Your note of January 12th reached me before I left Washington but too late to get an official answer from the Pan American
Health Organization; my last day in the office as Director was the 16th. I shall officially retire here in Geneva on the
Of course I am looking for a job. The two requirements for a position that I might be willing to accept are quite simple:
(1) that the salary represents approximately 50% of my own evaluation of my worth, (2) that the duties of the job be those
I myself care to establish from day to day!!
I regret that I cannot give you offhand the information which you request regarding DDT. It is my belief that Dr. Muller
and the Geigy Company did not fully appreciate the possibilities of DDT previous to the work done in Orlando. I understand
that DDT reached the United States at the end of 1941 or sometime early in 1942. I first heard rumors of it in Cairo while
I was with the United States of America Typhus Commission, probably in April or May of 1943. Of course I did not believe
the tales which were told. On July 3rd 1943, Dr. William Davis arrived in Algiers as part of the Rockefeller Foundation Typhus
Team with five pounds of DDT which he had been able to get from the laboratory in Orlando, Florida. It was with this 5 lbs.
that the careful studies were made at the Maison Carree Prison outside of Algiers in July, August and September, which definitely
established for us the practicability of DDT as a one shot method of bringing body lice down to a low level in any given population,
with expectation of maintaining this low level until typhus infection had died out of that population.
We experimented in our quarters in Algiers in August or September of 1943 with DDT as a residual insecticide sprayed on the
walls in kerosene and for many weeks thereafter had flies coming up from the Pasteur Institute stables dropping off the ceiling
into our soup. With the dramatic results of the Naples typhus campaign already known, General Stayer decided that the Army
was in a position to handle any or all threats of typhus in Europe and early in March 1944 requested that the Foundation group
turn its attention to studying the possibilities of using DDT for malaria control in Italy. A field programme was set up
in the Castel Volturno area and houses also sprayed with various formulations of DDT and certain houses were even powdered
with DDT. This field demonstration was proceeding beautifully when contrary to solemn commitments previously taken, Justin
Andrews suddenly moved into the area with Paris Green since unexpectedly our control area had been chosen as a staging area
for troops coming from Northern Italy in preparation for the invasion of Southern France. The 1944 tests then were convincing
to those of us who participated in them but were not as conclusive for the season as we desired. In June of 1944 our Headquarters
were moved to Rome and some of the work was carried out that year on a small scale on an island at the mouth of the Tiber
river. (Dr. Kumm participated in this programme). In 1945 a large scale test was organized with Dr. Kumm participating in
the beginning before leaving for Brazil and with Fred Knight actively working on the project in both 1944 and 1945. In 1945
the Tiber delta and the area north of the delta were completely sprayed, with Dr. Missiroli continuing his observations on
the occurrence of malaria in the area. This was probably the first well controlled complete demonstration in Europe and may
have been one of the first carefully controlled projects in an area where the history of malaria was known and where the machinery
of control existed. Dr. Missiroli's observations on the results of our work that year led him to declare publicly in
January 1946 that future use of bonifica should depend entirely on agricultural needs and not on health considerations. Dr.
Missiroli also undertook solemnly at that time to eliminate malaria from Italy within a 5 year period.
I have not canvassed the literature regarding other efforts. You will remember that during the war period there was great
secrecy and failure to publish, but I doubt that there was any place the convincing kind of demonstration carried out so early
where the incidence of malaria was high and where the control of results was so definite as in the Tiber Belta 1945 Demonstration.
You will remember this area was carefully prepared for the production of malaria by the German specialists before the German
retreat and 1944 was a highly malarious year. The physical conditions prepared by the Germans had not been corrected in 1945.
In reply to your second question referring to vaccination by scarification with 17D, I can say that 17D has not been widely
used by scarification. We believe it should be used by scarification and at long last some tests are being carried out in
Colombia under control conditions. The mass vaccinations by scarification which have been carried out thus far have mostly
been in Africa using the French so-called neurotropic virus. The only attempt to use this method in the Americas was in Costa
Rica in 1951 and resulted in the production of a number of cases of encephalitis with some fatalities. In 1952 the use of
this virus by scarification in Nigeria produced some 80 cases of encephalitis with 38 deaths. The laboratory studies suggest
that the neurotropic virus, whether given by scarification or by needle, can become dangerous when minimal amounts of the
virus are present. Apparently the French virus then becomes dangerous if not properly protected against great reduction of
the virus in the field.
Juliet and I continue with our home in Chevy Chase at 4104 Rosemary Street. We are now in Geneva and expect to make a trip
out to Asia with Bob Watson during the next few months. Plans are not definite but I presume we will be back in Washington
sometime in May.
I am delighted to know you are taking up the history once more of the I.H.D. although I can appreciate some of the difficulties.
I shall look forward to seeing the chapters on yellow fever at your convenience.