are
often difficult, not only because of the instinctive
wiles of the aegypti mosquito, but because of
the public relations and personnel problems in-
herent in any attempt to apply routinely even
the simplest measures in hundreds of thousands
of homes scattered over all Brazil.

The reduction of aegypti breeding to a point
where yellow fever disappears from the towns
and cities worked is relatively easy, as the dra-
‘matic results of early campaigns testify, but the
complete eradication of the species in a given
place is made difficult by the instinctive ability
of the female aegypti to lay her eggs in every
hidden inaccessible water container, by the
ability of the aegypti egg to withstand desic-
-eation for several months, and by the constant
‘transportation of the species from unworked to
worked areas (imagoes by boat and train, and
Jarvae and eggs in portable water containers,
such as the universally used clay water jars).

 

However, local species eradication has been ac-
complished in all the large cities intensively
worked in Brazil during the past decade, and
wide regions, including several entire states,
have been cleared of aegypti.

In using the technique described, it must be
borne in mind that the work in any given place
should undergo regular evolution and requires
different types of organization for its various
stages. Many of the methods, such as those of
the Vacant House and Roof-Gutter Services, are
necessary in the early stages of the campaign
while the aegypti density is high, but can be dis-
continued later; others, such as those of the
Adult Capture and the Producing Focus Serv-
ices are of little value as long as considerable
aegypti breeding continues to exist, but become
invaluable during the final clean-up of an area.
The most advantageous application of the tech-
nique is possible only when a careful current
analysis of the progress of the work is used as the
basis for timely modifications. The initially large
staff required to eradicate the aegypti mosquito
from infested areas can be reduced to the rela-
tively small number needed to prevent reinfesta-
tion only after careful analysis of the situation.
The numerous report forms, maps, and charts of
the Service are used not only as a check on the
work done, but also as a guide to when and how
the program may be modified to meet changing
conditions.

The permanent campaign against 4edes ae-
gypti falls naturally into three quite distinct
phases:

1. The initial clean-up campaign for the elimi-
nation of the easily accessible aegypti foci.
This phase is similar in all respects to the
early emergency yellow fever campaigns
which rid localities of yellow fever but not
of the vector species.

2. The discovery and elimination of the final
hidden, inaccessible breeding places re-
sponsible for maintaining the species in the
face of intensive anti-aegypti measures.

3. The permanent maintenance of a sentinel
service to discover and eliminate any rein-
festation which may occur. (Reinfestation
in the early months of the sentinel service
may be either “‘internal,” due to returning
8 ANTI-AEDES AEGYPTI MEASURES IN BRAZIL

to active use of dry containers with viable
eggs, or “external,” due to importation of
the vectors from infested areas, as already
described. Later reinfestations come only
from external sources.)

The initial clean-up campaign is always
costly, as is also the maintenance of the service
needed to guarantee the low indexes obtained.
The sentinel service to discover early any rein-
festation which may occur after zero indexes are
secured is inexpensive, and its cost declines pro-
gressively as the danger of reinfestation disap-
pears. The interval between adult capture
surveys can be increased with safety as the
cleaning of contiguous areas proceeds. Only spe-
cies eradication permits of permanent aegypti
control at low cost, and no effort should be
spared to clear tributary areas as widely as pos-
sible.

The stage is set for the second phase of the
campaign when well under 5 per cent of the
houses inspected are found with aegypti foci and
when only secondary, non-producing foci without
pupae are found. But even secondary foci may
disappear in well-worked areas before complete
eradication occurs. The capture of adults is the
most sensitive index of the presence or absence
of Aedes aegypti in a neighborhood and is an es-
sential weapon in the final clean-up. Negative
reports should not be taken to mean eradication
until careful search has been made for adult
mosquitoes. Adult aegypti in nature are on the
average short lived, and secondary foci or nu-
merous adults in a neighborhood always indicate
recent near-by pupal foci.

The final elimination of hidden inaccessible
aegypti foci is achieved by:

1. Oiling or destruction of all water containers
in which mosquito breeding is occurring.
(Rapid pouring out or drawing off of water
is almost useless; fish are expensive and are
used only where no other method of con-
trol is possible.)

2. Capturing adult mosquitoes to ascertain
persistence of aegypti and to locate hid-
den pupal producing foci.

3. Searching out pupal producing foci in
neighborhoods where aegypti mosquitoes

 

persist in the face of routine control meas-
ures.

Although Brazil has had since 1932 a rather
drastic yellow fever regulation (see Decree
21,434 of May 23, 1932, p. 129), its application
would be impossible in the absence of the whole-
hearted support of the Brazilian public. The
Brazilian householder has come to recognize in
the Yellow Fever Service employee who enters
his home, a person who has no political or
police objective, does not receive tips, applies
the same measures impartially in all the homes
under his jurisdiction, and is himself under care-
ful supervision not only by his superiors but
also by the householder, through a cumulative
record which he leaves in each home, listing the
time of each visit and the conditions found.

The local director of the service is always ac-
cessible to the public, and mosquito complaints
receive prompt attention. The householder, un-
der these circumstances, generally accepts the
impositions of the Service and seldom is it neces-
sary to have recourse to legal measures except in
those cases where the recommendations of the
Service involve the spending of money in struc-
tural modifications. The owner is held respon-
sible for any mosquito breeding due to structural
defects, the householder for conditions which are
independent of the building itself.

As in all administrative work the principal
problems of the Yellow Fever Service are those
of selection, training, and supervision of person- |
nel. The doctor entering the Service is given an
intensive course of training, not only in the field
work of the inspector but also in the statistical
and accounting sections of the Service. At the
end of his period of training the doctor is exam-
ined by officers of the Service on his knowledge
covering a long list of questions which are given
to him when he begins his training.

The inspector is carefully selected: he must be
free from physical defects and must present a
satisfactory police certificate. He is thoroughly
trained and examined before being given inde-
pendent responsibility. Everything is done to
maintain.a high esprit de corps. The inspector
works in uniform, bears a numbered badge with
the federal seal, and is instructed that he is an
INSTRUCTIONS FOR INSPECTORS 9

‘inspector, a teacher, and a sanitary policeman,
but never a “clean-up servant” as was too often
the case in previous campaigns. The inspector
works with confidence based on detailed written
instructions and a full knowledge of the legal
basis of the Service he represents; he works with
interest because he knows his work will be
checked, and that he individually will be given
credit, or will be blamed, in accordance with the
results he achieves.

The Yellow Fever Service operates on the ba-
sis of individual responsibility, fixed by written
instructions which can be altered only in writing,
and checked through detailed reports of work
done. Work worth doing is worth recording; rec-
ords are so planned as to serve the double pur-
pose of facilitating a rapid and easy checking of
the work and of giving a picture of the aegypti
situation in the areas in which operations are
in progress. Records are so dovetailed, one with
another and with the respective summaries, that
they can be analyzed rapidly by the director.
Routine work is reported on printed forms, and
in addition doctors, and at times other super-
visors, prepare narrative diaries. Full use is made
of maps and charts; all houses and even blocks
are numbered as an aid to specific fixing of re-
sponsibility for work done. Adequate provision
is made for checking all field work. It is not
enough to outline a given program and assign it
to well-trained employees; the director of a serv-
ice must assume the responsibility for knowing
that the work is done. No large administrative
service carries on long automatically, and provi-
sion has been made in the Yellow Fever Service
for the routine collection, summarizing, and
presentation of the data needed by the director
to follow and check the work accomplished.

GENERAL ADMINISTRATION

The central administrative office of the Yel-
low Fever Service is in the Federal District, Rio
de Janeiro. Regional offices, subordinate to the
central office and responsible for the administra-
tion of the work in the corresponding regions
(see map, page 2), are maintained in Belém,
Par, for the northern region; in Recife, Pernam-
buco, for the northeast region; in Salvador, for
the Baia region; in Belo Horizonte, for the

 

Minas Geraes region; and in Sao Paulo for the
southern region. Various administrative divi-
sions, styled sectors, divisions, and posts, are
formed within the region according to the num-
ber of doctors available, the presence or absence
of Aedes aegypti, and the facility of transporta-
tion. Of these divisions, only the sector has a

fully equipped statistical and accounting office.

The basic administrative unit is the zone,
which consists of a group of city blocks, or a
rural area, all the houses of which can be visited
by one inspector at regular intervals, following
an itinerary defined by the director. The unit
next in importance is the district, comprising
generally five or six zones so grouped as to per-
mit, during each cycle, a careful checking of all
zones by a single district inspector.

The zone inspector’s work constitutes the ba-
sis of, and is the most important element in, the
campaign against the aegypti mosquito. The
following section, “Instructions for Inspectors
of the Yellow Fever Service,” is a translation of a
book of instructions (Form FA74), prepared for
the use of zone and district inspectors in Brazil.
It contains a description of the essential points
of the duties of the zone inspector and of his
supervisor, the district inspector, and the prin-
cipal regulations covering their work.

Form FA 74

Instructions for Inspectors of the Yellow
Fever Service

Obedience.—The inspector of the Yellow Fever
Service shall at all times respect his superior officers,
show courtesy to the general public, and behave in a
manner creditable to the Service.

All orders received from superior officers are to be
executed without question. In case of doubt as to the
meaning of orders, explanation may be requested;
but once orders are clearly stated they are to be car-
ried out.

Uniform.—The following uniform is worn by the
inspector when on duty: khaki tunic, trousers, and
cap. The tunic has four exterior pockets, two breast
and two side. Side pockets measure 63 inches wide
by 84 inches deep, inside measurements. No buttons
are visible other than on pockets; these buttons are
nickel for the general inspector, brass for the district
inspector, and black for the zone inspector.
10 ANTI-AEDES AEGYPTI MEASURES IN BRAZIL

Each uniformed member of the field staff, from the
general inspector to the servant, wears on the left
arm a band of green cloth which bears a numbered
badge. The arm band is held in position above the
elbow by two loops, 3 inches long and of an inch
wide, in such a manner as to leave a clear space of 2}
inches,

The cap is made of the same material as the uni-
form, attached to a wire frame with a black visor.
The chin strap of the general inspector is gilded, that
of the district inspector is silver, and that of the zone
inspector is black. Each cap carries a badge with the
same number as that on the arm band, and no two
employees in the entire Service have the same num-
ber. The chin straps and badges are issued by the
Service. The cap and sleeve badges are returned to
the Service when an employee leaves. The loss or
destruction of these, when due to carelessness, is
charged against the monthly salary of the individual
concerned. Black shoes, socks, and ties are regulation
attire.

The laborer’s cap, chin strap, tunic, and trousers
are made of blue material in the same pattern as the
inspector’s uniform. Overalls of blue are worn by
laborers working on thoroughfares. Laborers working
on trench cleaning, or cutting bush, need not wear
uniforms. Shoes and socks are black.

Appearance.—When reporting for duty, the inspec-
tor shal] be shaven, correctly dressed, and neat in ap-
pearance.

Smoking.—An inspector may not smoke while on
duty.

Alcohol.—An inspector found drinking, or under
the influence of alcohol, while on duty, is instantly
dismissed.

Firearms.—The carrying of firearms of any de-
scription is absolutely prohibited.

Tips.—The inspector may not accept money or
any other reward for services executed or, more im-
portant, for services not executed, even during the
Christmas season or other festive periods. Breach of
this rule is punishable by dismissal.

Negligence.—Failure to carry out orders is in-
excusable, and a plea of ignorance or forgetfulness is
unavailing. Orders are written down by the inspector
in the blank notebook (Form FA 12) which is issued
to all members of the staff.

Report for duty.—Any member of the staff who,
because of sickness or for other reason, is unable to
report for duty, shall notify the office at least half an
hour before the day’s work begins.

Accidents.—If an accident occurs while an inspec-

 

tor is at work, the head office shall be notified as

quickly as possible.

Honesty.—The inspector shall be at all times
frank, honest, and truthful. He shall report carefully
unusual occurrences, all foci found, all houses visited,
and all failures to follow his routine. Any falsification
of report forms leads to immediate dismissal.

Duties of district inspector.—The district inspec-
tor is directly responsible for the supervision of his
district. His duties include:

1. Daily morning inspection of the equipment
and uniforms of his inspectors, with a report
on Form FA 110 of the conditions found.

2. Maintaining discipline, carrying out instruc-

tions, and reporting in writing any accidents,
breach of regulations, etc.
Superintending and checking the work of the
inspectors in the zones. Sometimes the district
inspector works with the zone inspector, at
other times he revises, independently, the
work which has been done. Working with the
inspector enables him to note the condition of
the zone and to correct any faults which he
may observe in the inspector’s technique with-
out interfering with the work. “Revision” by
the district inspector consists of visiting the
houses examined by the inspector on the same
or the preceding day, to detect foci overlooked
by the inspector. When the district inspector
accompanies an inspector he notes on the in-
spector’s work sheet (Form FA 2) the time of
joining and of leaving him, and initials the en-
try.

. Keeping the Time Sheet.

Reporting absentees immediately to the gen-

eral inspector, who arranges for substitutes.

Training of new personnel and orientation of

substitute inspectors in the district.

7. Settlement with courtesy and tact of all diffi
culties arising from contact of the inspectors
with the public, such as objections to visits
and to destruction of foci, and cases of as-
sault. Any failure to settle such difficulties is
reported immediately to the general inspector
in writing.

8. Advising zone inspectors as to their duties in
special situations. Should the district inspector
encounter any problem which he is unable to
solve he communicates with the general inspec-
tor.

9. Care of all equipment issued in his district;
preparation of weekly requisitions for material
required by the district; receipt and checking

»

in

>
 

Fic. 5. Lateral view of female Aedes aegypti.
 

Fic. 6, Details of head of male 4edes aegypti.
INSTRUCTIONS FOR INSPECTORS 13

of inspector’s equipment at the end of each
day’s work, (A locker for storing all equipment
is found in each district. The district inspector
is responsible for the key to this locker).

10. Checking of flashlights in use and replacing
weak batteries, noting date of issue on all bat-
teries dispensed.

11. Checking the stores of oil and fish in his dis-
trict and reporting to the general inspector any
irregularities found.

Duties of zone inspector.—The fundamental du-
ties of the zone inspector are:

To discover places where mosquitoes are breeding.

To destroy mosquito foci found.

To prevent the formation of other foci.

Necessary equipment.—The zone inspector must
always carry with him, when on duty, the following
material:

Service Identification Certificate.

_ The Instruction Book for Inspectors of the Yellow
Fever Service (Form FA 74).

Map of his zone.

Weekly itinerary by blocks.

Watch in good working order.

Lumberman’s wax pencil.

Inspector’s flag for marking position in zone.

Flashlight complete with extra bulb. Both bulbs

and battery units must be in good condition.
Each battery unit must be marked with the date
of issue by the district inspector dispensing it.

Large spoon, with copper mesh inset for collecting

mosquito larvae.

Specimen éottles for collections of larvae.

Tin or bottle with adequate supply of the mixed

oil larvicide used by the Service.

Lead pencil.

Printed forms, as listed below, adequate for regis-

try of all the work of the day:

FA 2. Inspector’s Work Sheet.

FA 12 Notebook containing blank pages,
lined and perforated, in which miscel-
laneous points not covered by regular
forms are noted.

FA 43 Notice to leave keys of closed houses
with one of the neighbors on day of
regular visit.

FA 52 Autograph House Visit Record for
registering in the house itself the date
of each visit.

FA 53 Label for larvae.

FA 63 Note for Legal Summons.

FA 64 Mosquito Complaint.

 

FA 65 Fish Requisition.
FA 66 Note for Oiler.
FA 122 Aegypti Focus Report.

Working hours.—The Service schedule calls for 44
hours of work each week, but the time of beginning
and closing work depends on local conditions. The
zone inspector is ready to begin work in his zone at
the established time and does not leave his zone be-
fore closing time without permission. Any failure to
observe this rule is punished by suspension or dismis-
sal,

The zone inspector meets with his district in-
spector each morning at a centrally located place
in the district early enough to obtain material,
pass inspection, and reach his zone promptly at the
hour set to begin work. At the close of the day’s work
he returns to the same meeting place and turns in his
material, which is kept overnight in a case expressly
designed for this purpose.

Itinerary.—A zone consists of a certain number of
blocks, the houses of which the zone inspector ex-
amines during the week. The zone inspector begins
his weekly round every Monday morning at the time
set, always at the same point in the zone. The corner
of each block at which work is to begin is indicated
in a special way, and all corners are marked with an
arrowhead (triangle) to indicate the direction in
which the block must be worked. After inspecting all
the houses in a block, the inspector continues his
tour block by block, following the order established
in the itinerary for his zone, until all the houses of
every block in the zone have been inspected. The
work of each day begins where the preceding day’s
work ended.

Flag.—Before entering a house, the zone inspector
places his Service flag on the door (window, gate,
hedge, or fence). The flag is put up at right angles to.
the front of the building (see p. 40) so that it is plainly
visible from a distance up and down the street.

Pennant.—On estates, in tenement yards, and
where there are several buildings on one piece of
property not arranged in blocks and with only one
entrance from the public thoroughfare, the zone in-
spector places the Service flag at the public entrance,
and a smaller triangular pennant at the entrance of
the building he is inspecting.

Entering the house.—The zone inspector rings the
doorbell (claps his hands, or knocks on the door),
and announces, “health inspector’s visit.” He greets
the person who opens the door with courtesy and
asks permission to enter the house; this permission is
obtained from a person of responsibility in the house,
14 ANTI-AEDES AEGYPTI MEASURES IN BRAZIL

and the inspector shows his identification card if re-
quested. The inspector does not pass from one house
to another by using intercommunications which
may exist, nor does he pass from one back yard to
another. Having finished his visit of inspection in
one house, he goes out to the street and begins his
visit to the next house in the way described above.

Refusal to permit inspection.—Should permission
to inspect a house, in whole or in part, be refused, the
zone inspector records all the facts in his notebook and
makes a report of the case in writing to the district
inspector. The zone inspector is absolutely forbidden
to argue, dispute, or discuss the reasons for or against
permitting visits: he retires from the scene without
comment and reports the incident.

Calling for help.—Only in cases of threatened
violence is the inspector permitted to call for help
from the police, and this should be done only with
the object of avoiding immediate physical injury.

Inspection.—Having received permission to in-
spect the house, the inspector always begins his sur-
vey in the yard; and after this is completed, he ex-
amines the bathroom, kitchen, pantry, living room,
bedrooms, and other dependencies of the house. The
inspector is directly responsible for the conditions in
his zone which pertain to the anti-aegypti work. Con-
sequently, he is answerable for whatever may be
found in places where he may have considered routine
inspection to be unnecessary.

Interior inspections.—When inspecting inside the
house, the zone inspector always asks a member of
the household to accompany him, particularly when
entering private rooms. The same rule applies when
he is inspecting hotels and rooming houses. He
always knocks and asks permission to enter private
rooms, bathrooms, and lavatories.

Inspections with an officer of the Service—When-
ever a zone inspector is accompanied by a doctor of
the Service he announces “doctor of the Public
Health Department.” The inspector precedes the
doctor into the house because his uniform facilitates
recognition by the family. However, the doctor leaves
first, since in this case he is the authority who deter-
mines whether or not the inspection has been com-
pleted. The inspector may leave the house before the
doctor only if he is given orders to do so. The inspec-
tor aids the doctor in making the inspection, facili-
tating as far as possible the examination of all con-
tainers to be inspected.

Autograph House Visit Record (Form FA 52).—
Each inspection of both the zone and the district in-
spector is registered on the Autograph House Visit
Record (Form FA 52) at the time of the visit. On his

 

first visit the inspector pastes the Autograph House
Visit Record at some point in the house which must
be inspected on each visit. This may be in the kitchen,
in the bathroom. or, in the more simple type of home,
on the back of the entrance door. In buildings with-
out wooden doors or other suitable places for the
form, it is pasted on a board prepared especially by
the occupant of the house and fixed at a convenient
place. When one Form FA 52 has been completely
filled, another is pasted over it and the last visit is
noted on this.

Potential mosquito breeding foci.—All containers
capable of holding water are carefully and minutely
examined, since they always must be considered as
potential places for mosquito breeding.

Water containers.—The zone inspector examines
all containers to see whether they have water in them.
In his report, however, he notes only those containers
which are found with water. A container recently
emptied and still wet is entered as a container with
water.

Empty containers.—Empty containers are placed
in such a position that they cannot collect water.

Classification of water containers (Form FA 2)

Inaccessible tank: a high tank, usually made of
zinc, with an outlet pipe, and placed at such a level
above the floor or ground that water is distributed by
gravity.

Vat; a large circular water reservoir generally con-
structed of wood and usually placed on brick pillars a
few feet above ground, with a tap at the base for dis-
tribution of water by gravity.

Tank: a large water container placed on the level
of the ground; it may be constructed of concrete,
metal, brick, or wood.

Clay vessels: pots, coolers, jars, filters, etc., vary-
ing in capacity from a quart or two to many gallons.

Barrels, tubs, and drums.

Special artificial containers: receptacles of various
types in which at times aegypti mosquitoes may be
found breeding. These include: toilet flush tanks and
basins which are not in use; tin cans; clay cups; sinks
and lavatories; drains; anti-ant rings for plants; wa-
ter tins used for keeping ants out of food; enamelled
pots and basins; tin basins; bowls; pails and buckets;
flower jars and vases; holy-water fonts; icebox pans;
garage pits; water drains, especially those containing
clean water; sheets of metal; egg and coconut shells;
abandoned tires; old shoes; boxes; drinking vessels
for chickens, birds, dogs, and other animals; pieces of
iron; tins and jars buried in ground, which may col-
lect water; crockery and shards; walls, especially
those with shells, shards, or broken bottles to ward
INSTRUCTIONS FOR INSPECTORS 15

off marauders; fallen leaves; catch basins, street
drains; caldrons for heating water; animal skulls;
crab, lobster, and other shells; bamboo trees; animal
horns; bones; tile; sprinkling cans; disconnected
plumbing pipes; grindstone troughs; water meters;
flooded basements; boat bottoms, etc.

Roof gutters: zinc or copper gutters at the eaves of
houses or on the roofs.

Trees and plants: rot holes, leaf crotches, etc.
(Water found on fallen leaves is not included in this
category, but listed under special artificial contain-
ers).

Wells and pits: pits; trenches and ditches; small
ponds, natural or artificial; unlined water drains;
crabholés; kitchen drains; hoofprints of animals,
etc., where, in general, Aedes aegypii is not found.

Blank column: not to be used unless instructions
are received to separate for special analysis some one
type of container of local importance.

Sealing water containers.—The Service does not
seal tanks or other containers which need sealing to
make them mosquitoproof. The inspector requests
the householder or some other responsible person to
have the container sealed, and in case this is not done
he fills out a Note for Legal Summons (Form FA 63).

Septic tanks; latrine pits——When an inspector
finds a latrine pit or septic tank which is not mos-
quitoproof, he asks the householder for oil or kero-
sene for immediate application, and fills out Form
FA 63.

Mosquito focus; notifying family——Every mos-
quito focus found is shown by the zone inspector to
some responsible member of the family in whose
home it is encountered.

Eliminating mosquito focus.—Every mosquito
focus found is eliminated either by oiling or by de-
stroying the container in which it is found. In case
the family refuses to allow one of these measures to
be taken the inspector reports the circumstances in
writing to the district inspector who, in turn, be-
comes responsible for enforcing the necessary meas-
ure. In case the family still refuses to have the focus
eliminated, as prescribed above, action is taken in
accordance with Decree 21,434 of May 23, 1932.

Recurring foci.—A house in which foci are found
repeatedly is reported to the district inspector in
writing so that the Producing Facus Service can
make an intensive search of the neighborhood for
missed pupal foci.

Oiling large foci.—Whenever the inspector finds a
large focus, too extensive to be treated with the oil
which he carries, he fills out Form FA 66 and hands
it to the district inspector, who details a special

 

oiler to the task. The inspector should not continue
indefinitely to request oiling of the same permanent
or potential foci but should take measures to have
these eliminated. Note for Legal Summons (Form
FA 63), should be filled in and the nuisance termi-
nated.

Fish.—For containers which cannot be protected
in any other way, the inspector may advise the use of
larviphagous fish to destroy mosquitoes in the
aquatic stage (larva, pupa).

The inspector hands to a responsible person in the
house a properly filled out Fish Requisition (Form
FA 65), on the presentation of which the nearest fish
depot of the Service will supply fish.

Mosquito complaint.—When an inspector hears
complaints of the prevalence of mosquitoes, he reports
these in writing to the district inspector on Form FA
64 (Mosquito Complaint) so that the neighborhood
may be worked by the capture and producing focus
inspectors.

Form FA 2.—The Inspector’s Work Sheet
(Form FA 2) is divided into three vertical sections by
two heavy black lines. There are 40 horizontal lines
for reporting the inspections of individual houses,
grouped in tens by four heavy black horizontal lines
to facilitate counting when the form is not full.

Identification of house.—In the first vertical sec-
tion of Form FA 2, to the left of the first heavy verti-
cal line, there are columns for the identification of the
house by name of the street, number of the house,
and number of the block.

Definition of ‘house.”—For the records of the
Yellow Fever Service a “house” is defined as any
building, or part of a building, which has an inde-
pendent entrance from the street or highway (or at
times from private grounds), without taking into
consideration the use for which it is intended, so long
as this use is not as an integral part of another
“house.” Examples: the garage of a residence may
have an entrance from the street but is not inde-
pendent; hotels and apartment houses count as one
house each unless business stores with independent
entrances from the street exist on the ground floor,
in which case each of these counts as a “house.”

When more than one family lives in a single house
with independent kitchens and bathrooms, it is con-
venient to report on the independent “visits” made,
but statistically the house is the unit.

Results of inspection of containers.—The space
included between the two heavy vertical lines of Form
FA 2 is used to note the number, and mosquito in-
festation, of the different types of water containers
in each house. (See sample tabulation, p. 16.)
16 ANTI-AEDES AEGYPTI

Recording of foci—In noting foci found, the fol-
lowing abbreviations are used:

F: Focus of eggs or larvae of all species of
mosquitoes except Aedes aegypti.

FP: Pupal focus of all species of mosquitoes
except Jedes aegypti.

FA: Focus of eggs or larvae of Aedes aegypti.

FAP: Pupal focus of Aedes aegypti.

As the inspector examines containers, he enters, in
the respective columns under the proper classifica-
tion, the number of each type encountered. When he
finds a mosquito focus he notes it on the report, using
the proper abbreviation. For example, if three inac-
cessible tanks be examined, and two of them have
foci, one of aegypti larvae and the other of aegypti
pupae, the inspector enters in the column “Inacces-
sible Tanks” to the left, the number “3” which indi-
cates that three tanks were inspected; then a short
dash, and above “1 FA” (focus of aegypti larvae) and
below this in the same column “1 FAP” (focus of
aegypti pupae), thus:

Inaccessible Tanks
1FA
1 FAP

If, now, one tank is examined and one pupal culex
focus is found, the inspector marks in the column
“Vats and Tanks,” to the left, the number “1,”
which indicates that one tank was inspected, draws
a short dash, and then writes “1 FP,” in this manner:

Vats and Tanks
1—1 FP
If, next, the inspector examines two barrels, in one
of which he finds a focus of culex eggs and larvae, he

MEASURES IN BRAZIL

writes in the column headed “Barrels, Drums, and
Tubs,” to the left, the number “2,” which indicates
that two barrels were inspected, a short dash, and
then “1 F,” in this manner:

Barrels, Drums, and Tubs
2—i1 F

When a mixed focus is found containing larvae of
two or more species, including aegypti mosquitoes, it
is entered only as an aegypti focus. In classifying foci
according to stage of development, the most ad-
vanced stage is recorded. Thus a focus containing
eggs, larvae, and pupae is classified as pupal; one
containing eggs and larvae is classified as larval.

Registry of containers protected.—The inspector
indicates in the respective columns, by means of the
letters ““X,” “O,” and “E,’” the measures taken for
the prevention of mosquito breeding in containers.
He notes the containers in which fish are found by
their number and the letter “X”; thus, the entry
“S—2 X’ indicates that five containers were in-
spected, and that fish were found in two of them.

Containers oiled by the inspector are indicated bya
number and the letter “‘O.”? Thus, the entry “3—2 O”
indicates that three containers were examined and
that two were oiled.

A container is considered eliminated (“E”) only if
it has been destroyed or left in such condition that
mosquitoes cannot breed in it, at least for a period of
several months; thus, a tank which has been sealed
with tape or a tree hole which has been filled with
cement may be entered in this category.

Summary of foci.—In the columns to the right of
the second heavy vertical line the inspector notes

 

the number and type of foci found, in the follow-

INSPECTOR’S WORK SHEET

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Locality Date Zone
(1) (2) (3) (4) (5) (6) 2) (8) (9) FOCI
n 2 F | FP | FA |FAP
5 a 4 a g
ao s 2
- | @/],]é8 |3 » | a | 2] s
g 2 & 318 |e] 8 A | RE
° = 2 o 2 <3 ~
b1 8 a g é ¢ | 58 : s | € | 6
ale] 3] 3 s > 3 a o a a s
2 & a eg 8 3 Db 52 g4# So 3 4 a
ee z &:) aa | && 8 2 3 s
alz/] Sim] § > 5 an | Ad rn BH = }
X } 20 1 26
32 E 2FA iF 1—! FP 5—9 F 3-3 FAP .
10 329 SHE 1E SE 3E 2—2 E}3—3 X/1—1E] 12 4 5 3

 

 

 

 

 

 

 

 

 

 

Sample tabulation showing how the inspector records,

on Form FA 2, the results of his examination of water containers.
INSTRUCTIONS FOR INSPECTORS 17

‘ing manner: In the column “F” he enters all foci
found of any species of mosquitoes, at whatever stage
of development encountered, whether as eggs, larvae,
or pupae. In the column “FP” he enters all pupal
foci of all species of mosquitoes. In the column “FA”
he enters only aegypti foci, whether the focus be
composed of eggs, larvae, or pupae. In the column
' “FAP” he enters exclusively the aegypti foci found
in the pupal state of development.

The tabulation on page 16 shows that (1) three in-
accessible tanks were examined, two were found
sealed (2 E), and the third, which was not sealed, was
oiled by the inspector (1 O); (2) three tanks were
examined, in two of which larval aegypti foci were
found (2 FA) and oiled (2 O), whereas the third
contained fish (1 X); (3) three clay vessels were ex-
amined, in one of which a larval focus of culex (1 F)
was found, and the vessel was destroyed (1 E),
whereas the others contained fish (2 X); (4) one bar-
rel was examined, was found to contain a pupal focus
of culex (1 FP), and was destroyed (1 E); (5) five spe-

cial artificial containers were found to have foci of |

culex larvae (5 F) and were destroyed (5 E); (6) three
roof gutters were found with pupal aegypti foci
(3 FAP), and these gutters were removed from the
house (3 E); (7) two trees were found with holes in
the trunks, which were filled with cement (2 E);
(8) three wells were examined and all were found with
fish (3 X); (9) one “other container,” a puddle, was
found, which was filled in with earth (1 E). In all, 12
foci were found, of which four were pupal; five of the
twelve foci had aegypti larvae or eggs and three had
aegypti pupae.

Totalling Form FA 2.—When the report form FA
2 is full, or the day’s work ended, the inspector enters
the number of houses visited in the column marked
“Number” and places the sum on the “Total” line.
Closed or vacant houses are not counted, unless ac-
tually inspected. The inspector sums up the number
of visits made and places the total at the bottom of
the column marked “Inspections.”

At the bottom of Form FA 2 are four lines marked
respectively “T. cont.” (total containers), “E”
(eliminated), “O” (oiled), and “‘X” (with fish). The
line “T. cont.” is for the totals of containers of
different types inspected; the line “E” is for the
totals of containers eliminated, the line “O” is for
the totals of containers oiled by the inspector, and
the line ““X”’ is for the totals of containers found with
fish.

Total of houses with foci.—At the bottom right-
hand side of Form FA 2 are spaces for summarizing
the number of houses with foci of different kinds.

 

Note: Houses with foci rather than number of foci
are recorded. Under “Houses with F” the total num-
ber of houses with foci of any kind irrespective of
stage of development (eggs, larvae, or pupae) is
noted; under “Houses with FP” all houses with
pupal foci of any kind are entered. Under “Houses
with FA” the total of houses with one or more
aegypti foci, irrespective of stage of development, is
recorded, and under “Houses with FAP” the num-
ber of houses with pupal aegypti foci. Thus:

 

Houses with

F /

Houses with . .
FP Registers one or more foci of
Houses with larvae not aegypti, in a single
FA house.

Houses with

FAP

 

 

Houses with

F /

Houses with

FP / Registers a pupal focus or foci
Houses with not aegypti, in a single house.
FA

Houses with

FAP

 

 

Houses with

F /

Houses with . :
FP Registers a larval focus or foci
Houses with containing aegypti larvae, not
FA / pupae, in a single house.
Houses with

FAP

 

 

Houses with

F /

Houses with

FP / Registers a pupal focus or foci
Houses with containing aegypti pupae, in a
FA / single house.

Houses with

FAP /

 

 

 

Noting foci on reverse of Form FA 2.—As soon
as the inspector has recorded a focus on Form FA 2
he makes the corresponding entry of it on the reverse
side of the form, under the heading “(A) Containers.”
18 ANTI-AEDES AEGYPTI MEASURES IN BRAZIL

(A) CONTAINERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Con | ; Con- | Con, =
Container | eines | Fast of | Rural | For of | nal) ane | canes | wey [Provide] Fish
spected nated Fish Fish buted
Inaccessible tanks
Vats and tanks ff Hf
Clay vessels /
Barrels, drums, and tubs / /
Special artificial containers SALT
Roof gutters Hid Mit | Hl Mf
Trees and plants
Wells and pits
Other containers
Total: _ _

 

 

 

 

 

 

 

 

 

Section of the reverse side of Form FA 2, showing how the mosquito breeding foci recorded on the sample form on page
16 are tabulated by the type of container in which they occur.

The tabulation above illustrates how the foci re-
corded on the sample Form FA 2 on page 16 are en-
tered on the reverse side of the form under the
heading ‘‘(A) Containers.” In a section headed “‘(B)
Houses” on the reverse side of the form the inspector
records the weekly summary of his work.

Closed vs. vacant house.—A closed house is one
from which the dwellers are temporarily absent, that
is, a house in which there is furniture. A vacant house
is one that is untenanted and unfurnished.

Closed houses noted in Form FA 2.—A house
found closed by the inspector is noted on Form FA 2
in its regular place on his itinerary, with an entry in
the column devoted to containers: “closed at nine
o’clock,” or whatever time the attempt was made to
visit the house. The inspector keeps a separate list of
closed houses, using another Form FA 2, and writing
at the top of it: “List of closed houses,” and filling
in on this list, the columns “Street,” “Number,”
“Inspections,” and “Block.” When summarizing
Form FA 2 the number of closed houses is not counted
in the total of houses inspected.

Inspection of closed houses.—After the itinerary
of the zone has been completed the inspector hands
a copy of his “List of closed houses” to his district
inspector. He then revisits these houses in the order
of listing. He enters the results of the second visits in
the column provided for this purpose, and also in-
cludes them in the weekly summary for the zone.

 

Closed houses not inspected.—The houses which
cannot be inspected on the second visit are entered
ona third Form FA 2, at the top of which is written
“List of houses not visited in the week of Sept. 17—
23,” or whatever the week may be. The inspector
keeps this form until the following week or cycle,
and, on this occasion, reports the houses which
remain unvisited. This form must be promptly de-
livered for the director’s information through the
district inspector. In rural districts these forms are
sent in with the District Inspector’s Work Sheet
(Form FA 4).

Houses habitually closed—On any house from
which the dweller is habitually absent on the occa-
sion of the inspector’s visit, Form FA 43 (Request for
Keys) is posted in a conspicuous place, or this docu-
ment is handed to a neighbor with the necessary in-
struction. If after the posting the occupant fails to
facilitate the inspector’s visit by leaving the key with
a neighbor, or leaving the door unlocked, the inspec-
tor forwards a note to this effect to the district in-
spector, who then consults with the director as to
what measures should be taken.

Houses partially closed.—In houses in which there
are several families, it may happen that all visits can-
not be made on account of the absence of some of the
families. In such cases the inspector enters in the
column “Inspections” on Form FA 2, the total
of visits which should be made in the house; next
AEDES AEGYFTI

ANTENNAE, short ond scorcely
visible

HEAD, rounded, smaller than
thorax

THORAX, relatively small

ABDOMEN, elongated and
gently tapering

SYPHON, short, thick, and
darker than body of
the larva

 

Fic. 7. Aedes aegypti larva.
 

CULEX

ep

 

Fic. 8. Culex larva.

ANTENNAE, large, more pro-
minent than in _gegypfi_

HEAD, relatively large and
wide

THORAX, prominent, much
wider than the abdomen

ABDOMEN, relatively short

SYPHON, longer and lighter
in color than in A. aegypti
Syphon of Culex is about
the same color as the
body of the larva
INSTRUCTIONS FOR INSPECTORS 21

to this in the same column he notes in brackets
the number of visits not made; thus, 3 (1) means
that three visits should have been made but only
_ two were possible as the other apartment was closed.
In his “List of closed houses’’ the inspector enters
the address of the house and writes in the column
“Inspections,” the number which remain unmade.
When visits to these houses or apartments are made
later, the result is added to the respective columns
provided for containers and foci, care being taken to
avoid double entries in the weekly summary.

Vacant houses: classification. Vacant houses are
divided into two categories: those which may be
visited by the regular inspector of the zone and those
which require a special visit.

Vacant houses inspected by zone inspector.—Va-
cant houses for which the keys are easily obtained, or
which are accessible to the inspector without change
in his itinerary, are visited by him and included in
his regular report (Form FA 2).

Vacant houses inspected by vacant house in-
spector.—Vacant houses difficult of access, because
the keys are with the owners or agents, are generally
most conveniently inspected by the special vacant
house inspector.

Census of vacant houses (Form FA 59).—Vacant
houses not visited by the zone inspector are listed on
Form FA 59 (Vacant House Census). The inspector
keeps up to date the copy of his census with the ad-
dresses of vacant houses not visited in his zone. When
he observes that a house has been vacated he reports
it to his district inspector.

Similarly, when a house in this list is reoccupied
he reports its reoccupation to his district inspector
and includes it in his routine inspections.

High tanks: classification.—High tanks may be
divided into two categories: those which are easily
accessible, and those which are inaccessible.

Accessible tanks.—Tanks easily reached by the
inspector without the use of a ladder are examined
by him. Should he find a tank sealed and mosquito-
proof, he reports it, on Form FA 2, as eliminated.

Inaccessible tanks.—Special inspectors, oriented
by lists on Form FA 105, inspect inaccessible tanks.

. Fach of these inspectors carries a list of the tanks
which he is to inspect and is responsible for reporting
in writing to his district inspector all unlisted un-
sealed tanks found.

Note for Legal Summons (Form FA 63).—-When
the inspector finds conditions which favor mosquito
breeding, he informs the householder and explains
what must be done by the householder to correct
them. The details of the unsatisfactory conditions

 

found, together with the measures recommended for
their correction, are then carefully written out on the
Note for Legal Summons (Form FA 63). This note is
handed to the district inspector, who visits the house
to verify the conditions and to ascertain whether or
not they are being corrected. The district inspector
explains in detail to the householder what work must
be done, and advises him that a formal legal sum-
mons will be served if this is not attended to. He
specifies the corrections to be made, explaining that
it is to the best interests of all concerned that this
work be completed as early as possible. Should the
district inspector find that the formal legal summons
to the householder is needed to get the corrections
made, he signs Form FA 63 and hands it in at the
office. Should he find that legal summons is not
needed, he writes on the Form FA 63 received from
the inspector “Summons not necessary,” or “AL
ready complied with.” (The Note for Legal Summons
does not have to be verified by the district inspector
before action is taken.)

Responsibility of inspector for delivering Sum-
mons.—When the Summons (Form FA 83) based on
Form FA 63, is issued the inspector delivers it to the
householder on his next visit. The copy is left with
the householder and the original, countersigned by
the householder, is returned to the district inspector,
with the notation, “Delivered and signed,” entered
on the back under “Results,” and followed by the
inspector’s name and the date. The district inspector
delivers the countersigned Summons to the office at
the first opportunity. Should the householder refuse
to countersign the Summons the inspector leaves
the copy at the house, and notes under “Results” on
the original, “Refused to sign; copy delivered.”

Should the householder be absent, the inspector
ascertains when and where he may be found and
enters this information under “Results.” Should the
inspector find that the requirements of the Summons
have been met, or that the house is closed, he makes
due note, signing and dating this in the proper place.
In no case should the inspector keep the Summons in
his possession beyond the date marked for delivery.
If for any reason the Summons cannot be delivered,
the inspector notes the reason under “Results,” and
returns the form, signed and dated, to the office
through the district inspector.

Visit to verify compliance with Summons.—When
the legal period given for compliance with the Sum-
mons has expired, the original Form FA 83 from the
files is reissued to the inspector, who verifies whether
or not the required corrections have been made. If
he finds that the recommendations have been carried
22 ANTI-AEDES AEGYPTI MEASURES IN BRAZIL

out he notes this under ‘‘Results.” Should unforeseen
difficulties occur, such as meeting with a refusal to
permit inspection, or the finding of a closed house,
this is reported under “Results,” and Form FA 83 is
returned to the office once more. The nature of the
difficulties is reported on the back of the Summons
and a new visit for verification ordered.

Mosquito Identification

Mosquitoes generally can be distinguished from
other insects by a glance at the proboscis, which in
mosquitoes is much longer in proportion to the body
than in other insects. The proboscis is used in feed-

‘ing, but only that of the female mosquito can pene-
trate the skin for a blood meal. The male generally
lives on plant juices. The sex of mosquitoes can be
determined rapidly by examining the antennae, which
are hairy and plumed in the male and simple in the
female.

| Aedes (Stegomyia) aegypti: Color dark. Light lyre-
like design on thorax; silvered spots on the sides of
thorax and abdomen; white rings on legs. Biting
takes place at any hour of the day or night, but there
is a preference for daylight feeding.

The female scatters her eggs in small lots and may
lay in several containers on the same day. The eggs

 

are small, single, dark, and difficult to see on the walls
of water containers with the naked eye.

Other species: The Brazilian book of instructions
carries short notes on Aedes scapularis, Aedes taenio-
rhynchus, Mansonia titillans, and Limatus durhami,
which are often encountered there.

Culex quinquefasciatus (fatigans): One of the most,
if not the most, widely distributed of all mosquitoes.
Body of a uniform brown color; proboscis black. Ab-
dominal segments have basal white bands. C. guin-
quefasciatus is a very domestic mosquito. It takes
advantage of a great variety of types of water con-
tainers for breeding, which makes it a year-round
companion to man in the tropics. Its eggs are laid
in rafts comprising an entire lot from a single female.
It prefers to deposit its eggs in dirty water containing
organic matter, but it will also use clean water. It be-
gins to bite late in the afternoon and feeds by prefer-
ence at night.

Genus Anopheles: Also called “Nail Mosquito”
from its perpendicular resting position on the wall.
Wings of most Anopheles species have character-
istic spots. All of the Nyssorhynchus species have
white bands on legs. The Anopheles gambiae, as seen
with the naked eye, has uniformly colored legs. The
anopheline mosquito is the vector of malaria.

 

Aedes aegypti

, Snake-like movement of the whole body.

Moves aimlessly, slow to reach its destination.
Always moves away from a bright light.

Very timid; at the first alarm, retreats rapidly to the bottom
of the water, where it may remain some minutes.

 

CHARACTERISTICS OF AEGYPTI AND CULEX LARVAE

Culex

Whip-like movement, more pronounced at the siphon than
at the head.

Quick to reach its destination.
Not affected by the light.

Not so timid as Aedes aegypti; after being disturbed returns
readily to the surface of the water.

 

 

Index to Instructions for Inspector of the
Yellow Fever Service

Accidents... 00... cc cece cece eee eee eeeee 10
Aedes aegypti, characteristics of larvae............ 22
description of adult............. 0 cece eee e eee 22
drawings of adult.............. 20002 cc cece uee IV, 11
drawing of head of adult...................... 12
drawing of larva... 6.0.2... cee cece eee ees 19
Alcohol. 2.0.0.2... 2. 0.22 c cee cence cree eee ennnee 10
Anopheles genus..............5 eka eee eens 22
Appearance of inspector....... 0.0... cece eee ees 10
Autograph House Visit Record................... 14

Containers, water, classification of................ 14-15

 

EMPty. eee cece cece cece cece etter ee nas 14
oiling Of... cence eee e eee eee 15
potential foci... 2.0.0.6... ee cee cease 14
report ON.............0. eee eee eet eens 15 .
sealing Of..... 00.2... cece cece cece eee eeeenes 15
Culex, characteristics of larva.................0.05 22
drawing of larva... 0.0... 0. eee eee eee ee 20
guinguefasciatus (fatigans)..................... 22
District inspector, duties of....................2. 10
Entering houses, method of, see under house
Equipment of zone inspector..................4.. 13
Firearms 22.0.0... ccc cence cee cece neces - 10
Fish oo... e cece cece cee cece even eeaes 15
Flag of zone inspector.........0.0 0000. c cece e eee 13
FORMS USED BY ZONE INSPECTORS 23

 

Foci of Aedes aegypti, abbreviations used to desig- Latrine pits......... 000 c cece center eeeee 15
nate type Of. 6.6... ieee eee eee 16 | Mosquitoes, characteristics of various species...... 22
elimination Of........ 0.0.0 beet ee eee eee 15 complaints of prevalence of.........+..-.0+++65 15
notifying householder of..........-.--0+--45555 15 drawings of ..........00 00 eee eee eens iv, 11, 12,19, 20
oiling of large... 2.6.6 eee tenes 15 | Negligence. ......... 0 cece cece eee eee eee tees 10
recording of, on Form FA 2........--..--2506-5 16-18 | Note for legal summons, see under Summons
potential. 6.0.0.0... cece cece teens 14. | Obedience......... ccc cece ene eees 9
FECUITING. 00... ee eee eee ees 15 | Pennant of zone inspector...........500- 2c sree 13
Form FA 2........0 00 cece eee een nenes 15-18 | Police, calling for help of...........0----eee eens 14
Honesty.......0 0.0 cece eee eee eee eens 10 | Report for duty, inability to..........---. eee ee 10
House, closed 0.0.2.0... 0c cece eee ee eee nes 18 | Smoking. ......... 0.000 c eee eee eee eens 10
closed vs. vacant. .....-. 0. eee cee eee e ene 18 | Summons, delivery of..........--.. eee eee e eee 21
definition of. .........-2: 0. cece eee eee ees 15 note for legal... 60... 0c cee eee eee eer eee 21
method of entering. ........-6 000s sence eee ee 13 verification of compliance with.............-.-- 21
with foci... 2.1 cee eee eee ee tenes 17 | Tanks, accessible... 2.0.0.0. .0: 60 cece ence eee eee 21
VACANE. oo cc eee eee eee e ener e tes 21 inaccessible........... 0c: eee e eect e teen nets 14, 21
Inspection, methods of..........-. 0.0220 2s seers 14 SEPtIC. 0 cece eet eee eee aee 15
with medical officer.......... 502200 e cere eres 14] Tips... 0... cee eee ene ete nee 10
refused by householder.............-- 002 0e00es 14. | Uniform... 0... eee nee ee nee 9
registry of, on Form FA 52.........--++-- 00-5 14 | Working hours..........6 0.00 e veer eee eee eee 13
Inspector, see District inspector and Zone inspector Working methods. ......-.6. 00-0 eee eee renee 13-15
Itinerary of zone inspector.......--. 260s e ee eee 13 | Zone inspector, duties Of. ........-. 20 eee eee eens 13
—~@~——.

Forms Used by Zone and District Inspectors

For ready reference, the forms used by the zone and
district inspectors are presented here although they
do not form part of the book of Instructions for In-
spectors of the Yellow Fever Service.

The district inspector uses the same daily report
form (FA 2) as does the zone inspector, noting always
whether his inspections were made with the zone in-
spector or in revision of the latter’s work.

When a complete cycle of

inspector is responsible for the accuracy of these sum-
maries.

Section C, “Inspections of District Inspectors,” is
taken from the daily reports (FA 2) of the district
inspectors themselves.

The district inspectors usually meet with the
medical director on Monday morning, to turn in all
reports for the preceding week and to receive instruc-
tions for the current week.

 

inspections has been termi-
nated for all the zones of his
district, the district inspec-
tor prepares his report
(FA 4), which summarizes
for the district both his own
and the zone inspectors’ re-
ports (FA 2) for all zones.

Section A of Form FA 4,
“Mosquito Breeding by Con-
tainers,” summarizes the
work of one complete cycle
of visits, whether this repre-
sents the work of one week,
two weeks, or a longer pe-
riod.

Section B, “Mosquito
Breeding by Houses,” is
filled in directly from the

Date

Form FA 52

 

ANTI-AEDES AEGYPTI SERVICE

Hour | Defects

   

The occupant or person responsible shall be fined in accordance with Decree
No. 21,434 should mosquito breeding be found on these premises or this notice
be defaced or destroyed.

INSPECTION

Initials Date Hour | Defects} Initials

 

 

 

summaries of the inspectors’
reports (FA 2). The district

Autograph House Visit Record
AUTOGRAPH HOUSE VISIT RECORD (Form FA 52, see p. 23 af
The Organization of Permanent Nation-Wide Anti-dedes
Aegypti Measures in Brazil by FLS)

This form which constituted a type of timeciock to be
punched by the inspector or other employee at the tins
t to-a given building was, I believe, intro-
duced into the Cooperative Yellow Fever Service in Brazil
from the Federal Goverment Service in Rio some tine
after 1930. This very useful~-ons can almost say indis-
pensable--form is described by Francisco Soares Senna in
Publication No. 1 of the Servico de Prophylaxia de Febre
Anarella: Instracgoes (Bahias Tmprensa Official de
Estado) in 1919 (YF VIII.110). He says (p. 15, par. 3)8

(over)

a
E
b

 

"For checking these visits, the will place in
each house, by preference on the water tank, an appre-
priate form on which will be marked the date of the

visit and the signature of the foreman.*

(Copy of this card in each book (p.23) and in Adminis-
trative Mamial.)
ANTI-AEDES AEGYPTI SERVICE Vien
DAILY INSPECTION OF INSPECTORS AT DISTRICT HEADQUARTERS

 

DISTRICT INSPECTOR’S REPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

cee eee e ees District Doctor
STATE OF MATERIAL
” & <
s Name of Inspector 8 . 2 a 3 E E |g a
s ¢/4|2 £ | 3] 8s » |e; | 8
g ey a . £16 a Be § & a | 2 s
od = et 3 za ue 3 1 wd 8 ot a= ‘3
& & s < g & Bd & e oO a & ov) av 2 2
3 a x = @ = | 28] 6 s = a 3 i oe 2
Se |e} ae] se] e] Dp laa] Fl) me] ope] Be] Biss! gts
=In good condition or present
Symbols + 8 ~ P
y ~=In bad condition or absent Date

 

 

District Inspector

Form FA 110
ANTI-AEDES AEGYPTI SERVICE
INSPECTOR’S WORK SHEET

Locality Date

Street :
F | FP | FA } FAP

Inspections
Clay Vessels
Barrels
Drums and Tubs
Containers
Roof Gutters
Wells and Pits

n
ae
a
a
el
ov
ss
o
a7)
nH
o
°o
oO
w
a
=

Vats and Tanks
Special Artificial
Trees and Plants

Other Containers

Totals , Houses with F
Abbreviations: Houses with FP

L—Larvae oO Houses with FA
P—Pupae

A—Aedes aegypit Houses with FAP
C—Other species
E—Eliminated
O—Oiled
X—Provided with fish

 

F—Focus Signature of Inspector

Form FA 2
(A) CONTAINERS

 

 

Containers
Found with
Water

Containers
Inspected

Foci of All
Species

Pupal Foci
Foci of Aegypti

Pupal
Foci

Cont.
Elimi-
nated

Cont.
Oiled

With
Fish

FISH

Fish

Provided, Fish

Distrib-
uted

 

Inaccessible
tanks

 

Vats and tanks

 

Clay vessels

 

Barrels, drums,
and tubs

 

Special artificial
containers

 

Roof gutters

 

Trees and
plants

 

Wells and pits

 

Other containers

 

 

Totals

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(B) HOUSES

 

 

Date Inspected

Not

Inspected

ALL SPECIES

AEDES AEGYPTI

 

Foci

Pupal

Index Foci

Index

Foci

Index

Pupal
Foci

Index

 

 

 

 

 

 

 

 

 

 

 

 

Week

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
ANTI-AEDES AEGYPTI SERVICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRICT INSPECTOR’S WORK SHEET Week. .......... 000s
State... eee ee eee County... ccc cc ccc cece ence enenceuceaceces Locality..... 0.0.0... cease ces eceseneeecenees
District... 2... ccc cc ccc ce ec encncneeseneatesneravaeuens Cycle of visits... 0... ccc cece ace cece eeces days
Dateofopening...................... Week of theservice... 0.20.00... cece cece cee eee from..........0005 TO... e eee ee eee 19 ......
No. of Zones PERSONNEL
Last census Name Position
Date:
Houses
Population
Altitude ........0.....00., meters
Meteorological data during the
period from ......... tO .......0. 19......
Rainfall mm. ..............0000005
Temperature: .............0000 00s
Maximum mean ..............05
Minimum mean ..............--
(A) MOSQUITO BREEDING BY CONTAINERS
a A. AEGYPTI dia
: SPECIES Cont.
Containers Found Cont. ee Cont. . .
. Elimi- Oiled With Provided Fish
with Water Inspected Foci Pupal Foci Pupal nated* 1 Fich with Distrib-
oct Foci a Foci 18 Fish uted

 

Inaccessible tanks

 

Vats and tanks

 

Clay vessels

 

Barrels, drums, and tubs

 

Special artificial containers

 

Roof gutters

 

Trees and plants

 

Wells and pits

 

Other containers

 

 

Totals

 

 

 

 

 

 

 

 

 

 

 

 

 

* In the space “Cont. eliminated” include the number of inaccessible tanks sealed.

Form FA 4
 

(B) MOSQUITO BREEDING BY HOUSES

 

 

ALL SPECIES AEDES AEGYPTI
Houses Houses
Zone Not In. With . With
Inspected spected With Index Pupal Pupal With Index Pupal Index
Foci Foci Index Foci Foci

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

District

 

 

TOTALS OF HOUSES INSPECTED AND HOUSES NOT INSPECTED

 

Houses not inspected two or more cycles... 0.10... 6 2.6 eee nen ener e denen net en erred ce teeeeeees

‘Houses not assigned to any Zone. 6.1. cece nee enn ene b eee bbe bec cn ene eepevetneeesrererettnntetnretitnnectenns

 

Total houses in the district or locality

 

 

Vacant houses inspected by the zone inspector

 

 

(C) INSPECTIONS OF DISTRICT INSPECTORS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITH THE INSPECTOR REINSPECTIONS
Zone Houses ALL SPECIES A. AEGYPTI Houses ALL SPECIES A. AEGYPTI
Inspected vie Index wee Index Inspected vie Index no Index
Total District
OBSERVATIONS

Form FA 4 (Reverse)
 

ANTI-AEDES AEGYPTI SERVICE
NOTE FOR LEGAL SUMMONS

 

 

140) «a Block... ........ccceeeeees Street..... 0.0... cece cece Nou... . 2. ec eee

Type of container......... 00. c cc ccc cee cree c ee eeee Foci... 2... cee ee eee No. of recurrences...........

Summoned for... 20... 6c ce cc nn een e cece rene neue eee e seen ene e een eneeee apa eneeeneeneegs

 

Signature of District Inspector

 

Signature of Inspector

 

 

 

 

Form FA 63
FIRST VERIFICATION
Delivered to... 00... cece ec eee ccc eee eee e eee ener nneeeeenee Inspector Of... 2.2.0.0... ccc eeceees
Date... 2. ccc cece cee e eee n ee teeneee To be verified On... ..... cece ccc eee cece neers eeeeees
Result... ccc ce ne een eee ERE EER EEE DOE DEE E EEE O OEE EE eee Re EEE RHE eee EEE ES
Signature of Inspector
Responsible for Verification
SECOND VERIFICATION

Delivered to... . ccc ccc cece ne cent etter ene eetettnnetenanes Inspector Of... 00... 00. c cece eee ees
Date... 2. cece cece cece tee e eect eenees To be verified On... ... ccc cece cece cece eee een eeeneees
Result... ccc eee een ene ened ROE EERE EEE TEED EOE e OE EME E OEE EE DEE EE ESS

 

Signature of Inspector
Responsible for Verification

Form FA 63 (Reverse)

 

 

 

The zone inspector enters on this form the details of unsatisfactory conditions found in any house in
his area.