Armstrong – Table of Contents

In additional discussion, he indicated that immunity was generally long lasting
among individuals infected during an epidemic; he did call attention, however, to
apparent repeat infections after several years. The information that dengue exists in
multiple serological types, that do not confer reciprocal immunity against one another,
appeared many years later (8).
Armstrong described the spread of infection by mosquitoes and the biologic
habits of Aedes aegypti, the species primarily responsible for the carriage and
transmission of dengue virus. He also discussed the various Culex varieties implicated in
the transmission of dengue and the mutual interrelationships of the periods of human and
mosquito infectivity for each other.
The manuscript contained a major portion devoted to a discussion of dengue
prevention. This section had several components. The first dealt with control of the
infected patient by isolation and the protection of the susceptible population by adequate
screening to prevent mosquito access. The second component was an outline of methods
then in use for control of mosquito proliferation. These were basically the control
methods previously used to retard the spread of yellow fever in Cuba during the Spanish-
American War and in Panama during the construction of the Canal earlier in the 20th
century.
Except for less detailed information about the biologic properties and nature of
the virus itself, Armstrong’s review was an up-to-date source of information in 1923 for
the medical practitioners and scientists who needed precise reference data about dengue
fever.