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Chevy chase, Marylarrl ~~15
August 22, 1967

Dr. Paul0 C. A. Anturrrs J
Rua Itipolis 990
Go Paul0 I, S.P., Ekasil

Dear Paulot

Orestings fromJul.ietandmetoyou and

    The most immediate reason for this note
festation of R&m do Para with
been believed ismdnent for

your family.

is the news of the rein-
This reinfestation ha6
since the full scale

reinfestation of Prench Ouiana and Guyana.  The situation is particularly
disturbing since I learned 601~ months ago that Dr. Cermano Paris, the
head of DRRRU, had expressed himself a6 not especially concernsd over the
threat of reinfestation with Aedes ae
fever could be readily handle ~ by vac~~ti~~ the threat of yellow

   I would point out that Belen lies at the mouth of the Amanon arxi

can readily become a distributing center for Aedes aegypti to the Amazon
Valley and to the coast of Rrani.1.

   Ristorically, unrecognized yellow fever was ahown to be present in
R&m in &y 1930 when the routine collection of liver tissue from indi-
viduals dying after less than ten day6 illness revealed a positive on the
third liver collected.  This was almost a year after the last recognized
case and a month before the local profession reported the disease.

   As you know, Del&n has an ideal climate for Aedes aegypti. Bradi-
cation was attained only after the ships engaged in river traffic
installed special tubulation which permitted oiling of the bilge water
from the upper deck.

   The reinfestation of BeUrn after a psriod of thirty years of free-
dom from thi6 mosquito is, I belie=, an event of such importance that a
full investigation and local eradication effort is indicated. Also, I
would insist that pressure be put on the Goverrrasnt authoritier to make
a major issue of this reinfestation at the Directing Council meeting in
Port-of-Spain, Trinidad, at the end of September.

   It mu6t be remembered that the campaign for the eradication of
       ti
N in the Western Hemisphere was initiated by action of the
      an e  gation at the first Directing Council in 1947. The
Braeilian rerrolution was based on the need to prevent reinfestation
across international border6.

   This objective of Braail was reached many pmrs ago with the
eradication of aegypti from all the South American countrie6 excepting


Dr. Paul0 C. A. Antunea

Vene6uel.a and Dutch Guiana and the ciicutaarea of ColomMa. The failure
to clean up the Caribbean ha6 resulted in reinfeatations of Guyana and
FrenchGuiana and repeated reinfestation6 of Trinidadlnrecentyears.
(Further to the north and we6t, El sslvador was found reinfeated in 1965,
and Mexico ha6 had minor reinfestation6 in 1965 and 1967.)

   The United States is working on the problem in Rrerto Rico, the
Virgin Islands, and 6ome of the infested area in the United States,

It is importantthatthe countrie8which have eradicated Aedea
jOintogetheriniXB3iS~~ that the infested area6 in thmt-
    be cleared before they all become reinfested.

   It should be remembered that the Rrazilian report of the eradica-
tioneffort submittedtothe RanAmerican SanitaryC8nferenoeinl9~
showed 617,000,ooO house vi6it6 between 1931 and 1958 when eradication
was Mnally certified.  Today the increarred urbanisatioa of Rrr~ai.1, the
increased facility of tran6portation in the interiOr, and the great
increase in disposable t&raw-aw6y containerr, including used automobil
tires, wotdd allincz~~~e greatlythe difficulties and coat of anyfutur6
eradication effort.

   Itmustbe rememberedthatDra6ilhas a great reservoir of jungle
p&n#fevertirus which has beenahowntoinvade from time to tim8 all
of the Rra6ilian state6 excepting only &~a&, Rio Grands do Sul, Fernam-
buco, Alagoa6, and Sergipe.  In recent years fatal ca8e6 have occurred
from Roraima in the north to Rio Grande do Sul in the south.

   I amwritdngyou at such length and reminding you of things you
already know because I believe the matter is of such importance that you
should stimulate what activity you can through professional contacts, and
August0 shoulddo the 6ame throughbuainera andpolitical contactshe m6y
have. Itise~ciallyiBlportantthatBra6ll~eilearsdiatGlytoellad-
nate this reinfestation and at the same time use every man6 to $et the
8upport of other countrierr no6 free of aegypti to insist on the Completion
of eradication of Aedes  as    in those countri.86 which have not met
their internatio           n thismatter.

Fred L. Soper