184 OTHER SPOROZOA 



There is no specific remedy known that will cure dengue. 

 Care of the general health, including measures to lessen the fever, 

 headache and bone aches, help in making life worth living during 

 the eight or ten days of suffering. 



Once an epidemic has broken out, it is almost as useless to 

 attempt to stop it as to stop a tidal wave, as far as the mass of 

 people is concerned. Houses screened against mosquitoes, if 

 available, are havens of refuge, but the tropical villages or cities 

 in which there are enough screened houses to care for even a 

 small per cent of the population are hopelessly lacking, and the 

 rapidity of the spread of the disease makes the isolation of early 

 cases in mosquito-proof wards almost futile. Anti-mosquito 

 campaigns, conducted not merely during an epidemic but at all 

 times, are the only methods now known of preventing epidemics 

 of dengue or of lessening their local prevalence. 



Phlebotomus Fever 



Of the same general nature as yellow fever and dengue, and 

 concluding this series of gradually milder diseases, is phlebot- 

 omus or three-days' fever. This disease occurs especially on 

 the shores of the Mediterranean and in India, and possibly also 

 in other parts of the world. In endemic countries it occurs in 

 the form of annual epidemics. It is estimated that in the earth- 

 quake regions of Italy where the disease is especially prevalent, 

 50,000 persons are attacked annually, incurring a financial loss 

 of over $7,000,000 by the prolonged incapacitation for work which 

 follows the disease. In central India, every non-immune person 

 is said to be attacked by the end of June each year. 



Phlebotomus fever begins suddenly, like dengue, with a high 

 fever, severe headache and aches in the bones and joints. The 

 nervous symptoms are marked, and the pulse and respiration are 

 accelerated. Usually the fever subsides on the third day, though 

 in India it often lasts four or five days. The aches and general 

 depression continue for ten or twelve days or even longer after 

 the disappearance of the fever. 



The disease, the parasite of which has never been discovered, 

 is transmitted by the gnat or sandfly, Phlebotomus papatasii 

 (see p. 470, and Fig. 212), which is extremely abundant in the 

 regions where phlebotomus fever is endemic. The appearance 

 and habits of this insect are described on p. 471. The prevalence 



