Notes on Human Spiroch.ktosis 



BY 



Cait.vin L. Housfibi-I). M.A., ^f.D. (O.vntab.), M.R.C.S.. L.R.r.P., H.A.M.C. 



late attachcil Egyptian Army 



The following article is founded on observations derived from six cases of relapsing 

 fever, which occurred amongst the troops at Khartoum in January, 1910, and from 

 two cases seen in Cairo in March of the same year. 



I believe relapsing fever had never been diagnosed in the Sudan before 

 Captain A. G. Cummins, R.A.M.C., reported it in two cases at El Obeid, both i)eing 

 Egyptian soldiers who had just returned of!' furlough from Egypt. 



Late in 1909 a case was found at the Civil Hospital at Khartoum, aiul this case 

 apparently came from Egypt, as did iive of the six cases treated at the Military Hospital, 

 Khartoum. 



Human spirochaBtosis probably is not endemic in the Northern Sudan, for it seems 

 scarcely possible that it could have missed recognition, and everything tends to uphold 

 the view tliat all the above-mentioned cases were imported from Egypt, where the 

 disease is well known and causes considerable epidemics. 



The important question arises whether the Egyptian may not be able to introduce 

 this disease into the Sudan and so permanently infect a district at present apparently 

 free, a question which has also to be faced with regard to bilharziosis, at least in certain 

 localities. 



Of the six Kliartouiu military cases the first was taken ill in Cairo twelve days 

 after joining from his village, Ashmun Gurice, Moudiriah Manoufia, where it seems 

 probable that he contracted it, for Captain R. G. Anderson, R.A.M.C., kindlv made 

 enquiries and found that there was an epidemic of this fever in a neighbouring village, 

 Kafr-El-Gazzar. 

 History of the The other recruits with whom he mixed were apparently healthy. 



He was admitted to hospital in Cairo for six days with fever; probably this was 

 his first attack as he asserted he had no fever in his village. 



Very shortly after discharge he started for Kliartoum and gave the history of being 

 ill with fever most of the journey up country. 



Arriving at Khartoum on January 1, he was admitted on the '2nd with fever, 

 temperature 102' F., and suffered from a marked rigor shortly after admission. 



Only a few spirochtetes were found after a prolonged search. 



_The other patients were taken ill on January 3, 7, 9, (two) and 14 respectively, 

 but were not admitted to hospital till January 5, 10 (two), 12 and 15. 



The first five cases all occupied the same l)arrack-room at Cairo, all stated they 

 were bitten by bugs while there, but only No. 1 was taken ill. 



All occupied the same railway carriage on the way up to Khartoum and durin<; this 

 time must have been in intimate contact with each other. 



On arrival at Khartoum the four yet unaffected went to separate barrack rooms, all 

 of which probably harboured bed-bugs. 



The main point of interest centres round the sixth and last case, the only one to 

 contract the disease in Khartoum, for he had been resident in the Sudan for over a year. 



first case 



