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Malaria in Europe
PUBLIC HEALTH.
122
(97 J.P. 295), and 'to Baker v. Kidderminster R.D.C., decided by Judge Rooke Reeve on August 14th, 1934. Judge Tebbs, without hearing any evidence from the Corporation's witnesses, held that this particular van dwelling was not within the meaning of the Housing Acts, 1925 and 1930, and therefore quashed the demolition order.
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Malaria in Europe.
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R. 1.. W. HACKETT, Assistant Director of the International Health Division of the Rockefeller Foundation, a malariologist of worldwide repute and Heath Clark Lecturer in 1934, in a series of five lectures entitled " Malaria in Europe," at the London School of Hygiene and Tropical Medicine, submitted the results of investigations in which he has been engaged for a number of years, and in the course of which he has made contributions to the knowledge of malaria of the greatest importance. For several centuries, he explained, malaria had steadily decreased in many parts of Europe, though in some places, such as Holland, Italy and the Baltic, it had persisted. After the Great War. there was a considerable increase of malaria in Europe, particularly in Russia, Italy and the Balkans, and this induced the League of Nations to investigate the subject through their Malaria Commission. In their first report on malaria (1924) the League stated there was no correlation between the number of anopheles and the amount of malaria: in some places there were enormous numbers of anopheles and no malaria; in other places, a relatively small number of anopheles produced intense malaria. In these circumstances anti-larval measures seemed irrelevant. and the Commission advocated social measures on the lines of improvement in housing and nutrition, and medical assistance. The researches of Hackett, Missiroli, Swellengrebel and others in Italy, Holland and elsewhere, supplied the explanation. It was that some races of anopheles maculipennis preferred to feed on animals rather than on man, while others were more or less indifferent. The races which fed regularly on man were those which gave rise to malaria; their distribution was found to be identical with the places in which malaria existed. The various races could be distinguished by their eggs, but not in the adult stage. The lecturer also spoke of the ways in which the mosquito and the parasite survive the long
JANUARY,
winters of Europe when no transmission of malaria takes place, and he devoted one lecture to the complexities of the malaria parasite. There are, as is well known, not merely four spe<:ies of human malaria paras~tes, but. many strains of each of these four species; an mdividual may be immune to one strain but not to others. During an outbreak of malaria an individual is liable to he infected by many strains, and it is consequently more difflcult for him to acquire adequate tolerance. Ten years' experience of practical work had convinced the Rockefeller Foundation that they could delay an outbreak of malaria by means of drugs; they could reduce the amount of sickness and the number of deaths; but drugs alone could not permanently stamp out the disease. They had found it more expensive to cure malaria than to prevent it. Prevention could be accomplished only by reducing the mosquito, either by temporary or by permanent measures. Temporary measures include oiling or dusting with Paris Green; the permanent measures are drainage, or some biological process such as making the water brackish where the mosquito requires fresh water, or by converting brackish water into fresh water where the mosquito requires brackish water. Of the lectures it may be said that they were very well attended, and of Dr. Hackett as a lecturer that he proved most attractive, and succeeded in making a complicated subject clear and interesting even to those who are not experts.
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Pasteurisation and Milk-Borne Diseases. N G to a recent report of the A CCORDI United States Public Health Service, 41 outbreaks of milk-borne disease were reported in the United States in 1933. Typhoid fever heads the list of diseases with 25 outbreaks (289 cases, 26 deaths). In addition to this there Was one outbreak due to paratyphoid infection (17 cases with no deaths). Scarlet fever Occurred in two outbreaks (143 cases, 3 deaths); septic sore throat in seven (515 cases,S deaths), and there was one outbreak of scarlet fever and sore throat (95 cases with I death). Finally, there were two outbreaks of diphtheria (19 cases, 3 deaths), two of milk sickness (10 cases, 1 death) and one due to staphylococcus toxin (248 case~ with no deaths). In not a single outbreak had the milk been pasteurised. Most of the outbreaks occurred in
122
(97 J.P. 295), and 'to Baker v. Kidderminster R.D.C., decided by Judge Rooke Reeve on August 14th, 1934. Judge Tebbs, without hearing any evidence from the Corporation's witnesses, held that this particular van dwelling was not within the meaning of the Housing Acts, 1925 and 1930, and therefore quashed the demolition order.
•
•
Malaria in Europe.
D
•
•
•
R. 1.. W. HACKETT, Assistant Director of the International Health Division of the Rockefeller Foundation, a malariologist of worldwide repute and Heath Clark Lecturer in 1934, in a series of five lectures entitled " Malaria in Europe," at the London School of Hygiene and Tropical Medicine, submitted the results of investigations in which he has been engaged for a number of years, and in the course of which he has made contributions to the knowledge of malaria of the greatest importance. For several centuries, he explained, malaria had steadily decreased in many parts of Europe, though in some places, such as Holland, Italy and the Baltic, it had persisted. After the Great War. there was a considerable increase of malaria in Europe, particularly in Russia, Italy and the Balkans, and this induced the League of Nations to investigate the subject through their Malaria Commission. In their first report on malaria (1924) the League stated there was no correlation between the number of anopheles and the amount of malaria: in some places there were enormous numbers of anopheles and no malaria; in other places, a relatively small number of anopheles produced intense malaria. In these circumstances anti-larval measures seemed irrelevant. and the Commission advocated social measures on the lines of improvement in housing and nutrition, and medical assistance. The researches of Hackett, Missiroli, Swellengrebel and others in Italy, Holland and elsewhere, supplied the explanation. It was that some races of anopheles maculipennis preferred to feed on animals rather than on man, while others were more or less indifferent. The races which fed regularly on man were those which gave rise to malaria; their distribution was found to be identical with the places in which malaria existed. The various races could be distinguished by their eggs, but not in the adult stage. The lecturer also spoke of the ways in which the mosquito and the parasite survive the long
JANUARY,
winters of Europe when no transmission of malaria takes place, and he devoted one lecture to the complexities of the malaria parasite. There are, as is well known, not merely four spe<:ies of human malaria paras~tes, but. many strains of each of these four species; an mdividual may be immune to one strain but not to others. During an outbreak of malaria an individual is liable to he infected by many strains, and it is consequently more difflcult for him to acquire adequate tolerance. Ten years' experience of practical work had convinced the Rockefeller Foundation that they could delay an outbreak of malaria by means of drugs; they could reduce the amount of sickness and the number of deaths; but drugs alone could not permanently stamp out the disease. They had found it more expensive to cure malaria than to prevent it. Prevention could be accomplished only by reducing the mosquito, either by temporary or by permanent measures. Temporary measures include oiling or dusting with Paris Green; the permanent measures are drainage, or some biological process such as making the water brackish where the mosquito requires fresh water, or by converting brackish water into fresh water where the mosquito requires brackish water. Of the lectures it may be said that they were very well attended, and of Dr. Hackett as a lecturer that he proved most attractive, and succeeded in making a complicated subject clear and interesting even to those who are not experts.
•
•
•
•
•
Pasteurisation and Milk-Borne Diseases. N G to a recent report of the A CCORDI United States Public Health Service, 41 outbreaks of milk-borne disease were reported in the United States in 1933. Typhoid fever heads the list of diseases with 25 outbreaks (289 cases, 26 deaths). In addition to this there Was one outbreak due to paratyphoid infection (17 cases with no deaths). Scarlet fever Occurred in two outbreaks (143 cases, 3 deaths); septic sore throat in seven (515 cases,S deaths), and there was one outbreak of scarlet fever and sore throat (95 cases with I death). Finally, there were two outbreaks of diphtheria (19 cases, 3 deaths), two of milk sickness (10 cases, 1 death) and one due to staphylococcus toxin (248 case~ with no deaths). In not a single outbreak had the milk been pasteurised. Most of the outbreaks occurred in