Acute poliomyelitis (Heine-Medins disease) / translated by W.J.M.A. Maloney.

  • Wickman, Ivan.
Date:
1913
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Licence: In copyright

Credit: Acute poliomyelitis (Heine-Medins disease) / translated by W.J.M.A. Maloney. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    The 1905 epidemic comprised 1,031 cases. Their distribution was irregular; foci of 4 or 5 or more or fewer cases were widely scattered. In the regions intervening there was either no instance of the disease or only an isolated case. These infected foci oc- curred in no relation to the density of the population; ravaged rural districts; and practically spared the cities. Within the large groups, it was possible to investigate minutely only restricted areas where every case was publicly known, and where the determining factor could be sought. In these areas contact between all afflicted with the disease could be proved to have taken place; whereas, no other factor which would satisfactorily explain the manner in which the malady spread, could be incriminated. The transmis- sion may be indirect. It is not absolutely necessary for direct contact of patient with patient to occur. Indeed, the disease seems more often to be propagated through the mediation of the healthy. As in many other epidemic maladies, spread occurs in Heine- Medin's disease by transmission from person to person. I shall demonstrate a few examples of this diffusion. Fig. 7 illustrates an outbreak within the little parish of Trastena. The parish lies some distance from the highroad and has somewhat more than 500 inhabitants. The houses, 102 in number, are dotted singly over an area of 32.5 sq. kilometers. Each house, almost without exception, is occupied by only one family. The inter- course between the individual families is limited. Each house- hold possesses a spring and, usually, one or more cows. The products of their farming supply their simple wants, and from the outside world little enters their spheres. In such a community the spread of an infectious disease can be accurately studied. In this parish, between June 28 and August 14, not less than 49 people, chiefly children, were attacked by acute poliomyelitis. In 26 cases paralysis resulted; in the others motility was unim- paired. The dates of affection of the latter are placed in paren- thesis in the figure. The conditions under which the people lived- obviously pre- cluded infection from either milk or water; and the only supplies which entered the parish came from a village where the disease was yet unknown. The search for a common source of infection led to the public school of the parish. Not less than seven patients, who in their
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