TYPHOID FEVER IN THE PHILIPPINES. 



309 



There are few data available to indicate what proportion of healthy 

 men in any country might give a positive serum reaction from causes 

 other than antecedent typhoid. The length of time that the Widal 

 reaction persists after convalescence from enteric fever is variable, ranging 

 from six weeks to twenty years, the long continuance in some cases 

 perhaps being due to bacilli persisting in the gall bladder. The fact 

 that 6.5 per cent of the adults we tested showed a positive reaction in 

 1 to 20 dilution and 2.9 per cent in 1 to 50 dilution probably points to 

 an antecedent attack of typhoid in some of these individuals and, when 

 taken with the statistical evidence already presented, is suggestive of a 

 wide spread distribution of the disease in the native population. 



THE INFKEQUENCY OF SEVERE AND FATAL EPIDEinCS AMONG NATIVES. 



The above quoted statistics and examinations indicate to our minds 

 that typhoid is very generally present in the Philippines. The water sup- 

 plies are almost iiniversally bad, the proper disposal of excreta is almost 

 entirely neglected, the crowding in the habitations and the native manner 

 of eating favor contact infection. Yet, in spite of these unfavorable 

 conditions, there is little evidence that severe and destructive epidemics 

 of typhoid fever occur among the Filipinos. The relative scarcity of 

 typhoid among the natives in India is thought by Eogers to be due to 

 immunity acquired in childliood. Nichols (H) expresses the opinion that 

 typhoid is prevalent among children in the Philippines. To determine 

 if evidences of previous typhoid in Filipino children could be detected, we 

 performed Widal reactions on the blood of 284 healthy school children. 

 The results are shown in Table VII and are entirely negative except for 

 three cases at Ormoc, a town where we had good reason to believe that 

 typhoid had recently prevailed. 



Table VII. — Widal examinations on the blood of healthy Filipino school 



children. 



Town. 



Island. 



Race 



or 

 tribe. 



Number. 



Widal, dilutions 

 about 1 to 20. 



Widal, dilutions 

 about 1 to 50. 



Positive. 



Negative. 



Positive. 



Negative. 



Baguio 



Luzon 



. do 



Igorot 



Tagalog — 

 do - - 



45 

 30 

 50 

 14 

 7 

 30 

 22 

 36 

 26 

 24 





 

 

 3 

 

 

 

 

 

 



45 

 30 

 50 

 11 

 7 

 30 

 22 

 36 

 26 

 24 















_..do 







Ormoc 



Leyte 



Mindanao -__ 

 do 



Visayan — 

 Filipino — 

 do - 



1 



2 



Malabang 



Parang 









do . 



._do- 







Jolo - 



Jolo 



Moro 



Filipino ___ 

 do 







Floridablanca 



San Nicolas 



Luzon 



do 











Total __ 











2S4 



3 

 1.0 



281 

 99.0 



1 

 0.3 



2 



Percentage - 

















