Annual report on the Health and Medical Services of the State of Queensland for the year 1935-36.
- Queensland. Department of Public Health
- Date:
- [1936]
Licence: Public Domain Mark
Credit: Annual report on the Health and Medical Services of the State of Queensland for the year 1935-36. Source: Wellcome Collection.
26/166 (page 26)
![Fevers of uncertain nature occur in Brisbane apart from the abattoirs. In the last four years there have been twenty-four such cases treated at the General Hospital. Ten of the twenty-four patients were farm workers, and three more were from the country, all thirteen being males. The city cases included females as well as males. Clinical Features— The fever lasts seven to twenty-four days, the temperature reaching 103 to 105 deg. Fahr. The onset is acute. The fever may be of three types:— (1) A short type lasting seven to eleven days, ending with a crisis or rapid lysis, and resembling the fever of typhus. (2) A typhoid type lasting seventeen to twenty-four days, ending by lysis. Clinically these cases strongly resemble typhoid. (3) Several cases have had definite relapses, with three to seven afebrile days between, suggesting undulant fever. One case of fever in an abattoir worker has been regarded as undulant fever. Shivers and sweats are common. The pulse is slow in comparison with the temperature. Headache is present in nearly every ease. It may be severe and persistent, and is often the chief complaint. Pains in back and limbs occur frequently. Constipation is the rule. A rash is rare. Jaundice occurred in one case. The leucocyte count tends to be low. Patients are often quite ill, but no fatal case is known. Convalescence may be slow, many complaining of weakness for some time after .resuming work The time off work has varied from ten to sixty days, the average in fourteen cases being twenty-five days. Specific Diagnosis.—Guinea-pigs are easily infected by injection of blood from human patients or blood or liver from infected guinea-pigs. After an incubation period of four to> eighteen days they develop a fever of one to six days’ duration, the temperature on an average reaching 1054 deg. One attack of the fever in a guinea-pig confers immunity. This immunity provides a specific test for its diagnosis. Blood is taken from a patient during the fever and injected equally into two guinea-pigs, one new and one immune. A typical febrile response in the first and no fever in the second would be a positive result. The test promises to be valuable, but has not been used in many cases yet. A point to be remembered is that with a small infecting dose the infection in the susceptible guinea-pig may be inapparent and require a further passage to become obvious. The test has proved of great help in studying the disease and for retrospective diagnosis, but the time it takes greatly limits its clinical value. By it, it has been shown that in six cases of fever in abattoir workers the infecting agent is identical. This confirms the clinical impression that this fever is a definite entity. The Nature of This Fever Type.—All attempts so far to correlate it with known fevers have been unsuccessful. Blood cultures have been negative. Agglutination tests have been negative for typhoid, paratyphoid, typhus, and pyoeyaneus fevers, and (except in one case) for undulant fever. Leptospiras have not been found, nor have infected guinea-pigs shown any sign of Weil’s disease. i his fever does not appear to be related to any of the commoner diseases of the abattoir animals. We have not been able to reproduce the disease in guinea-pigs by injections of blood or liver from series of cattle, sheep, pigs, and rats. 1 In* prevalence of Brucella abortus in Queensland cattle and the special incidence of undulant fever in slaughtermen in other countries caused the organism to be examined closely. A case of probable undulant fever in an abattoir worker is at present (July 1936) under ti eat men t in the General Hospital. The charts of other cases of fever in abattoir workers suggest that undulant fever is responsible for a small proportion. But the new fever ]s not undulant fever, for the two fevers in guinea-pigs run quite different courses, and there is no cross-immunity between them. The new fever distinct, for in it a negative. L pe has many points of analogy with typhus, but it appears to be rash is exceptional, and the Weil-Felix reaction has been constantly 1 in' failure oi the infecting agent to grow on ordinary microscopical examination suggest that it belongs to the viruses, however, so far been indefinite. media, and its invisibility on Filtration experiments have,](https://iiif.wellcomecollection.org/image/b31494055_0026.jp2/full/800%2C/0/default.jpg)
