536 PATHOGENIC MICROORGANISMS 



DIPLOCOCCUS Mucosus. A form of Gram-negative diplococcus, 

 the description of which we take from Elser and Huntoon. Its 

 colonies may resemble meningococcus colonies on ascitic agar. They 

 are said to differ from the meningococcus colonies by being more 

 mucoid, resembling the colonies of the B. capsnlatus mucosus. The 

 colonies have a tendency to confluence and the above writers say 

 that the luxuriance of its growth on serum free media helps to tell 

 it from the meningococcus. It also grows at room temperature, and 

 shows capsules with capsule stains. 



EPIDEMIOLOGICAL PROBLEMS IN MENINGITIS 



Although sporadic cases of meningitis may occur in a community 

 for a considerable number of years after an epidemic is over, and 

 the disease may, therefore, be regarded as, to some extent, endemic 

 in all crowded cities, it is chiefly important for its epidemic occur- 

 rence. In 1905 a recognizably described epidemic occurred in 

 Switzerland. Since that time epidemics have been reasonably fre- 

 quent, especially at times of war, when they appeared among armies 

 in barracks and mobilization camps. During the many continental 

 campaigns in the time of Napoleon, outbreaks occurred in the 

 various armies, and secondary epidemics among the civilian popula- 

 tion in many cities followed in the train of these. In America, a 

 number of limited epidemics occurred in the States along the Eastern 

 sea board during the early half of the 19th century, and in these 

 civilian epidemics the disease particularly selected children and 

 young adults. Extensive civilian epidemics occurred in different 

 parts of the world in the early years of the 20th century. In 1903 

 the disease appeared in East Prussia and spread to other parts of 

 Germany from there. In 1904 and 1905 it appeared in New York 

 City, and the adjacent country, on an extensive scale causing the 

 death of 3,000 people and altogether about 7,000 cases in New York 

 City alone. In the summer following its appearance in New York, 

 it extended to Canada, and in the years since then, small outbreaks 

 and sporadic cases have appeared with gradually decreasing fre- 

 quency all through the more thickly populated parts of North 

 America. 



During the late war, there was little meningitis among the 

 European armies until an extensive outbreak occurred among the 



