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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    case retaining the infection 47 days. Forrest1 found the germs remaining 6 weeks. Kirchner 2 says that the spirilla are sometimes carried for weeks or months. Zlatogoroff says that Jakowleff found the germs in the feces 56 days after the attack, and Zeidler 93 days. Zlato- goroff himself found them for 56 days. Chronic and Intermittent Carriers. — Until recently it was thought that cholera carriers were always of the temporary type, and that propagation of the spirilla was confined to the intestinal contents. It was believed that they did not invade the gall bladder or other organs as do typhoid bacilli. Observations by Kulescha, however, show that the spirilla can be found in the gall bladder in 10 per cent of the cases, sometimes producing lesions and propagating in the biliary passages. Consequently it is not surprising that Kulescha reports a case which was dis- charged from the hospital in January, 1909, after having had the spirilla in the feces for 57 days, and which re-entered the hospital in October of the same year with hepatic trouble and soon died. Cholera germs were found in the biliary passages. McLaughlin,3 who takes these facts from Kulescha, states that Gaffky reports a cholera convalescent who was a carrier for 6 months. Adami, Vallee and Mar- tineau4 have published notes of a case which arrived in Quebec from Russia 16 November, 1910. The man had perhaps had a slight attack of cholera on the steamship. At any rate cholera germs were found in his feces, and he remained a carrier until the next May. The spirilla were identified by agglutination. Intermittent Excretion of Spirilla. — Intermittent excre- tion, which at first was not suspected, is now known to occur. Zirolla states that 2 cases observed by him showed 1 Forrest, J. Trop. M. [etc.], Lond., 1908, XI, 321. 2 Kirchner, Klin. Jahrb., Jena, 1908, XIX, 483. 3 McLaughlin, Boston M. & S. J., 1911, CLXV, 561. < Adami, Vallee and Martineau, Canad. M. Ass. J., 1910, I, 697.