FOREWORD 
It is rare indeed that a reviewer finds that a publication completely 
changes his orientation to the matter discussed. In all honesty that 
was the end result of reading this detailed, comprehensive, and 
fascinating review of the relationships, both probable and possible, of 
cockroaches and disease. 
Although the cockroach has long been the target of intensive control 
efforts in both the civilian and the military communities, my personal 
grudge against the insect has been based more on suspicion than fact. 
I would surmise that most physicians, like myself, have been influenced 
by the lack of emphasis on the disease transmission potential of the 
cockroach in most medical curricula. This review has corrected that 
deficiency. It has replaced a complacent acceptance of the insect as 
an unpleasant nuisance in areas of poor sanitation with a firm belief 
that greater attention must be placed on increased attempts to demon- 
strate, both in the laboratory and in the field, possible relationships 
between the prevalence of cockroaches and the incidences of certain 
diseases. Perhaps these insects have received less attention in this 
country than they have deserved. One could say the same for typhoid 
fever, smallpox, yellow fever, dengue, and malaria. The pronounced 
and sustained increase in the level of sanitation in the United States 
over the past one hundred years has relegated many diseases and 
disease vectors to a very low level of attention. It is only appropriate 
that the general medical population in this country should turn great- 
est attention toward problems of current domestic importance. On the 
other hand, the Medical Officer and related medical scientists of the 
Armed Forces must of necessity consider such problems in the light 
of conditions existing today in areas in which they may be required 
to serve. With complete candor I recommend this review to all who, 
in uniform or out, practice the art and skill of disease prevention the 
world over. 
Lt. Cot. Hersert L. Ley, Jr., MC 
Research and Development Division, Office of The Surgeon General 
Department of the Army 
