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Bovine tuberculosis in primitive races
32
TUBERCLE
TUBERCLE. OCTOBER, 1936.
Bovine Tuberculosis in Primitive R~ce$.
LITTLE is known at present as to the extent of bovine tuberculosis amongst primitive peoples. There is abundant evidence that the European has carried with him the human strain of tubercle bacillus, but it seems highly probable that he has not acted to anything like the same extent as a carrier of the bovine strain. In Europe this strain is for the most part confined to children and adolescents, often with crippling non-pulmonary forms of the disease, and tllese are not the people who are likely to migrate to sub-tropical and 9tropical climates. European cattle, too, for obvious economic reasons, have not found their way into the possession of native races and are chiefly imported by settlers. H u m a n tuberculosis of bovine origin, therefore, if it exists amongst primitive peoples, is likely to be an indigenous product. At present, however, very few data .on the subject exist and such as there are refer chiefly to the indirect evidence of infection of native cattle. At the Pan-African Health Conference held at Johannesburg in November last year and reported in the Qzlarterly Bulletin of the Health Organisatiou of the League of Nations this year, this subject was introduced by Dr. P. J. du Toit [1], and a recommendation was made by the Conference that investigations should be continued to determine definitely whether bovine tuberculosis is a menace to t h e h u m a n .population under conditions obtaining m African territories. According to the latest report on vital statistics in the Union of South Africa, about 11"5 per cent. of the deaths from tuberculosis are due to non-pulmonary forms of the disease, but it is not known how many of these are of bovine o r i g i n . No extensive testing of cattle appears to h a v e been done in South Africa. The
[Oct0ber, 1936
figures quSted by Dr. du Toit show that the percentage of infection with Bavillus tuberculosis in tested herds iE, about 6 per cent. In tile larger towns it rises to 40 per cent. and in rural areas it is below 2 percent. Amongst slaughtered stock very little tuberculosis is found. Of over a million cattle slaughtered in Johannesburg from 1917-1929, only 0'031 per cent. showed tube'rculous lesions, whilst in the same period cows, chiefly of native and African breeds, slaughtered showed 0"152 per cent. infection. In tropical and sub-tropical Africa the reports quoted from veterinary authorities of Kenya, Anglo. Egyptian Sudan, the Gold Coast and Tanganyika, show that the disease is rare, though there is occasional evidence of it in imported cattle. In :French West Africa and the British Cameroons infection is reported to have spread rather rapidly following its introduction from overseas, whilst in one district in Northern :Rhodesia a very large percentage of the cattle is infected. Most of the records refer to imported stock and the indigenous cattle appear to be more resistant. The African zebu, for instance, appears to be remarkably immune from tuberculosis, an immunity which seems to be a breed characteristic and not necessarily due to the open air life. The Ankole cattle, however, are considered to be exceptional in this respect. Looking at the matter from the particular angle of the Union of South Africa, Dr. du Toit considers that the various schemes for the eradication of tuberculosis in cattle which have been tried in various parts of the world, such as the methods of Bang and Os'tertag and of those employed in England under the Tuberculosis Order of 1925, arc n o t entirely satisfactory. Immunisation with B.C.G. also seems unlikely to provide a solution of the problem. Complete eradication9 is therefore suggested. No doubt this could be more easily achieved in South Africa where the incidence is evidently low, than in this country whore the incidence is high and the economic problem, therefore, a serious one. Discussing the matter from the point of view of Central Africa, Hornby [2] some timeagocited in~tandes of infection
October, 1936]
~OW~E W~J~ERCULOSIS ~N ~'RI.'U~TIVE RACES
amongst cross-bred imported herds in Northern:Rhodesia. A serious state of affairs is also reported from Madagascar where the infection, as judged by abattoir statistics, had reached more than 50 per cent. in 1930. Cummins, in commenting upon :Hornby's figures, emphasises tim importance of the problem in territories such as tropical Africa, where natives depend upon their cattle both for food and property, and where, too, they often live in close con-
33
tact with their animals. Ig would be an added tragedy if the European, having carried the human strain of tubercle bacillus to Africa, should take the bovine strain in imported herds. REFERENCES. [1] DU Tmr, P. J., Qzearterly BulletiT~, IIealth Orgauisatlou of the League of Nations, s~Iarch, 1936. ['2] HonNBv, H. E,, Eas$ African Med. Jozlrn., 1931, 5, 11, abstracted by Cummins, S. L., Bull. of Ityg., 1935, 1O, 315.
BOOK NOTICES.
Die Tuberkelbazill~,mie in ihrer Auswirkung auf die Gesamtmedizin. By Prof. Dr. Ernst Loewenstein, with a Clinical Section by Prof. Dr. Carl llcittcr, Prof. Dr. "Wilhelni Neumann a.nd Prof. Dr. Otto Krcu. Leipzig and Vienna : Franz Deuticke, 1936. Pp. 388. Price Ihn. 20 and 23. :Readers of this Journal are probably already well acquainted with the work of Professor Loewenstein on the cultivation of tubercle bacillus from the blood. This book brings together the extensive researches of the author since his first publication thirty-five years ago, during which time he has made some 24,000 tests. The'book covers the whole range of the subject and gives the latest figures for cultural results, including those for diseases such as chorea, polyarthritis, dementia pr0ecox and other diseases in Which Professor Loewenstein has obtained positive blood cultures for t?. tz,berculosis. Amongst the mos~ arresting of these results are the figures for diseases of the eye by Meller and himself. Meller's figures show 68 positive cultures out of a total number of 508 cases of eye disease, including 20'8 per cent. in iridocyclitis after trauma and operation, which seems to us to be a very high figure. Other perturbing figures arc those for dementia prmcox and chorea" a s already mentioned. Professor Loewenstein also gives details 3
for the prleparation of his medium which we think all laboratory workers ha;co found to be an extremely valuable one. There is also a section of the book dealing with the general pathology of tuberculosis, based upon the positive blood cultural findings, and a very good bibliography and a collection of abstraets on the tuberculosis findings in dementia prmcox and multiple sclerosis, together with clinical sections by Professors Carl Reitter, Wilhelm Neumann and Otto Kren. There are also two pages of beautifully eolourod plates of positive blood cultures on the Loewenstein media and some black and white illustrations of acid-fast bacilli in hmmoglobin--free washed deposit from blood cultures by the author's method. I t is rather difficult to realize that s u c h large numbers of bacilli can be obtained from such deposits, and one cannot help wondering if they are really tubercle bacilli. In conclusion, tlle book is a valuable statement of Professor Lowenstein's position, and we welcome it as an authoritative statement of his results and beliefs. Unfortunately workers in other laboratories have found his results impossible to repeat and the whole question has recently been careftilly investigated by a committee of the League of Nations.
TUBERCLE
TUBERCLE. OCTOBER, 1936.
Bovine Tuberculosis in Primitive R~ce$.
LITTLE is known at present as to the extent of bovine tuberculosis amongst primitive peoples. There is abundant evidence that the European has carried with him the human strain of tubercle bacillus, but it seems highly probable that he has not acted to anything like the same extent as a carrier of the bovine strain. In Europe this strain is for the most part confined to children and adolescents, often with crippling non-pulmonary forms of the disease, and tllese are not the people who are likely to migrate to sub-tropical and 9tropical climates. European cattle, too, for obvious economic reasons, have not found their way into the possession of native races and are chiefly imported by settlers. H u m a n tuberculosis of bovine origin, therefore, if it exists amongst primitive peoples, is likely to be an indigenous product. At present, however, very few data .on the subject exist and such as there are refer chiefly to the indirect evidence of infection of native cattle. At the Pan-African Health Conference held at Johannesburg in November last year and reported in the Qzlarterly Bulletin of the Health Organisatiou of the League of Nations this year, this subject was introduced by Dr. P. J. du Toit [1], and a recommendation was made by the Conference that investigations should be continued to determine definitely whether bovine tuberculosis is a menace to t h e h u m a n .population under conditions obtaining m African territories. According to the latest report on vital statistics in the Union of South Africa, about 11"5 per cent. of the deaths from tuberculosis are due to non-pulmonary forms of the disease, but it is not known how many of these are of bovine o r i g i n . No extensive testing of cattle appears to h a v e been done in South Africa. The
[Oct0ber, 1936
figures quSted by Dr. du Toit show that the percentage of infection with Bavillus tuberculosis in tested herds iE, about 6 per cent. In tile larger towns it rises to 40 per cent. and in rural areas it is below 2 percent. Amongst slaughtered stock very little tuberculosis is found. Of over a million cattle slaughtered in Johannesburg from 1917-1929, only 0'031 per cent. showed tube'rculous lesions, whilst in the same period cows, chiefly of native and African breeds, slaughtered showed 0"152 per cent. infection. In tropical and sub-tropical Africa the reports quoted from veterinary authorities of Kenya, Anglo. Egyptian Sudan, the Gold Coast and Tanganyika, show that the disease is rare, though there is occasional evidence of it in imported cattle. In :French West Africa and the British Cameroons infection is reported to have spread rather rapidly following its introduction from overseas, whilst in one district in Northern :Rhodesia a very large percentage of the cattle is infected. Most of the records refer to imported stock and the indigenous cattle appear to be more resistant. The African zebu, for instance, appears to be remarkably immune from tuberculosis, an immunity which seems to be a breed characteristic and not necessarily due to the open air life. The Ankole cattle, however, are considered to be exceptional in this respect. Looking at the matter from the particular angle of the Union of South Africa, Dr. du Toit considers that the various schemes for the eradication of tuberculosis in cattle which have been tried in various parts of the world, such as the methods of Bang and Os'tertag and of those employed in England under the Tuberculosis Order of 1925, arc n o t entirely satisfactory. Immunisation with B.C.G. also seems unlikely to provide a solution of the problem. Complete eradication9 is therefore suggested. No doubt this could be more easily achieved in South Africa where the incidence is evidently low, than in this country whore the incidence is high and the economic problem, therefore, a serious one. Discussing the matter from the point of view of Central Africa, Hornby [2] some timeagocited in~tandes of infection
October, 1936]
~OW~E W~J~ERCULOSIS ~N ~'RI.'U~TIVE RACES
amongst cross-bred imported herds in Northern:Rhodesia. A serious state of affairs is also reported from Madagascar where the infection, as judged by abattoir statistics, had reached more than 50 per cent. in 1930. Cummins, in commenting upon :Hornby's figures, emphasises tim importance of the problem in territories such as tropical Africa, where natives depend upon their cattle both for food and property, and where, too, they often live in close con-
33
tact with their animals. Ig would be an added tragedy if the European, having carried the human strain of tubercle bacillus to Africa, should take the bovine strain in imported herds. REFERENCES. [1] DU Tmr, P. J., Qzearterly BulletiT~, IIealth Orgauisatlou of the League of Nations, s~Iarch, 1936. ['2] HonNBv, H. E,, Eas$ African Med. Jozlrn., 1931, 5, 11, abstracted by Cummins, S. L., Bull. of Ityg., 1935, 1O, 315.
BOOK NOTICES.
Die Tuberkelbazill~,mie in ihrer Auswirkung auf die Gesamtmedizin. By Prof. Dr. Ernst Loewenstein, with a Clinical Section by Prof. Dr. Carl llcittcr, Prof. Dr. "Wilhelni Neumann a.nd Prof. Dr. Otto Krcu. Leipzig and Vienna : Franz Deuticke, 1936. Pp. 388. Price Ihn. 20 and 23. :Readers of this Journal are probably already well acquainted with the work of Professor Loewenstein on the cultivation of tubercle bacillus from the blood. This book brings together the extensive researches of the author since his first publication thirty-five years ago, during which time he has made some 24,000 tests. The'book covers the whole range of the subject and gives the latest figures for cultural results, including those for diseases such as chorea, polyarthritis, dementia pr0ecox and other diseases in Which Professor Loewenstein has obtained positive blood cultures for t?. tz,berculosis. Amongst the mos~ arresting of these results are the figures for diseases of the eye by Meller and himself. Meller's figures show 68 positive cultures out of a total number of 508 cases of eye disease, including 20'8 per cent. in iridocyclitis after trauma and operation, which seems to us to be a very high figure. Other perturbing figures arc those for dementia prmcox and chorea" a s already mentioned. Professor Loewenstein also gives details 3
for the prleparation of his medium which we think all laboratory workers ha;co found to be an extremely valuable one. There is also a section of the book dealing with the general pathology of tuberculosis, based upon the positive blood cultural findings, and a very good bibliography and a collection of abstraets on the tuberculosis findings in dementia prmcox and multiple sclerosis, together with clinical sections by Professors Carl Reitter, Wilhelm Neumann and Otto Kren. There are also two pages of beautifully eolourod plates of positive blood cultures on the Loewenstein media and some black and white illustrations of acid-fast bacilli in hmmoglobin--free washed deposit from blood cultures by the author's method. I t is rather difficult to realize that s u c h large numbers of bacilli can be obtained from such deposits, and one cannot help wondering if they are really tubercle bacilli. In conclusion, tlle book is a valuable statement of Professor Lowenstein's position, and we welcome it as an authoritative statement of his results and beliefs. Unfortunately workers in other laboratories have found his results impossible to repeat and the whole question has recently been careftilly investigated by a committee of the League of Nations.