MALTA FEVER 141 



it occurs in the same way. The hands of the milker, moist with the 

 infected milk of one animal may easily transfer it to another. The 

 udders of Malta goats are unusually large and in some drag on the 

 ground. They generally show slight wounds, and through these the 

 virus may easily find its way from the hands of the milker. Biting 

 flies have been suspected and have been examined with negative 

 results. 



Man and apes are easily infected by feeding. Of twenty-eight apes 

 fed with infected milk, twenty-six developed the disease. The course 

 is shorter and the fever higher in apes than in man. The milk of 

 infected goats is often a pure culture of the coccus and it may be that 

 man occasionally receives the virus through minute wounds ; the great 

 source of infection is the drinking of milk. There are several illus- 

 trations of infection from drinking milk. In 1905 the Nicholson sailed 

 from Malta with sixty-five milk goats. The first destination was 

 Antwerp. Of the ten men who drank the raw milk from the goats on 

 this voyage, eight developed Malta fever within from eighteen to 

 thirty-four days after leaving Malta. From Antwerp the Nicholson 

 proceeded to New York. The captain and crew used the goats' milk 

 on this trip and subsequently many of them developed the disease. 

 Five of the goats died between Malta and New York, and of the sixty 

 placed in quarantine, thirty-two were shown to have Malta fever by 

 the agglutination test and the coccus was found in the milk of several. 

 In 1910 an epidemic of Malta fever appeared in the valley of Cavenne 

 following the importation of goats from the island and the use of 

 their milk. Malta fever, formerly frequent among English soldiers 

 and sailors stationed at Malta, has disappeared on the discontinuance 

 of the use of uncooked milk from goats, while it has continued among 

 the natives who still use the raw milk. 



