The American Journal of Tropical Medicine and Hygiene - Volume 18, Issue 3, May 1969

This study was undertaken to define the nature and extent of arbovirus activity in the environment of Tucson, Arizona; especial interest was centered in the prevalence of arthropod-borne encephalitis. Field collections of mosquitoes, ticks, birds, and small mammals were made in the selected study areas along the valleys of the Santa Cruz River and the Rillito in or near Tucson. Flocks of sentinel chickens were maintained during the hot seasons in the same areas. The virus of St. Louis encephalitis (SLE) was isolated 12 times from mosquitoes in three separate summer seasons. The virus of Western encephalitis (WE) was recovered in the summer of 1966 in three different lots of mosquitoes. The results of serologic tests on the chickens maintained as sentinels in the study areas confirmed that active transmission of SLE and WE viruses had occurred during the summers that the isolations had been obtained. There was a relative scarcity of Culex tarsalis in the areas studied. The explanation for this is not clear. As a result of this study it appears clear that arthropod-borne encephalitis poses a continuing threat to the population of southern Arizona.

Aedes aegypti and Aedes albopictus mosquitoes collected in and near Saigon, South Vietnam, during May through December 1967 were tested for arboviruses in LLC-MK2 cell cultures and suckling mice. Thirty strains of dengue viruses were recovered from 46,862 A. aegypti collected in or near homes of patients with dengue hemorrhagic fever. All four dengue serotypes were recovered, with dengue-2 predominating. High infection rates were noted among A. aegypti in some areas, and multiple virus recoveries from the same area occurred frequently. No viruses were recovered from 8,006 Aedes albopictus tested.

An outbreak of St. Louis encephalitis (SLE) occurred in St. Louis County in late summer 1966. Thirteen serologically confirmed or presumptive cases were observed. The most intense SLE-virus activity was in University City, a suburban community of St. Louis, Missouri. A serologic survey conducted 3 months after the outbreak indicated a low level of antibody prevalence among the residents of University City. Most persons with SLE antibody were in the older age groups. A serologic survey conducted in a nearby community that had no reported encephalitis cases revealed antibody patterns similar to those observed in University City. Four cases of central-nervous-system infection that were investigated were related to Coxsackie virus A9 and two to herpes simplex.

The failure to detect yellow fever-virus antibody in baboons known to have been previously vaccinated suggested an attempt to explain this finding. Accordingly, a study was initiated to test baboon and human serum specimens before and after vaccination for the presence of yellow fever neutralizing antibody, two different preparations of vaccine for determination of antibody being employed. Neutralization tests in mice were employed with 1:5 serum dilutions. The results indicated that good immunologic responses are obtained if the vaccine is handled and used according to specifications. Failures in vaccination arise in the field presumably as a result of mishandling of this highly labile material.

This paper is the result of an analysis of a publication by Muñoz, Pérez, and Scrimshaw in this Journal and of another by the same authors. The former lists the findings in 22 entire departments in Guatemala; the latter, the observations in each of the 105 localities in which the survey was conducted. It notes several inconsistencies and errors in the first paper and concludes that the statement (p. 966): “The incidence of endemic goiter in Guatemala does show a definite correlation with altitude” is contradicted by the facts.

The third paragraph opens with: “A total of 39,484 persons of all 22 departments of the country were examined of whom 70 per cent were school children, 2 per cent pre-school children and 28 per cent adults.”

The total examined, as arranged by sex and age on page 965 is not 39,484 but 39,777 (Table 1) or 39,767 (Table 2), of whom 65.4% were from 0 to 12 years old, 23.3% from 13 to 18, and 11.3% of 19 years or more.

Employing a bacteriologic medium in which the sole nitrogen source was the organic molluscicide. Bayluscide,® isolations were made of organisms from more than 40 field and laboratory sites in Puerto Rico, the Dominican Republic, St. Lucia, and Venezuela. Materials were subcultured four times, then selected strains isolated from the snail Biomphalaria glabrata were subjected to standard diagnostic procedures. In all, six different bacterial strains were identified as members of the genus Pseudomonas and two as members of the genus Aerobacter. Distribution of molluscicide-utilizing bacteria was practically universal, being found in water, sediment, and snail intestinal contents. Bacteria were associated with 15 species of mollusk tested for the presence of such organisms. The possible significance of molluscicide-degrading organisms, relative to snail control projects, is discussed.

World Review of Nutrition and Dietetics, Vol. 9, edited by Geoffrey H. Bourne. x + 290 pages, illustrated. S. Karger, Basel (Switzerland), New York. Distributed in U. S. A. by Albert J. Phiebig, P.O. Box 352, White Plains, New York 10602. 1968. $18.00.

Malnutrition, Learning, and Behavior, edited by Nevin S. Scrimshaw and John E. Gordon, Proceedings of an International Conference cosponsored by The Nutrition Foundation, Inc., and The Massachusetts Institute of Technology held at Cambridge, Massachusetts, 1 to 3 March 1967. xiii + 566 pages, illustrated. The M.I.T. Press, Massachusetts Institute of Technology, 50 Ames Street, Cambridge, Massachusetts 02142. 1968. $12.50.

Der bakteriologisch-serologische Kurs, by Professor Dr. med. habil. Siegfried Ortel, Direktor des Instituts fur Medizinische Mikrobiologie und Epidemiologie der Martin-Luther Universitat Halle, Wittenberg. 185 pages, illustrated. Veb Gustav Fischer Verlag, Villengang 2, Postschliessfach 176, East Germany. 1968. 18.00 M.

This is a small book dealing with the subject of hematology. It is succinctly written in an appealing style. Dispersed throughout the book are timely critical comments pointing out those areas of hematology where there is more speculation than fact. Unlike many other short books on broad subjects, the writer has managed to cover many subjects comprehensively. This is especially true of the chapter on iron deficiency and megaloblastic anemias. The chapter dealing with hematologic findings in diseases of the kidney, liver, and the endocrine system is also good. The section on hemostasis is brief but better than one usually encounters in this type of book. In the tables, figures, and texts of these chapters, one can often find the answers to questions that are sometimes difficult to find in larger, more comprehensive, hematology textbooks.

Most disappointing are the sections dealing with the hemolytic anemias and hematologic malignancies, where much of the discussion is too sketchy to be of much benefit.

This book is a translation by F. K. Plous of the Proceedings of the 4th Conference on Natural Nidality of Diseases in Kazakhstan and the Republics of Middle Asia, held in the Institute of Zoology at Alma-Ata, Kazakhstan, U.S.S.R. on 15–20 September 1959. It begins, appropriately, with a concise review of the scope of the subject by Academician E. N. Pavlovsky, who began a long series of important contributions to the ecology of the zoonoses in 1939 and was the first to use the word “nidality” in this context. Among other ideas, Pavlovsky discusses the possibility that viruses are altered by natural transmission sequences through various hosts. He also pays tribute to workers in other parts of the world and is especially complimentary to Czech and Chinese workers for their methodical contributions. The second contribution is also a review by I. G. Galuzo.

This volume of the British Medical Bulletin contains a brief introduction by J. A. B. Gray, 15 articles on various aspects of computing in medicine, and a glossary of terms. There has been no attempt to cover all aspects of the problem, but rather to give authoritative accounts in a few carefully chosen areas. In particular, the committee that planned this Bulletin decided to leave out from consideration the administrative aspects of the medical services.

The first paper, by L. C. Payne, considers the basic principles of computer technology. The computer can receive, store, select, evaluate, and transmit information—features that are characteristic of the cerebral cortex. Whereas historically machines have been principally concerned with deploying muscle power more effectively, the computer augments cerebral functions. With its help an untrained person can do things that otherwise entail trained cerebral activity. This theme is again taken up in a later article by I. D. P. Wootten, where examples are given from the biochemistry laboratory.

Here is a book on statistical method intended for the medical student and physician. The author acknowledges in the preface that the illustrations used will cause medical experts to shudder, and that, to make the concepts easily understood, he has taken liberties “which would make theoretical statisticians cringe, advanced applied statisticians cower, and pure mathematicians … pretend the book does not exist.” The sad thing about this book is not so much that these liberties have been taken, but that the result will so often still leave the reader perplexed and bewildered.

The first chapter introduces the subject by discussing general topics, using terms that are not defined until much later in the book—“as a result some points made in this chapter may not be fully understood.” This is hardly the way to introduce statistics to the beginner. The author repeats the same mistake, probably unwittingly, later on in the book—terms such as probability sample and normal curve are used long before they are explained.

This book is a softback of some 200-plus pages divided into three sections. In Section I, the author discusses the Urban Environment of a Developing Country from the erroneous attitude of some doctors on the subject of parasitic diseases found through a general description of the country, its people, and all the various factors that make it difficult to have an ideal community free of disease.

Section II describes the pattern of parasitic diseases to include topography, climate, incidence of parasites, and those parasitic diseases of universal prevalence such as amebiasis, malaria, hookworm, onchocerciasis, schistosomiasis, filariasis, etc., and those of sporadic parasitic diseases of limited distribution. He then goes into skin diseases and broadens the parasitic to microbial diseases that certainly are of considerable significance. Parasitic diseases in the rural communities and the effects on children are described. An interesting chapter is “The Fate of Acquired Resistance to Certain Parasitic Diseases in Nigerians Migrating to Urban Areas.”

This is a monograph presented by the author as a thesis for the degree of Doctor of Medicine given to him by the University of Natal in 1965. The book consists of 207 pages including an extensive table of contents covering the preface, eight chapters, a résumé, a bibliography, and 121 figures. Each chapter has many tables.

The purpose of this study was to correlate the disease processes produced by Schistosoma haematobium and Schistosoma mansoni and to assess the lesions produced in relation to morbidity and mortality. This study compares the manifestation of the disease in a local population compared with the findings in other major endemic areas. The Europeans and Indians, most of whom are second- and third-generation in Africa, provided a setting for a comparative study of the effect of schistosomiasis in different races; however, it was not possible to investigate the Europeans in this particular study.

To the Editor:

The paper “Health Protection in a Shrinking World” by David J. Sencer, appearing in this issue of the Journal, contains a potentially dangerous assumption.

The statement is made, with reference to yellow fever, “… surveillance should be such that the initial case, or at least the first generation of cases, arising from an importation is recognized and the second prevented.” It is further stated, “The technology to accomplish this in the case of yellow fever is available with rapid, mass vaccination and vector control.” Unfortunately, although not specifically stated, this leaves the reader with the inference that the technology for early recognition of cases is also available.

It is my belief that the early recognition of yellow fever, “the initial case, or at least the first generation of cases,” cannot be assumed. Yellow fever is manifested clinically not necessarily or even usually by the classic symptoms and signs described in textbooks.

To the Editor:

I am indebted to Dr. David Sencer for a prepublication copy of his Charles Franklin Craig Lecture entitled “Health Protection in a Shrinking World.” Dr. Sencer's recommendations regarding yellow fever are of such grave import that I hasten to comment on them, hoping for simultaneous publication. As one who made his first yellow fever field trip in Brazil in 1920 while General William C. Gorgas was still director of The Rockefeller Foundation's campaign for the eradication of yellow fever, and as one who participated for many years in the study and prevention of yellow fever, I cannot remain silent in the face of these surprising proposals. Especially is it important to state that the words of the Director of the National Communicable Disease Center of the Public Health Service do not necessarily constitute a declaration of official policy of the United States Government.