The American Journal of Tropical Medicine and Hygiene - Volume s1-9, Issue 4, July 1929

Sera from five of six persons convalescent from yellow fever in Rio de Janeiro, Brazil, 1928, protected M. rhesus against lethal doses of monkey blood-virus. The specimen giving negative results against blood-virus, as well as two others that gave positive results, protected monkeys against infection by known infective A. aegypti.

The serum of four native Africans who had yellow fever in as many localities in West Africa were tested against the same doses of blood-virus. Three conferred passive immunity and one failed. The serum that failed protected six monkeys in tests done before and after this experiment.

On the basis of these experiments, the conclusion of our previous report is further confirmed, that immunological evidence is added to the identity of yellow fever as it occurs in the Western Hemisphere and West Africa.

Although a long time has elapsed since the last known outbreak of yellow fever on the west coast of South America, there may be some interest in an analysis of the statistics covering a portion of the epidemic.

The data forming the basis of this study by no means cover the total number of cases, but represent that portion concerning which the information was sufficiently complete to include in a “Memoria” which was prepared and presented to the writer as a souvenir of one of the tensest campaigns of the kind on the west coast of South America.

The portion of the epidemic concerned in this paper is that occurring during the months of January to July, in the year 1921. The fever spread to all the principal towns in the Departments of Lambayeque and Libertad. At times it seemed that there was danger of its spread down the coast to Callao, Lima and on towards Chile.

(The material from two of the cases of blackwater fever was obtained through the kindness of Dr. Andrew Connal, Director of the Medical Research Laboratory, Lagos, Nigeria.)

The incidence of jaundice among cases of malaria varies considerably in different districts, dependent in part upon the type of malarial parasite, the virulence of the infection, and the susceptibility of the individual. In Nigeria I had the opportunity of observing a considerable number of cases of acute sub-tertian malaria, accompanied by jaundice in the native and a few in the white population. The severe acute malaria in the native occurs chiefly in childhood, and although the infection is not infrequent in adults the disease is not so commonly of the severe variety. The adult community possesses an acquired immunity. The white population consists of adults only, and these arriving as non-immunes require a varying period of years to demonstrate a resistance of any value.

The study of the effects of Chara fragilis (fig. 1) on mosquito development reported in 1928 (6) has been continued and expanded during the past season. Our investigations were directed along five principal lines: (a) Continued studies of the effects of Chara fragilis on larval development under experimental conditions. (b) A survey of a portion of the central New York area to determine the distribution of Chara spp. and their effect on mosquito density. (c) The introduction of Chara fragilis into various types of ponds, marshes, etc., to study its rate of growth and effect on future mosquito breeding. (d) A continued study of the food 2 (plankton) in Chara ponds and typical mosquito breeding pools. (e) The effects of other aquatic plants on the larvae of Culicidae.

The results of this season's work can be presented best under these five headings.

Experimental Work With Chara Spp.

In a recent paper, Bauer (1928) has shown that three species of mosquitoes are capable of transmitting experimental yellow fever to Indian monkeys, Macacus rhesus, in addition to the notorious yellow fever mosquito, Aedes aegypti. These are A. (Stegomyia) luteocephalus (Newst.), A. (Aedimorphus) apicoannulatus (Edw.) and Eretmopodites chrysogaster Graham, and are all indigenous to West Africa.

Investigations of other species have continued with the hopes of contributing to a clearer understanding of the feasibility of yellow fever control in that area. Three other Stegomyiae have thus been found to transmit the disease to experimental monkeys, two of which were logically predicted by Bauer (loc. cit.).

Aedes vittatus (Bigot) (= sugens Theo.). This and the following species are included by Patton and Cragg (1913) among the “five common species of Stegomyia.” It is a rapidly maturing and semi-domestic species favoring rain-holding depressions in rocks and masonry for purposes of breeding, but larvae have also been reported as collected from “buckets, roadside puddles and … antiformicas” (Patton and Cragg).

The plan of the work is a clinical study of the heart in beriberi by Aalsmeer, (56 pages) followed by a theoretical explanation of the phenomena by Wenckebach. No attempt will be made to present the observations here recorded in detail, for the peculiar changes in the heart have been described by all students of the disease. We need only say that the study has been thorough, including a clinical description of the heart in mild, moderate and severe cases, and of the so-called acute pernicious form. Modern methods include the study of the blood pressure, skiagrams of the heart (plate 1) and electrocardiogram tracings (plate 2).

The beriberi cardiac syndrome may be regarded as total heart muscle weakness, without any sign of left insufficiency, but the regular presence of right insufficiency with all its recognized physical signs and results, but no congestion of the lungs.

This book is intended as a practical guide in Parasitology for students of medicine. It is not a complete enumeration of the parasites of man; only the more important are mentioned and the description of each is very brief, while the pathology and the treatment of the diseases concerned is entirely omitted. The parasites treated are the blood-sucking insects and other arthropods as well as those parasitic in the larval state, the worms, protozoa, spirochetes and molds (hyphomycetes). The book is an abbreviation of the senior author's well known Precis de Parasitologie.

There is a chapter on the examination of the blood and one on the examination of the stools. Certainly the text here is inadequate, even in a brief practical guide. It may be said that, just because the book is intended to be a guide to practical work in Parasitology, these chapters on the technique of actual laboratory procedures are disappointing.

This is No. 2 of the Memoir Series of The London School of Hygiene and Tropical Medicine. No. 1 of the Series, by the same author assisted by G. H. E. Hopkins, M.D., F.E.S., bore the title “Researches in Polynesia and Melanesia Entomology” and was reviewed in this Journal, vol. VII, no. 6, November, 1927. The author says of the present memoir, “In this volume I deal with our studies on Filariasis in man, and I publish a number of notes on other human diseases, and on the effect of the inter-action of European and Polynesian cultures on the races of man living in the Pacific. These subjects make a somewhat disconnected whole, but they can not be avoided as they are no more than a by-product of the expedition.”

Part V deals with human filariasis and makes up the larger part of the volume.

This work is an English translation of the author's treatise on “Kalaazar” in Mense's “Handbuch der Tropenkrankheiten,” vol. IV, 1926, brought up to date. It contains all of the latest facts regarding the etiology, prophylaxis, and treatment of this infection, and is of special interest because written by one who has contributed so many basic additions to our knowledge of the subject. The author's discovery of the fact the Leishmania donovani not only produces visceral leishmaniasis but also a form of dermal leishmaniasis, thus linking this species still more closely with Leishmania tropica, was a most valuable contribution to our knowledge, while his studies of the chemotherapy of the aromatic antimonials, resulting finally in the discovery of urea stibamine, have resulted in placing the treatment of this infection upon a scientific foundation and have rendered it possible to regard all cases as amenable to treatment except those with fatal complications.

In this very excellent work Dr. Kolmer has given a summary of the clinical and laboratory investigations he has made during the past nine years in this subject, together with the most important work that has been accomplished in complement fixation in the diagnosis of disease by others. In Part I the author states in a simple and interesting manner the underlying principles of serum-hemolysis and complement fixation; in Part II, the principles of technique which are so important in the application of complement fixation to diagnosis; in Part III, the results of his own methods in the application of complement fixation tests; and in Part IV, the sensitiveness, specificity and practical applications of the methods in the serum diagnosis and treatment of syphilis, tuberculosis, gonorrhoea, glanders, contagious abortion, typhoid fever, echinococcus disease, dourine, and numerous other bacterial, protozoal, and metazoal diseases of human beings and the lower animals.