82 LEISHMAN BODIES AND LEISHMANIASIS 



unsanitary is to burn them with all their junk. This method of 

 stamping out the disease before it has had time to spread has 

 been successfully used on some of the tea estates in Assam. 

 For the successful prevention of the spread of the disease, an 

 isolation of 300 to 400 yards has been found sufficient, a fact 

 which exonerates most flying insects as transmitters. Houses in 

 endemic regions should be kept scrupulously free from bedbugs, 

 and any place where bugs might be acquired should be care- 

 fully avoided. 



Since the parasites have been shown to exist in the faeces of 

 infected persons, careful and thorough disposal of the faeces 

 should be attended to. The possibility exists that non-blood- 

 sucking flies which frequent human faeces may be instrumental 

 in spreading infection. Until proved otherwise, precautions 

 against this should be taken in endemic places. 



Infantile Kala-azar 



In many of the countries bordering the Mediterranean — Algeria, 

 Tunis, Malta, Crete, Greece, southern Ital}^, Sicily, Spain and 

 other regions — there occurs a disease which in many respects 

 closely resembles true kala-azar, but differs from it very strikingly 

 in other ways. While true kala-azar attacks young and old 

 alike, the Mediterranean disease attacks infants and children 

 almost if not quite exclusively. Children between one and two 

 years old are most frequently subject to it, while children over 

 six years old are practically exempt. While true kala-azar is 

 not readily communicable to other animals than man, the Medi- 

 terranean disease occurs naturally in the dogs of endemic regions 

 and in some places where the disease is not known to occur in 

 children. It can be experimentally transmitted not only to 

 dogs but also to rats, mice and, with more difficulty, to monkeys. 

 Cats cannot be successfully inoculated. It is believed by some 

 that the disease in dogs is different from that in children, but the 

 similarity in vSymptoms, and geographic distribution, as well as 

 the fact that dogs can be infected by parasites from human 

 beings, and other dogs from these dogs, all point to the identity 

 of the diseases. 



Transmission. — A remarkable fact ' connected with artificial 

 inoculation of the disease is the great quantity of infective ma- 



