The sources and modes of infection / by Charles V. Chapin.

  • Charles V. Chapin
Date:
1912
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Licence: In copyright

Credit: The sources and modes of infection / by Charles V. Chapin. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    Recently Bates 1 has reported a series of mild atypical typhoid fever cases in Panama Canal Zone, and states that such cases are quite common there, and are the chief factor in the extension of the disease. At the time Koch made his investigation of the four Trier villages there were 8 recog- nized cases, but a thorough bacteriological investigation of suspects discovered 64 more. Of these 49 were children.2 These mild unsuspected walking typhoid cases not rarely result in death. Velich 3 notes 36 such cases, and a number of others are reported by Curschmann, and they also have been seen by the writer. I have recently investigated two milk outbreaks, in one of which the cause was apparently a mild unrecognized case, and in the other either a con- valescent or a carrier associated with him. Neufeld 4 de- votes considerable space to this class of cases. Lemoine5 for three years examined the blood of every case^of gastro-intestinal disturbance and jaundice in his ser- vice at the military hospital at Val-de-Grace and found ty- phoid bacilli in 40 per cent, although there was little to lead him to suspect typhoid fever. Ledingham quotes Billet, etc., who report an outbreak of typhoid fever of 142 cases in a regiment at St. Brieuc. Besides these, there were 57 other atypical cases which doubtless would not have been recognized except for the epidemic. Bruckner6 reports three outbreaks, all originating in mild missed cases. He finds that children are very susceptible, the most suscep- tible age being 11 to 15 years, and that in them the disease is apt to run an atypical course. More recently7 he has reported an outbreak in an institution for boys in which 1 Bates, J. Am. M. Ass., Chicago, 1908, L, 585. 2 Koch, Die Bekiimpfung des Typhus, Berl., 1893, 14-15. 3 Velich, Arch. f. Hyg., Munchen u. Leipz., 1904, XLIX, 113. 4 Kolle u. Wassermann, Handbuch [etc.], Jena, 1903, II, 271. 5 Lemoine, Presse med., Par., 1910, XVIII, 113. 11 Bruckner, Munchen med. Wchnschr., 1910, LVII, 1213. 7 Bruckner, Munchen., med. Wchnschr., 1911, LVIII, 1008.