- Email: [email protected]
Helminthic infection in Jerusalem
46
COMMUNICATIONS/ tIELMINTHIC
INFECTION
IN JERUSALEM.
BY L J. K L I G L E R , M.A., PH.D., B.Sc.,
Director, k[alaria ~esearch Uctit, Departqne,nt of tYealth, Haifa. (PReSenTED B¥ D~. R. B R I E R C L I F F E . )
I n medical and public health questions, as in other phases of life, :Palestine is still an untilled field. There exists a body of general information regarding the occurrence of various diseases. W i t h regard to diseases such as malaria and trachoma this information is a little more definite; but with regard to other infections, particularly those of parasitic character, there are few, if any, data available regarding incidence, distribution, etc. On taking charge of the laboratory of the l%othschild Hospital, we began to collect data on the incidence of helminthic infections in the Jerusalem population. The doctors were requested to send stools from the patients who came to the clinic, irrespective of the malady. I n addition to this, all stools which came to the laboratory f()r typhoid or dysentery examinations were also examined for worm ova. General examinations were also made of the population of tWO orphan asylums. I n this way 2,369 stools were examined in the course of one year and a half--l,615 from adults and 754 from children. Because of the relatively large n u m b e r of examinations and the long period over which they were spread, the results may be accepted as characteristic of the Jewish population of Jerusalem. Although a few Moslems and Christians were included in the examinations, the number was too small to be considered representative. The results are summarised in the table on page 48. I t may be seen that there was little difference in percentage incidence of infection in the adult and child population. I n both groups about 45 per cent. harbored one or another type of worm ova. Often, mixed infections * W i t h a v i e w to m a k i n g t h e TRANSACTIONS m o r e i n t e r e s t i n g , it is p r o p o s e d to i n s e r t S H O R T C O M M U N I C A T I O N S f r o m F e l l o w s r e l a t i v e to a n y m a t t e r s of m e d i c a l , s a n i t a r y o r p a r a s i t o l o g i e a l i n t e r e s t . I t is f e l t t h a t m a n y F e l l o w s in v a r i o u s p a r t s of t h e w o r l d m u s t b e i n a p o s i t i o n to c o n t r i b u t e s h o r t p a p e r s o n t h e s e s u b j e c t s , a n d t h e S e c r e t a r i e s will b e p l e a s e d to r e c e i v e a n y s u c h f r o m t h e m .
ttELMINTtIIC
INFECTION
IN ff]~I%IJSALI~M.
47
were observed. The relative prevalence of the different types of worms varied somewhat in the two groups. I n both groups Ascaris lumbricoides was most frequently found, but it was more common in children t h a n in adults. Trichiuris trichiuris was next in order of frequency, but was relatively more common in adults than in the children. A striking and constant difference was noted in the relative presence of the T~enias. Tcenic~ nana was more t h a n three times as frequent among children as among adults, while exactly the reverse relationship was noted with T. sceginata. As m i g h t have been expected, T. solium was not encountered. Oxyuris was of particular interest. I t was equally prevalent in a small percentage in both groups; but, in the course of the routine work, ova of this worm were noted occasionally in ci~ses of appendicitis. I n consequence of these casual observations routine examinations were made of every appendix which came to the laboratory, with the result that out of eighteen consecutive examinations Oxyuris worms were found in six appendices. This frequency would suggest a more t h a n accidental relationship between this worm and the inflammation. Another point of interest is the very low incidence of Aneylostoma. Throughout the y e a r and a half Aneylostoma ova were found only nine t i m e s - - a total incidence of less than I per cent. : The worm infections are usually considered unimportant, but recent work by SHWAaTZ has demonstrated that even the mild Ascaris secretes h~emolytic substance. I t is not at all unlikely that the high incidence f worm infections is responsible, at least in part, for the anaemia noted ~ong the children in Jerusalem. I t is also probable that m a n y of the iinor.intestinal aliments so common here are due to worm invasion. I t will be of interest in the future to determine the incidence of ~m infections in rural communities, particularly with reference to ~ylostomiasis.
48
IIELNIINTIIIC
~'~
INFECTION
~
IN
~
,IERUSALEPI.
~+
+
+~
© B~ ~
~
~
o
COMMUNICATIONS/ tIELMINTHIC
INFECTION
IN JERUSALEM.
BY L J. K L I G L E R , M.A., PH.D., B.Sc.,
Director, k[alaria ~esearch Uctit, Departqne,nt of tYealth, Haifa. (PReSenTED B¥ D~. R. B R I E R C L I F F E . )
I n medical and public health questions, as in other phases of life, :Palestine is still an untilled field. There exists a body of general information regarding the occurrence of various diseases. W i t h regard to diseases such as malaria and trachoma this information is a little more definite; but with regard to other infections, particularly those of parasitic character, there are few, if any, data available regarding incidence, distribution, etc. On taking charge of the laboratory of the l%othschild Hospital, we began to collect data on the incidence of helminthic infections in the Jerusalem population. The doctors were requested to send stools from the patients who came to the clinic, irrespective of the malady. I n addition to this, all stools which came to the laboratory f()r typhoid or dysentery examinations were also examined for worm ova. General examinations were also made of the population of tWO orphan asylums. I n this way 2,369 stools were examined in the course of one year and a half--l,615 from adults and 754 from children. Because of the relatively large n u m b e r of examinations and the long period over which they were spread, the results may be accepted as characteristic of the Jewish population of Jerusalem. Although a few Moslems and Christians were included in the examinations, the number was too small to be considered representative. The results are summarised in the table on page 48. I t may be seen that there was little difference in percentage incidence of infection in the adult and child population. I n both groups about 45 per cent. harbored one or another type of worm ova. Often, mixed infections * W i t h a v i e w to m a k i n g t h e TRANSACTIONS m o r e i n t e r e s t i n g , it is p r o p o s e d to i n s e r t S H O R T C O M M U N I C A T I O N S f r o m F e l l o w s r e l a t i v e to a n y m a t t e r s of m e d i c a l , s a n i t a r y o r p a r a s i t o l o g i e a l i n t e r e s t . I t is f e l t t h a t m a n y F e l l o w s in v a r i o u s p a r t s of t h e w o r l d m u s t b e i n a p o s i t i o n to c o n t r i b u t e s h o r t p a p e r s o n t h e s e s u b j e c t s , a n d t h e S e c r e t a r i e s will b e p l e a s e d to r e c e i v e a n y s u c h f r o m t h e m .
ttELMINTtIIC
INFECTION
IN ff]~I%IJSALI~M.
47
were observed. The relative prevalence of the different types of worms varied somewhat in the two groups. I n both groups Ascaris lumbricoides was most frequently found, but it was more common in children t h a n in adults. Trichiuris trichiuris was next in order of frequency, but was relatively more common in adults than in the children. A striking and constant difference was noted in the relative presence of the T~enias. Tcenic~ nana was more t h a n three times as frequent among children as among adults, while exactly the reverse relationship was noted with T. sceginata. As m i g h t have been expected, T. solium was not encountered. Oxyuris was of particular interest. I t was equally prevalent in a small percentage in both groups; but, in the course of the routine work, ova of this worm were noted occasionally in ci~ses of appendicitis. I n consequence of these casual observations routine examinations were made of every appendix which came to the laboratory, with the result that out of eighteen consecutive examinations Oxyuris worms were found in six appendices. This frequency would suggest a more t h a n accidental relationship between this worm and the inflammation. Another point of interest is the very low incidence of Aneylostoma. Throughout the y e a r and a half Aneylostoma ova were found only nine t i m e s - - a total incidence of less than I per cent. : The worm infections are usually considered unimportant, but recent work by SHWAaTZ has demonstrated that even the mild Ascaris secretes h~emolytic substance. I t is not at all unlikely that the high incidence f worm infections is responsible, at least in part, for the anaemia noted ~ong the children in Jerusalem. I t is also probable that m a n y of the iinor.intestinal aliments so common here are due to worm invasion. I t will be of interest in the future to determine the incidence of ~m infections in rural communities, particularly with reference to ~ylostomiasis.
48
IIELNIINTIIIC
~'~
INFECTION
~
IN
~
,IERUSALEPI.
~+
+
+~
© B~ ~
~
~
o