ENTERIC FEVER IN THE TROPICS 213 



During the Balkan War, 1913, Greece used devitalized vaccines 

 with interesting results : — 



Those with two vaccinations, 91,224 soldiers had 644 cases, or 

 1-1,000. 



Those with one vaccination, 14,613 soldiers had 618 cases, or 

 42-1,000. 



The non-inoculated, 8,968 soldiers had 834 cases, or 93-1,000. 



Those not vaccinated had fourteen times more cholera cases than 

 those vaccinated twice. 



When the vaccinations were completed cholera disappeared as if 

 by enchantment, sporadic cases only arising from newly arrived, non- 

 inoculated soldiers. 



Equally good results were obtained from the civil population. 



One has to remember that the type of the disease was not a very 

 virulent one. Epidemics of cholera vary much in their mortality from 

 90 to 20 per cent. 



Carriers are always troublesome. A convalescent may carry the 

 vibrios for three weeks, some up to one year. The stools should be free 

 on two examinations before the patient is discharged. At present there 

 is no satisfactory way of clearing them out of the gall-bladder. 



ENTERIC FEVER IX THE TROPICS. 

 DEFINITION. 



A specific infectious fever, three varieties caused by : — 

 (i) Bacillus typhosus (Ebert) causes typical typhoid fever. 



(2) Bacillus paratyphosus A causes paratyphoid fever A. 



(3) Bacillus paratyphosus B causes paratyphoid fever B accom- 

 panied by diarrhoea, pea-soup stools, rose coloured rash and 

 running a prolonged course of about 21 davs. 



Typhoid fever has long existed in the tropics but was previously 

 concealed under the term of " remittent fever," &c. It is now well- 

 known to exist in many if not most tropical countries, occurring in 

 Europeans and natives. It is alarminglv prevalent among young 

 soldiers and civilians in the East, especiallv during their first three 

 years' residence. 



AETIOLOGY. 



Caused by the above organisms. 



It attacks both sexes usually between 15 and 25 years, but no age 

 is exempt. 



Infection is conveved bv : — 



(i) Contaminated water, ice or milk. 



(2) Foods contaminated by flies. 



