Excerpt from Annual Report of the Bureau of Health for the Philippine Islands: Period From September 1, 1904 to August 31, 1905

The vaccine virus furnished by the serum institute has been, in the main, good but great difficulty was experienced in preserving it when sent to the provinces. It was found necessary to construct special ice boxes, in which the vaccine virus was placed, in a small, opaque receptacle. The boxes are locked, and shipped by boat to the medical inspector in charge of the vaccination company, who has in his possession a duplicate key. These boxes are Of such a nature that they can be transported in bancas or in carromatas throughout the provinces, and the ice in them usually lasts ten days or two weeks.

As soon as the vaccine virus in one of these boxes is used up by the vaccination company, the empty box is locked and returned at the first opportunity to the central Board Of Health. In the meantime telegraphic information is sent to the central Board of Health that more vaccine virus is needed, and that the empty box is en route, so that there is a continuous stream of boxes with virus going out from the central office and empty boxes returning to the central office from the field. This system has been fairly efficacious, a large percentage of takes has been Observed, and so far no single case of any grave infection has been reported.

It was found necessary to instruct all the vaccinators in the technique of their work, and it was only after they had learned how to apply strict antisepsis that they were allowed to proceed to the provinces and vac cinate. This preparation required time, but the good results obtained by it more than compensate for the disadvantages attending Had circumstances been such that the number of vaccinators asked for, namely, 310, could have been authorized, the work of vaccination would now be half through at least, but with the small number which the Bureau Of Health has available, the question arises whether vaccination will not have to be practiced continuously for many years, in order to immunize the inhabitants who are now in these Islands, and their offspring as it arrives. I desire to call particular attention to the gravity of the Situation.

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