CHAPTER XLIV 



PAPPATACI FEVER 



Synonyms — Definition — History • — Climatology — ^Etiology — • Pathology — 

 Morbid anatomy — Symptomatology — Diagnosis — Prognosis — Treatment 

 ■ — Prophylaxis— References. 



Synonyms. — Three days' fever, Phlebotomus fever. Sandfly fever, Summer 

 fever. French : Fievre des trois jours, Fievre de Pick, Fievre de Pym. 

 Italian : Febbre gastrica, Febbre estiva, Febbre climatica. Influenza estiva, 

 Influenza malarica, Mai della secca, Febbre dei tre giorni. German : Hunds- 

 krankheit, Sommerfieber, Endemischer Magenkatarrh. Latin : Febricula pro 

 parte, Gastro-enteritis endemica, Gastro-enteritis climatica. 



Definition. — An acute specific fever of unknown causation, lasting 

 three days, and characterized by nervous symptoms, pains in various 

 parts of the body, and gastro-intestinal disturbance, and spread by 

 the agency ot Phlebotomus papatasii Scopoh, 1786. 



History. — In 1804 Pym described a fever of three days' duration 

 as occurring in the Mediterranean basin, and this was confirmed 

 by Burnett in 1816. From that time constant references may be 

 found to this complaint in the English Army^ reports concerning 

 Malta, where it was sometimes called ' summer fever.' In 1855-56 

 there was- a considerable number of cases in that island, due to the 

 passage of the troops en route to the Crimea. The fever was also 

 described by Cicoli in 1874-75 in Pola, by Pick in 1887, by Karlinski 

 in 1889, by Taussig, who was the first to suspect P. papatasii, in 

 1905, and in the same year by Panec. In 1903 McCarrison was 

 the first observer to differentiate the disease, which he did in 

 Chitral, when he suspected the sandfly as the causal agent. In 

 1907 it was noticed that although undulant fever had almost dis- 

 appeared from Malta there were no less than 340 admissions for 

 ' simple continued fever ' into the Army hospitals, and in this year 

 Gerrard and Marratt drew attention to this fever. In 1909 Doerr, 

 Franz, and Taussig published their classical account of the aetiology 

 and symptomatology of the disease, thus placing it upon a sound 

 basis, and in the succeeding year Birt confirmed and extended these 

 discoveries, and in the same year Tiraboschi found it in South 

 America, and Phillips in Cairo. In 1911-12 Miorcec and Laplanchi 

 found it in Crete, Niclot in Oran, Sergent in Biskra, Leger and 

 Sequinaud in Corsica, and Wall described it again in Chitral. In 

 1915 Castellani found it in Serbia and Macedonia and showed that 

 the so-called Skoplji or Uskub fever is pappataci fever. It occurs 

 in Khartum. 



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