LEISHMAN1A INFANTUM III 



the finding of parasites in the mucous flakes of the stools of a three- 

 year-old Maltese child. 1 Intestinal lesions rarely occur in infantile 

 leishmaniasis. 



^Etiology. Infantile leishmaniasis is stated to be transmitted by 

 fleas, especially dog fleas, Ctenocephalus canis (= Pulex serraticeps) , and 

 by Pulex irritans. Children living in contact with infected dogs may be 

 bitten by infected dog fleas, and so contract the disease. Basile (1910-11) 

 and Sangiorgi (1910) state that they found L. infantum parasites in the 

 digestive tract of the dog flea. After searching they found infected 

 dog fleas on the beds, mattresses, and pillows used by children 

 suffering from the disease. Franchini (1912) thinks that Anopheles 

 maculipennis may be concerned in the transmission. 



Basile 2 tried a number of experiments to show that infantile 

 leishmaniasis is transmitted by fleas, thus : 



(1) Fleas were taken from a healthy dog. They were placed in 

 vessels containing infected spleen-pulp and allowed to feed thereon. 

 The fleas were then killed and dissected, and portions of the gut- 

 contents examined for parasites. The remainder of the gut was 

 emulsified and injected into a young puppy, whose bone-marrow had 

 been shown previously to be uninfected. Basile states that the puppy 

 became infected. The parasites are said to increase in number in 

 the flea's gut. 



(2) Two healthy pups, each a month old, and born in the labora- 

 tory, were placed in a disinfected, flea-proof cage. A few days after, 

 an infected dog was placed in the cage, so that fleas from the 

 infected dog could pass on to the puppies. A month later the two 

 pups became infected, parasites being found in them after liver 

 puncture. A number of control puppies from the same litter 

 remained uninfected and in good health. 



(3) Basile next used other laboratory-born puppies, a month old. 

 Four of the litter were placed in a disinfected, flea-proof gauze cage 

 in Rome. The cage was isolated from other dogs. Fleas obtained 

 from an infected area in Sicily were placed in the cage. The puppies 

 were examined by hepatic puncture, but were found to be negative 

 for two months. Then two of the puppies showed infection, and 

 six days later the remaining two puppies were found to be infected, 

 and all four died. They showed irregular temperatures, and were 

 getting thin. Control puppies remained healthy. 



From these experiments Basile concludes that fleas transmit 

 leishmaniasis. However, Basile did not exclude the possible occur- 

 rence of natural herpetomonads in the gut of the fleas. 3 Herpetomonas 



1 Quoted by Leishman (191 1) in his interesting review of Leishmaniasis, [ourn. Roy. Army 

 Med. Corps, xvii, p. 567, xviii, pp. I, 125. Also Quart. Journ. Med. v, pp. 109-152. 



2 Numerous papers in Rendiconti R. Accad. del Lincei (Rome), xix, xx (1910-11). 



3 See Fantham, Brit. Med. /<?;-., 1912, ii, p. 1196. 



