1322 



THE RELAPSING FEVERS 



Prophylaxis. — ^The prophylaxis is based on the avoidance of 

 localities where ticks abound and the destruction of these parasites. 

 Koch rightly advised that Europeans should camp at least 20 to 

 30 yards away from infected native huts and rest-houses. 



2. The Relapsing Fever of East Africa. 



The relapsing fever found in Uganda and East Africa is clinically 

 indistinguishable from the West African type, and is carried by 

 the same tick, but the Spiroschaudinnia, according to Frankel, is 

 a different species (S. rossi Nuttall, 1908). Recent researches seem, 

 however, to identify it with the West African type. 



THE TICK FEVER OF MIANA, PERSIA. 



Definition. — A specific fever of unknown cause, brought about by the bite 

 of a tick [Ay gas persicus Oken, 181 8). 



Historical. — Dupre, in 1809, first described this disease, stating that the 

 bite of A. persicus, locally known as ' Guerib-guez/ ' Garib-guez,' ' Miane- 

 bug,' or ' punaise de Miana ' (MaMet de Mianeh), was at times dangerous, 

 producing prolonged illness. Kotzebue, in 1819, stated that the natives 

 were immune, and only foreigners suffered. Fischer de Waldheim, in 1823, 

 said that the bite was fatal, and Heller, in 1858, described the effects as being 

 caused by the mechanical injury of the bite of the tick. Taschenburg, in 

 1873, considered the symptoms to point to a disease, and not merely to the 

 effects of the bite of the tick; and Schlimmer, in 1874, considered the im- 

 munity of the natives to be due to the fact that they had been bitten, and 

 so become vaccinated, Megnin, in 1882, showed that the bite per se was not 

 dangerous, and later was supported by Fumouze and Loundsbury. 



etiology. — The causation of the disease is quite unknown, but some virus 

 must be inoculated when the tick bites, for the disease is apparently confined 

 to Persia ; and the experiments of Megnin, Loundsbury, and others show that 

 in certain regions the effects of the bite are insignificant. 



Manson thinks that this virus will some day be found to be a spirochaete, 

 which, indeed, is not unlikely, as A . persicus is well known to be the carrier 

 of Spiroschaudinnia marchouxi Nuttall, 1904, which causes a very fatal disease 

 in fowls. Native Persians probably develop a relative immunity due to 

 previous slight infections, but new-comers suffer severely. 



Symptomatology. — The knowledge of the symptoms of the disease is very 

 meagre. Severe pain is felt at the site of the bite of the tick, and this is 

 followed by remittent fever lasting from a few days to several weeks, delirium, 

 convulsions, and even at times by death. 



Treatment. — The treatment is entirely symptomatic, but salvarsan might 

 be tried. 



Prophylaxis. — According to Nuttall, the Persians burn their villages when 

 they su^er severely from the attentions of the tick. In order, however, to 

 devise a rational method of prophylaxis, it must be remembered that A . per- 

 sicus is essentially a parasite of the domestic fowl and other birds, and that 

 its eggs are laid in batches of 20 to 100 in cracks in the walls, and take three 

 weeks to develop into the larva, which, after sucking blood, in eight days 

 becomes the nymph. This may require several weeks before it becomes the 

 adult, which is said to feed only once a month. After considering this life- 

 history, it will be obvious that fowls should be disinfected with a kerosene 

 emulsion, creozozone, or oil of sassafras in the case of old birds, while young 

 birds may be isolated in cages until the ticks drop off. Houses and fowl- 

 houses should be cleansed and treated by lime and corrosive sublimate, and 

 old nests and roosts should be burnt, and after that the new fowl-houses may 

 be sprayed with kerosene emulsion. 



