"SPOTTED FEVER"

Dominion, Volume 12, Issue 81, 31 December 1918, Page 5

"SPOTTED FEVER"

FIGHTING A STRANGE DISEASE BRITISH ARMY MEDICAL CORPS VICTORY

(By Frank Fox, H.F.A.)

A strange, subtle disease is "spotted fever," or cerebrospinal lever, to give it the proper name—a disease which lias not yielded up yet all its secrets to the bacteriologist, and which cannot theretore be fought with the same certainty as, say, enteric or diphtheria. The British Army Medical Service has had to meet a bold offensive on the part of cerebro-spinal lever daring this great war, and cannot report a decisive victory yet. But the enemy has been "held"; he has not been able to ravage either our troops or our civil population, and there are reasonable hopes that soon he will bo beaten out of tlie field, considering the scientific organisation concentrated against him. Cerebrospinal fever, like most oilier diseases, is caused by a germ. But the bacteriologist has not yet been able to find out all about this" germ. Tracking up a germ is. interesting'work, and one or two features of it may be explained here. The cerebrospinal fever germ lives at the back of the nose and throat, and also in the cerebrospinal lluid. Away from its haunts it is rather a delicate fellow and dies easily. If it is put on a culture bed with other and hardier germs it is. apt. to fail to grow. So the first necessity in studying this germ is to ti> • to get it on a swab as ranch to itsr.it as possible. The British Royal Army Judical Corps lias a special little instrument for that purpose. The cerebrospinal fever germ proves on culture to be a diplo-coccus (shaped like a double bean) and Gram-negative, that is to say, it does not stain when treated with a standard bacteriological preparation known as Giamslain. A diplo-coccus germ from the back of the throat which will not take Gram's stain is open to some suspicion. The next test is that of growth at certain temperature. At a temperature of 23 degrees C, on certain media the cerebrospinal fever germ will not grow, whilst most otherwise similar germs will. So a diplo-coccus, Gram-negalivo germ . that does not grow and flourish at a temperature of 23 degrees C is open to deep suspicion. The person who carried it may be reasonably charged as being liable to 'infect with cerebrospinal fever. But here the chain is broken. There arc some diplo-cocei, Gram-negative, not-growing-at-23-degrees-C germs which are not cerebrospinal fever germs and do not cause the disease. The real evil-doer has not yet been fully identified from all of his less dangerous relations. Until ho is there cannot be a fully successful campaign against cerebrospinal fever. Experiments are going on with a view to see if the culprit can be distinguished absolutely by agglutination tests. It would take too much space to go into that; sufficient has been said to show the bacteriologist's difficulties in regard to cerebrospinal fever. The British Aimy Medical, Service is trusting to preventive organisation to keep the disease from getting a hold in our country, whilst carrying on an exhaustive bacteriological investigation at a. chain of laboratories throughout the Kingdom. When the disease first threatened, the Army authorities summoned to command Hie defences against it a medical officer who was at the time doing regimental duty, but who was known in civil life to have specially studied tho disease. The promptness with which the attack was met is ono of the best Vstimonials to the efficiency of the Royal Army Medical Corps. Preventive work rarely arouses its due measure of public enthusiasm. We ought to be more grateful than we are for the invasions which the Navy has prevented, and the epidemics which.the Eoyal Army Medical Corps has strangled at birth. The campaign against cerebrospinal fever probably .smothered a great outburst. In I!HS thei'o was a widespread incidence of ..cases. The cases were not numerous, but they wero all over the country, and that was the dangerous condition. In 1917 it cannot be said tnat tho danger is over but the future can be faced with confidence. Tlio further effort c gainst cerebrospinal fever began with tho establishment in Loudon of a central laboratory for the special instruction of bactenolo°ists and their assistants in cerebrospinal fever wort and to carry on identification, curative and investigation work, and the organisation of district laboratories throughout the country, the existing university laboratories were coordinated, and in other districts new laboratories established. A motor bacteriological laboratory was fitted up as a "flying force" to go to any place required. An "intelligence" service was organised to watch out for suspected cases and for "carriers," the people who carry about the germs of this disease without apparent harm to themselves, but with danger of infecting others, lo see that eases of tho disease, and so far as is practicable, suspicious cases and carriers are promptly identified and isolated until no longer dangerous, is a fundamental principle of aU warfare against infectious and contagious disT'o supplement tho bacteriological and "Intelligence" service came the preparation of a curative serum and treatment for disinfection of contacts. In addition, throughout the whole country there is tho close and cordial co-operation which exists between tho Army and Hie civil health authorities in all administrative | measures undertaken to maintain the I public health of troops and of civilians at. the highest standard. Cleanliness is the primary factor in preserving tho public health. The .sanitarian, whether military or civil, aims at securing cleanliness of the air we breathe, of the wate» we drink, and of the food we cat. In the prevention of a dissase such as cerebrospinal fever, in which the infection is acquired by breathing specifically polluted air, tho main object to secure is free and thorough ventilation and avoidance of overcrowding in all huts and barracks and buildings in which soldiers are quartered. The importance of these essential points cannot bo overestimated.