Volume 2

Reports of the commission appointed by the Admiralty, the War Office, and the civil government of Malta, for the Investigation of Mediterranean Fever / under the supervision of an Advisory Committee of the Royal Society.

Date:
1905-1907
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Reports of the commission appointed by the Admiralty, the War Office, and the civil government of Malta, for the Investigation of Mediterranean Fever / under the supervision of an Advisory Committee of the Royal Society. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    than the staff, and would, in addition, constantly present fresh matetial. It is possible that an aggregation of cases of Mediterranean Fever in one place may be more infective than the same number spread over a large ai-ea, but we have no evidence to point to this. In the Naval Hospital during 1904—a very short period, no doubt—only one case of Mediterranean Fever arose amongst the patients occupying the adjoining wards to the Mediterranean Fever wards. A table showing the cases of Mediterranean Fever which occurred amongst patients in the Naval Hospital during 1904 will be found on p. 49. (2) Excreted infection may occur by means of infected dust inhaled or swallowed, by contamination of the hands, and thence the mouth, or by contamination of food or drink. Dust is very prevalent out of doors in Malta, because of the friable nature of the rock and the hot sun, and owing to the high winds prevalent, opportunity of inhaling or swallowing it is present during the greater part of the year. There is, without doubt, possibility of frequent pollution of the dust by the excreta of mild or unrecognised cases, more especially in the suburban area, where conveniences are few and scavenging desultory. Horrocks has shown that the Micrococcus melitensis is found in the urine of Mediterranean Fever patients, and that it can live for long periods in a desiccated condition. The seasonal curves of temperature and rainfall are such that the degree of dust prevalence corresponds closely with the degree of Mediterranean Fever prevalence. It is true that the Mediterranean Fever curve begins to fall immediately after attaining its maximum, while the curve of temperature remains high and the curve of rainfall low; but that may be accounted for by the fact that the Sciroc wind begins to blow in August. I am informed that this wind is so laden with moisture that it renders the roads damp during its pre- valence in August and September. I cannot say I observed this phenomenon during my stay in Malta, but during the summer of 1904 there was very little Sciroc, although the temperature was unusually high. The rainfall curve is on the whole consistent with the theory of dust infection, being in general the inverse of the Mediterranean Fever curve; but I understand that during long periods in the rainy season there is little or no dust. If this be so, and dust be largely concerned in the spread of infection, it would be expected that there would be corresponding periods almost free from Mediterranean Fever notifi- cations, which is not the case. I have made out the following table with a view to comparing the incidence during the most dusty months of the period 1894 to 1903 with that during the least dusty months, for the three areas, urban, suburban, and rural.