494 Malta or Mediterranean Fever 



of them were actually secreting the cocci in their milk. The au- 

 thorities permit no milk to be used in the garrison unless it is boiled, 

 and notice that by this simple measure the incidence of the disease, 

 which was 9.6 in 1905, had fallen to 2 in the corresponding month of 

 1906. In Report VII of the Mediterranean Fever Commission 

 (1906-07) we read: 



"The epidemiologists are led to believe that quite 70 per cent, of the cases 

 are due to the ingestion of goat's milk." In their opinion ordinary contact with 

 the sick, conveyance of infection by biting insects, house-flies, dust, drain emana- 

 tions, food (other than milk) and water, play a very subordinate part, if any, 

 in setting up Mediterranean fever in man. The' excellent results following the 

 preventive measures directed against goat's milk in barracks and hospitals also 

 point to goat's milk as being the chief factor. Among the soldiers this resulted 

 in a diminution of about 90 per cent. 



"For example, in the second half of 1905 there were 363 cases of Mediter- 

 ranean fever, whereas in the corresponding part of 1906 there were only 35 cases. 

 Among the sailors there was also as marked a fall in the number of cases. The 

 Naval Hospital had a bad reputation, as about one-third of the cases of fever 

 occurring in the fleet at Malta could be traced to residence in this hospital, 

 either as patients suffering from other diseases or among the nursing staff. 

 The goats supplying the hospital were found to be infected, and since their milk 

 was absolutely forbidden, not a single case of Malta fever has occurred in or 

 been traced to residence in this hospital." 



